Posttraumatic Stress Disorder Scores Research Articles

Post-traumatic stress disorder interventions for children and adolescents affected by war in low- and middle-income countries in the Middle East: systematic review.

Millions of children and adolescents are exposed to wars, affecting their psychological well-being. This review focuses on psychosocial interventions in low and middle-income countries (LMICs) in the Middle East, where mental health services are limited. Our primary aim was to evaluate the effectiveness of trial-assessed psychosocial interventions in reducing post-traumatic stress disorder (PTSD) symptoms in children and adolescents aged ≤18 years who were exposed to war in LMICs in the Middle East. Changes in other psychological conditions and symptoms were evaluated where reported. PubMed, Cochrane Library and Ovid were searched without year restriction, in December 2021. Previous review reference lists were also checked. Only studies published in English were included. Each study was evaluated for risk of bias and results are presented as a narrative synthesis. Three group-based interventions were identified and evaluated across six studies: 'Teaching Recovery Techniques', 'Writing for Recovery' and 'Advancing Adolescents'. Two studies took place in post-war settings, and four in a context of ongoing conflict. Positive experiences and improved social skills were indicated following most interventions, but Teaching Recovery Techniques was the only programme associated with a statistically significant reduction in PTSD score. Differences in follow-up interval limited comparability of outcomes. This review highlights a paucity of evidence for effective treatment options for children and adolescents affected by war from LMICs in the Middle East. Promising indications of reductions in PTSD symptoms, specifically from Teaching Recovery Techniques, require further rigorous evaluation and long-term follow-up.

The child and Adolescent Trauma Screen 2 (CATS-2) – validation of an instrument to measure DSM-5 and ICD-11 PTSD and complex PTSD in children and adolescents

ABSTRACT Background: The study examined the psychometric properties of the Child and Adolescent Trauma Screen 2 (CATS-2) as a measure of posttraumatic stress disorder (PTSD) according to DSM-5 and (Complex) PTSD following the ICD-11 criteria in children and adolescents (7–17 years). Methods: Psychometric properties were investigated in an international sample of traumatized children and adolescents (N = 283) and their caregivers (N = 255). We examined the internal consistency (α), convergent and discriminant validity, the factor structure of the CATS-2 total scores, latent classes of PTSD/Complex PTSD (CPTSD) discrimination, as well as the diagnostic utility using ROC-curves. Results: The DSM-5 total score (self: α = .89; caregiver: α = .91), the ICD-11 PTSD total score (self: α = .67; caregiver: α = .79) and the ICD-11 CPTSD total score (self: α = .83; caregiver: α = .87) have proven acceptable to excellent reliability. The latent structure of the 12-item ICD-11 PTSD/CPTSD construct was consistent with prior findings. Latent profile analyses revealed that ICD-11 CPTSD was empirically distinguishable from ICD-11 PTSD using the CATS-2. ROC-analysis using the CAPS-CA-5 as outcome revealed that CATS-2 DSM-5 PTSD scores of ≥21 (screening) to ≥25 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. For the ICD-11 PTSD scale scores of ≥7 (screening) to ≥9 (diagnostic) were optimally efficient for detecting probable DSM-5 PTSD diagnosis. Conclusions: The CATS-2 is a brief, reliable and valid measure of DSM-5 PTSD, ICD-11 PTSD and CPTSD symptomatology in traumatized children and adolescents, allowing crosswalk between diagnostic systems using one measure. HIGHLIGHTS The CATS-2 screens for potentially traumatic events (PTEs) and PTSD symptoms. The CATS-2 captures DSM-5 and ICD-11 criteria for PTSD and CPTSD and enables clinicians and researchers to crosswalk between both diagnostic systems. International validation has proven good psychometric properties and presents cut-off scores The CATS-2 is a license-free instrument and is freely accessible.

Personality traits and risk of posttraumatic stress disorder among dental residents during COVID-19 crisis.

