Posttraumatic Stress Disorder Scores Research Articles

Assessment of the impact of COVID-19 and political instability on mental health of university students in Sudan.

The mental health of students plays a crucial role in their learning and performance. The COVID-19 pandemic, the political turmoil and a coup in Sudan has exacerbated stress and anxiety among university students in Sudan due to uncertainty about their academic activities. To assess post-traumatic stress disorder (PTSD) occurrence and coping strategies adopted by university students in Sudan. This cross-sectional survey was conducted from March to June 2022. It used the Coping Orientation to Problems Experienced (Brief-COPE) and Impact of Event Scale-Revised (IES-R) questionnaires to assess the occurrence of PTSD and coping strategies among 596 university students in Sudan. Descriptive statistics were used to determine the frequency and percentage, Student's t test was used to compare the means of 2 groups and one-way analysis of variance to compare the means of ≥ 3 groups. There was a high prevalence of PTSD among the students, with a score of 31.2 (SD 16.4). The total score of PTSD was higher among female students. Around 36% of the students had a PTSD score > 37, which is considered high enough to suppress immune function. The most widely adopted coping strategies were religion and acceptance of the situation, while substance use was the least. Students who had COVID-19 infection during the pandemic differed significantly from uninfected students in the application of coping strategies. In contrast, students whose family members or friends had COVID-19 were not significantly different from students with uninfected family members or friends in the application of the coping strategies, such as self-blame, denial, substance use, and behavioural disengagement. We recommend the initiation and implementation of psychological counselling programmes for university students in Sudan onsite or remotely. Further research should be carried out to assess the long-term effects of the pandemic and the political conflicts so as to design and implement appropriate and efficient interventions.

A Combined Kundalini Yoga and Cognitive Behavioral Therapy Program for Posttraumatic Stress Disorder: A Pilot Study.

Cognitive behavioral therapy (CBT) is one of the standard conventional treatments for posttraumatic stress disorder (PTSD). However, recent studies have reported the benefits of yoga for reducing PTSD symptoms including a Kundalini Yoga (KY) intervention. The purpose of this study was to test the efficacy of a novel combined 8-week CBT and KY program for treating PTSD symptoms and improving sleep quality in a single group trial of 26 adults with PTSD. PTSD symptoms (PTSD checklist-5) and sleep quality (Pittsburgh Sleep Quality Index) were assessed at baseline, post intervention, and at 2-month follow-up. Both CBT and yoga homework compliance were also measured. Total PTSD symptom scores as well as the cluster symptoms (intrusion, avoidance, arousal/reactivity, and negative alterations in cognitions and mood) were significantly improved following the program, all p < .01. The improvements in total PTSD scores, intrusion, avoidance, arousal/reactivity were maintained at follow-up, with all values still less (p < .01) than baseline. The negative alterations in cognitions and mood symptom cluster continued to improve further at follow-up compared to post-intervention values (p < .05). Total sleep score (p < .05) and the subscales of sleep disturbance (p < .01), daytime dysfunction (p < .05), and sleep quality (p < .01) were significantly improved after the program and these improvements were maintained at follow-up compared to baseline. Sleep medication use was decreased (p < .05) and sleep latency was improved (p < .01) at follow-up only compared to baseline. There was a significant positive correlation (p < .05) between the completion of the yoga home practice and post change in total sleep scores. These results show that a combined KY and CBT intervention resulted in decreased PTSD symptoms and improved sleep quality and suggest this program may constitute an additional treatment option for PTSD.

The relationship between earthquake-induced post-traumatic stress disorder and breastfeeding attitude and behavior

BackgroundThis study aimed to investigate the prevalence and severity of post-traumatic stress disorder (PTSD) and analyze the relationship between PTSD and breastfeeding attitudes and behaviors among breastfeeding mothers and women with children aged 0–24 months, all of whom had experienced the earthquake.MethodsIn this cross-sectional survey, a face-to-face questionnaire was administered to 173 earthquake survivors in Adıyaman, Turkey, during June and July 2023. The PTSD Checklist-Civilian scale was used to assess the presence of PTSD, while the Breastfeeding Attitudes of the Evaluation Scale (BAES) was employed to evaluate breastfeeding behaviors in mothers.ResultsSignificantly higher PTSD scores (47.6 ± 17.4) were found among women staying in tents, while lower scores (37.0 ± 16.4) were observed in those who continued breastfeeding. 78.6% of women reported decreased breast milk because of the earthquake. Mothers with reduced milk supply had higher PTSD scores (46.1 ± 17.3). Breastfeeding training was associated with higher BAES scores (106.8 ± 56.8) and lower PTSD scores (32.5 ± 11.0). A significant negative correlation was observed between the PTSD score and BAES (r = -0.742; p < 0.001).ConclusionsThe study demonstrated that breastfeeding may protect mothers against PTSD in the aftermath of earthquakes, emphasizing the importance of breastfeeding education. The higher frequency and severity of PTSD observed among earthquake survivor mothers residing in tents underscores the importance of promptly transitioning to permanent housing after the earthquake.

