Posttraumatic Stress Disorder Checklist-Civilian Version Research Articles

An investigation of the incidence of post-traumatic stress disorder, turnover intention and psychological resilience among medical staff in a public hospital in China during the outbreak of the omicron variant in the COVID-19 pandemic in 2022.

ObjectiveTo investigate the incidence of post-traumatic stress disorder (PTSD), turnover intention and psychological resilience of medical staff during the Outbreak of the Omicron Variant in the COVID-19 pandemic in 2022 and to provide a basis for adopting relevant psychological interventions to reduce medical staff turnover.MethodsUsing the PTSD Checklist-Civilian Version (PCL-C) and a total score ranging from 17 to 85 points, a total score ≥ 38 indicates significant PTSD symptoms and a diagnosis of PTSD. The Chinese version of the Turnover Intention Scale (TIS) has a total score of 6 to 24 points; the higher the score, the stronger the turnover intention. The Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) has a total score of 0 to 100 points, with higher scores indicating a better level of psychological resilience. A total of 443 front-line medical staff working in Chinese public hospitals and still treating all patients normally during COVID-19 were invited via the internet to complete a survey from 15 May to 30 May 2022 in China.ResultsThe incidence of PTSD was 14.4%, the total turnover intention score was 13.38 ± 4.08, and the total psychological resilience score was 87.16 ± 18.42. The prevalence of PTSD was higher among medical staff who were married, had children, and were worried about being infected; in addition, the PTSD group had a higher level of education, higher turnover intention, and lower psychological resilience than the non-PTSD group. The total scores for turnover intention and fear of being infected were risk factors for PTSD, while a high total psychological resilience score and high education level were protective factors for PTSD; the differences were statistically significant (all P < 0.05).ConclusionPost-traumatic stress disorder among Chinese medical personnel was associated with the marital status, childbirth, education level, turnover intention, and psychological resilience. Among these factors, psychological resilience might be exploited as a protective factor.

Randomised clinical non-inferiority trial of breathing-based meditation and cognitive processing therapy for symptoms of post-traumatic stress disorder in military veterans

ObjectiveTest whether Sudarshan Kriya Yoga (SKY) was non-inferior to cognitive processing therapy (CPT) for treating symptoms of post-traumatic stress disorder (PTSD) among veterans via a parallel randomised controlled non-inferiority trial.SettingOutpatient...

Long-term effectiveness of rehabilitation services delivery for Wenchuan earthquake survivors with impairments over a 4-year period: a prospective cohort study

ObjectiveTo examine long-term effectiveness of rehabilitation services on physical function, pain severity and post-traumatic stress disorder (PTSD) in earthquake survivors over a 4-year period.DesignProspective cohort study with early and late...

Resilience and its association with post-traumatic stress disorder, anxiety, and depression symptoms in the aftermath of trauma: A cross-sectional study from Nepal

BackgroundResilience is a multidimensional construct. Despite its importance as protective against psychiatric disorders, it remains largely unexplored in context of Nepal. We investigated the role of resilience in the development of various psychiatric symptoms as post-traumatic stress disorder, anxiety and depression following trauma in clinical population in a psychiatry outpatient. MethodsWe interviewed one hundred patients who sought treatment in psychiatry outpatient of Tribhuvan University Teaching Hospital in Kathmandu, Nepal. The sampling strategy was purposive and inclusion criteria were 18–60 years and trauma history. We used the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization, the Post-Traumatic Stress Disorder Checklist-Civilian version to measure the post-traumatic stress disorder symptoms, and the 25-item Hopkins Symptom Checklist-25 to assess the level of anxiety and depression symptoms. We used Nepali adapted resilience scale derived from the original Wagnild and Young Resilience scale to measure resilience. We investigated the associations between resilience scores and the scores on depression, anxiety and post-traumatic stress disorder using bivariate and multivariate analysis. We adjusted for trauma type, socioeconomic status, employment, marital status and gender in the final models. ResultsResilience was found to have negative relation with post-traumatic stress disorder, anxiety, and depression symptoms even after adjusting for other important factors in patients with trauma in the final multivariate analysis. ConclusionResilience was independently and negatively related with symptoms of post-traumatic stress disorder, anxiety, and depression in patients with history of trauma presenting to the hospital. Interventions aiming to promote resilience in trauma patients might be effective in reducing psychiatric symptoms such as stress disorder, anxiety and depression. Prospective studies using more robust measures of resilience combining personal attributes to social support systems, across different settings in trauma population should be the focus of future research.