Purpose/objectivesThe coronavirus disease 2019 (COVID‐19) pandemic has presented mental health challenges among healthcare professionals, including posttraumatic stress disorder (PTSD). Few studies have examined PTSD predictors in dental settings. This cross‐sectional study aimed to describe the relationship between personality traits and PTSD symptoms among US dental residents engaged in patient care during the pandemic.MethodsAn online survey was administered to residents in advanced education in general dentistry, dental anesthesia, general practice residency, oral and maxillofacial surgery, and pediatric dentistry programs between September 2020 and April 2021. The survey included a sociodemographic questionnaire, the Big Five Inventory, and the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Logistic regression models, analysis of variance, and Tukey tests were used to examine the association between variables and PTSD scores and assess differences in personality traits and PTSD by specialty.ResultsAmong 149 respondents (mean age = 29.9 ± 4.9 years; 57.0% female), 53.7% reported experiencing stress during the pandemic. Many residents (38.9%) were not aware of available mental health resources. A total of 17.4% of residents met the diagnostic criteria for PTSD, but only 1.3% reported a previous PTSD diagnosis. The most significant predictors of PTSD were neuroticism (odds ratio = 2.90, p = 0.046) and stress unrelated to the resident's program role during the pandemic (odds ratio = 5.88, p = 0.02).ConclusionsPTSD symptoms were highly prevalent among dental residents, with stress and neuroticism being the most significant predictors.

High-density EEG sleep correlates of cognitive and affective impairment at 12-month follow-up after COVID-19

ObjectiveTo disentangle the pathophysiology of cognitive/affective impairment in Coronavirus Disease-2019 (COVID-19), we studied long-term cognitive and affective sequelae and sleep high-density electroencephalography (EEG) at 12-month follow-up in people with a previous hospital admission for acute COVID-19. MethodsPeople discharged from an intensive care unit (ICU) and a sub-intensive ward (nonICU) between March and May 2020 were contacted between March and June 2021. Participants underwent cognitive, psychological, and sleep assessment. High-density EEG recording was acquired during a nap. Slow and fast spindles density/amplitude/frequency and source reconstruction in brain gray matter were extracted. The relationship between psychological and cognitive findings was explored with Pearson correlation. ResultsWe enrolled 33 participants ( 17 nonICU) and 12 controls. We observed a lower Physical Quality of Life index, higher post-traumatic stress disorder (PTSD) score, and a worse executive function performance in nonICU participants. Higher PTSD and Beck Depression Inventory scores correlated with lower executive performance. The same group showed a reorganization of spindle cortical generators. ConclusionsOur results show executive and psycho-affective deficits and spindle alterations in COVID-19 survivors – especially in nonICU participants – after 12 months from discharge. SignificanceThese findings may be suggestive of a crucial contribution of stress experienced during hospital admission on long-term cognitive functioning.

The Survivor Moms’ Companion Trauma‐Specific Perinatal Psychoeducation Intervention in a Community Outreach Program: An Open Pilot

Posttraumatic stress disorder (PTSD) confers significant risk during the childbearing year, including for maternal substance use, inadequate prenatal care, preterm birth, and impaired maternal-infant bonding. Although several treatments are available for PTSD, few are specific to the perinatal period. The purpose of this pilot study was to evaluate outcomes of a PTSD- and pregnancy-specific psychoeducational intervention, the Survivor Moms' Companion (SMC). The SMC includes psychoeducation with tutor support to address maternal posttraumatic stress, affect regulation, and interpersonal sensitivity. This open pilot was conducted in a large city in a mid-Atlantic state within an organization that provides perinatal services via community health workers (CHWs). The majority of participants were aged 20 to 25 years and African American and had low levels of income and educational attainment. The SMC learning modules were supplied to participants by specially trained CHWs who provided weekly face-to-face support during 30-to-60-minute tutoring sessions. Pretest-to-posttest analyses using multiple imputation methodology and paired-samples t tests examined PTSD symptom counts and scores related to theorized mechanisms of affect dysregulation and interpersonal sensitivity. Nonparametric statistical tests examined clinically meaningful changes. Of 56 women who completed pretests, 38 (67.9%) completed the core dose of a minimum of 4 of 10 learning modules. Examination of intention-to-treat (n = 56) pretest-to-posttest scores revealed statistically significant improvements in PTSD symptoms (P < .001), affect regulation (depression [P < .001] and anger expression [P < .05]), and interpersonal sensitivity (P < .001). Per-protocol analyses (n = 38) revealed significant changes from clinical to nonclinical range scores for PTSD (P < .01) and depression (P < .05). These findings suggest that a psychoeducational intervention with tutor support can be influential in fostering positive mental health changes in a high-risk perinatal population. CHWs with intervention-specific training can be effective at implementing a trauma-specific intervention.

