Risk For Posttraumatic Stress Disorder Research Articles

Stress-induced increase in heart-rate during sleep as an indicator of PTSD risk among combat soldiers.

Discerning the differential contribution of sleep behavior and sleep physiology to the subsequent development of posttraumatic-stress-disorder (PTSD) symptoms following military operational service among combat soldiers. Longitudinal design with three measurement time points: during basic training week (T1), during intensive stressed training week (T2), and following military operational service (T3). Participating soldiers were all from the same unit, ensuring equivalent training schedules and stress exposures. During measurement weeks soldiers completed the Depression Anxiety and Stress Scale (DASS) and the PTSD Checklist for DSM-5 (PCL-5). Sleep physiology (sleep heart-rate) and sleep behavior (duration, efficiency) were monitored continuously in natural settings during T1 and T2 weeks using wearable sensors. Repeated measures ANOVA revealed a progressive increase in PCL-5 scores from T1 and T2 to T3, suggesting an escalation in PTSD symptom severity following operational service. Hierarchical linear regression analysis uncovered a significant relation between the change in DASS stress scores from T1 to T2 and subsequent PCL-5 scores at T3. Incorporating participants' sleep heart-rate markedly enhanced the predictive accuracy of the model, with increased sleep heart-rate from T1 to T2 emerging as a significant predictor of elevated PTSD symptoms at T3, above and beyond the contribution of DASS stress scores. Sleep behavior did not add to the accuracy of the model. Findings underscore the critical role of sleep physiology, specifically elevated sleep heart-rate following stressful military training, in indicating subsequent PTSD risk following operational service among combat soldiers. These findings may contribute to PTSD prediction and prevention efforts.

Serum cortisol and neuroticism for post-traumatic stress disorder over 2 years in patients with physical injuries.

This study aimed to explore the relationships between serum cortisol levels, personality traits, and the development of Post-Traumatic Stress Disorder (PTSD) over 2 years among individuals with physical injuries. Participants were consecutively recruited from a trauma center and followed prospectively for 2 years. At baseline, serum cortisol levels were measured, and personality traits were categorized into five dimensions (Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness), using the Big Five Inventory-10. The diagnosis of PTSD during follow-up (at 3, 6, 12, and 24 months post-injury) was determined using the Clinician-Administered PTSD Scale for DSM-5. Binary and multinomial logistic regression analyses were conducted to examine the interactions between cortisol levels, personality traits, and PTSD development. Among 923 patients analyzed, 112 (12.1%) were diagnosed with PTSD at some point during the study period, with prevalence rates decreasing from 8.8% at 3 months to 3.7% at 24 months post-injury. Direct associations between cortisol levels or personality traits and PTSD were not observed. However, a significant interaction between lower cortisol levels and higher Neuroticism in relation to PTSD risk was identified, especially during the early follow-up periods (3 to 6 months), but this association waned from the 12-month follow-up onward. Our findings reveal Neuroticism-dependent associations between serum cortisol levels and PTSD development, exhibiting temporal variations. These results suggest that PTSD development may be influenced by a complex, time-sensitive interplay of biological and psychosocial factors, underscoring the importance of considering individual differences in stress reactivity and personality in PTSD research and treatment.

The impact of potentially morally injurious experience of betrayal on PTSD and depression following the October 7th terror attack

