Posttraumatic Stress Disorder In Women Research Articles

Characteristics and dynamics of the emotional condition and mental health of women during pregnancy and after childbirth in the COVID-19 pandemic

BACKGROUND: The coronavirus pandemic has been a powerful and long-term stressor, and pregnant women are among the most vulnerable groups in the population. Modern foreign studies have shown an increase in the level of anxiety, depression, and post-traumatic stress disorder in women during pregnancy and after childbirth in the COVID-19 coronavirus pandemic, which, in turn, can affect both the course of pregnancy and childbirth and the development of the child. Meanwhile, there are currently very few domestic studies of these characteristics and their dynamics in women in the pre- and postnatal period. AIM: The aim of this study was to assess the characteristics and dynamics of the emotional condition and mental health of women during pregnancy and after childbirth in the COVID-19 coronavirus pandemic. MATERIALS AND METHODS: In this study, we used the State-Trait Anxiety Inventory by Ch.D. Spilberger, adapted by Yu.L. Khanin; the Achenbach System of Empirically Based Assessment (Adult Self-Report 18–59) by T. Achenbach and L. Rescorla, adapted by E.R. Slobodskaya; the Impact of Event Scale-Revised by D.S. Weiss and C.R. Marmar, adapted by N.V. Tarabrina; socio-biographical questionnaire during pregnancy and after childbirth; and postpartum interview. At the I stage, the study included 248 pregnant women, with the average age of 30.7 (18–44) years and the average gestational age of 31.1 (4–40) weeks. At the II stage, we enrolled 98 women from the initial sample four to six months after childbirth. RESULTS: Our study showed the presence of predominantly average levels of anxiety, a high frequency of depressive disorder and avoidance, cognitive problems and withdrawal, as well as somatic problems during pregnancy. Pandemic-related post-traumatic stress disorder was identified in 7.7% of pregnant women and 6% of women after childbirth. Analysis of the dynamics of the emotional condition and mental health disorders in women before and after childbirth revealed a significant decrease in the levels of post-traumatic stress disorder (p 0.01), depressive (p 0.05) and somatic (p 0.01) disorders, and avoidance disorder (p 0.05). Predictors of the emotional condition, post-traumatic stress disorder and mental health disorders in women after childbirth are the same as those during pregnancy. CONCLUSIONS: The study showed a high incidence of post-traumatic stress disorder, depression and avoidance disorders with an average level of anxiety in pregnant women during the pandemic. After childbirth, patients experienced a decrease in depressive, somatic and avoidance disorders, as well as post-traumatic stress disorder.

Post-traumatic Stress Disorder in Women in Post-Natal Period

Objective: To assess and evaluate the presence of post-traumatic stress disorder and its associated factors affecting the women in post-natal period. Material and Methods: Data was collected through a cross-sectional survey from February 2023-July, 2023 at the Department of obstetrics and gynaecology, Ghurki Trust Teaching Hospital Lahore and 101 women fulfilling various diagnostic criteria for post-traumatic stress disorder in post-natal period were included in the study. PTSD symptoms were assessed using the “City Birth Trauma Scale” (CBTS) questionnaire including various stratification of events. SPSS 27.0 software was used for data analysis. Results: The results showed the possible outcome of several factors such as mode of delivery, family system, support and terms with partner or any previous psychiatric illness/PTSD or PTSD following child birth. Women with partner support had a significantly lower incidence of distress & impairment symptoms (33.3%) compared to those without support (81.8%) as p<.05. Conclusion: Our study depicted statistically significant link between PTSD criteria for distress and impairment and partner support and good terms with partner. Given that, partner support ought to be more than what is provided to lower the incidence of PTSD in women following child birth.