Prediction of PTSD related to COVID-19 in emergency staff based on the components of self-compassion and perceived social support

BackgroundOn March 11th, 2020, the World Health Organization (WHO) proclaimed Coronavirus Disease of 2019 (COVID-19) a pandemic. In addition to severe health problems, the disease has had a major psychological impact on the public. The aim of this research was to examine the association between Post-Traumatic Stress Disorder (PTSD) related to COVID-19 in emergency staff and self-compassion and perceived social support.MethodsData were collected from 222 emergency staff working in two referral educational and health centers for COVID-19 affiliated to Tabriz University of Medical Sciences. The participants were recruited six months following the first case of hospitalization for COVID-19 in these two hospitals in Tabriz, Iran. Four questionnaires were used to measure the variables, including a researcher-made demographic checklist, PTSD Checklist for DSM-5 (PCL-5), the Multidimensional Perceived Social Support Scale (MSPSS) and the Self-Compassion Scale.ResultsThe findings showed that age (r = 0.17, P = 0.034), self-judgment (r = 0. 36, P < 0.001), isolation (r = 0.44, P < 0.001) and over-identification (r = 0.15, P = 0.031) were associated with PTSD score, and there was also a statistically significant inverse relationship between the score of the self-kindness (r = - 0.19, P = 0.006) subscale and the overall score of PTSD in the emergency staff.ConclusionDuring the COVID-19 pandemic, emergency staff have persistently faced potentially traumatic situations as first-line healthcare workers, suggesting the direness of this group’s mental health. By identifying the predisposing factors of the psychological pathology under study, this research can be applied in clinical practice and provide useful information for designing special interventions and protocols for emergency staff.

The Effect of Creative Arts Therapy on Psychological Distress in Health Care Professionals

BackgroundWork-related psychological distress is common among health care professionals. We determined whether 4 creative arts therapy (CAT) programs were acceptable, feasible, and improved psychological distress and job turnover intention in health care professionals with burnout symptoms. MethodsHealth care professionals were enrolled during the coronavirus disease (COVID-19) pandemic from September 2020 until July 2021. Participants attended in-person weekly 90-minute group session for 12 consecutive weeks. Intervention and control subjects completed surveys before the beginning and after the end of their cohort. The study outcomes were session attendance (feasibility), program satisfaction (acceptability), and change in symptoms of anxiety, depression, burnout, posttraumatic stress disorder (PTSD), and job turnover intention. ResultsWe randomized 165 participants into 4 CAT interventions and 1 common control group across 3 sequential cohorts. Thirty-five randomized participants dropped out before the start of the cohort, and 16 were replaced from a waiting list. Therefore, the cohort consisted of 146 participants. On average, participants were 35 years old, white (85%), and female (92%). Overall, 52% were nurses, 10% were doctors, and 16% were behavioral health specialists. Participants attended a median of 9.5 [8-11] sessions. Program satisfaction was high with a median Client Satisfaction Questionnaire (CSQ-8) score of 31 [17-32] out of a possible score of 32. Participants randomized to the intervention had improvements in anxiety (P < .0001) and depression scores (P = .0007), total posttraumatic stress disorder score (P =.0002), burnout scores (P = .001, .003, .008), and turnover intention (P = .001). ConclusionsA CAT program is feasible, acceptable, and may reduce psychological distress and turnover intention for health care professionals.