Relationship of Earthquake Exposure, Locus of Control, Coping Strategy, and Posttraumatic Stress Disorder Among Adolescent Survivors.

A cross-sectional study was performed to examine the incidence of posttraumatic stress disorder (PTSD) among adolescent survivors 2 years after the 2017 Jiuzhaigou earthquake, and to identify risk factors and their interaction effects. A total of 4,131 adolescents were recruited. PTSD was assessed using the PTSD Checklist-Civilian Version, and locus of control (LOC) and coping strategy were assessed using the Internality, Powerful Others and Chance Scale and Coping Styles Scale, respectively. The prevalence of PTSD was 5% and the relationship between external LOC and PTSD and negative coping and PTSD seemed moderated by environmental factors. These factors should be considered along with external LOC, especially among adolescents with high levels of earthquake exposure. Positive coping strategies may help adolescents manage stress after a severe earthquake. [Journal of Psychosocial Nursing and Mental Health Services, 60(11), 41-47.].

Resilience and its association with post-traumatic stress disorder, anxiety, and depression symptomatology in the aftermath of trauma: a cross-sectional study from Nepal

IntroductionResilience is a multidimensional construct. Despite being quoted as protective against mental disorders, it remains largely unexplored in our context.ObjectivesWe attempted to explore the role of resilience in the development of various psychiatric symptoms as depression, anxiety and post-traumatic stress disorder following trauma in clinical population in a psychiatry outpatient of a university hospital.MethodsWe interviewed one hundred patients who sought treatment in psychiatry outpatient in a university hospital in Kathmandu, Nepal. We collected sociodemographic and trauma related information using semi-structured interview format. Other instruments used were the World Health Organization Composite International Diagnostic Interview version 2.1 for trauma categorization, the Post-Traumatic Stress Disorder Checklist-Civilian version to measure the post-traumatic stress disorder symptoms, and the 25-item Hopkins Symptom Checklist-25 to assess the level of depression and anxiety symptoms. We used Nepali adapted resilience scale derived from the original Wagnild and Young Resilience scale to measure resilience. We explored the associations between resilience scores and the scores on depression, anxiety and posttraumatic stress disorder using bivariate and multivariate analysis.ResultsResilience had negative correlations with depression, anxiety, and post-traumatic stress disorder symptoms after adjusting for other variables such as gender, marital status, employment status, socioeconomic status and trauma types which were observed to have significant association in the bivariate analysis.ConclusionsThere was inverse correlation between resilience scores and depression, anxiety, and post-traumatic stress symptoms. Resilience should be considered in studies involving trauma population.DisclosureNo significant relationships.

Network structure of PTSD symptoms in Chinese male firefighters

The network perspective of mental disorder offers a novel way of understanding the psychopathology of post-traumatic stress disorder (PTSD). In this framework, PTSD may arise from direct interactions between its symptoms. In the present study, we used the Post-Traumatic Stress Disorder Checklist-civilian Version (PCL-C) to investigate the network structure of PTSD symptoms in 994 Chinese male firefighters. We also calculated the micro (i.e., edges weight and node expected influence) and middle (i.e., community) indicators of the final network. Nine strongest edges existed in the final network were from the same dimension of PCL-C, like "avoidance of thoughts" and "avoidance of reminders". Symptoms "emotional reactivity", "avoidance of reminders" and "exaggerated startle response" had the highest expected influence. As for the results of community detection, the spinglass and walktrap algorithm detected the same three communities which are slightly different from the original dimensions of PCL-C (i.e., symptoms "avoidance of thoughts", "avoidance of reminders" and "trauma-related amnesia" of avoidance dimension of PCL-C were added to the intrusion dimension of PCL-C). The present study explored the network structure of PTSD symptoms in Chinese male firefighters and provided several implications for clinical prevention and intervention to address the mental health needs in this special group.