With about 1200 individuals murdered, the massacre of October 7th was one of the deadliest terrorist attacks in modern history. The mental health consequences of terrorist attacks have been documented. However, little is known of the impact of the potentially morally injurious experience (PMIE) of betrayal––in which individuals feel betrayed by leaders they once trusted––on levels of psychological burden in the aftermath of such an attack. In this national prospective cohort study, we examined to what extent the PMIE of betrayal exacerbates the risk for posttraumatic stress disorder (PTSD) and depression in the wake of the October 7th terrorist attack. A representative sample of 710 Israeli adults (362 female, 51.1%), Jews (557, 79.9%) and Arabs (153, 20.1%), aged 18–85 (M = 41.01, SD = 13.72) completed validated self-report questionnaires assessing PTSD, depression, and PMIE-betrayal at two timepoints: T1, in August 2023 (6–7 weeks before the attack) and T2, in November 2023 (5–6 weeks after the attack). In two hierarchical logistic regressions, we found that experience of PMIE-betrayal predicted diagnoses of both PTSD (OR 1.92, 95% CI 1.26–2.92) and depression (OR 2.03, 95% CI 1.37–3.01) at T2, beyond probable PTSD/depression at T1 and demographic and trauma-related variables. Moreover, in two repeated-measure analyses predicting PTSD/depression symptoms, we found significant interactions between PTSD/depression trajectories and PMIE-betrayal, meaning that the increase of PTSD/depression symptoms was significantly higher among participants experiencing betrayal in the context of the attack. Our study highlights the impact of PMIE of betrayal on the dramatic increase in psychopathology following the October 7th terror attack on Israel’s population. Clinicians treating individuals coping with PTSD and depression should attend to their patients’ possible exposure to betrayal following the attack. Moreover, national leaders and policymakers should take significant steps to repair the public’s betrayal experience.

Migration-related trauma and PTSD among Latinx parents in the southeast during COVID-19.

Latinx immigrants are at risk for migration-related trauma that can lead to posttraumatic stress disorder (PTSD). Among parents in immigrant families with undocumented family member(s) (i.e., mixed-status), risk for PTSD may be exacerbated by policies that threaten family separation and exclude immigrants from systems of support. Understanding these relationships in context is important to equip practitioners to address traumatic stress in this population. Our community-based participatory research (CBPR), mixed-methods study explored migration-related trauma and PTSD among Latinx immigrant parents in a restrictive immigration climate during the COVID-19 pandemic. We conducted 145 surveys with Latinx parents in mixed-status families and conducted multivariable linear analyses to test if immigration policy vulnerability strengthened the relationship between migration-related trauma and PTSD symptoms. Then, we conducted 15 interviews with frontline workers serving Latinx immigrant families to contextualize the relationships between migration-related trauma, immigration-related policies, and PTSD during the COVID-19 pandemic. Parent surveys revealed was no observed relationship between premigration-related trauma and PTSD symptoms (β = 0.12, p = .15). However, increases in policy vulnerability was associated with PTSD symptoms (β = 0.25, p < .01) and strengthened the relationship between postmigration trauma and PTSD symptoms (β = 0.19, p = .03). Frontline workers described how social isolation due to immigration-related policies worsened under the COVID-19 pandemic and deportation fears remained a constant stressor. Results from our CBPR study highlight the need for policies and practices that address compounding effects of migration-related trauma, policy vulnerability, and the COVID-19 pandemic to promote mental health equity among Latinx immigrant families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Virtual-reality exposure treatment for first responder PTSD: a pilot investigation

Introduction: There is increasing recognition that first responders’ exposure to multiple traumatic events puts them at risk for the development of emotional distress, including depression, substance misuse, posttraumatic stress disorder (PTSD), and suicide. Despite this increased risk and higher prevalence of PTSD and other trauma-related disorders, there are few data on treatment for first responders.Method: This investigation describes the outcome of an intensive outpatient program (IOP), initially developed for military trauma, as applied to the treatment of first responders with PTSD. This treatment is unique in that it utilizes virtual reality to enhance the immersion into the exposure scene. Furthermore, we assessed the utility of both fixed-length and unbounded-length exposure sessions.Results: The results indicate that the intervention was feasible to implement and did not produce iatrogenic effects. Participants reported significantly reduced symptoms of PTSD and related emotional distress, reduced disability, and improved daily functioning. These positive outcomes were maintained at 3-month follow-up. There was no difference in outcomes between the fixed- and unbounded-length sessions.Discussion: These results suggest that an efficacious, short-term intervention incorporating virtual reality has the potential to quickly return first responders to their profession.

Effects of a psychological first aid (PFA) based on the SIX Cs model on acute stress responses in a simulated emergency.