Factors influencing first responders’ mental health during COVID-19

As the world adapts to the coronavirus-2019 (COVID-19) pandemic, healthcare professionals have been performing lifesaving medical interventions under intensely stressful conditions. First responders are a subset of this population that experience traumatic emergency situations daily while working in hazardous conditions during COVID-19. Past studies on first responders’ mental health have reported that post-traumatic stress disorder (PTSD) and suicidality are higher than anticipated in this population. In order to understand the factors influencing mental health in first responders during COVID-19, a survey was distributed to a convenience sample of 415 emergency responders from across the country. This survey addressed the influence of demographics and COVID-19 on cumulative PTSD and stress scores; 67 percent of survey respondents indicated that they knew another first responder who has contemplated or committed suicide, with 11 percent of respondents indicating that they themselves have suicidal tendencies. The results determined a variety of factors that influence mental health in first responders including age, gender, diagnosis of a previous mental health disorder, and career vs. volunteer departments. This study emphasizes the role that government funding plays in ensuring mental health resource access for first responders. Furthermore, this study has revealed that improved agency safeguards against COVID-19 can help reduce stress in emergency services personnel during this pandemic.

The Risk of Post-Traumatic Stress Disorder (PTSD) among Frontline Healthcare Workers in Saudi Arabia during the COVID-19 Pandemic: A Cross-sectional Study

Background: Frontline healthcare workers (HCWs) are at risk of developing post-traumatic stress disorder (PTSD) due to the nature of their work and, due to the additional stress and mental fatigue brought on by the COVID-19 pandemic, this risk has increased significantly. A proper understanding of the risk factors for PTSD in this context is crucial to the development of both preventive and corrective measures that will improve the psychological and emotional health of HCWs and reduce their predisposition to PTSD in the short and long term. This study was conducted to determine the prevalence and associated risk factors of PTSD among frontline HCWs in Riyadh, Saudi Arabia, during the COVID-19 pandemic. Methods: This cross-sectional survey study examined responses from emergency medical services personnel (paramedics, nurses, and physicians) in eleven large public hospitals in Riyadh, Saudi Arabia, between June 01 and July 01, 2020. The total number of respondents was 613. The PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (PCL-5), a self-administered tool, was used to diagnose PTSD. Additionally, demographic factors, such as age, gender, race, marital status, occupation, and years of experience, were identified, and the effects of these factors were assessed using statistical analysis. Results: The results revealed a prevalence of PTSD of 33.4% among participants. The highest prevalence was found among paramedics and nurses, while physicians had the lowest prevalence. The study also found statistically significant differences in PTSD scores based on marital status, job title, and years of experience. Half of the participants were aware of the availability of psychological/emotional support and perceived the process for obtaining that support to be clear and accessible. Conclusion: Frontline healthcare workers are at increased risk of developing PTSD, with the degree of risk significantly associated with marital status, job title, years of experience, and the accessibility of psychological/emotional support. Healthcare organisations within Saudi Arabia and elsewhere should use this information to strengthen their psychological and emotional support systems and reduce the risk of PTSD in their employees.

Associations among Caesarean Section Birth, Post-Traumatic Stress, and Postpartum Depression Symptoms.