Persistent emotional stress, fatigue and impaired neurocognitive function in recovered COVID-19 patients: a longitudinal prospective study

IntroductionSeveral surveys report that post-COVID-19 patients (pts) could be at risk of persistent emotional distress, fatigue and impaired neurocognitive function (NCF).ObjectivesThe aim was to assess emotional distress, fatigue and NCF in order to provide adequate care.MethodsPatients with persistent physical or mental symptoms, at least 8 weeks post-COVID-19, were eligible for this ongoing prospective longitudinal single center trial. Data on depression, anxiety, cognition, post-traumatic stress symptoms (PTSS) and fatigue were collected using 4 validated questionnaires at study entry (T0) and at 6 months (T1).ResultsNinety-three pts were recruited between November 2020-March 2021. Test results from 64 eligible pts (15 male pts) were analyzed at T0; 63 pts (98%) were treated in outpatient settings. Median age was 47 years [range 27-75]). Median time since COVID-19 was 29 weeks [range 8-53]. Twenty-two pts (34%) had a history of psychiatric disorders. According to the Hospital Anxiety Depression Scale (HADS), 44 pts (73%) reported anxiety symptoms and 26 pts (41%) reported depressive symptoms; 48 pts (69%) reported cognitive complaints according to the Cognitive Failure Questionnaire and 29 pts (45%) suffered from PTSS, according to the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C). Fifty-five pts (86%) had an elevated score on the Fatigue Severity Scale, indicating severe fatigue. Twenty-seven pts (42%) were still on sick leaf. Diminished social support and psychiatric history were predictive factors for neurocognitive dysfunction and PTSS.ConclusionsA majority of patients who recovered physically from COVID-19, are at risk for suffering from persistent anxiety, PTSS and neurocognitive dysfunction.DisclosureNo significant relationships.

PTSD as a Moderator of the Relationship Between the Distribution of Personal Resources and Spiritual Change Among Participants of Hostilities in Ukraine.

The theory of conservation of resources (COR) can be used to search for mechanisms that explain spiritual changes caused by trauma. The present study aimed to verify whether PTSD could be a potential moderator between the distribution of personal resources and spiritual changes. The study included a total of 324 adults (75 women and 243 men) aged 18-74. The mean age was 34.3 (SD = 9.9). The Polish adaptation of Hobfoll's Conservation of Resources-Evaluation (COR-E), the posttraumatic stress disorder (PTSD) Checklist-Civilian Version and the Posttraumatic Growth Inventory were employed in the research. This study analyzed the spiritual change, which is one of the five domains of posttraumatic growth. The outcomes indicated the significant role of PTSD as a moderator of the relationships between 1) personal resources gain and spiritual change and 2) personal resources loss and spiritual change. PTSD is not a moderator in the relationship between assigning value to personal resources and spiritual change.

Low resilience following traumatic brain injury is strongly associated with poor neurobehavioral functioning in U.S. military service members and veterans

ABSTRACT Objective The purpose of this study was to examine the relationship between resilience and self-reported neurobehavioral functioning following traumatic brain injury (TBI) in U.S. military service members and veterans (SMVs). A secondary objective was to examine the interaction between resilience and posttraumatic stress disorder (PTSD) on neurobehavioral functioning. Method Participants included 795 SMVs classified into four groups: Uncomplicated Mild TBI (MTBI; n=300); Complicated Mild, Moderate, Severe, or Penetrating TBI (STBI, n 162); Injured Controls (IC, n=185); and Non-injured Controls (NIC, n=148). Two independent cohorts were evaluated – those assessed within 1-year of injury and those assessed 10-years post-injury. SMVs completed self-report measures including the PTSD Checklist-Civilian version, Neurobehavioral Symptom Inventory, and TBI-Quality of Life. Results Results showed that (1) lower resilience was strongly associated with poorer neurobehavioral functioning across all groups at 1-year and 10-years post-injury, and (2) PTSD and resilience had a robust influence on neurobehavioral functioning at both time periods post-injury, such that SMVs with PTSD and low resilience displayed the poorest neurobehavioral functioning. Conclusion Results suggest that regardless of injury group and time since injury, resilience and PTSD strongly influence neurobehavioral functioning following TBI among SMVs. Future research evaluating interventions designed to enhance resilience in this population is indicated.

