Post-traumatic Stress Disorder In Participants Research Articles

A Pilot Study Exploring the Feasibility of Virtual Written Exposure Therapy with Underserved Black Perinatal Women.

In the USA, Black pregnant women are at the highest risk for maternal morbidity. They also experience the highest rates of trauma exposure and posttraumatic stress disorder (PTSD). PTSD takes a toll on Black women's mental and physical health, placing them at risk for maternal morbidity. It increases several mental health symptoms such as suicidality, anxiety, re-living the trauma, and numbness. These mental health conditions adversely affect health behaviors, including those essential for maternal health, such as attending prenatal and postpartum appointments. Furthermore, untreated PTSD is associated with higher blood pressure, increasing Black mothers' risk of pre-eclampsia. For a variety of reasons including cultural mistrust, stigma, transportation, time constraints, and access to care, PTSD is frequently underassessed and undertreated among Black perinatal women. Written exposure therapy (WET) is a state-of-the-art brief treatment for PTSD. In this study, we explored the initial feasibility of the virtual delivery of WET to reduce PTSD symptoms among Black perinatal women. Results found the virtual delivery of WET to be feasible. Symptom reduction for PTSD in participants was 50-100% during follow-up, suggesting potential effectiveness of the intervention. Implications for virtual delivery of WET in reducing risk for Black maternal morbidity are discussed.

Posttraumatic stress disorder intervention for people with severe mental illness in a low-income country primary care setting: a randomized feasibility trial protocol

BackgroundIn this protocol, we outline a mixed-methods randomized feasibility trial of Brief Relaxation, Education and Trauma Healing (BREATHE) Ethiopia. BREATHE Ethiopia is a culturally and contextually adapted intervention for PTSD in participants with severe mental illness. BREATHE Ethiopia maps onto the World Health Organization’s guidelines for posttraumatic stress disorder (PTSD) treatment in low- and middle-income country primary care settings.MethodsSpecifically, this study includes a non-randomized pre-pilot (n = 5) and a randomized feasibility trial comparing BREATHE Ethiopia to Treatment as Usual (n = 40) to assess trial procedures, acceptability, and feasibility of intervention delivery, and investigate potential effectiveness and implementation. In a process evaluation, we will collect data that will be critical for a future fully randomized controlled trial, including the numbers of participants who are eligible, who consent, who engage in treatment, and who complete the assessments, as well as the feasibility and acceptability of assessments and the intervention. Qualitative data on facilitators and barriers to intervention delivery and quantitative data on provider fidelity to the intervention and participant and provider satisfaction will also be collected. Quantitative assessments at baseline, post-treatment, 1-month follow-up, and 3-month follow-up will assess change in mental health symptoms and functional impairment and hypothesized intervention mechanisms, including knowledge about PTSD, stigma, trauma-related cognitions, and physiological arousal.DiscussionFindings from this study will inform a future fully-powered randomized controlled trial, and if found to be effective, the intervention has the potential to be integrated into mental healthcare scale-up efforts in other low-resource settings.Trial registrationRegistered with ClinicalTrials.gov (NCT04385498) first posted May 13th, 2020; https://www.clinicaltrials.gov/ct2/show/NCT04385498?term=ethiopia&cond=PTSD&draw=2&rank=1.

P.610 Complex post-traumatic stress disorder in participants of the military actions in the operation military groups