Testing an Intervention to Improve Health Care Worker Well-Being During the COVID-19 Pandemic: A Cluster Randomized Clinical Trial.

Stress First Aid is an evidence-informed peer-to-peer support intervention to mitigate the effect of the COVID-19 pandemic on the well-being of health care workers (HCWs). To evaluate the effectiveness of a tailored peer-to-peer support intervention compared with usual care to support HCWs' well-being at hospitals and federally qualified health centers (FQHCs) during the COVID-19 pandemic. This cluster randomized clinical trial comprised 3 cohorts of HCWs who were enrolled from March 2021 through July 2022 at 28 hospitals and FQHCs in the US. Participating sites were matched as pairs by type, size, and COVID-19 burden and then randomized to the intervention arm or usual care arm (any programs already in place to support HCW well-being). The HCWs were surveyed before and after peer-to-peer support intervention implementation. Intention-to-treat (ITT) analysis was used to evaluate the intervention's effect on outcomes, including general psychological distress and posttraumatic stress disorder (PTSD). The peer-to-peer support intervention was delivered to HCWs by site champions who received training and subsequently trained the HCWs at their site. Recipients of the intervention were taught to respond to their own and their peers' stress reactions. Primary outcomes were general psychological distress and PTSD. General psychological distress was measured with the Kessler 6 instrument, and PTSD was measured with the PTSD Checklist. A total of 28 hospitals and FQHCs with 2077 HCWs participated. Both preintervention and postintervention surveys were completed by 2077 HCWs, for an overall response rate of 28% (41% at FQHCs and 26% at hospitals). A total of 862 individuals (696 females [80.7%]) were from sites that were randomly assigned to the intervention arm; the baseline mean (SD) psychological distress score was 5.86 (5.70) and the baseline mean (SD) PTSD score was 16.11 (16.07). A total of 1215 individuals (947 females [78.2%]) were from sites assigned to the usual care arm; the baseline mean (SD) psychological distress score was 5.98 (5.62) and the baseline mean (SD) PTSD score was 16.40 (16.43). Adherence to the intervention was 70% for FQHCs and 32% for hospitals. The ITT analyses revealed no overall treatment effect for psychological distress score (0.238 [95% CI, -0.310 to 0.785] points) or PTSD symptom score (0.189 [95% CI, -1.068 to 1.446] points). Post hoc analyses examined the heterogeneity of treatment effect by age group with consistent age effects observed across primary outcomes (psychological distress and PTSD). Among HCWs in FQHCs, there were significant and clinically meaningful treatment effects for HCWs 30 years or younger: a more than 4-point reduction for psychological distress (-4.552 [95% CI, -8.067 to -1.037]) and a nearly 7-point reduction for PTSD symptom scores (-6.771 [95% CI, -13.224 to -0.318]). This trial found that this peer-to-peer support intervention did not improve well-being outcomes for HCWs overall but had a protective effect against general psychological distress and PTSD in HCWs aged 30 years or younger in FQHCs, which had higher intervention adherence. Incorporating this peer-to-peer support intervention into medical training, with ongoing support over time, may yield beneficial results in both standard care and during public health crises. ClinicalTrials.gov Identifier: NCT04723576.

Prevalence of anxiety, depression, and post-traumatic stress disorder among Omani children and adolescents diagnosed with cancer: a prospective cross-sectional study

