Posttraumatic Stress Symptoms Scores Research Articles

Parents' knowledge and attitudes towards extracorporeal membrane oxygenation and their post-traumatic stress symptoms

This cross-sectional study, conducted between January 2020 and July 2023, aimed to assess the knowledge, attitude, and post-traumatic stress symptoms (PTSS) among parents with children undergoing extracorporeal membrane oxygenation (ECMO) treatment. Out of 201 valid questionnaires collected, the median knowledge score was 3.00, the mean attitude score was 27.00 ± 3.20, and the mean PTSS score was 3.50 ± 1.54. Logistic regression identified associations between PTSS and parents with lower education levels, particularly junior high school and high school/technical secondary school education, as well as those occupied as housewives. Structural equation modeling highlighted direct effects, such as the impact of residence on education, education on employment status, and associations between knowledge, attitude, PTSS, employment status, monthly income, and parental demographics. The findings indicated inadequate knowledge and suboptimal attitudes among parents, especially those with lower education levels, emphasizing the need for educational resources. Furthermore, addressing parental PTSS through psychosocial support and screening was deemed essential, providing valuable insights for tailored interventions in this context.

The influence of trauma symptoms on interpersonal attributions in daily life.

There is well-documented evidence that trauma exposure can disrupt relationships. However, limited research has examined whether posttraumatic stress symptoms (PTSS) moderate interpersonal processes in daily life. To this end, undergraduates (N = 98) completed a measure of PTSS at baseline. They then completed smartphone-based surveys after every interpersonal interaction that lasted longer than 3 min. for 10 days. These surveys assessed perceptions of self and other agency and communion as well as feelings of rejection, neglect, abandonment, worthlessness, emptiness, guilt, and shame. Results of multilevel modeling suggest that interpersonal perception and PTSS predicted 10%-26% of the variance in outcomes. Regarding agency, more agentic participants reported higher levels of negative attributions, γs=.47-.56. Participants also reported higher rejection and guilt when they experienced their interaction partner as more agentic than usual, γs=.07, and PTSS did not moderate these associations. For communal perceptions, participants who experienced themselves and others as warmer than other participants reported fewer negative outcomes, γs = -.44--.58. Individuals also reported more negative outcomes when they experienced themselves and others as warmer than they usually did, γs = -.10--.28, and PTSS moderated these associations. The negative associations between self- and other communion ratings and feelings of neglect, abandonment, and shame were stronger in individuals with higher PTSS scores. Together, these findings support continued efforts to understand the ways in which trauma exposure and PTSS disrupt interpersonal dynamics in daily life.

Changes to women’s childbirth plans during the COVID-19 pandemic and posttraumatic stress symptoms: a cross-national study

AbstractA considerable number of women giving birth during COVID-19 pandemic reported being concerned about changes to their childbirth plans and experiences due to imposed restrictions. Research prior to the pandemic suggests that women may be more at risk of post-traumatic stress symptoms (PTSS) due to unmet expectations of their childbirth plans. Therefore, this study aimed to examine if the mismatch between women’s planned birth and actual birth experiences during COVID-19 was associated with women’s postpartum PTSS. Women in the postpartum period (up to 6 months after birth) across 11 countries reported on childbirth experiences, mental health, COVID-19-related factors, and PTSS (PTSD checklist DSM-5 version) using self-report questionnaires (ClinicalTrials.gov: NCT04595123). More than half (64%) of the 3532 postpartum women included in the analysis reported changes to their childbirth plans. All changes were significantly associated with PTSS scores. Participants with one and two changes to their childbirth plans had a 12% and 38% increase, respectively, in PTSS scores compared to those with no changes (Exp(β) = 1.12; 95% CI [1.06–1.19]; p < 0.001 and Exp(β) = 1.38; 95% CI [1.29–1.48]; p < 0.001). In addition, the effect of having one change in the childbirth plan on PTSS scores was stronger in primigravida than in multigravida (Exp(β) = 0.86; 95% CI [0.77–0.97]; p = 0.014). Changes to women’s childbirth plans during the COVID-19 pandemic were common and associated with women’s postpartum PTSS score. Developing health policies that protect women from the negative consequences of unexpected or unintended birth experiences is important for perinatal mental health.