A diagnostic questionnaire for childbirth related posttraumatic stress disorder: a validation study

Labor and delivery can entail complications and severe maternal morbidities that threaten a woman's life or cause her to believe that her life is in danger. Women with these experiences are at risk for developing posttraumatic stress disorder. Postpartum posttraumatic stress disorder, or childbirth-related posttraumatic stress disorder, can become an enduring and debilitating condition. At present, validated tools for a rapid and efficient screen for childbirth-related posttraumatic stress disorder are lacking. We examined the diagnostic validity of the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, for detecting posttraumatic stress disorder among women who have had a traumatic childbirth. This Checklist assesses the 20 Diagnostic and Statistical Manual of Mental Disorders, posttraumatic stress disorder symptoms and is a commonly used patient-administrated screening instrument. Its diagnostic accuracy for detecting childbirth-related posttraumatic stress disorder is unknown. The sample included 59 patients who reported a traumatic childbirth experience determined in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, posttraumatic stress disorder criterion A for exposure involving a threat or potential threat to the life of the mother or infant, experienced or perceived, or physical injury. The majority (66%) of the participants were less than 1 year postpartum (for full sample: median, 4.67 months; mean, 1.5 years) and were recruited via the Mass General Brigham's online platform, during the postpartum unit hospitalization or after discharge. Patients were instructed to complete the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, concerning posttraumatic stress disorder symptoms related to childbirth. Other comorbid conditions (ie, depression and anxiety) were also assessed. They also underwent a clinician interview for posttraumatic stress disorder using the gold-standard Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A second administration of the Checklist was performed in a subgroup (n=43), altogether allowing an assessment of internal consistency, test-retest reliability, and convergent and diagnostic validity of the Checklist. The diagnostic accuracy of the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, in reference to the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, was determined using the area under the receiver operating characteristic curve; an optimal cutoff score was identified using the Youden's J index. One-third of the sample (35.59%) met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for a posttraumatic stress disorder diagnosis stemming from childbirth. The Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, symptom severity score was strongly correlated with the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, total score (ρ=0.82; P<.001). The area under the receiver operating characteristic curve was 0.93 (95% confidence interval, 0.87-0.99), indicating excellent diagnostic performance of the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. A cutoff value of 28 optimized the sensitivity (0.81) and specificity (0.90) and correctly diagnosed 86% of women. A higher value (32) identified individuals with more severe posttraumatic stress disorder symptoms (specificity, 0.95), but with lower sensitivity (0.62). Checklist scores were also stable over time (intraclass correlation coefficient, 0.73), indicating good test-retest reliability. Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, scores were moderately correlated with the depression and anxiety symptom scores (Edinburgh Postnatal Depression Scale: ρ=0.58; P<.001 and the Brief Symptom Inventory, anxiety subscale: ρ=0.51; P<.001). This study demonstrates the validity of the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, as a screening tool for posttraumatic stress disorder among women who had a traumatic childbirth experience. The instrument may facilitate screening for childbirth-related posttraumatic stress disorder on a large scale and help identify women who might benefit from further diagnostics and services. Replication of the findings in larger, postpartum samples is needed.

Fear-Conditioning to Unpredictable Threats Reveals Sex and Strain Differences in Rat Fear-Potentiated Startle (FPS).

Fear-potentiated startle (FPS) has been widely used to study fear processing in humans and rodents. Human studies showed higher startle amplitudes and exaggerated fear reactivity to unpredictable vs. predictable threats in individuals suffering from post-traumatic stress disorder (PTSD). Although human FPS studies use both sexes, a surprisingly limited number of rodent FPS studies use females. Here we investigate the effects of signal-threat contingency, signal-threat order and threat predictability on FPS in both sexes. We use a classic fear-conditioning protocol (100% contingency of cue and shock pairings, with forward conditioning such that the cue co-terminates with the shock) and compare it to modified fear-conditioning protocols (70% contingency; backward conditioning; or cue and shock un-paired). Although there are no sex differences in the startle amplitudes when corrected for body weight, females consistently demonstrate higher shock reactivity during fear-conditioning. Both sexes and strains demonstrate comparable levels of cued, non-cued, and contextual fear in the classic FPS and FPS following fear-conditioning with 70% contingency or backward order (cue co-starts with shock). However, in the classic FPS, Sprague-Dawley females show reduced proportion between cued fear and cue-elicited vigilant state than males. Lastly, a prominent sex difference is uncovered following unpredictable fear-conditioning (cue and shock un-paired), with Wistar, but not Sprague-Dawley, females showing significantly higher startle overall during the FPS recall, regardless of trial type, and higher contextual fear than males. This striking sex difference in processing unpredictable threats in rodent FPS might help to understand the mechanisms underlying higher incidence of PTSD in women.