Post-traumatic Stress Disorder Symptoms and Quality of Life of COVID-19 Survivors at 6-Month Follow-Up: A Cross-Sectional Observational Study.

Background: Post-traumatic stress disorder (PTSD) is the most common psychiatric sequelae among novel coronavirus disease (COVID-19) patients. The aim of this study was to determine the prevalence of PTSD symptoms, PTSD-related factors, and its relationship with quality of life at long-term follow-up in hospitalized COVID-19 survivors.Methods: A cross-sectional study was undertaken to evaluate the health consequences of hospitalized COVID-19 survivors. All participants were interviewed face-to-face through a series of questionnaires: a researcher-developed symptom questionnaire, the Post-traumatic Stress Disorder Checklist–Civilian Version, the Generalized Anxiety Disorder 7-item, and the 36-item Short Form.Results: A total of 574 participants were enrolled with an average age of 57 years. The median follow-up time post-discharge was 193.9 days (SD = 15.32). Among the participants, 77.9% of survivors presented with at least one symptom, where fatigue or muscle weakness (47.9%) was reported the most frequently, followed by chest distress (29.4%) and sleep difficulty (29.4%). The prevalence of PTSD was 11.15% [95% confidence interval (CI): 8.56, 13.73] with a cut-off score of 44. Factors such as respiratory symptoms [odds ratio (OR): 3.53; 95% CI: 1.68–7.42], anxiety (OR: 14.64; 95% CI: 7.09–30.21), and sleep difficulty (OR: 2.17; 95% CI: 1.14–4.16) were positively related to PTSD. Those COVID-19 survivors with potential PTSD had significantly lower quality of life than those without (P < 0.05).Conclusion: Our study illustrated that a significant number of COVID-19 survivors were suffering from physical or mental distress to varying degrees at 6 months post-discharge. People with PTSD were more likely to experience persistent respiratory symptoms and sleep difficulty, as well as anxiety and a decreased quality of life. Such survivors require greater attention to their mental health, particularly the PTSD symptoms at the early phase, which may play an important role in the recovery of both the physical and psychological health of COVID-19 survivors.

Insertion/deletion polymorphism at angiotensin-converting enzyme gene in PTSD individuals and their reciprocal effects on blood pressure

ABSTRACT Objectives: The aim of the present study was to investigate relationships between insertion/deletion (I/D) polymorphism at angiotensin-converting enzyme gene (ACE) and post-traumatic stress disorder (PTSD), as well as their interactions on blood pressure. Methods: Variants of ACE I/D were identified by polymerase chain reaction method and verified by DNA sequencing. PTSD symptoms were assessed by the PTSD Checklist-Civilian Version (PCL-C) based on DSM-IV-TR criteria among high school students at 6 months after the 2008 Wenchuan earthquake. Results: Female subjects were found to have higher prevalence of PTSD and PCL-C scores than male counterparts in the II homozygotes (p = .038 for PTSD and p = .003 for PCL-C scores) and the ID heterozygotes (p = .000 for PTSD and p = .000 for PCL-C scores), but not in the DD homozygotes. Male subjects with the ID (p = .046) or the DD genotype (p = .039) had lower pulse pressure (PP) than the male II homozygotes, while the female II homozygotes had lower diastolic blood pressure (DBP) than the female DD homozygotes (p = .036). ACE I/D, PTSD, or PCL-C scores, as well as gender and BMI, were found to be the predictors of PP. Conclusions: These results indicate that there are interactions of ACE I/D and PTSD, together with gender and BMI, on PP. This finding may be the additional explanation for the heterogeneous relationships between PTSD and blood pressure, and suggest psychiatry care and different medication strategies for patients with comorbidities of PTSD and hypertension and with different genotypes of ACE I/D.