Predictors of Post-traumatic Stress Symptoms (PTSS), Depression, and Anxiety among Caregivers of Children with Acute Lymphoblastic Leukaemia (ALL).

The caregivers of children diagnosed with acute lymphoblastic leukaemia (ALL) are believed to experience post-traumatic stress symptoms (PTSS), depression and anxiety. This present study endeavoured to explore the prevalence and predictors of PTSS, depression, and anxiety among the caregivers of children with ALL. Purposive sampling was used to select the 73 caregivers of children with ALL who participated in this cross-sectional study. The Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were used to measure psychological distress. There was a low prevalence (11%) of post-traumatic stress disorder (PTSD) among the participants. Although all the criteria for PTSD were not met, a few post-traumatic symptoms remained, suggesting that PTSS was likely present. Most of the participants reported minimal symptoms of depression (79.5%) and anxiety (65.8%). Anxiety, depression, and ethnicity predicted the PTSS scores (R2 = .77, p =.000). Subsequently, depression predicted the PTSS scores (R2 = 0.42, p =0.000). Participants of 'Other' or 'Indigenous' ethnicity had lower PTSS scores and higher anxiety scores (R2 = 0.75, p =0.000) than participants of Malay ethnicity. The caregivers of children with ALL experience post-traumatic stress symptoms (PTSS), depression, and anxiety. These variables co-exist and may have different trajectories in different ethnic groups. Therefore, healthcare providers should take ethnicity and psychological distress into consideration when providing paediatric oncology treatment and care.

Prevalence and correlates of externalizing behaviors among youth seeking treatment following trauma exposure.

Trauma-exposed youth often experience impairing externalizing problems (EXTs), yet the relationship between EXTs, trauma exposure, and posttraumatic stress symptoms (PTSS) are not well understood. To examine the extent of their co-occurrence, we report the rates and correlates of youth EXTs relative to clinically elevated PTSS in a sample of youth referred to a trauma and grief specialty clinic. Self- and caregiver-report measures were obtained from 260 youth ages 7-19 years (M = 11.92, SD = 3.21; 53.5% female) during a pretreatment assessment. The sample was divided into 4 groups according to the youths' PTSS and EXT score elevations, and these groups were then compared according to rates of youth depressive symptoms, youth suicidal ideation, and caregiver strain. The 4 groups were comorbid PTSS and EXTs (18%); EXTs-only group (36%); PTSS-only group (13%), and subclinical symptom group (34%). The comorbid PTSS and EXTs group had the highest scores on all other child and caregiver symptom measures. Compared to the subclinical group, youth in the PTSS-only group had increased depressive symptoms and suicidal ideation, whereas youth in the EXTs-only group had elevated levels of caregiver strain. Co-occurring PTSS and EXTs is a common presentation among trauma-exposed youth referred to treatment. These youth are also likely to suffer from other problems of clinical concern, including suicidal ideation, and their problems are associated with caregiver distress. More research is needed to examine unique risk and resiliency factors related to the development of youth EXTs in response to trauma exposure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An Online Survey on the Relationship Between Positive Coping and Post-Traumatic Stress Symptoms (PTSS) of Medical Students in China During the COVID-19 Pandemic: The Mediating Role of Social Support.

BACKGROUND The COVID-19 pandemic has caused varying degrees of psychological stress among medical students. This research explored the post-traumatic stress symptoms (PTSS) of medical students in China and their relationship with positive coping and social support. MATERIAL AND METHODS In the form of cross-sectional online survey, 2280 medical students locked down at home were selected by random cluster method to investigate social support, coping style, and PTSS using the Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire (SCSQ), and Post-traumatic Stress Disorder (PTSD) Checklist-Civilian Version (PCL-C), respectively. RESULTS This research found that the PTSS detection rate in medical students was 10.42% during the COVID-19 pandemic. The PTSS scores of females were significantly higher than that of the males. However, the PTSS detection rate in females (9.71%) was not significantly different from that in males (11.24%). Compared with those of the non-PTSS group, the total score and its all-factor score of social support, the total score of coping style and the positive coping score of the PTSS group were much lower, while the negative coping score of the PTSS group was much higher (P<0.01). Positive coping was positively correlated with social support, while positive coping and social support were negatively correlated with PTSS. The total effect of positive coping on PTSS was -0.310 (P<0.001), the direct effect was -0.128 (P<0.01), and the indirect effect was -0.182 (P<0.001). Social support played a mediating role between positive coping and PTSS, with the mediating effect accounting for 58.81% of the total effect. CONCLUSIONS Social support plays a mediating role between positive coping and post-traumatic stress symptoms. Objective support and positive coping are the 2 main protective factors of PTSS.