Asthma and chronic obstructive pulmonary disease (COPD) are common chronic airway diseases that may overlap in some individuals. Asthma COPD overlap (ACO) is a heterogeneous conditions that includes smoking-asthma (SA) and COPD with eosinophilia (COPDe). MicroRNAs (miRNA) are regulators of gene expression with a great potential as biomarkers.The objective of this study was to identify distinctive miRNA signatures in patients from the whole spectrum of chronic obstructive bronchial disease (SA, COPDe, non-smoking asthmatics (NSA), and COPD) that could serve as diagnostic biomarkers or describe differential molecular mechanisms with potential therapeutic implications.From a previously characterized cohort of ACO, COPD and asthma patients, we selected a discovery group of 40 patients for miRNA expression profiling by means of microarray technology. Differential expression of miRNAs were validated by quantitative PCR in the complete cohort (n = 274).Thirty differentially expressed miRNAs (eBAYES p < 0.05, fold change ≥2) were found among the different groups of patients regarding COPDe: 19 COPD-vs-COPDe, 13 NSA-vs-COPDe, 11 SA-vs-COPDe. A characteristic down-regulated miRNA expression pattern was identified in COPDe patients. Differential expression of miR-619-5p and miR-4486 in COPDe patients were validated in the complete cohort (n = 274).We postulate that COPDe patients show a characteristic expression profile of miRNAs distinctive from asthma and COPD. Also that SA and COPDe patients, which have been typically clustered in the ACO group, display distinct molecular events.El asma y la enfermedad pulmonar obstructiva crónica (EPOC) son enfermedades crónicas comunes de la vía aérea y pueden solaparse en algunos individuos. El solapamiento de asma y EPOC (ACO, por sus siglas en inglés) es una enfermedad heterogénea que incluye el asma en fumadores (AF) y la EPOC con eosinofilia (EPOCe). Los microRNA (miRNA) son reguladores de la expresión de genes con gran potencial para su uso como biomarcadores.El objetivo de este estudio fue identificar las firmas características de miRNA en pacientes del espectro de enfermedades pulmonares obstructivas crónicas al completo (AF, EPOCe, asmáticos no fumadores y EPOC) que pudieran servir como biomarcadores diagnósticos o describir mecanismos moleculares diferenciales con potenciales implicaciones terapéuticas.A partir de una cohorte previamente caracterizada de pacientes con ACO, EPOC y asma, seleccionamos un grupo de descubrimiento de 40 pacientes para realizar sus perfiles de expresión de miRNA mediante microarrays. La expresión diferencial de miRNA se validó mediante PCR cuantitativa en la cohorte completa (n = 274).Se encontraron 30 miRNA expresados diferencialmente (eBayes p < 0,05, fold change [cambio en incremento] ≥ 2) entre los diferentes grupos de pacientes en relación con la EPOCe: 19 EPOC comparado con EPOCe, 13 asmáticos no fumadores comparado con EPOCe, 11 AF comparado con EPOCe. Se identificó un patrón característico de expresión con regulación a la baja de miRNA. La expresión diferencial de miR-619-5p y miR-4486 en los pacientes con EPOCe se validó con la cohorte al completo (n = 274).Postulamos que los pacientes con EPOCe muestran un perfil de expresión de miRNA característico y diferente al del asma y la EPOC. También que los pacientes con AF y con EPOCe, que se han agrupado típicamente en el grupo de ACO, muestran eventos moleculares diferenciales.

Attention control therapy for acute stress disorder: A randomized controlled trial.

A subset of people exposed to traumatic events develop acute stress disorder (ASD), and approximately half of people with ASD develop posttraumatic stress disorder (PTSD). This randomized controlled trial examined the efficacy of internet-delivered attention control therapy (ACT), previously shown to reduce PTSD symptoms, as an adjuvant to treatment as usual in the community for patients with ASD. About 119 participants with ASD were randomly assigned to ACT or treatment as usual in the community within the first month following their traumatic event. PTSD symptoms and attention patterns were measured. A significant reduction in stress-related symptoms was noted across participants with no difference between the two groups. Approximately half of the participants developed PTSD 2 months after the trauma. High attention bias variability was associated with elevated PTSD symptoms. However, attention bias variability did not change due to the therapy sessions. Internet-delivered ACT was no more effective in reducing risk for PTSD in participants with ASD than treatment as usual in the community. Although elevated attention bias variability was detected in the patients with ASD, ACT failed to engage this cognitive target. Finally, ACT-based prevention research should proceed with caution given the possibility that this intervention might be associated with symptom worsening as indexed by the Clinical Global Impression scale.

Stress response in the daily lives of simulation repeaters. A randomized controlled trial assessing stress evolution over one year of repetitive immersive simulations.