Male adolescents with Interleukin 10 rs1800872 AA genotype had higher prevalence and slower recoveries of post-traumatic stress disorder at late stage of a follow-up

BackgroundPathophysiological mechanisms of post-traumatic stress disorder (PTSD) are elusive and heterogeneous relationships have been reported among PTSD, Interleukin 10 (IL-10), and other factors after stresses. The present study aimed to longitudinally investigate associations of PTSD with environmental factors and genetic variation of rs1800872 at IL-10 gene. MethodsSymptoms of PTSD were measured by PTSD Checklist-Civilian Version (PCL-C) in 462 high school students at 6, 12, and 18 months after Wenchuan earthquake in China. Genotypes of IL-10 rs1800872 were identified by polymerase chain reaction-restriction fragment length polymorphism analysis and verified by DNA sequencing. ResultsAA homozygotes had higher PTSD prevalence than C allele carriers only at 18 months in male, but not female subjects. PTSD prevalence at 18 months was lowered in all subjects except male AA homozygotes when compared to that at 6 months, and only in female C allele carriers when compared to that at 12 months. PCL-C scores at 18 months were decreased in all students but not in male AA homozygotes when compared to those at 6 months. IL-10 rs1800872 was associated with PTSD at 18 months. Patterns of predictors of PCL-C scores were different between AA homozygotes and C allele carriers at different times during the follow-up. ConclusionThere were different reciprocal actions of IL-10 rs1800872 with other potential factors or predictors on PTSD in a time-course and gender-dependent manner. Male students with IL-10 rs1800872 AA genotype had higher prevalence and slower recoveries of PTSD at late stage of the follow-up, suggesting requirements of special psychiatric care or drug supplementation at this stage.

Relevant Factors and Intervention Measures of Psychological Stress-Induced Hyperthermia among Medical Staff in Temporary COVID-19 Negative Pressure Wards.

Background:Medical staff working in COVID-19 wards must be isolated and observed for 14 days upon the occurrence of psychological stress-induced hyperthermia (PSH). Such measures could result in great psychological pressure and incur considerable losses in anti-disease resources.Methods:In this study, the psychological conditions of medical staff were assessed over a period of 7 days in COVID-19 isolation wards of the People’s Hospital of Guangxi Zhuang Autonomous Region, China and 7 days after leaving the wards by using the Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Impact of Event Scale-Revised (IES-R), and Post-traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C). The relevant factors of PSH were analyzed by t- and rank sum tests.Results:A total of 10 females with an average body temperature of 37.36 ± 0.07 °C were included in the PSH group. Another 103 females and 53 males with an average body temperature of 36.66 ± 0.21 °C were included in the control group. The PSQI, GAD-7, PHQ-9, IES-R, and PCL-C scores of the PSH group were higher than those of the control group. Binary regression analysis indicated that the odds ratios of the PSQI and GAD-7 scores were 12.98 and 3.81, respectively (P < 0.05). After positive intervention, the body temperature and psychological scale scores of both groups returned to normal ranges.Conclusion:Working in COVID-19 wards could cause susceptible medical staff to suffer from PSH. Female sex, somnipathy, and GAD are independent risk factors of PSH.

Self-compassion and resilience mediate the relationship between childhood exposure to domestic violence and posttraumatic growth/stress disorder during COVID-19 pandemic.

BACKGROUNDStudies have indicated that childhood exposure to domestic violence is a common factor in posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD), but it is unclear whether PTG and PTSD share a common/different underlying mechanism.AIMTo explore the common/different underlying mechanism of PTG and PTSD.METHODSBetween February 12 and 17, 2020, a nationwide cross-sectional online survey was conducted in China among 2038 university students, and a self-administered questionnaire was used for the data collection. The data included demographic characteristics, such as age, gender, and subjective social economic status, and childhood exposure to domestic violence scale that was selected from the Chinese version of revised Adverse Childhood Experiences Question, Self-compassion Scale, Connor–Davidson Resilience Scale, Posttraumatic Growth Inventory, and the Abbreviated PTSD Checklist-Civilian version. A structural equation model was used to test the hypotheses.RESULTSExposure to domestic violence was significantly associated with PTG and PTSD via a 1-step indirect path of self-compassion (PTG: β = -0.023, 95%CI: -0.44 to -0.007; PTSD: β = 0.008, 95%CI: 0.002, 0.014) and via a 2-step indirect path from self-compassion to resilience (PTG: β = -0.008, 95%CI: -0.018 to -0.002; PTSD: β = 0.013, 95%CI: 0.004-0.024). However, resilience did not mediate the relationship between exposure to domestic violence and PTG and PTSD.CONCLUSIONPTG and PTSD are common results of childhood exposure to domestic violence, which may be influenced by self-compassion and resilience.