Recent Economic Intimate Partner Violence and Posttraumatic Stress Symptoms Among a Racially and Ethnically Diverse Sample of U.S. Women Experiencing Intimate Partner Violence.

Posttraumatic stress disorder (PTSD) is a prevalent consequence of physical and sexual intimate partner violence (IPV); however, little is known about the unique contributions of economic IPV. Furthermore, women's economic self-sufficiency may explicate the potential relationship between economic IPV and PTSD symptoms. Guided by the Stress Process Theory and Intersectionality, this study examined associations between economic IPV and women's PTSD symptoms and assessed economic self-sufficiency as a mediator. Participants were 255 adult women experiencing IPV recruited from metropolitan Baltimore, MD, and the state of CT who participated in two different studies. Participants completed surveys on IPV, economic self-sufficiency, and PTSD. Path analyses were conducted to examine direct and indirect associations of economic IPV with economic self-sufficiency and PTSD. Economic IPV was uniquely associated with PTSD symptoms while controlling for other forms of IPV. Economic self-sufficiency significantly partially mediated the association between economic IPV and PTSD symptoms such that economic IPV was associated with PTSD symptoms through economic self-sufficiency. Economic IPV may limit women's ability to make autonomous decisions related to finances, which could be distressing. The mental health impact of economic IPV may be particularly debilitating for women with low economic self-sufficiency as their posttraumatic stress occurs within the context of feeling unable to meet their financial goals and also having a partner control their economic resources. Fostering economic empowerment and asset building may be a strengths-based approach to reduce the PTSD symptomatology among women experiencing IPV.

A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder

This systematic review examines the relationship between severe maternal morbidity (SMM) and women's post-traumatic stress disorder (PTSD). The review brings together the findings of various studies to provide information into the predominant rates of SMM and PTSD, risk factors, systems, and pathways, the impact on maternal health, and recommendations for clinical practice. The review uncovers that ladies with SMM are bound to foster PTSD, which essentially affects their mental prosperity and in general maternal prosperity. This review discusses the meanings of deliberate screening and assessment, evidence-based contraception and intercession philosophies, and efforts to detect the psychological effects of SMM by close-to-home welfare and maternal welfare providers. Regardless, there are locales in which additional investigation is expected, for instance, studying the suitability of interventions, filling in data openings, and checking out the effect of various peoples and social characteristics. By keeping an eye on these gaps, researchers can advance the field and encourage assigned interventions to lessen the effects of SMM and PTSD, ultimately transforming outcomes for women and their families.

Brain Monoamine Dysfunction in Response to Predator Scent Stress Accompanies Stress-Susceptibility in Female Rats.

Post-traumatic stress disorder (PTSD) is prevalent in women; however, preclinical research on PTSD has predominantly been conducted in male animals. Using a predator scent stress (PSS) rodent model of PTSD, we sought to determine if stress-susceptible female rats show altered monoamine concentrations in brain regions associated with PTSD: the medial prefrontal cortex (mPFC), nucleus accumbens (NAc), and dorsal (dHIPP) and ventral (vHIPP) hippocampus. Female Sprague-Dawley rats were exposed to a single, 10-min PSS exposure and tested for persistent anhedonia, fear, and anxiety-like behavior over four weeks. Rats were phenotyped as stress-Susceptible based on sucrose consumption in the sucrose preference task and time spent in the open arms of the elevated plus maze. Brain tissue was collected, and norepinephrine, dopamine, serotonin, and their metabolites were quantified using high-performance liquid chromatography. Stress-susceptibility in female rats was associated with increased dopamine and serotonin turnover in the mPFC. Susceptibility was also associated with elevated dopamine turnover in the NAc and increased norepinephrine in the vHIPP. Our findings suggest that stress-susceptibility after a single stress exposure is associated with long-term effects on monoamine function in female rats. These data suggest interventions that decrease monoamine turnover, such as MAOIs, may be effective in the treatment of PTSD in women.