The Predictors of Posttraumatic Stress Symptoms in Recovered COVID-19 Patients: Illness-Related Factors, Depressive and Anxiety Symptoms, Alexithymia and Social Support

Objective: The COVID-19 pandemic had a profound impact on millions of people, affecting their biological, psychological, and social well-being. The biological effects of SARS-CoV-2 have reportedly been linked to cognitive, emotional, and behavioral symptoms. Traumatic experiences associated with the disease and treatment procedures are regarded as potential risk factors for the emergence of posttraumatic stress symptoms (PTSS); as a result, the severity of the disease and the experience of hospitalization can significantly influence the mental well-being of individuals who have contracted COVID-19. This study aims to assess the factors that influence the development of PTSS among individuals who have recovered from COVID-19. Method: Sociodemographic features, hospitalization status, and physical symptoms of COVID-19 were assessed and PTSS, alexithymia, perceived social support, anxiety, and depression were examined with validated self-report questionnaires (Impacts of Events Scale-Revised, Toronto Alexithymia Scale-20, The Multidimensional Scale of Perceived Social Support, Hospital Anxiety and Depression Scale) in a sample with 105 inpatients and 107 outpatients. Results: PTSS and depression scores of inpatients and outpatients were not significantly different (t(210)=1.246, p=0.214, and t(210)=-0.493, p=0.623, respectively), however, anxiety scores of outpatients were higher (t(209.880)=-2.938, p=0.004). Hospitalization did not significantly affect avoidance and hyperarousal symptoms but was associated with increased intrusion symptoms (t(210)=2.095, p=0.037). In a hierarchical regression model, predictors of PTSS were identified; in step 3 sleep disturbance and initial loss of smell and taste were significant factors (β=0.282, p&lt;0.010; β=0.163, p=0.019, respectively). In step 4, the effects of depression, anxiety, and alexithymia were superior to all other variables (β=0.211, β=0.318, β=0.261, respectively, p&lt;0.010) and initial loss of smell and taste and sleep disturbance did not remain significant in the final model. The final results indicated that psychological assessments made a distinctive contribution to the overall variation in Impacts of Events Scale-Revised scores, extending beyond demographic characteristics, individual variations, and COVID-19 symptoms. Additionally, social support had an indirect impact on PTSS, which was mediated by anxiety, depression, and alexithymia (total bunstd=-0.446, S.E.boot=0.057, CIboot 95% (-0.563, -0.338)). The direct effect of social support on PTSS was non-significant (cunstd=-0.004, S.E.=0.072, CI 95% (-0.146, 0.137)). Conclusion: This study contributes to the literature about the worldwide effects of COVID-19 on mental trauma by establishing the possible predictors for PTSS; and highlights the importance of reflecting on the COVID-19 history of patients and providing appropriate support.

Post-Traumatic Stress Symptoms in Adolescent Hodgkin Lymphoma Survivors: A Report from Children's Oncology Group AHOD0031.