Coping strategies in patients with acute myeloid leukemia

AbstractPatients diagnosed with acute myeloid leukemia (AML) face sudden-onset life-threatening disease that requires intensive treatments. Although their early disease trajectory is characterized by significant, toxic side effects, limited data are available describing coping strategies among patients with AML and how these inform patient-reported outcomes. We used cross-sectional secondary data analyses to describe coping in 160 patients with newly diagnosed high-risk AML. The Brief COPE, Hospital Anxiety and Depression Scale, Post-Traumatic Stress Disorder Checklist–Civilian Version, and Functional Assessment of Cancer Therapy–Leukemia were used at time of AML diagnosis to measure coping strategies, psychological distress, and quality of life (QOL), respectively. The median split method for distribution of coping domains and multivariate regression models were used to assess the relationship between coping and patient-reported outcomes. Participants (median age, 64.4 years) were mostly non-Hispanic White (86.3%), male (60.0%), and married (73.8%). Most (51.9%) had high utilization of approach-oriented coping strategies, whereas 38.8% had high utilization of avoidant coping strategies. At time of diagnosis, use of approach-oriented coping was associated with less psychological distress (anxiety, β = –0.262, P = .002; depression symptoms, β = –0.311, P < .001; and posttraumatic distress disorder symptoms, β = –0.596, P = .006) and better QOL (β = 1.491, P = .003). Use of avoidant coping was associated with more psychological distress (anxiety, β = 0.884, P < .001; depression symptoms, β = 0.697, P < .001; and posttraumatic distress disorder symptoms, β = 3.048, P < .001) and worse QOL (β = –5.696, P < .001). Patients with high-risk AML use various approach-oriented and avoidant coping strategies at time of diagnosis. Use of approach-oriented coping strategies was associated with less psychological distress and better QOL, suggesting a possible target for supportive oncology interventions.

The Prevalence and Determinant of PTSD Symptoms among Home-Quarantined Chinese University Students during the COVID-19 Pandemic.

Background: When COVID-19 emerged in China in late 2019, most Chinese university students were home-quarantined to prevent the spread of the virus, considering the great impact of the lockdown on young people habits and their psychological well-being. This study explored the prevalence of post-traumatic stress disorder (PTSD) and its associated factors among Chinese university students who are isolated at home during the COVID-19 pandemic. Method: 4520 participants from five universities in China were surveyed by online questionnaire and the PTSD Checklist—Civilian Version (PCL-C) was adopted as a screening instrument. Results: Exposure to virus was significantly related to PTSD outcomes. The most important predictors for PTSD outcomes were parents’ relationship and the way parents educated, and university-provided psychological counseling was a protective factor against developing PTSD. Conclusions: The COVID-19 pandemic had adverse psychological consequences on Chinese university students who were isolated at home due to the relatively high prevalence rate of PTSD which was reported. Adverse parental relationships and the extreme way parents educate their children could be the major risk factors for PTSD outcomes. Psychological interventions need to be made available to home-quarantined university students, and those in the worst-hit and exposed areas to virus should be given priority focus.

Network Analysis of Neurobehavioral and Post-Traumatic Stress Disorder Symptoms One Year after Traumatic Brain Injury: A Veterans Affairs Traumatic Brain Injury Model Systems Study.