BackgroundChildren and adolescents diagnosed with cancer often experience psychological distress, encompassing anxiety, depression, and post-traumatic stress disorder (PTSD). This study aimed to evaluate the prevalence of these conditions among Omani children and adolescents diagnosed with cancer, alongside identifying contributing factors.MethodsA prospective cross-sectional study was conducted from October 2021 to June 2023 among a cohort of Omani children and adolescents (6–18 years old) diagnosed with cancer at three primary cancer referral centres in Oman. Validated Arabic-language versions of the Screen for Child Anxiety Related Disorders, the Center for Epidemiologic Studies Depression Scale for Children, and the Impact of Event Scale-Revised instruments were used to assess symptoms of anxiety, depression, and PTSD, respectively. An initial assessment (T1) was undertaken within the first 3 months of diagnosis, followed by a second assessment (T2) 3–6 months later.ResultsOf 113 eligible participants, 101 agreed to participate in the study (response rate: 95.6%), with 92 (91.0%) completing both assessments and included in the final analysis. Prevalence rates of anxiety, depression, and PTSD decreased from 43.5%, 56.5%, and 32.6%, respectively, at T1, to 38.0%, 35.9%, and 23.9% at T2. All average scores were below diagnostic cut-off points, except for the depression score at T1. Anxiety and depression scores decreased significantly (p = 0.043 and 0.001, respectively) between T1 and T2, as did the overall prevalence of depression (p = 0.004). At T1, linear regression analysis showed significant correlations between anxiety scores and the child’s age and PTSD score (p < 0.05); these variables were also correlated with depression scores (p ≤ 0.001). At T2, significant correlations were observed between anxiety scores and the child’s age and PTSD scores (p < 0.001). At both T1 and T2, anxiety, depression, and PTSD scores remained significantly correlated (p < 0.001).ConclusionsOmani children and adolescents recently diagnosed with cancer exhibit a high prevalence of anxiety, depression, and PTSD over time. Age-appropriate communication, ongoing support, and mental health services are recommended to help this patient group cope with their diagnosis and manage their emotional wellbeing. There is a need for future research to determine the effectiveness of specific psychological interventions in reducing the frequency of these disorders.

Gender and Race Differences in Mental Health and Well-Being Among Older Americans During the COVID-19 Pandemic

AbstractThe objectives of this study were to investigate (1) gender and race differences in mental health and psychological well-being among older adults during the COVID-19 pandemic and (2) whether there were significant interaction effects between gender and race. This study used the National Health and Aging Trends Study (NHATS) and COVID-19 public use data files. It focused on mental health and psychological well-being, including loneliness, no time to yourself, poor sleep quality, anxiety, depression, and post-traumatic stress disorder (PTSD). The sample consisted of 2465 older adults, and multivariate logistic and linear regression models were adopted for the analysis. The results show that approximately two out of five older people (43%) experienced poor sleep, followed by loneliness (35%), anxiety (30%), depression (23%), and no time to themselves (11%). The average PTSD score was 11. Mental health and psychological well-being varied by gender and race. There were significant interaction effects on anxiety and depression between females and Black older adults. Black females reported lower levels of anxiety and depressive symptoms than Black males, although the differences were not statistically significant. Black older adults were more likely to experience PTSD but less likely to feel lonely and have poorer sleep than their White counterparts. Female older adults reported poorer mental health and psychological well-being than males, except for Black females. Black females had the lowest levels of anxiety, depression, loneliness, and highest quality of sleep among all females of different ethnic and racial origins.

Investigating the Impact of Psychological Interventions in Response to Depression, Stress, Anxiety, Post Traumatic Stress Disorder and Cognitive Functioning in Covid-19 Recovered Patients

The COVID-19 outbreak, in addition to the threat to physical health, may also negatively affect mental health.In this study, we intended to study the changes in psychological parameters in covid-19 recovered patients after they get the psychological intervention. This study conducted in three phases. In the first phase, Depression, Anxiety and Stress Scale - 21 (DASS-21), Post traumatic stress disorder (PTSD) Checklist PCL-5 and Montreal Cognitive Assessment were administered on a total of 477 covid-19 recovered patients. After a gap of 3 months, through clinical interview it was found out that 220 patients needed intervention. In the second phase of the study, psychological intervention was given to 190 patients. In the final phase, after a gap of three months from the intervention phase, all the tests were re-administered on the patients. Data were scored and analyzed using descriptive statistics. Result showed that significant difference was found in the score of depression, anxiety, stress and PTSD. Depression, anxiety, stress, PTSD scores were significantly reduced after intervention. (p &lt; 0.01). No significant difference was observed between the MOCA score. These findings of the study suggest that, psychological intervention may have a beneficial effect on COVID-19 patients’ mental health.