Purpose: The intrusive thoughts of cancer diagnosis, treatments, re-experiencing, and avoidance associated with post-traumatic stress symptoms (PTSS) can negatively affect Hodgkin lymphoma (HL) survivors. This study investigates the associations between experiences and beliefs and PTSS among adolescent survivors of intermediate-risk HL treated on the Children's Oncology Group (COG) AHOD0031 study. Methods: COG AHOD0031 participants completed self-report surveys at end of therapy concerning post-treatment medical conditions, activity limitations, fatigue, future concerns, exercise, and PTSS. Results: One thousand one hundred ten of 1721 participants in AHOD0031 completed the first survey at a median of 6.7 months post-diagnosis (interquartile range: 5.3-11.5 months), and of these, 736 (66.3%) completed a second survey at a median of 12.4 (10.1-17.6) months following the first. The mean PTSS score (ranging from 0 to 20) was 5.5 (standard deviation [SD] = 5.1) on survey 1 and 4.4 (SD = 4.8) on survey 2. Increased fatigue (odds ratio [OR] = 1.14, p < 0.01), concerns for the future (OR = 1.13, p < 0.01), activity limitations (OR = 1.05, p < 0.01), and relapse history (OR = 2.18, p < 0.05) were associated with higher PTSS scores in the initial survey. Increased fatigue (OR = 1.16, p < 0.01), concerns for the future (OR = 1.14, p < 0.01), activity limitations (OR = 1.05, p < 0.05), and higher PTSS scores on the first survey (OR = 1.19, p < 0.01) were associated with higher PTSS scores in the subsequent survey. Longer time since diagnosis (OR = 0.85, p < 0.05; OR = 0.84, p < 0.05) was associated with lower PTSS scores on both surveys. Conclusions: Based on our findings, future research should examine the onset and trajectory of PTSS among HL survivors, focusing on early recognition and intervention to improve quality of life.

Temporal Associations Between Posttraumatic Stress Symptoms and Depression in Response to Online Expressive Writing Interventions in a Hispanic Sample

Some expressive writing (EW) interventions targeting posttraumatic stress symptoms (PTSS) may reduce both PTSS and comorbid depression symptoms. The temporal associations between PTSS and depression symptom levels in response to EW interventions are unknown. This study examined the directionality of PTSS and depression symptom levels from baseline to 1-week, 1-month, and 3-month follow-ups of two online EW interventions in a Hispanic sample with diverse trauma experiences. Participants (n = 70) completed either emotion-focused or fact-focused writing for 3 consecutive days online. A manifest autoregressive model with cross-lagged effects and treatment condition was analyzed. All but one first-order autoregressive path were statistically significant, with later PTSS and depression scores significantly predicted by those scores at preceding time points. The cross-lagged effects findings suggest that earlier PTSS levels influenced later depression levels, but earlier depression did not influence later PTSS, demonstrating a unidirectional temporal association. Severe PTSS may hinder EW treatment gains in depression. Superior outcomes for emotion-focused writing relative to fact-focused writing were also found.

Timing of Exposure to ICU Diaries and Its Impact on Mental Health, Memories, and Quality of Life: A Double-Blind Randomized Control Trial.

OBJECTIVES:Optimal time for ICU diary delivery and impact on mental health (MH), anxiety-depression, post-traumatic stress symptoms (PTSS), quality of life (QOL), and memories is unclear. We evaluated the effect of ICU diaries, dispatched at different time points, on outcomes in an Indian cohort.DESIGN:Double-blind randomized controlled trial.SETTING:A 1,000-bedded teaching hospital in East India.PATIENTS:Mechanically ventilated (>24 hr) adults were recruited, excluding those dead or incapable of meaningful-communication at discharge or follow-up. Eighty-three patients, aged 46.2 ± 17.2 years, Acute Physiology and Chronic Health Evaluation II scores 13.7 ± 4.9 were assessed. Length of ICU stay was 8.2 ± 7.1 days with 3.7 ± 3.2 ventilator days.INTERVENTION:Of 820 screened, 164 had diaries created. Including photographs, diaries were comaintained by healthcare workers and family members. Ninety patients were randomized at 1-month follow-up: diary sent to 45 at 1 month (group ID1) and to 45 at 3 months (ID3).MEASUREMENTS AND MAIN RESULTS:Anxiety-depression, memory, and QOL were assessed telephonically or home visits by a psychologist using the Hospital Anxiety-Depression Scale (HADS) and other tools at ICU discharge, 1-month (prerandomization), and 3 months of discharge. ID3 was reassessed after receiving diaries at 3.5 months. Primary outcome was anxiety-depression; secondary outcomes included PTSS, QOL, and memories. There was 100% follow-up. At 3 months, ID1 patients had a significant (p < 0.001) reduction in HADS from baseline when compared with ID3 that had not received diaries (4.16 ± 2.9 vs 2.15 ± 1.8; 95% CI, 2.8–1.2). PTSS scores were likewise better (p < 0.001). ID3 patients demonstrated significant improvement (p < 0.01) in QOL and memories along with HADS and PTSS when assessed at 3.5 months.CONCLUSIONS:ICU diaries improve MH but not QOL when delivered at 1 month and assessed 2 months thereafter. Assessed after 15 days, delayed exposure at 3 months significantly improved QOL and memories in addition to MH.