Traumatic brain injury (TBI) is often experienced under stressful circumstances that can lead to symptoms of post-traumatic stress disorder (PTSD) and neurobehavioral symptoms of brain injury. There is considerable symptom overlap in the behavioral expression of these conditions. Psychometric network analysis is a useful approach to investigate the role of specific symptoms in connecting these two disorders and is well suited to explore their interrelatedness. This study applied network analysis to examine the associations among PTSD and TBI symptoms in a sample of Service Members and Veterans (SM/Vs) with a history of TBI one year after injury. Responses to the Neurobehavioral Symptom Inventory (NSI) and PTSD Checklist-Civilian version (PCL-C) were obtained from participants who completed comprehensive inpatient rehabilitation services across five Veterans Affairs polytrauma rehabilitation centers. Participants (N = 612) were 93.1% male with an average age of 36.98 years at injury. The analysis produced a stable network. Within the NSI symptom groups, the frustration symptom was an important bridge between the affective and cognitive TBI symptoms. The PCL-C nodes formed their own small cluster with hyperarousal yielding connections with the affective, cognitive, and somatic symptom groups. Consistent with this observation, the hyperarousal node had the second strongest bridge centrality in the network. Hyperarousal appears to play a key role in holding together this network of distress and thus represents a prime target for intervention among individuals with elevated symptoms of PTSD and a history of TBI. Network analysis offers an empirical approach to visualizing and quantifying the associations among symptoms. The identification of symptoms that are central to connecting multiple conditions can inform diagnostic precision and treatment selection.

Influence of Diagnostic Informing on Negative Emotions, Illness Perception, Self-Perceived Burden, and Posttraumatic Stress Disorder in Patients with Gastrointestinal Tumors.

Objective To investigate the influence of diagnostic informing on negative emotions, illness perception (IP), self-perceived burden (SPB), and posttraumatic stress disorder (PTSD) in patients with gastrointestinal tumors. Methods A total of 261 patients with gastrointestinal tumors admitted to our hospital from January 2018 to December 2020 were selected. According to whether the patients were informed of the disease diagnosis, they were divided into the informing group (n = 125) and the concealment group (n = 136). The self-rating anxiety scale (SAS), the self-rating depression scale (SDS), the brief illness perception questionnaire (BIPQ), the self-perceived burden scale (SPBS), and the PTSD checklist-civilian version (PCL-C) were used to investigate the two groups. Results The SAS and SDS scores of the informing group were lower than those of the concealment group (t = 7.853 and 6.444, P < 0.05). The total BIPQ score of the informing group was higher than that of the concealment group (t = −4.089, P < 0.05). The total SPBS score of the informing group was lower than that in the concealment group (t = 2.443, P < 0.05). The total PCL-C score of the informing group was lower than that of the concealment group (t = 2.173, P < 0.05). Conclusion Diagnosis informing can reduce the negative emotions, increase positive IP, and reduce the risk of SPB and PTSD in patients with gastrointestinal tumors.

Drugs age-of-onset as a signal of later post-traumatic stress disorder: Bayesian analysis of a census protocol

Individuals with PTSD have an increased risk of drug use disorders. Conversely, we aim to evaluate how early onset of alcohol, tobacco and psychoactive drugs use are associated with PTSD later in life. 2,193 brazilian young adults completed modularized assessments: The Trauma History Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C, transformed to PCL-5 through a crosswalk procedure), the Barratt Impulsivity Scale; and a survey on drug use with self-report questions about first use, current use, frequency, quantity, and interpersonal consequences. Bayesian inference and multivariate regression models were used to examine the effects on the risk of PTSD, considering different assumptions of information flow. Raw and unbiased (multivariate) estimates consistently revealed that earlier age of onset of alcohol and tobacco use increased risk for PTSD (Odds-ratios between 2.39 and 3.19 (Alcohol) and 1.82 to 2.05 (Tobacco). Among those who had PTSD (310), 10.3% (32) were very precocious at the onset age (12 to 18 years) of alcohol consumption (No-PTSD: 89 out 1883, 4.7%). Data supports a model in which age of onset effects are partially mediated by the number of trauma exposures. Early intoxication might suggest vulnerability for qualifying trauma events, or it may increase chances of exposure. Also, PTSD may be more likely to occur among trauma-exposed individuals with early intoxicating experiences due to alcohol or drug self-administration. The last possibility resonates with the idea that early intoxication might disrupt adolescent brain development, with a subsequent reduction in resilience when qualifying trauma events occur.