The SIX Cs model, a neuropsychological framework for psychological first aid, addresses acute stress responses that may lead to functional failure and heighten the risk for posttraumatic stress disorder. Unlike emotional interventions, this model prioritizes Cognitive Communication to diminish emotional overwhelm and bolster cognitive functioning. It introduces a Challenge for active engagement, Control for cognitive management of situations, Commitment from the helper to reduce loneliness, and Continuity to ensure narrative coherence. This study evaluates the SIX Cs model's effectiveness in an experimental setup to alleviate acute stress reaction symptoms. Sixty-three participants voluntarily participated. They were randomly assigned to the SIX Cs intervention (experimental) or to supportive emotional expression (control). They listened to a 3-min audio recording of a real emergency 911 phone call. Interventions were provided before and after listening to the recording. Before, immediately after, and 5 min later (recovery), participants' anxiety, heart rate variability, and mental resilience levels were measured. For all three outcomes, the Time × Group interactions were statistically significant. Follow-up analyses revealed that the SIX Cs participants showed lower anxiety and less reductions in heart rate variability and resilience than controls immediately after the stressor. Furthermore, the SIX Cs participants recovered faster on all three outcomes compared to controls. The results demonstrate the superior effect of the psychological first aid based SIX C's protocol over control in all outcomes, immediately after a simulated stressor and 7 min later as well as possible contribution for posttraumatic stress disorder risk reduction. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of cognitive behavioural therapy on neural, inflammatory, & autonomic markers in a sample with PTSD and cardiovascular risk: protocol for a pilot randomised controlled trial

ABSTRACT Background: Individuals with posttraumatic stress disorder (PTSD) are at heightened risk for cardiovascular disease (CVD) compared to the general population. Inflammation and autonomic dysfunction are candidate mechanisms of CVD risk in PTSD; however, these mechanisms have not been well-characterised in the PTSD-CVD link. Further, these mechanisms may operate through altered stress-related neural activity (SNA). Yet, it remains unknown if changes in PTSD are associated with changes in CVD risk mechanisms. Objective: This manuscript describes the design and procedures of a pilot randomised controlled trial to assess the impact of a first-line treatment for PTSD (Cognitive Processing Therapy; CPT) versus waitlist control on mechanisms of CVD risk. Further, this study will test the hypothesis that CPT reduces CVD risk through its effects on inflammation and autonomic function and that these changes are driven by changes in SNA. Methods: Adults with PTSD and CVD risk (N = 30) will be randomised to CPT or waitlist control. Participants complete two laboratory visits (baseline and post-treatment) that include surveys, brain and peripheral imaging via 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and resting measures of autonomic function. Primary outcomes include arterial inflammation and heart rate variability. Secondary outcomes include leukopoiesis (bone marrow uptake), heart rate, and blood pressure. The indirect effects of PTSD treatment on changes in inflammation and autonomic function through SNA will also be examined. Conclusions: This study seeks to characterise candidate neuroimmune mechanisms of the PTSD-CVD link to identify treatment targets and develop personalised interventions to reduce CVD events in PTSD populations. Trial registration: ClinicalTrials.gov identifier: NCT06429293..

Symptoms of Posttraumatic Stress Disorder Among Japanese Peacekeepers Deployed in South Sudan