Caesarean section (C-section) deliveries account for nearly 30% of births annually with emergency C-sections accounting for 7–9% of all births. Studies have linked C-sections to postpartum depression (PPD). PPD is linked to reduced quality of parent-child interaction, and adverse effects on maternal and child health. New mothers’ perceptions of more negative childbirth experiences, such as unplanned/emergency C-sections, are linked to post-traumatic stress disorder (PTSD), which in turn is related to PPD. Our objectives were to determine: (1) the association between C-section type (unplanned/emergency vs. planned) and PPD symptoms, and (2) if postnatal PTSD symptoms mediate this association. Employing secondary analysis of prospectively collected data from 354 mother-child dyads between 2009 and 2013 from the Alberta Pregnancy Outcomes and Nutrition (APrON) study, conditional process modeling was employed. The Edinburgh Postnatal Depression Scale (EPDS) and the Psychiatric Diagnostic Screening Questionnaire (PDSQ) were administered at three months postpartum, to assess for postpartum depressive and post-traumatic stress symptoms. The direct effect of emergency C-section on PPD symptoms was non-significant in adjusted and non-adjusted models; however, the indirect effect of emergency C-section on PPD symptoms with PTSD symptoms as a mediator was significant after controlling for prenatal depression symptoms, social support, and SES (β = 0.17 (SE = 0.11), 95% CI [0.03, 0.42]). This suggests that mothers who experienced an emergency or unplanned C-section had increased PTSD scores of nearly half a point (0.47) compared to mothers who underwent a planned C-section, even after adjustment. Overall, emergency C-section was indirectly associated with PPD symptoms, through PTSD symptoms. Findings suggest that PTSD symptoms may be a mechanism through which emergency C-sections are associated with the development of PPD symptoms.

Posttraumatic stress disorder and related factors among nurses working during the COVID-19 pandemic.

AimTo analyse the prevalence of posttraumatic stress disorder (PTSD) and examine its related factors among nurses who worked during the coronavirus disease 2019 (COVID‐19) pandemic in Daegu, South Korea.BackgroundNurses are a high‐risk population for PTSD, especially during the COVID‐19 pandemic. This study was conducted to identify the nursing work environmental factors that should be addressed to reduce PTSD.MethodsUsing a cross‐sectional design, 365 nurses were enrolled. Their characteristics (intrapersonal, interpersonal, organizational, and COVID‐19‐related) and PTSD Checklist‐5 scores were analysed.ResultsThe average PTSD score was 14.98 ± 15.94, and 16.5% of the participants had a high risk of PTSD. Nurses were more likely to have PTSD if they were married (odds ratio = 3.02, p = .013) and when nurse managers' abilities, leadership, and support of nurses were low (odds ratio = 3.81, p < .001).ConclusionsThe nursing work environment was found to be associated with PTSD. Therefore, interventions are necessary to increase nurse managers' abilities, leadership, and support for nurses to reduce the risk of PTSD among nurses.Implications for Nursing ManagementEffective professional and social support and interventions to improve nurse managers' abilities, leadership, and support of nurses are needed to reduce PTSD.

Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape

IntroductionThe prevalence of posttraumatic stress disorder (PTSD) in rape survivors is considerably higher than the prevalence in non-sexual trauma survivors. Few studies have investigated risk and protective factors in survivors early-after-rape in a prospective longitudinal design. MethodsIn a sample of 639 rape-exposed women who were assessed within 20 days of rape and over 6 months, baseline data were used to predict PTSD symptom severity scores up to 6 months post-rape. ResultsThe incidence of PTSD at 3 months was 48.5% and the cumulative incidence at 6 months post-rape was 54.8%. Baseline experience of rape stigma (guilt, shame, self-blame, social devaluation and discredit) and depression were significant predictors of PTSD symptom scores over time, in mixed linear regression models. Higher levels of depression and rape stigma were associated with higher PTSD scores. Assault-related factors were not associated with PTSD scores. LimitationsWe could not measure PTSD symptom trajectories in all rape survivors, some of who may be at greater risk for PTSD e.g. non-disclosing rape survivors, those who declined participation and those who were extremely distressed at the time of recruitment. ConclusionAddressing internalised and externalised stigma and resultant mental health effects on women who present to rape clinics may reduce the long-term adverse effects of rape on mental health outcomes, such as PTSD. Rape survivors who present with high levels of depression soon after a rape should be carefully monitored and appropriately treated in order to reduce PTSD severity.