Abstract P229: Cross-Sectional Relationship Between Posttraumatic Stress Disorder and Atherosclerotic Disease Assessed by Coronary Calcium Score: A Counterfactual Model of Older Male Twins

Background: Posttraumatic stress disorder (PTSD) is a risk factor for cardiovascular disease. However, the causal relationship between PTSD and atherosclerotic burden is controversial, leaving uncertain whether atherosclerosis is implicated in the association between PTSD and cardiovascular events. Objective: To test the cross-sectional relationship between lifetime PTSD and coronary atherosclerotic burden assessed by calcium score by comparing PTSD-discordant twin pairs, a design that inherently controls for familial and early environmental factors. Methods: We examined 218 male twins from the Vietnam Era Twin Registry, who underwent coronary calcium score assessment with computed tomography as part of the Emory Twin Study Follow-Up study. Lifetime history of PTSD was obtained with the Structured Clinical Interview and PTSD symptom severity with the Clinician-Administered PSTD Scale (CAPS) for DSM-IV diagnostic criteria. Coronary calcium scoring was performed by the Agatston Method as a measure of atherosclerotic burden. The relationship between PTSD and calcium score was tested across individuals and within PTSD-discordant twin pairs as a counterfactual model for genetic and early environmental factors. Initially, 2 linear mixed models were built according to the exposure variable (PTSD clinical diagnosis or symptoms scale), with log-transformed coronary calcium score as the dependent variable. We defined a priori that the model with the lowest Akaike Information Criteria (AIC) would be the primary analysis to drive the conclusion. Based on a priori direct acyclic graph decision process, we defined the need to adjust for income and education as potential confounders and not to adjust for traditional risk factors, considering their potential roles as mediators. Results: Of the 218 twins analyzed, the median age was 68 (IQR 67-70) years, and the calcium score had a median of 114 (IQR 5.2-347). There were 88 twin pairs (30 monozygotic), 26 discordant for the binary diagnosis of PTSD, and 40 discordant for the ordinal PTSD symptom score (within-pair differences in scale points ranged from zero to 48.5). The model with the best AIC was the one with the PTSD score, and showed no increment of log-calcium score as the PTSD symptoms increased, both between individuals (Beta coefficient = - 0.005; 95% CI = -0.02 to + 0.03) and within twin pairs (Beta coefficient = - 0.010; 95% CI = -0.03 to + 0.01). Conclusion: The present analysis does not support a relationship between PTSD and coronary atherosclerotic burden. The link between PTSD and cardiovascular events may occur through other pathways, such as microvascular disease.

‘Hidden’ anger as a risk factor for operational health: An exploratory approach among French military personnel

ABSTRACT Military personnel are repeatedly exposed to multiple stressors, and are sometimes characterized by high levels of anger. Evidence suggests that this anger can become dysfunctional, and impact the health status of populations chronically exposed to stress. In particular, rumination (understood as perseverative thoughts about a past event), provides a theoretical framework for investigating how anger may impact stress regulation abilities in military personnel declared fit for deployment. This exploratory study aimed therefore to examine the impact of the anger profile on psychological suffering in terms of burnout and post-traumatic stress disorder (PTSD), along with the reactivity of the autonomic nervous system, measured as cardiac variability. One hundred and seventeen French soldiers were tested before deployment to Operation BARKHANE. Anger rumination, burnout, and PTSD symptoms were assessed using questionnaires, and cardiac variability was measured as the questionnaires were completed. The results revealed two profiles related to anger trait and anger rumination. Burnout and PTSD scores were higher among military personnel with high levels of anger trait and rumination, and this group also had lower parasympathetic activity and flexibility after completing the questionnaires. These results suggest that there may be a link between an angry profile and psychological suffering, notably burnout and PTSD. Rumination could be involved in this link, as it is associated with poor adaptation to stress in a military context. Prospective researches including post-deployment will establish whether this ruminative response can account for the relationship between problematic anger, stress regulatory capacities and psychological health in military populations.

Healthcare Workers’ General Health and Its Relation with Anxiety, Anger, and Posttraumatic Stress Disorder during COVID-19 Outbreak in Southeast Iran