Peacekeepers in United Nations missions experience potentially traumatic events, resulting in increased risk for posttraumatic stress disorder (PTSD). Understanding the course and risk factors of PTSD symptom severity is crucial to ensure personnel safety. To investigate the incidence of PTSD, symptom severity trajectories, and potential risk factors associated with adverse trajectories among Japanese peacekeepers deployed in South Sudan. Data for this 6-year prospective cohort study were collected from December 2011 to December 2018 from Japan Ground Self-Defense Force personnel deployed at the United Nations Mission in South Sudan, corresponding to before and up to 78 months after deployment. Of 3799 potential participants, 80 were excluded because of multiple deployments and 757 because of missing data, incomplete responses, or not providing informed consent. Therefore, 2962 participants were included in the analysis. Data analysis was performed from February 2022 to February 2024. The participants were deployed to United Nations Mission in South Sudan for 6 months. The 22-item Impact of Event Scale-Revised was used to assess PTSD symptoms, with 25 or more points indicating probable PTSD (p-PTSD). Sociodemographic data were collected, and the 30-item General Health Questionnaire was administered before deployment to identify risk factors for PTSD symptom severity. In the 2962 participants studied (2901 [97.9%] male; mean [SD] age, 33.9 [7.2] years), the incidence of p-PTSD was 3.95%. Latent growth mixture models identified 4 symptom severity trajectories: resilient (2143 [72.3%]), recovery (479 [16.2%]), protracted (182 [6.1%]), and delayed (158 [5.3%]). Multinomial logistic regression showed that sleep disturbance was a common risk factor for the 2 most severe trajectories (protracted: odds ratio [OR], 1.29; 95% CI, 1.08-1.54; delayed: OR, 1.26; 95% CI, 1.03-1.53), whereas older age (OR, 1.25; 95% CI, 1.06-1.48), anxiety and dysphoria (OR, 1.45; 95% CI, 1.20-1.75), and general illness (OR, 1.30; 95% CI, 1.06-1.59) were associated with the protracted trajectory. This cohort study found that approximately 4% of the participants developed p-PTSD and identified 4 distinct PTSD symptom trajectories. The findings suggest that addressing sleep disturbance and general health issues could effectively prevent PTSD symptoms among peacekeepers.

Understanding Intensive Care Unit Family Caregivers' Vulnerability to Post-Traumatic Stress Disorder: The Impact of Neurotic Personality Traits, Emotional Suppression, and Perceptions of Unexpected Death.

Rationale: Family members of patients who die in an intensive care unit (ICU) are at heightened risk of post-traumatic stress disorder (PTSD) symptoms. Not all surrogates develop these symptoms and heterogeneity exists in PTSD symptom clusters. Objectives: The study tested a personality model of PTSD symptoms in bereaved family caregivers of ICU patients. It was hypothesized that family members endorsing higher levels of neurotic personality traits would report higher levels of PTSD symptom clusters and that these associations would be explained by tendencies to view the patient's death as unexpected and to cope by suppressing their emotions. Methods: Participants were family members of ICU patients at an urban, academic medical center who either died or were discharged to an inpatient hospice unit. Participants were contacted for participation at least six months after the patient's death. Participants completed measures of personality, emotion regulation, and PTSD symptoms. Data were analyzed using path analysis. Results: Approximately one-third (35%) of the sample of 162 caregivers endorsed at-risk levels of PTSD. Individuals reporting higher levels of neurotic personality traits reported more PTSD symptoms (r = 0.53, p < 0.001). Perceptions that the patient death was unexpected partially explained the association of neuroticism with the intrusive re-experiencing PTSD symptoms (B = 0.45, p = 0.031). In contrast, emotional suppression partially explained the association of neuroticism with avoidance (B = 0.70, p = 0.010) and hyperarousal symptom clusters (B = 0.37, p = 0.041). Conclusions: Family vulnerability to PTSD after an ICU death can be conceptualized based on neurotic personality traits. Tendencies to view the patient's death as unexpected may contribute to intrusive thoughts and memories of the ICU experience. Individuals may avoid reminders and remain at heightened levels of arousal when they suppress their emotional experiences. Key Message: Family members who experience the death of a loved one following ICU treatment are vulnerable to PTSD symptoms. These reactions to ICU-related losses may be shaped by family members' personalities, expectations, and emotion regulation styles. Understanding these characteristics could inform family screening and intervention efforts in the ICU.

Do appraisals of military service indicate current distress in aging Vietnam War combat veterans?