Posttraumatic Cognitions and Posttraumatic Stress Symptoms Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking.

The impact of posttraumatic cognitions on the development and maintenance of posttraumatic stress symptoms (PTSS) is understudied among children and adolescents who have experienced commercial sexual exploitation/trafficking (CSE/T). The objectives of this study were to (1) explore posttraumatic cognitions among help-seeking young people aged 11-19 who have experienced CSE/T; (2) determine whether experiencing direct violence, witnessing violence, polyvictimization (ie, multiple exposures to different categories of potentially traumatic events), or demographic characteristics differentially affect whether these young people meet clinical criteria for posttraumatic cognitions using established cutoffs; and (3) explore associations between posttraumatic cognitions and PTSS among young people who have experienced CSE/T. This study is a secondary analysis of a baseline cross-sectional survey of 110 young people with substantiated CSE/T experiences who started trauma-focused cognitive behavioral therapy (mean [SD] age = 15.8 [1.5]) from August 1, 2013, through March 31, 2020, in a southeastern US state. We used descriptive statistics, adjusted modified Poisson regression, and adjusted linear regression to test study objectives. Fifty-seven of 110 (51.8%) young people aged 11-19 met clinical criteria for posttraumatic cognitions. Increased age and a greater number of trauma categories experienced were significantly associated with meeting clinical criteria for posttraumatic cognitions. On average, higher posttraumatic cognition scores were associated with higher PTSS scores, controlling for demographic characteristics (β = 0.95; 95% CI, 0.64-1.26). These findings underscore the importance of assessing comprehensive trauma history and PTSS of young people who have experienced CSE/T, with added usefulness of measuring cognitive appraisals to inform a therapeutic treatment plan. Measuring cognitive appraisals that may influence PTSS and therapeutic success can ensure an effective public health response for this population.

Association between post-traumatic stress symptoms and functional health among internally displaced people in Myanmar.

INTRODUCTION: Internally displaced persons (IDPs) are individuals forced to leave their homes and move within their country. Post-traumatic stress symptoms (PTSS) are prevalent in this population. To investigate trauma symptoms and functional health of IDPs in Myanmar and identify the factors associated with their functional health according to the presence/absence of PTSS. This cross-sectional study included 201 IDPs who completed a questionnaire on functional health, PTSS, resilience, social support and hope. The analysis included descriptive statistics, t-tests, Pearson's correlation coefficients and multiple linear regression with interaction analyses. Over one-third of the participants had PTSS, with low functional health scores. The greater the resilience, the better the functional health. The higher participants' PTSS, the poorer their functional health. There was a significant interaction between resilience and PTSS. Tailored resilience-building programs, as well as health policies and services, are needed to enhance IDPs' functional health and help them overcome PTSS. Psychological first aid should be provided to minimize PTSS experienced in situations of ongoing conflict and violence. Mental health nurses should be trained to assess IDPs' health status and tailor interventions accordingly.

Sex differences in the experience of COVID-19 post-traumatic stress symptoms by adults in South Africa