Background. Healthcare workers during the COVID-19 pandemic played an effective role in providing preventive and curative measures. Scientific evidence confirmed that the outbreak of this disease has caused numerous psychological problems such as pre- and posttraumatic stress disorder (PTSD), anxiety, depression, and anger at a global level. This study is aimed at investigating the general health of healthcare workers and its relationship with anxiety, anger, and posttraumatic stress disorder during the outbreak of COVID-19. Methods. This research was a cross-sectional study conducted on 455 healthcare workers of four teaching hospitals in Kerman, southeast of Iran. The convenience sampling method was used. The research tools included the 12-Item General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), the trait anxiety section of State-Trait Anxiety Inventory (STAI), and the trait anger section of Trait-State Anger Expression Inventory 2 (STAXI-2). Data analysis was done in IBM SPSS Statistics version 25 and using Pearson’s correlation tests, independent t-test, ANOVA, and multivariate linear regression. Results. 28.1% (n=128) of the participants had mental health disorders. The mean score of anxiety was 43.99±9.24 which was at moderate to high level of anxiety. The mean score of anger was 18.65±5.72 which was at the moderate level. The mean score of PTSD was 34.77±15.24 which was less than the midpoint of the questionnaire, i.e., the score of 44. The results of the multiple linear regression model that showed anxiety, anger, gender, and hospital were predictors of mental health (P&lt;0.05). Conclusion. The results of the present study showed that about a quarter of the healthcare workers faced with the COVID-19 pandemic had mental health disorders and suffered from moderate to high anxiety, moderate anger, and PTSD. It was also observed in this study that there was a weak to moderate significant correlation between general health and anxiety, anger, and PTSD in healthcare workers. So, healthcare workers need a lot of social and psychological support.

Embitterment in Vietnam War Veterans Predicted by Symptoms of Posttraumatic Stress Disorder.

Research on the association between posttraumatic embitterment disorder (PTED) and other psychopathologies in veterans and adults aged ≥65 years is lacking. This study aimed to assess embitterment among elderly war veterans and its association with major psychopathological factors. Participants included Vietnam War veterans who visited a psychiatric clinic. Based on the Posttraumatic Embitterment Disorder Self-Rating Scale (PTEDS) score, the participants were divided into the embitterment (PTED(+), mean score of PTEDS items [mPTEDS] ≥1.6) and non-embitterment (PTED(-), mPTEDS <1.6) groups. Demographic characteristics, combat exposure severity, depression, anxiety, sleep, and alcohol use disorder symptom scores of the participants were collected and compared between the PTED(+) and PTED(-) groups. A correlation analysis between symptom measure scores and the mPTEDS was conducted. The influence of psychopathology on embitterment was investigated using stepwise multiple linear regression analysis. In total, 60 participants (28 in PTED(+) and 32 in PTED(-)) were included. Among those in PTED(+), 21 (35.0%) showed mild embitterment symptoms (1.6≤ mPTEDS <2.5) and 7 (11.7%) reported moderate or severe embitterment symptoms (mPTEDS ≥2.5). The mean scores of posttraumatic stress disorder (PTSD), depression, and anxiety were significantly higher in the PTED(+) than in the PTED(-) group. The mPTEDS were significantly correlated with PTSD, depression, anxiety, and sleep disorder scores. The PTSD symptoms significantly explained the higher mPTEDS score in a regression model. Embitterment symptoms were associated with PTSD, depression, anxiety, and insomnia symptoms in elderly veterans, similar to the results of prior studies involving only the general population.

The spectrum of psychological disorders in family members of patients suffering from delirium associated with critical illness: a prospective, observational study

During intensive care unit admission, relatives of critically ill patients can experience emotional distress. The authors hypothesized that families of patients who are diagnosed with intensive care unit (ICU) delirium experience more profound depression and anxiety disorders related to stress than do families of patients without delirium. We performed a prospective observational single-center study including families of adult patients (age above 18 years) hospitalized in a 17-bed ICU of a university hospital for at least 48 h who completed research questionnaires at day 2 after admission and day 30 after initial evaluation using dedicated questionnaires (HADS, CECS, IES, PTSD-C). A total of 98 family members of patients hospitalized in the ICU were included in the final analysis (50 family members whose relatives were CAM-ICU positive (DEL+), and 48 family members of patients without delirium (DEL−)). No statistically significant differences in demographics and psychosocial data were found between the groups. In the follow-up 30 days after the first conversation with a family member, the mean PTSD score for the relatives of patients with delirium was 11.02 (Me = 13.0; SD = 5.74), and the mean score for nondelirious patients' family members was 6.42 (Me = 5.5; SD = 5.50; p < 0.001). A statistically significant increase in IES scores for family members of patients with delirium was observed for total PTSD (p = 0.001), IES—intrusion (p < 0.001), and IES—hyperarousal (p = 0.002). The prevalence of anxiety symptoms, depression, and posttraumatic stress disorder (PTSD) was higher in families of patients diagnosed with ICU delirium within 48 h of admission to the ICU. No factors increasing the depth of these disorders in family members of patients with ICU delirium were identified. Taking appropriate actions and thus providing families with appropriate support will contribute to the understanding of unfavorable emotional states, including anxiety, stress, depression, anger, agitation, or avoidance.