Appraisals of military service, both desirable and undesirable, assessed via Elder and Clipp's (1989) scale, are associated with psychological distress in veterans. Aging combat veterans (CV) are at increased risk for posttraumatic stress disorder and other psychological disorders yet may underreport symptoms and not seek treatment that could be beneficial. It is unknown whether desirable and undesirable appraisals of military service are associated with mental health outcomes above and beyond typical risk and protective factors, such as age, education, and combat exposure. Therefore, we examined associations between appraisals of military service and assessments of psychological distress in Vietnam War CV, currently the largest cohort of aging veterans. Male Vietnam War CV aged 60 and older (n = 134) were selected from a larger study. Regression analyses examined the associations between appraisals of military service and measures of physical and psychological well-being and distress. Both desirable and undesirable appraisals of military service exhibited associations with measures of psychological distress, with undesirable appraisals being more strongly associated with distress than desirable appraisals. In regression analyses, appraisals were related to mental health outcomes over and above covariates. In addition, appraisals were more strongly related to psychological versus physical well-being measures, with undesirable appraisals more strongly related to mental health and well-being measures than desirable appraisals. Assessing appraisals of military service may identify veterans experiencing psychological distress who may benefit from referral for psychological interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors Influencing Post-Traumatic Stress Disorder in Hospital Clinical Nurses during COVID-19 in Korea: Resilience, Social Support, and Professional Pride in Nursing.

During the COVID-19 pandemic, clinical nurses in hospitals in South Korea were exposed to extreme stress, and many continue to suffer from post-traumatic stress disorder (PTSD). This study explores the factors influencing PTSD among hospital clinical nurses during COVID-19. In total, 121 hospital clinical nurses participated in 2022, providing demographic information and completing surveys designed to measure PTSD, resilience, social support, professional pride in nursing (PPN), and variables related to COVID-19. We observed statistically significantly higher levels of resilience (91.48 vs. 70.00), social support (47.37 vs. 35.41), and PPN (88.36 vs. 68.06) in the low-risk PTSD group compared with the high-risk PTSD group. Resilience was associated with a reduced risk of PTSD (OR, 0.91; 95% CI = 0.84-0.98). The subfactors of control (OR = 0.60; 95% CI = 0.43-0.86) and sociability (OR = 0.68; 95% CI = 0.44-0.97) decreased PTSD risk. Among the social support subfactors, family support had an OR of 0.47 (95% CI = 0.26-0.86) for reducing PTSD risk. Programs involving family participation that enhance resilience and provide psychological support can help hospital nurses affected by the COVID-19 pandemic manage their PTSD. Our findings serve as foundational data to develop interventions on psychological well-being for nurses dealing with new infectious diseases.

Risk for posttraumatic stress disorder symptoms by trauma type: The role of self-compassion.

Public health systems need evidence-based, feasible, and acceptable preventive interventions for trauma-exposed Black Americans. Self-compassion often serves as a protective factor following trauma exposure, but whether it alleviates risk for posttraumatic stress disorder (PTSD) symptoms and the extent to which it buffers against the deleterious effects of particular trauma types in a high-risk, community sample remains unknown. The present study examined whether the association between various trauma types (noninterpersonal vs. physical vs. sexual) and PTSD symptom severity was moderated by self-compassion in a sample of trauma-exposed Black Americans seeking primary care. Participants (n = 77; 87.5% female; Mage = 45.3 years; SDage = 12.8) were recruited from a large, publicly funded health care system. Participants completed self-report measures assessing trauma history and self-compassion and a structured clinical interview administered by a trained clinician. Cumulative sexual violence, r(77) = .32, p < .01, was positively associated with PTSD symptom severity, whereas cumulative noninterpersonal trauma was not; the relation between cumulative physical violence and PTSD symptom severity was trending toward significance, r = .22, p = .06. The interactions between noninterpersonal trauma/sexual violence, self-compassion, and PTSD symptom severity were trending toward significance, and a significant interaction between physical violence and self-compassion was observed, B = 1.94, SE = .67, p < .01, at high, t = 3.21, p < .01, levels of self-compassion. Implementing brief, mindfulness-based psychotherapies that enhance self-compassion in the primary care setting may help mitigate PTSD risk among Black Americans with lower levels of physical violence and noninterpersonal trauma exposure and those with higher levels of sexual violence exposure. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Virtual Reality Simulation to Examine the Relationship Between Post-Traumatic Stress Symptoms and Decision-Making in First Responders