Neural correlates of PTSD in women with childhood sexual abuse with and without PTSD and response to paroxetine treatment: A placebo-controlled, double-blind trial

ObjectiveChildhood sexual abuse is the leading cause of posttraumatic stress disorder (PTSD) in women, and is a prominent cause of morbidity and loss of function for which limited treatments are available. Understanding the neurobiology of treatment response is important for developing new treatments. The purpose of this study was to assess neural correlates of personalized traumatic memories in women with childhood sexual abuse with and without PTSD, and to assess response to treatment. MethodsWomen with childhood sexual abuse with (N = 28) and without (N = 17) PTSD underwent brain imaging with High-Resolution Positron Emission Tomography scanning with radiolabeled water for brain blood flow measurements during exposure to personalized traumatic scripts and memory encoding tasks. Women with PTSD were randomized to paroxetine or placebo followed by three months of double-blind treatment and repeat imaging with the same protocol. ResultsWomen with PTSD showed decreases in areas involved in the Default Mode Network (DMN), a network of brain areas usually active when the brain is at rest, hippocampus and visual processing areas with exposure to traumatic scripts at baseline while women without PTSD showed increased activation in superior frontal gyrus and other areas (p < 0.005). Treatment of women with PTSD with paroxetine resulted in increased anterior cingulate activation and brain areas involved in the DMN and visual processing with scripts compared to placebo (p < 0.005). ConclusionPTSD related to childhood sexual abuse in women is associated with alterations in brain areas involved in memory and the stress response and treatment with paroxetine results in modulation of these areas.

The psychological impact of Early Pregnancy Loss in Portugal: incidence and the effect on psychological morbidity.

Worldwide, up to a quarter of all recognized pregnancies result in Early Pregnancy Loss (EPL), also known as miscarriage. For many women, this is a traumatic experience that leads to persistent negative mental health responses. The most common morbidity reported in studies from different countries is complicated grief, usually comorbid with depression, anxiety, and Post-Traumatic Stress Disorder (PTSD). To our best knowledge, no studies characterizing the psychological impact of EPL have been made in Portugal. An online survey was conducted to evaluate clinical symptoms of perinatal grief, anxiety, depression, and PTSD in women who suffered a spontaneous loss within 20 weeks of gestation. Out of 1,015 women who answered this survey, 873 were considered eligible, and subsequently distributed in 7 groups according to the time passed between their loss and their participation in the study. The proportion of women showing symptoms of all comorbidities was greater in those whose loss had happened within a month, and there was a significant gradual decrease over time in scores and proportions of clinical perinatal grief and PTSD. In terms of depression symptoms, scores dropped significantly in the group whose loss occurred 13-24 months before their participation but proportions oscillated without great changes in the other groups. Regarding anxiety, there were small oscillations, but there was no significant decrease of symptoms over time. Overall, despite a general drop in scores for most morbidities over time, substantial proportions of women showed persistent symptoms of clinical morbidities 3 years or more after the loss. Therefore, it is essential to promote monitoring of possible complicated responses to the event, to provide appropriate and timely intervention to those women in need.

The link between Pos-Traumatic Stress Disorder and Childbirth

IntroductionChildbirth can be experienced as distressing or even traumatic for some women and her partners, which could cause psychological distress, intense fear or helplessness and increases the risk of anxiety, depression and even post-traumatic stress disorder (PTSD). The reported prevalence of post-traumatic stress disorder after childbirth ranges from 1.5% to 6%.ObjectivesThe current study aimed to elaborate a narrative literature review to identify predictors associated development of PTSD in women and the partners.MethodsPubMed database searched using the terms “post-traumatic stress disorder” and “childbirth” and “trauma”. Only research conducted in the past 20 years was considered for inclusion.ResultsSeveral variables were associated with risk to development PTSD after childbirth, including negative experiences and severe fear of childbirth, subjetive distress, previous abortion, psychological difficulties in pregnancy, previous psychiatric problems, history of PTSD and trauma. Futhermore, obstretic and birth-related factors such as pregnancy complications, type of birth could also contribute to PTSD in women and her partners. Additionally, diferent environmental factors like poor interaction between provider and mother, low social support during labour and birth are associated with development of PTSD.ConclusionsClinicians should be aware that many women and her parterns have a risk to development PTSD following childbirth. We need to research risk factors in routine clinical practice and carefully monitored the patients with high risk.Disclosure of InterestNone Declared