Traumatic stress in Egyptian doctors during COVID-19 pandemic

ABSTRACT COVID-19 pandemic has heavily burdened healthcare systems throughout the world, causing substantial mental distress to medical professionals. We aim to investigate the associated traumatic stress in a sample of practicing physicians in Egypt during the COVID-19 pandemic. This cross-sectional study assessed depression, and Post-traumatic stress disorder (PTSD) among a sample of Egyptian physicians using an electronic survey. It included demographic and practice-related data, PTSD Checklist – Civilian Version (PCL-C) and the nine-item Patient Health Questionnaire (PHQ-9). Of the 124 respondents, 66.9% were at high risk for depression and 37.9% met criteria for diagnosis of PTSD. Female gender and perceived work-related stress were significantly associated with PTSD. PTSD and depression severity scores were positively correlated. These findings highlight the importance of timely mental support and intervention for medical workers.

The children of the Argentinean desaparecidos: Traumatic attachment-related experiences

During the military dictatorship (1976–1983), an estimated 30,000 people were murdered. The lives of the Disappeared Victims’ Children (DVCs) have been characterized by trauma: some of them were born in detention centers and were illegally adopted by military acquaintances, while others lived with their surviving and grieving relatives. This research attempted to explore the relationships among eighteen DVCs’ disorganized/unresolved attachment, their dissociative and Post-Traumatic Stress Disorder (PTSD) symptoms, and the description of their caregivers as frightened or abusive, by administering the Dissociative Experience Scale (DES), the PTSD Checklist (PCL-C) and the Adult Attachment Interview, using a mixed method based on the qualitative analyses of the AAIs in conjunction with the standard AAI coding. Even though all eighteen participants described traumatic experiences, only eight showed a disorganized/unresolved attachment. Disorganized/unresolved DVCs showed higher scores for both PTSD (M = 36.00) and DES (M = 22.89) compared to resolved ones (PCL-C mean = 31.40; DES M = 13.46).Furthermore, all narratives included childhood fears, and twelve accounts included imaginative absorption which are related to disorganized/unresolved attachment and to dissociative tendencies. Finally, abusive but not frightening/frightened caregiving was always related to disorganized/unresolved state of mind. This study contributes to shedding light on the relationship between traumatic experiences, PTSD, disorganized attachment and dissociative sequelae in an exceptional sample.

The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis.

Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response. A range of post-traumatic sequelae have been found to mediate the relationship between trauma and psychotic experiences, including the “traditional” symptoms of post-traumatic stress disorder (PTSD). The International Classification of Diseases-11th Edition recognizes a more complex post-traumatic presentation, complex PTSD (cPTSD), which captures both the characteristic symptoms of PTSD alongside more pervasive post-traumatic sequelae known as ‘disturbances in self-organization’ (DSOs). The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored. In the first study of this kind, 144 participants with psychosis recruited from North West United Kingdom mental health services completed measures assessing trauma, PTSD and cPTSD symptoms and symptoms of psychosis. Forty-percent of the sample met criteria for cPTSD, compared to 10% who met diagnostic criteria for PTSD. PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership. Both PTSD and DSOs mediated the relationship between trauma and affective symptoms but did not explain a significant proportion of variance in negative symptoms. Cognitive and excitative symptoms of psychosis did not correlate with trauma, PTSD or DSO scores. These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies.

The Relationship Between Post-Traumatic Stress Disorder After Childbirth and Social Support and Marital Satisfaction