ABSTRACT First responders (FRs) are continuously exposed to critical incidents, considered traumatic events (TEs). This cumulative exposure increases the risk for post-traumatic stress disorder (PTSD). However, there is no evidence about the relationship between PTSD symptoms and emergency decision-making (EDM). The objective of this study was to examine the EDM of FRs during a virtual reality through the simulation of two emergency scenarios to collect data on the reaction time and the number of incorrect decisions. We also assessed PTSD symptoms, TE, and sociodemographics. The sample included 368 Portuguese FRs, were 295 (80.20%) males and 73 (19.80%) females, with a mean age of 33.96 (SD = 9.38). Considering the probable PTSD diagnosis according to the DSM-5, 85 (23.10%) of the FRs met the criteria. These individuals who meet the criteria exhibited higher EDM scores (M = 19.60, SD = 5.99) compared to those without probable PTSD (M = 17.87, SD = .5.66) (F(1, 360) = 5.32, p = .02, partial η 2 = .015). We found that TEs had a direct effect on EDM, β = −.16, Z = −3.74, p < .001), and the pathway of trauma-PTSD symptoms-decision-making an indirect effect, β = .02, Z = 3.10, p = .002). Individuals exposed to more TEs demonstrated faster and more accurate decision-making in the context of EDM. However, when these individuals developed PTSD symptoms, their decision-making became slower and less accurate. The inclusion of a trauma-informed approach for FRs to prevent individual and job-related consequences is discussed.

Mental Health Disorders, Organizational Stigma, and Health Service Utilization among U.S. Fire Investigators: A Cross-Sectional Survey.

Estimate in a sample of U.S. fire investigators the: (1) prevalence of generalized anxiety disorder (GAD), depression, post-traumatic stress disorder (PTSD) risk and mental health services use; and (2) association between organizational stigma and mental health disorders. Cross-sectional study design used to administer between November 2023 and January 2024, a 35-item behavioral/mental health survey. Approximately 18.0% of fire investigators had GAD, 22.8% depression, and 18.2% PTSD risk. Organizational stigma about mental health disorders was reported by 53.3% of fire investigators. The most frequently used behavioral/mental health services were cognitive behavioral therapy (40.1%) and medication management (36.1%). Organizational stigma around reporting mental health disorders was significantly associated with PTSD risk (aOR = 5.25;[2.41-11.43]). Mental health disorders are present in the fire investigator workforce and organizational stigma is associated with limited report of PTSD risk.

Posttraumatic Stress Disorder Among Adults in Communities With Mass Violence Incidents

Mass violence incidents (MVIs) are prevalent in the US and can have profound and long-lasting psychological consequences on direct survivors, but their outcomes among the broader communities where the MVI occurred are unknown. To investigate the prevalence of and factors associated with past-year and current posttraumatic stress disorder (PTSD) among adults in communities that experienced an MVI. This cross-sectional survey was completed between February and September 2020 with a household probability sample of adults from 6 communities that had experienced an MVI between 2015 and 2019: Dayton, Ohio; El Paso, Texas; Parkland, Florida; Pittsburgh, Pennsylvania; San Bernadino, California; and Virginia Beach, Virginia. Address-based sampling was used to identify randomly selected households, mail invitations, and select 1 adult per household to complete a self-administered paper or online survey. Data analysis was performed from September to November 2023. The primary outcome was presumptive diagnostic-level past-year PTSD and current (past month) PTSD determined using American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) PTSD criteria. A total of 6867 adults aged 18 years or older accessed the website with a description of the study and consent materials. Of these, 5991 (87.2%) agreed to participate and completed the survey, 343 (6.3%) partially completed the survey, and 443 (6.5%) did not meet eligibility criteria or refused to participate. Most of the 5991 respondents were female (3825 individuals [53.5%]) and had a mean (SD) age of 45.56 (17.58) years. A total of 1261 of 5931 individuals (21.0%) reported high exposure to the MVI (either they or a close friend and/or family member was on site during the shooting). Nearly one-quarter (23.7%; 1417 of 5977 participants reporting PTSD) met presumptive DSM-5 diagnostic criteria for past-year PTSD, with 8.9% (530 participants) meeting the criteria for current PTSD. Regression analyses found that being female (odds ratio, 2.32; 95% CI, 2.01-2.68) and having a history of both physical or sexual assault and other potentially traumatic events (odds ratio, 9.68; 95% CI, 7.48-12.52) were associated with the greatest risk of past-year PTSD. In this survey study of 5991 participants, presumptive PTSD was quite prevalent long after the MVI among adults in communities that have experienced an MVI, suggesting that MVIs have persistent and pervasive public health impacts on communities, particularly among those with prior exposure to physical or sexual assault and other potentially traumatic events. Focusing exclusively on direct exposure to MVIs is not sufficient. Incorporating these findings into screening should improve efforts to identify the individuals most in need of prevention or mental health service after MVIs.