PS-BPC05-1: HEART RATE VARIABILITY INDICES AS POTENTIAL POST-TRAUMATIC STRESS DISORDER BIOMARKERS

Objective: Psychological distress, such as posttraumatic stress disorder (PTSD), is commonly evaluated using subjective questionnaires, a method prone to self-report bias. The working hypothesis was that levels of autonomic dysfunction determined by heart rate variability (HRV) measures are associated with the severity of PTSD in women following pregnancy loss. Design and Methods: This was an observational prospective cohort study with 53 patients enrolled. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) PTSD scale (PCL-5) was used to assess the severity of PTSD in women after pregnancy loss. The cardiac autonomic function was assessed using HRV measurements during a deep breathing test using an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. HRV measures were: standard deviation (SD) of normal R-R wave intervals [SDNN, ms], square root of the mean of the sum of the squares of differences between adjacent normal R wave intervals [RMSSD, ms], and the number of all R-R intervals in which the change in consecutive normal sinus intervals exceeds 50 milliseconds divided by the total number of R-R intervals measured [pNN50 = (NN50/n-1)x100%] [pNN50%]. Results: The PCL-5 scores had a statistically significant association with HRV indices (SDNN; RMSSD, and pNN50%). Patients with PTSD had similar mean heart rate values as compared to patients without PTSD (PCL-5), but significantly higher SDNN [median[IQR, interquartile range]: 90.1 (69.1 - 112.1) vs. 52.5 (36.8 - 65.6)], RMSSD [59.4 (37.5 - 74.9) vs. 31.9 (19.3 - 44.0)], and PNN50% values [25.7 (16.4 - 37.7) vs. 10.6 (1.5 - 21.9)]. The SDNN of the deep breathing test HRV was effective at distinguishing between patients with PTSD and those without, with an AUC = 0.83 +/- 0.06 (95 % CI 0.94, p = 0.0001) of the ROC model. Conclusions: In this study, HRV indices as biomarkers of cardiac dysautonomia were found to be significantly related to the severity of PTSD symptoms in women after pregnancy loss.

The migrant Hazara Shias of Pakistan and their social determinants for PTSD, mental disorders and life satisfaction

BackgroundEnsuring safety and wellbeing of all the minority populations of Pakistan is essential for collective national growth. The Pakistani Hazara Shias are a marginalized non-combative migrant population who face targeted violence in Pakistan, and suffer from great challenges which compromise their life satisfaction and mental health. In this study, we aim to identify the determinants of life satisfaction and mental health disorders in Hazara Shias and ascertain which socio-demographic characteristics are associated with post-traumatic stress disorder (PTSD). MethodsWe used a cross-sectional quantitative survey, utilizing internationally standardized instruments; with an additional qualitative item. Seven constructs were measured, including household stability; job satisfaction; financial security; community support; life satisfaction; PTSD; and mental health. Factor analysis was performed showing satisfactory Cronbach alpha results. A total of 251 Hazara Shias from Quetta were sampled at community centers through convenience method based on their willingness to participate. ResultsComparison of mean scores shows significantly higher PTSD in women and unemployed participants. Regression results reveal that people who have low community support, especially from national and ethnic community, religious community, and other community groups, had higher risk of mental health disorders. Structural equation modeling identified that four study variables contribute to greater life satisfaction, including: household satisfaction (β = 0.25, p < 0.001); community satisfaction (β = 0.26, p < 0.001); financial security (β = 0.11, p < 0.05); and job satisfaction (β = 0.13, p < 0.05). Qualitative findings revealed three broad areas which create barriers to life satisfaction, including: fears of assault and discrimination; employment and education problems; and financial and food security issues. ConclusionsThe Hazara Shias need immediate assistance from state and society to improve safety, life opportunities, and mental health. Interventions for poverty alleviation, mental health, and fair education and employment opportunities need to be planned in partnership with the primary security issue.