Sleep, mental health, and access to health care of women truck drivers.

The numbers of women in trucking are growing steadily, yet because they represent a minority group, little is known about their health issues. Most studies of truck drivers have focused on the mental and physical health, sleep, and health care access of male truck drivers. The purpose of this study was to characterize chronic stress, sleep, and mental health service and overall access to care among women truck drivers. Twenty-five female truck drivers were a subsample of participants from a larger parent study of truck drivers. After approval from the institutional review board, participants completed a 59-item Qualtrics survey; data were transferred from Qualtrics to SPSS v. 24 for analysis. No acute sleepiness or excess daytime sleepiness was observed, but participants only slept 6 hr per night, and all experienced poor sleep quality. Although 28% of participants met or exceeded the threshold score for posttraumatic stress disorder (PTSD), only 8% sought care for feelings of upset or distress. Also, 80% of the women had health insurance, yet there were those who did not seek care because of job-related conflicts. Participants were sleep deprived and experienced poor-quality sleep. Mental health and other health services utilization was low. Implications for practice include consideration of telehealth services to improve health care access and screening and referral as needed to mental health care providers by Department of Transportation medical examiners. Future research should include younger women truck drivers to determine the potential contribution of perimenopause/menopause to some of the health issues experienced by this group of workers.

Prevalence of post-traumatic stress disorder and its relationship with coping strategies among flood victims: Evidence from Iran

IntroductionPost-traumatic stress disorder (PTSD) is a prevalent and highly debilitating mental disorder that often occurs following accidents and natural disasters. This study aimed to assess the prevalence of PTSD among flood victims in Lorestan, Iran and examine its relationship with coping strategies. MethodsThis descriptive-analytical study included 470 flood victims in Lorestan, Iran within the first year after the flood in 2019. Participants were selected through simple random sampling. The research utilized the PTSD checklist and coping strategies questionnaire as data collection instruments. Data analysis involved independent t-tests, one-way analysis of variance, and the Pearson correlation coefficient, with a significance level of 0.05, using SPSS software version 22. ResultsThe prevalence of PTSD among flood victims in Lorestan, Iran was found to be 12.8 %. Women, individuals over 35 years old, those with an education level below high school, married individuals, and people with low income exhibited higher PTSD prevalence and average total coping strategies scores. Passive coping strategies (r = 0.267, p < 0.001), social coping strategies (r = 0.148, p = 0.004), and the overall coping score (r = 0.153, p = 0.003) demonstrated a direct and significant correlation with the average PTSD score. ConclusionThis study highlights the prevalence of post-traumatic stress disorder (PTSD) among flood survivors, especially among vulnerable groups such as the elderly, women, and those with low socio-economic status. To enhance post-disaster adaptation, support organizations should implement various strategies including resilience-building, mental health awareness campaigns, and improved access to healthcare services. Effective screening and promoting positive coping strategies are crucial for supporting survivors' psychological well-being.

Changes in attachment dimensions during the treatment of acute post-traumatic stress disorder in sexually assaulted Brazilian women.

Attachment patterns are established during early childhood; however, extreme experiences throughout life may change this structure, either toward attachment security or insecurity. We analyzed changes in attachment dimensions in women with acute post-traumatic stress disorder (PTSD) following sexual assault, that were randomized to a 14-week treatment with either the medication sertraline or Interpersonal Psychotherapy. Seventy-four adult women who presented significant reduction in PTSD symptoms across the trial responded to the Revised Adult Attachment Scale at baseline, on week 8 of treatment, and at the end of the trial, on week 14. We fitted a generalized linear model to explain the attachment anxiety and avoidance scores at baseline. A generalized linear mixed model investigated how attachment dimensions changed over time. Socioeconomic data, treatment type, history of childhood trauma, and PTSD severity over the 14-week period were the considered covariates. At baseline, attachment anxiety was associated with a history of early trauma. Attachment anxiety remained stable during the follow-up. Attachment avoidance, on the other hand, significantly increased from baseline to week 14. Higher avoidance was observed in patients with higher total PTSD scores and on the cluster of hyperarousal symptoms. Races other than White (black, mixed-race, or Asian) and younger age were associated with higher attachment avoidance. Contrary to our expectations, attachment avoidance increased during follow-up, indicating changes in the interpersonal realm beyond the symptoms of PTSD.

Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder in People with Long COVID, ME/CFS, and Controls

BackgroundPrevalences of post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD) have not previously been compared between individuals with long coronavirus disease (COVID) and individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and healthy age-matched controls. For these reasons, this study aimed to determine the prevalence of PTSD and CPTSD in individuals with long COVID (n = 21) and ME/CFS (n = 20) and age-matched controls (n = 20). MethodsA case-case-control approach was employed; participants completed the International Trauma Questionnaire, a self-report measure of the International Classification of Diseases of PTSD and CPTSD consisting of 18 items. Scores were calculated for each PTSD and Disturbances in Self-Organization (DSO) symptom cluster and summed to produce PTSD and DSO scores. PTSD was diagnosed if the criteria for PTSD were met but not DSO, and CPTSD was diagnosed if the criteria for PTSD and DSO were met. Moreover, each cluster of PTSD and DSO were compared among individuals with long COVID, ME/CFS, and healthy controls. ResultsIndividuals with long COVID (PTSD = 5%, CPTSD = 33%) had more prevalence of PTSD and CPTSD than individuals with ME/CFS (PTSD = 0%, CPTSD = 20%) and healthy controls (PTSD = 0%, CPTSD = 0%). PTSD and CPTSD prevalence was greater in individuals with long COVID and ME/CFS than controls. Individuals with long COVID had greater values controls for all PTSD values. Moreover, individuals with long COVID had greater values than controls for all DSO values. Individuals with ME/CFS had greater values than controls for all DSO values. Both long COVID and ME/CFS groups differed in overall symptom scores compared with controls. ConclusionFindings of this study demonstrated that individuals with long COVID generally had more cases of PTSD and CPTSD than individuals with ME/CFS and healthy controls.

Provision of online eye movement and desensitisation therapy (EMDR) for people with post-traumatic stress disorder (PTSD): a multi-method service evaluation

ABSTRACT Background: The evidence for the effectiveness of online EMDR for PTSD is scarce. Objective: This service evaluation aimed to assess how online EMDR compared to in-person EMDR, in terms of its potential effectiveness and acceptability to therapists and patients. Method: The evaluation was carried out in the Cardiff and Vale University Health Board Traumatic Stress Service. We compared the outcome of therapy (PTSD scores at end of treatment), number of sessions, drop-out rate, and adverse events using linear/logistic regression in those receiving online EMDR over a 12-month period with those who had received in-person therapy in the year previous to that. Interviews with therapists and clients who had provided or undertaken online EMDR explored their views and experiences of treatment. Interviews were analysed thematically. Results: 33 people received in-person EMDR (15.3 sessions, SD = 1.4), and 45 received online EMDR (12.4 sessions, SD = 0.9). 24 individuals completed therapy in-person, and 32 online. There was no evidence of a difference in therapy completion, drop-out rates or adverse events between the two delivery modes. There was weak evidence that those who completed EMDR online and had available data (N = 29), had slightly lower PTSD scores at the end of therapy compared to those who received in-person EMDR (N = 24) (17.1 (SD = 3.2) versus 24.5 (SD = 3.0), mean difference = 7.8, 95% CI −0.3, 15.9, p = .06). However, groups were not randomised and only those who completed treatment were analysed, so estimates may be biased. 11 patients and five therapists were interviewed. Overall, both therapists and clients viewed online EMDR as safe and effective. Benefits mentioned by clients included feeling more in control and not having to travel. Clients’ concerns related to lack of privacy and ‘transition time/space’ between therapy and their daily lives. Conclusion: Results suggest that online EMDR is an acceptable, safe and effective alternative to in-person EMDR for PTSD in this service.

Strength in the Face of Adversity: Perseverance and Resilience of Racialized Staff in the Homeless Sector During COVID-19