Background: Childbirth is among the most significant and pleasant events in a woman’s life. This event can be a traumatic event and a threat to the mother’s mental health. This study recognizes the relationship between Post-Traumatic Stress Disorder (PTSD) after childbirth and social support and marital satisfaction. Methods: This Cross-sectional analytical study was performed on a sample of 400 mothers who had delivered at Shohadaye-15-Khordad Hospital in Varamin (in two groups with &amp; without PTSD). The research instruments include the Demographic, Midwifery, Neonatal Factors checklist, Enrich Marital Satisfaction, Weinfeld and Tigman Social Support, and the PTSD Symptoms Scale. We used SPSS to analyze the descriptive and Pearson correlation and logistic regression data. A P&lt;0.05 was considered significant. Results: The prevalence of PTDS in this study was equal to 16.8%. There was no significant correlation between the mean of the total score of PTSD in all dimensions with social support (P&gt;0.05). Marital satisfaction significantly affected the probability of PTSD after childbirth (P=0.001). There was a significant correlation between PTSD total score and dimension of avoidance symptoms and infant gender (P=0.038). There was also a significant correlation between gestational age and avoidance symptoms (P=0.001) and type of nutrition feeding and motivational symptoms (P=0.041) of PTSD dimensions. Conclusion: According to the relationship between marital satisfaction and PTSD, it is recommended to design suitable interventions to improve the marital status and promptly diagnose the susceptible mothers to prevent the spread of this complication.

Prevalence of Anxiety, Depression, and Post-Traumatic Stress Disorder Among Amputees Attending Jaipur Foot Trust Artificial Limb Centre in Kenya

Background: Amputees have been noted to present various psychiatric disorders including anxiety, body image disturbances, depression, and Post-Traumatic Stress Disorder (PTSD). However, there is limited data available on the prevalence of anxiety, depression, and PTSD among amputees in Kenya despite the high incidences of amputations in Kenyan hospitals. This study aimed at finding out the prevalence of anxiety, depression, and post-traumatic stress disorder among amputees attending the Jaipur Foot Trust Centre in Kenya. Method: This study took a cross-sectional descriptive study design. One hundred and forty-one patients attending the Jaipur Foot Trust were recruited to participate in the study after giving informed consent using a non-probability purposive sampling method. A socio-demographic questionnaire was used to collect socio-demographic characteristics. The Patient Health Questionnaire (PHQ-9) was used to assess the patient's depression. The Generalized Anxiety Disorder (GAD-7) scale was used to assess the patient's anxiety level and The Impact of Event Scale (IES-R) was used to assess the severity of post-traumatic stress disorder (PTSD). Data analysis was done using Statistical Package for Social Science (SPSS) version 23. Results: Findings from this study showed high rates of psychiatric morbidity where two-thirds of the patients reported PTSD (65%) with more than three-quarters of patients being diagnosed with depression (89.4%) and anxiety (91.5%). Also, there was a significant correlation between depression, anxiety, and PTSD, such that participants who had higher scores on anxiety and depression had significantly higher PTSD scores. Conclusion: Anxiety, Depression, and PTSD are very common psychological reactions in patients who have undergone amputation. The researchers expected that some of the sociodemographic factors and some amputation-related characteristics would have a relation with psychiatric comorbidity. However, the findings of this study did not show any such relationship except the relation between anxiety, depression, and PTSD. Early psychological assessment and interventions after amputations will help alleviate psychological distress.

Trauma Exposure and Mental Health Prevalence Among First Aiders.

IntroductionFirst aiders are commonly exposed to different forms of traumatic event (TE) during their duties, such as Chronic Indirect Vicarious Exposure which refers to an indirect exposure to aversive details of the trauma (APA, 2013). If the psychopathological impact of TE is well documented, the mental health of first aiders remains neglected. Therefore, our main objectives are (i) to study the link between exposure to traumatic events and psychopathological outcomes and (ii) to quantify the rates of mental health disorders among first aiders.MethodOur sample comprised of 53 volunteer first aiders (21 females and 32 males) with an average age of 32.4 years (SD = 13.6 years). Traumatic event exposure and mental health were assessed through a set of validated questionnaires completed online.ResultsRates of mental health outcomes were higher than within the general population. Females showed higher scores of post-traumatic stress disorder (PTSD) than males. PTSD scores were significantly correlated with all mental issues scores, apart from tobacco use and eating disorders scores. There was a significant correlation between the number of traumatic events and the years of experience. Exposure to traumatic events only correlated with nicotine dependency. No other correlation reaches statistical significance.DiscussionThe scores of all mental health outcomes were high; a surprising result, as volunteer first aiders are thought to be recruited for their strong dispositional cognitive and emotional abilities. The high levels of post-traumatic stress disorder and burnout, along with the prevalent anxiety and depression, highlight the need for greater psychosocial support. Resilience training and peer support would be useful interventions in this group.