Analysis of risk factors and construction of a prediction model for posttraumatic stress disorder among Chinese college students during the COVID-19 pandemic

BackgroundTo explore the risk factors of post-traumatic stress disorder (PTSD) among Chinese college students during the COVID-19 pandemic and the construction and validation of risk prediction models. MethodsA total of 10,705 university students were selected for the study. The questionnaire included the Generalized Anxiety Disorder 7 (GAD-7), Patient Health Questionnaire 9 (PHQ-9), PTSD Checklist for DSM-5 (PCL-5), and self-designed questionnaire. These assessments were conducted to facilitate the survey, construct the predictive model and validate the model's validity. ResultsSex, left-behind experience, poverty status, anxiety score, and depression score were identified as independent risk factors influencing psychological trauma among Chinese college students during the COVID-19 pandemic, while COVID-19 infection emerged as a protective factor against psychological trauma. A column chart was constructed to visualize the six independent risk factors derived from logistic regression analysis. The Hosmer–Lemeshow test results (χ2 = 13.021, P = 0.111) indicated that the risk prediction model fitted well. The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.864 in the model group and 0.855 in the validation group. The calibration curves of the model closely resembled the ideal curve. Decision curve analysis (DCA) revealed that the model provided net benefit and demonstrated good clinical utility. LimitationsThe validation of the model is currently restricted to internal assessments. However, further confirmation through larger sample sizes, multicenter investigations, and prospective studies is necessary. ConclusionsThe model effectively predicted PTSD risk among Chinese college students during the COVID-19 pandemic, indicating strong clinical applicability.

Posttraumatic stress disorder mediating associations between child sexual abuse and substance use among transgender adults in the United States.

Transgender people experience an excess burden of child sexual abuse (CSA), mental health concerns, and substance use compared to cisgender populations. Posttraumatic stress disorder (PTSD) has been found to mediate the association between CSA and substance use behaviors in cisgender populations, but this dynamic has not been previously examined among transgender adults. The aim of this study is to test if PTSD may mediate a relationship between CSA and substance use among transgender adults. Data were analyzed from the U.S. Transgender Population Health Survey (2016-2018), a national probability sample of transgender adults (N = 274). CSA was measured using the Adverse Childhood Experiences subsection for sexual abuse. Past-month PTSD was measured using the Primary Care-PTSD Diagnostic and Statistical Manual of Mental Disorders, fourth edition screening tool. Substance use was determined by lifetime binge drinking, polydrug use, and the Drug Use Disorders Identification Test. Baron and Kenny's approach was used to assess PTSD as a mediator between CSA and substance use. Within our sample, nearly half (45%) of the transgender adults experienced CSA. Lifetime binge drinking (40%), polydrug use (20%), and indications of drug-use-related problems (Drug Use Disorders Identification Test x¯ = 4.52) were frequently reported. Transgender adults who have experienced CSA had increased risk of PTSD and substance use, and PTSD was a mediator in all models. Results suggest that adult transgender CSA survivors are at increased risk of drug and alcohol use, and that PTSD may be an important contextual factor for substance use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prevalence of mental health symptoms and associated risk factors among healthcare workers in specialized COVID-19 hospitals in Anyang, China: A cross-sectional survey