Vagal control moderates the association between endothelial function and PTSD symptoms in women with T2DM

BackgroundIndividuals with posttraumatic stress disorder (PTSD) are more likely to present with metabolic diseases such as type-2 diabetes mellitus (T2DM), and cardiovascular dysfunction has been implicated in this link. These diseases disproportionately affect women and individuals exposed to chronic environmental stressors (e.g., community violence, poverty). We examined associations among PTSD, cardiovascular indices, and metabolic function in highly trauma-exposed Black women with T2DM. MethodsParticipants (N = 80) were recruited for a follow-up study of stress and T2DM as part of the Grady Trauma Project. PTSD symptoms were assessed with the Clinician Administered PTSD Scale (CAPS-IV). Cardiovascular indices included heart rate (HR), blood pressure (BP), respiratory sinus arrhythmia (RSA), and endothelial function (assessed via flow-mediated dilation; FMD). An oral glucose tolerance test was used as an indicator of metabolic function. ResultsOf the cardiovascular indices, only FMD was significantly associated with PTSD symptoms (CAPS Avoidance symptoms; β = −0.37, p = .042), and glucose tolerance (β = −0.44, p = .019), controlling for age and body mass index. The association between FMD and PTSD Avoidance was moderated by RSA such that the effect of FMD was only significant at low levels of RSA (simple slopes β = −0.87, p = .004). ConclusionsOur results indicate that endothelial function is significantly related to PTSD and glucose tolerance, over and above other cardiovascular measures (HR, BP, RSA). Further, our results suggest that low RSA may be a risk factor for the link between poor endothelial function and PTSD in women with T2DM.

The correlation between postpartum stress disorder and maternal anxiety in different types of delivery (vaginal and cesarean section)

Aim: Post-traumatic stress disorder refers to a person&#8217;s experience of a traumatic event. Traumatic experiences during childbirth can cause postpartum stress in some women. The present study aimed to investigate the correlation between postpartum stress disorder in different types of delivery (normal vaginal delivery and cesarean section) and maternal anxiety. Design: This was a cross-sectional study. Methods: This cross-sectional study was performed on 714 pregnant mothers selected via cluster sampling six-eight weeks after their delivery in selected health centers. The data were collected using Post-Traumatic Stress Disorder Symptom Scale I and the Spielberger State-Trait Anxiety Inventory. The data were then entered into the SPSS 20 software and were analyzed using a chi-square test. The significance level was set as p &lt; 0.05. Results: The results showed that most of the participants in the two groups had medium to low anxiety levels, and the two groups were homogeneous in this regard. However, the mean scores of obvious anxiety (p &lt; 0.0001) and hidden anxiety (p &lt; 0.0001) were significantly higher in the normal vaginal delivery group compared to the cesarean section group. Moreover, post-traumatic stress score was significantly correlated to both obvious anxiety and hidden anxiety in the two study groups. Conclusion: Postpartum stress disorder had a positive relationship with obvious anxiety and hidden anxiety in both study groups. Counseling may be effective in reducing post-traumatic stress disorder in women.