Post-traumatic stress disorder following childbirth: prevalence and associated factors—a prospective cohort study

ObjectiveTraumatic experiences during or after childbirth are subject of intense discussions in mainstream and social media as well as in scientific literature. Aim of this evaluation is to estimate the prevalence of post-traumatic stress disorder (PTSD) following childbirth in postpartum women and to evaluate the influence of maternal, obstetrical and neonatal characteristics on the degree of PTSD symptoms measured by the Impact of Events Scale questionnaire (IES-R).MethodsIn total, 589 women who gave birth in the University Medical Center Mainz, Germany in 2016, participated in a survey within the first days after birth. Of these, 278 also participated 6 months later. All participants received the validated Impact of Events Scale questionnaire (IES-R). The influence of maternal, obstetric and fetal parameters on PTSD score was evaluated.ResultsPTSD overall prevalence was 2.9%. Patients with PTSD had significantly less often personal support during labor (p < 0.001). Maternal age (p < 0.001), parity (p < 0.001), migration background (p < 0.001), mode of delivery (p < 0.001) and assistance during labor (p < 0.001) were parameters significantly influential on the PTSD symptom level measured by the IES-R.ConclusionsMaternal PTSD prevalence after childbirth seems to be quite rare with 2.9%. Nevertheless, recent findings assume that this prevalence may only represent the “tip of the iceberg”. PTSD after childbirth should not be underestimated. As PTSD depends on personal vulnerability and existing risk factors, patients at risk have to be detected before childbirth, which appears to be challenging especially for obstetric and family care professionals.

The Immediate Mental Health Effects of the 2020 Artsakh War on Armenians: A Cross-Sectional Study

Background: While previous studies show the long-term and transgenerational effects of war on mental health, immediate effects on mental health are relatively understudied. The 44-day 2020 Artsakh War (September 27-November 10, 2020) resulted in an estimated 5,000 Armenian casualties, displacement of half the Artsakh population, and ongoing captivity of Armenian prisoners of war. This is the first study post-war to quantify depression, anxiety, and post-traumatic stress disorder (PTSD) levels among the Armenian population. Methods: We conducted a cross-sectional study from February 3-May 31, 2021. Using Google Forms, we implemented a 75-item survey, including depression (PHQ-9), anxiety (GAD-7), and PTSD (PCL-5) questionnaires. We used six binary (yes/no) questions to define direct-exposure (DE) and no direct exposure (NDE) groups. We used independent samples t-tests to compare mean scores between groups. Results: There were 825 participants from 32 countries, 48% from the United States and 33% from Armenia and Artsakh. All participants from Artsakh (100%), 89.2% from Armenia, and 46.6% from the United States were directly exposed to the war. The DE (n=529) group exhibited significantly higher PHQ-9 (p=0.0001), GAD-7 (p=&lt;0.0001), and PCL-5 (p=0.0001) mean scores, than the NDE (n=296) group. Those who sustained a physical injury (n=20) had the highest average clinically relevant PTSD score (mean=39.5, SD=24). Conclusion: Our results suggest an association between direct exposure to war in Artsakh and increased depression, anxiety, and PTSD severity, suggesting an immediate need for mental health resources. Those who lost a loved one, had a loved one get injured, and had a loved one participate in the 2020 Artsakh War had higher PHQ-9, GAD-7, and PCL-5 mean scores relative to those who did not. Implications of this study include the development of targeted evidence-based psychotherapeutic methods based on specific direct exposure factors.