The emotional toll that individuals experience while working in the homeless sector ranges from traumatic stress and burnout to depression and decreased job satisfaction. Recent evidence highlights significant levels of post-traumatic stress symptoms among homeless service providers in some regions of Canada, which are higher than those reported prior to the Coronavirus disease of 2019 (COVID-19) pandemic. This study seeks to examine the impact of gender and ethnicity on work-related stressors among frontline staff in the homeless sector. Utilizing data from a survey on mental health stressors and needs completed by a robust sample of 566 frontline workers in the homeless sector across Canada, we investigate traumatic stress, burnout, post-traumatic stress disorder (PTSD), compassion satisfaction, and resilience between three key staff groups including Black, non-Black racialized, and Caucasian. Quantitative analysis revealed key themes related to 1) workplace traumatic experiences reported, 2) lived experience of homelessness, 3) lifetime traumatic events, 4) rates of traumatic stress symptoms, and 5) PTSD scores. Overall, Black staff demonstrated significantly fewer traumatic symptoms and lower burnout, and fewer on-the-job traumatic events, while non-Black racialized persons report slightly higher traumatic stress, burnout, and traumatic events, including traumatic experiences reported on the job. Non-Black racialized staff also report the highest PTSD Checklist (PCL) scores, indicating qualification for PTSD diagnosis. Caucasian staff reported the highest levels of lifetime traumatic events, traumatic events on the job, and burnout. Overall, racialized staff demonstrated lower levels of traumatic stress, and greater overall perseverance and resilience compared to their Caucasian counterparts. While areas such as coping practices and race-specific differences require additional research, the implications of this study can be used to inform institutional and organizational change and address mental health needs for racialized staff within homeless-serving organizations.

PTSD, depression, and suicidality among survivors of childhood sexual trauma (CST), military sexual trauma (MST), and sexual revictimization (CST + MST).

Research to date has not examined how childhood sexual trauma (CST) followed by sexual trauma during military service (MST) relates to posttraumatic stress disorder (PTSD), depression, and suicidality among women and men. Given the strong association between MST in particular, and these serious posttraumatic outcomes, the current study sought to address this gap. The current study compared the mental health concerns of 268 treatment-seeking veterans who were survivors of CST, MST, or both (CST + MST). We hypothesized that MST would be associated with greater severity of symptoms compared with CST and that those who experienced sexual revictimization (CST + MST) would report more severe symptoms than veterans who experienced CST or MST alone. Veteran men presented with significantly higher suicidality but not higher PTSD or depression scores than women. Controlling for gender, MST survivors had significantly higher PTSD and depression symptom severity scores, but not suicidality, than CST survivors. PTSD, depression, and suicidality scores were significantly higher for the CST + MST group than for CST only survivors, but did not significantly differ from survivors of MST alone. Findings support the more severe clinical impact of CST + MST-specific sexual revictimization compared with CST-only among military men and women, but also suggest that MST alone can have negative consequences similar to revictimization. While results point to the need to consider context and trauma history in future trauma research and clinical applications, they should be interpreted in light of our sample demographics, which were representative of the southwest U.S. veteran population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Mental health and post-traumatic stress disorder in firefighters: an integrated analysis from an action research study.

The presence of post-traumatic stress disorder (PTSD) symptomatology in firefighters is an ever-pressing issue that requires close attention for adequate interventions. The present study investigated PTSD and global psychopathology prevalence in a sample of highly risk-exposed Portuguese firefighters, collected after the widespread deadly wildfires in 2017 that ravaged the country. Following an action research approach, the aim of this study was to depict this sample and examine the impact of cumulative adverse experiences on their mental health, which is a phenomenon worth attention. From an initial sample of 283 firefighters who manifested interest in participating, a total of 139 firefighters from the Coimbra District, of whom 130 unequivocally experienced a potentially traumatic/adverse event as a firefighter, completed BSI (to obtain indicators on psychopathology), QEPAT (an inventory of adverse events possibly experienced as a firefighter), and PCL-5 (a measure of PTSD symptomatology) through an online survey during the year 2018 by the Regional Medical Organization, as proposed and supervised by the local Centre for Prevention and Treatment of Psychological Trauma (CPTTP). We found a global prevalence of 8.6% of possible PTSD and 14.4% of possible psychopathology (n = 139). When considering only firefighters who unequivocally reported a potentially traumatic/adverse event as a firefighter (n = 130), 9.2% present possible PTSD, and 13.8% present possible global psychopathology. This sample experienced a mean of 28 adverse events during firefighting work. Linear regressions (n = 118) demonstrated that the perceived severity of the most traumatic event reported and the experience of more adverse events were both related to an increase in PTSD symptomatology. Global psychopathology was associated with PCL-5 scores, with an emphasis on paranoid ideation, hostility, depression, anxiety, and phobic anxiety. The severe wildfires of 2017 did not impact PTSD scores in this sample (collected the year after), suggesting that cumulative adverse events are more important than particular episodes. However, the number of reported events was related to PTSD scores. These results can be used to develop interventions that target all firefighters by addressing risk and protective factors. This action research study motivated specialized aid for firefighters involved in this study.