Serum adiponectin-levels are predictive of posttraumatic stress disorder in women

BackgroundAccumulative evidence indicates a role for adiponectin, a polypeptide secreted by adipose tissue, in the pathophysiology of posttraumatic disorder (PTSD) via metabolic and inflammatory pathways. This study examined adiponectin as a potential predictive biomarker for PTSD among female rape survivors. MethodsWe evaluated the relationship of baseline serum adiponectin levels to the development of probable PTSD at 3- and 6-months post rape-exposure and compared adiponectin levels between 542 rape-exposed (RE) and 593 rape-unexposed women (RUE). Probable PTSD were defined as a Davidson Trauma Scale score ≥40. Data were analysed using multivariate regression models and a generalized estimating equation (GEE) model. We adjusted for clinically relevant covariates associated with PTSD, as well as adiposity indices. ResultsParticipants who were in the mid-and high adiponectin tertile groups versus the lowest tertile group had a significantly reduced risk of probable PTSD at 6 months follow-up, independent of adiposity(aOR = 0.45[0.22–1.05], p = 0.035; aOR = 0.44[0.22–0.90], p = 0.024). However, there was no effect of group (RE vs. RUE). LimitationsAdiponectin assays were conducted on non-fasting blood samples and information on chronic medication, dietary factors and levels of physical activity were not collected. There was a high attrition rate among rape exposed participants. ConclusionsOur results show that higher serum adiponectin levels are associated with reduced risk of probable PTSD over a 6-month period. This finding supports the hypothesis that serum adiponectin is a potential risk biomarker for PTSD.

Neural Networks for Early Diagnosis of Postpartum PTSD in Women after Cesarean Section

The correlation between the kind of cesarean section and post-traumatic stress disorder (PTSD) in Greek women after a traumatic birth experience has been recognized in previous studies along with other risk factors, such as perinatal conditions and traumatic life events. Data from early studies have suggested some possible links between some vulnerable factors and the potential development of postpartum PTSD. The classification of each case in three possible states (PTSD, profile PTSD, and free of symptoms) is typically performed using the guidelines and the metrics of the version V of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) which requires the completion of several questionnaires during the postpartum period. The motivation in the present work is the need for a model that can detect possible PTSD cases using a minimum amount of information and produce an early diagnosis. The early PTSD diagnosis is critical since it allows the medical personnel to take the proper measures as soon as possible. Our sample consists of 469 women who underwent emergent or elective cesarean delivery in a university hospital in Greece. The methodology which is followed is the application of random decision forests (RDF) to detect the most suitable and easily accessible information which is then used by an artificial neural network (ANN) for the classification. As is demonstrated from the results, the derived decision model can reach high levels of accuracy even when only partial and quickly available information is provided.

Limbic Responses Following Shock Wave Exposure in Male and Female Mice.

Blast traumatic brain injury (bTBI) presents a serious threat to military personnel and often results in psychiatric conditions related to limbic system dysfunction. In this study, the functional outcomes for anxiety- and depressive-like behaviors and neuronal activation were evaluated in male and female mice after exposure to an Advanced Blast Simulator (ABS) shock wave. Mice were placed in a ventrally exposed orientation inside of the ABS test section and received primary and tertiary shock wave insults of approximately 15 psi peak pressure. Evans blue staining indicated cases of blood-brain barrier breach in the superficial cerebral cortex four, but not 24 h after blast, but the severity was variable. Behavioral testing with the elevated plus maze (EPM) or elevated zero maze (EZM), sucrose preference test (SPT), and tail suspension test (TST) or forced swim test (FST) were conducted 8 days–3.5 weeks after shock wave exposure. There was a sex difference, but no injury effect, for distance travelled in the EZM where female mice travelled significantly farther than males. The SPT and FST did not indicate group differences; however, injured mice were less immobile than sham mice during the TST; possibly indicating more agitated behavior. In a separate cohort of animals, the expression of the immediate early gene, c-Fos, was detected 4 h after undergoing bTBI or sham procedures. No differences in c-Fos expression were found in the cerebral cortex, but female mice in general displayed enhanced c-Fos activation in the paraventricular nucleus of the thalamus (PVT) compared to male mice. In the amygdala, more c-Fos-positive cells were observed in injured animals compared to sham mice. The observed sex differences in the PVT and c-Fos activation in the amygdala may correlate with the reported hyperactivity of females post-injury. This study demonstrates, albeit with mild effects, behavioral and neuronal activation correlates in female rodents after blast injury that could be relevant to the incidence of increased post-traumatic stress disorder in women.

Cognitive-Emotional Aspects of Post-Traumatic Stress Disorder in the Context of Female Genital Mutilation.