BackgroundThe novel coronavirus disease 2019 (COVID-19) pandemic spread worldwide and brought unprecedented challenges to healthcare systems. Healthcare workers experienced tremendous pressure and psychological issues. MethodsA cross-sectional online survey was conducted from January 2022 to April 2022 among healthcare workers in Anyang, Henan Province, China. Insomnia, anxiety, depression, post-traumatic stress disorder (PTSD), and problematic internet use (PIU) were evaluated. Logistic regression analyses were used to explore the factors that were associated with mental health problems. ResultsA total of 242 participants (mean [SD] age, 34.7 [6.6] years, 187 female [77.3 %]) were included in the study. The prevalence of symptoms of insomnia, anxiety, depression, PTSD and PIU during the COVID-19 pandemic in China was 53.7 %, 100.0 %, 7.0 %, 20.3 %, and 19.4 %, respectively. Participants who smoked, used sedative-hypnotic drugs and may need psychological assistance were at a higher risk for mental health problems. Respondents who were older than 45 years and were married displayed a lower risk of insomnia and PTSD, respectively. ConclusionsMental health symptoms are pervasive among healthcare workers in specialized COVID-19 hospitals during the outbreak. Risk factors include smoking, sedative-hypnotic drug use, and the need for psychological assistance, while protective factors include age and marital status. Developing social media platforms and providing psychological assistance may be effective interventions for healthcare workers.

Clinical specificities of patients with substance use disorder and comorbid borderline personality disorder compared to patients with substance use disorder only: a retrospective study

Introduction Substance use disorder (SUD) is a common condition often associated with borderline personality disorder (BPD), and patients with both disorders (SUD + BPD) have more complex presentations and poorer outcomes in treatment. Thus, there is a need to identify more clearly the clinical differences between patients with SUD + BPD and those with SUD only to help clinicians in their diagnostic process. Methods Data from medical files of 92 patients with SUD (SUD only: n = 42; SUD + BPD: n = 50) treated in an outpatient psychiatry and addiction treatment center were extracted to compare the differences in terms of sociodemographic characteristics, substance used, psychopathological dimensions, comorbidity prevalence, and functional impairment. Results Compared to the SUD only group, patients in the SUD + BPD group were younger, more disabled, and less satisfied with their social life. Regarding substance used, the comorbid group had more frequently cannabis use disorder and poly nonalcoholic SUD. Regarding psychopathological dimensions, the comorbid group had higher levels of impulsivity, emotion regulation difficulties and alexithymia. Finally, regarding comorbidities, the comorbid group had a higher risk of comorbid anxiety, obsessive-compulsive, and post-traumatic stress disorders. Conclusion While being only exploratory, these results add evidence on the impact of the BPD comorbidity in patients with SUD and underline important dimensions that should be considered by clinicians working with this population.

Adherence to Gender Roles on PTSD Symptoms of Hurricane Harvey Survivors

The purpose of this study was to explore the relationships between trauma and adherence to gender roles among a sample of Hurricane Harvey survivors (N = 225). Posttraumatic stress disorder (PTSD) resulting from natural disasters has been associated with an increased risk of negative psychological outcomes. Previous studies have found increased risks of PTSD resulting from hurricane exposure, and there also appears to be a correlation between PTSD and gender. Specifically, women have been found to be more likely to endorse PTSD symptoms. However, this relationship has not yet been examined specifically among survivors of trauma from natural disasters. The Hayes Process Macro (v3.5) was utilized to test for the potential moderating effect of adherence to traditional gender roles on the relationship between trauma exposure and PTSD symptoms, as well as trauma exposure and depression. Results indicated that adherence to traditional female gender roles significantly moderated the relationships both between trauma severity and PTSD symptoms and between trauma severity and depression. Those with more androgynous gender roles have been found to have an increased ability to utilize more situation-specific coping skills. Future research could explore the specific aspects of traditional female and male gender roles that increase or decrease ability to cope with trauma.