BackgroundSimulations in healthcare reproduce clinical situations in stressful conditions. Repeated stress exposure might influence the learning process in simulation as well as real-life.Objectives1) To record heart rate and heart rate variability evolution during one-day simulation over one year; 2) To analyze the effect of repetitive high-fidelity simulations on the risk of post-traumatic stress disorder.Study designSingle-center, investigator-initiated RCT. 48 participants were randomized in 12 multidisciplinary teams of French Emergency Medical Services to manage infant shock in high-fidelity simulations. In the experimental group, 6 multidisciplinary teams were exposed to 9 different simulation sessions over 1 year. In the control group, 6 multidisciplinary teams participated in only 3 simulation sessions, in common with those of the experimental group (initial, intermediate after 6 months, and finally after 1 year). Heart rate (HR) and heart rate variability (HRV) were analyzed on a 24-hour Holter from the day prior to simulation until the end of simulation. Questionnaires of Impact of Event Scale-Revised at 7 days and Post-traumatic Check-List Scale at 1 month were used to detect possible post-traumatic stress disorder in participants. p<0.05 was considered significant.ResultsStress increased during each simulation in the two groups. After analysis on the 24-hour period, there was no significant difference between the two groups during the initial simulation session in terms of heart rate and heart rate variability. In the 24-hour period of the intermediate and final simulation sessions, the level of stress was higher in the control group during the diurnal (p = 0.04) and nocturnal periods (p = 0.01). No participant developed post-traumatic stress disorder after the 72 simulation sessions.ConclusionsDespite the stress generated by simulation, the more the sessions were repeated, the less were their repercussions on the daily lives of participants, reflected by a lower sympathetic activity. Moreover, repetition of simulations did not lead to post-traumatic stress disorder.Trial registrationClinicalTrials.gov NCT02424890.

Complex post-traumatic stress disorder in participants of the military actions in the operation militarygroups in the view of the eleven edition of the International classification of diseases

The introduction of the new concept of complex post-traumatic stress disorder (cPTSD) in the International Classification of Diseases of the 11th Edition deserves attention in a country where active fighting is taking place. The increase in the number of PTSD sufferers among military personnel and civilians on the territory of hostilities increases the likelihood of PTSD occurring among the contingent. At present, we have no experience in the diagnosis of cPTSD. The objective of our study, along with the diagnosis of PTSD symptoms, is to use a quality of life questionnaire to evaluate the symptoms of cPTSD. The result revealed that the level of community and service support was below average, indicating the need to improve community social support. The self-realization of the combatants has a low average level, which further influences the level of adaptation after the end of the service. Physical and psychological well-being are also low, and this indicator to the need for psychological and physical rehabilitation of demobilized soldiers. At the same time, communication with friends and family, performance were at a high enough level, and these are positive factors that influence the adaptation to civilian life. Summarizing the research, we suggest that in order to organize the help of the combatants more effectively, it is necessary to evaluate, along with a purely psychiatric diagnosis of PTSD, the level of social and physical adaptation of patients with PTSD.

Post-traumatic stress disorder in participants of foot-and-mouth disease epidemic control in Miyazaki, Japan, in 2010.

Foot-and-mouth disease (FMD) occurred in Miyazaki, Japan, in 2010, and 290,000 animals were culled. This paper describes the mental distress of the volunteers who had been dispatched to Miyazaki for disease control two years after the epidemic. It also assesses risk factors for post-traumatic stress disorder (PTSD). A participatory appraisal and self-administered questionnaire survey were conducted in 2012 for those who were dispatched to Miyazaki in 2010. The Impact of Event Scale-Revised (IES-R) was used as an indicator of PTSD, and univariate and multivariable analyses were performed. Of the 875 respondents, 1.3% had higher IES-R scores than the cut-off point (25), which is suggestive of PTSD. Mental stresses during and soon after FMD control and after two years were described. Four risk factors associated with high IES-R scores were found: transporting culled animals (P<0.01), stress during FMD control (P<0.01) and at the time of the survey (P<0.01), and lack of someone to talk to about FMD-associated stress at the time of the survey (P<0.01). Veterinarians, livestock technicians and clerical officers involved in FMD control still suffer from mental stress two years later. Public services should provide an opportunity for them to consult with mental health specialists. These findings should be used to better prepare workers who deal with infectious diseases of animals, especially when they must be culled. The establishment of a collaborative framework between veterinary and mental health services is recommended.