Around 200 million women and girls worldwide are affected by female genital mutilation/cutting (FGM/C). FGM/C is a procedure that harms or alters the external female genitals for non-medical reasons, and is usually performed on children. Often, this procedure leads to severe consequences for the women’s physical and mental health. In a cross-sectional sample of 112 women seeking medical counseling, physical and mental health characteristics associated with FGM/C were examined and possible predictors for the development of post-traumatic stress disorder (PTSD) in women affected by FGM/C were identified. A total of 55.4% (n = 66) of the women reported symptom levels of probable PTSD. Predictors for higher PTSD symptomology were an older age at the time of the FGM/C procedure, feelings of guilt and the centrality of the event in the woman’s life. Thus, cognitive–emotional processing was found to play an important role in the emergence of PTSD in women suffering from FGM/C. However, interventions taking into consideration these characteristics are mostly lacking and need to be investigated further in the context of FGM/C.

A randomized controlled trial of the influence of yoga for women with symptoms of post-traumatic stress disorder

BackgroundSurvivors in motor vehicle accident (MVA) may have posttraumatic stress disorder (PTSD). Yoga is a complementary approach for PTSD therapy.MethodsThis randomized controlled trial explored whether yoga intervention has effects on reducing the symptoms of PTSD in women survived in MVA. Participants (n = 94) were recruited and randomized into control group or yoga group. Participants attended 6 45-minuite yoga sessions in 12 weeks. Depression Anxiety Stress Scales (DASS) and Impact of Events Scale-Revised (IES-R) were used to assess psychological distress.ResultsPost-intervention IES-R total score of yoga group was significantly lower than that of control group (p = 0.01). At both post-intervention and 3-months post intervention, the DASS-21 total scores of yoga group were both significantly lower than those of control group (p = 0.043, p = 0.024). Yoga group showed lower anxiety and depression level compared to control group at both post-intervention (p = 0.033, p < 0.001) and post-follow-up (p = 0.004, p = 0.035). Yoga group had lower levels of intrusion and avoidance compared to control group after intervention (p = 0.002, p < 0.001).ConclusionResults illustrate that yoga intervention may alleviate anxiety and depression and improve the symptoms of PTSD in women with PTSD following MVA.

Factors affecting the emotional wellbeing of women and men who experience miscarriage in hospital settings: a scoping review

BackgroundMiscarriage can be a devastating event for women and men that can lead to short- and long-term emotional distress. Studies have reported associations between miscarriage and depression, anxiety, and post-traumatic stress disorder in women. Men can also experience intense grief and sadness following their partner’s miscarriage. While numerous studies have reported hospital-related factors impacting the emotional wellbeing of parents experiencing miscarriage, there is a lack of review evidence which synthesises the findings of current research.AimsThe aim of this review was to synthesise the findings of studies of emotional distress and wellbeing among women and men experiencing miscarriage in hospital settings.MethodsA systematic search of the literature was conducted in October 2020 across three different databases (CINAHL, MEDLINE and PsycInfo) and relevant charity organisation websites, Google, and OpenGrey. A Mixed Methods appraisal tool (MMAT) and AACODS checklist were used to assess the quality of primary studies.ResultsThirty studies were included in this review representing qualitative (N = 21), quantitative (N = 7), and mixed-methods (N = 2) research from eleven countries. Findings indicated that women and men’s emotional wellbeing is influenced by interactions with health professionals, provision of information, and the hospital environment. Parents’ experiences in hospitals were characterised by a perceived lack of understanding among healthcare professionals of the significance of their loss and emotional support required. Parents reported that their distress was exacerbated by a lack of information, support, and feelings of isolation in the aftermath of miscarriage. Further, concerns were expressed about the hospital environment, in particular the lack of privacy.ConclusionWomen and men are dissatisfied with the emotional support received in hospital settings and describe a number of hospital-related factors as exacerbators of emotional distress.Implications for practiceThis review highlights the need for hospitals to take evidence-informed action to improve emotional support services for people experiencing miscarriage within their services.