BackgroundThe COVID-19 pandemic has created multiple mental health challenges. Many residents in South Africa face pre-existing elevated levels of stress and the pandemic may have had varying impacts on sub-populations. The aims of this study were to determine: 1) the factors associated with post-traumatic stress symptoms (PTSS) and 2) sex differences in the factors associated with PTSS in adults residing in South Africa during the COVID-19 pandemic.MethodsStudy participants aged 18 years and above, were recruited for this cross-sectional study through an online survey implemented from June 29, 2020 to December 31, 2020. The outcome variable was PTSS; explanatory variables were sex at birth, COVID-19 status, social isolation and access to emotional support. Confounders considered were age, education level completed and current work status. Logistic regressions were used to determine the association between the outcome and explanatory variables after adjusting for confounders.OutcomesThere were 489 respondents. Among all respondents, those who were older (AOR: 0.97; 95% CI: 0.95 – 0.99) and had access to emotional support from family and relatives (AOR: 0.27; 95% CI: 0.14 – 0.53) had significantly lower odds of PTSS. Respondents who felt socially isolated had higher odds of PTSS (AOR: 1.17; 95% CI: 1.08 – 1.27). Females had higher PTSS scores and higher odds of PTSS compared to males (AOR: 2.18; 95% CI: 1.41-3.39). Females (AOR: 0.27; 95% CI: 0.08 – 0.95) and males (AOR: 0.26; 95% CI: 0.11, 0.59) who had access to emotional support had significantly lower odds of PTSS than those who had no support. Females (AOR: 1.15; 95% CI: 1.04 -1.27) and males (AOR: 1.19; 95% CI: 0.11, 0.59) who felt socially isolated had higher odds of PTSS compared to those who did not feel socially isolated.InterpretationCompared to males, females had higher scores and higher odds of reporting PTSS during the COVID-19 pandemic. Access to emotional support ameliorated the odds of having PTSS for both sexes, while feeling socially isolated worsened the odds for both sexes.

Posttraumatic stress symptom severity is associated with impaired processing of emotional faces in a large international sample.

Trauma exposure and posttraumatic stress symptoms (PTSS) are associated with biases in emotional face processing. Existing research has utilized a variety of methodological techniques to demonstrate hyperreactivity to threatening cues in posttraumatic stress disorder (PTSD; i.e., fearful faces), but studies to date have shown conflicting findings, including both increased and decreased time fixating on fearful faces. Moreover, the impact of PTSS severity on emotional face processing in the general population is unknown, as the generalizability of prior work is limited. The current study aimed to examine the associations between PTSS and sensitivity to detecting differences in fearful, angry, and happy faces in a large international sample. Participants were 1,182 visitors (M age = 31.13 years, SD = 13.57, range: 18–85 years) to TestMyBrain.org who completed three emotion sensitivity tasks and the PTSD Checklist for DSM‐5. The results indicated that higher PTSS scores were associated with poorer performance in detecting happiness, fear, and anger, ps < .001, with the largest effect for fear, f 2 = .06, controlling for age and gender. Participants who experienced more recent and more direct trauma exposure displayed higher levels of PTSS, with a small but significant effect whereby more direct trauma exposure was associated with higher (i.e., better) scores for anger and fear, f 2s = .02. Women showed heightened sensitivity to detecting fear compared to men, d = 0.17. The present findings underscore the value of citizen science initiatives that allow researchers to obtain clinical data from diverse samples with a high degree of PTSS variability.

Traumatic events, daily stressors and posttraumatic stress in unaccompanied young refugees during their flight: a longitudinal cross-country study

BackgroundUnaccompanied young refugees constitute an especially vulnerable population, reporting high rates of trauma and mental health problems. There is a significant gap in the literature on trauma and posttraumatic stress symptoms (PTSS) in unaccompanied young refugees who are still on the move and live in precarious circumstances such as refugee camps. This study therefore aimed to contribute to this gap by investigating pre- and peri-migration (potentially) traumatic experiences of unaccompanied young refugees; longitudinal trajectories of trauma, daily stressors and PTSS; and the impact of gender, trauma, and daily stressors on PTSS over time.MethodsThis longitudinal, mixed-method, and multi-country study was conducted in various settings (e.g. refugee camps, reception centers) across nine European countries. A heterogeneous sample of N = 187 unaccompanied young refugees (78.4% male) from 29 different countries was assessed via interviews at 3 time-points during a period of 27 months. Data was analyzed via growth curve modelling.ResultsPrevalence rates of (potentially) traumatic experiences ranged from 29.5 to 91.9%. Peri-migration traumatization remained stable over time (b = − 0.02; p = 0.371), but the number of reported daily stressors (b = − 0.24; p = 0.001) and PTSS scores significantly decreased over time (b = − 0.98; p = 0.004). Females reported higher PTSS compared with males at baseline (p = 0.002), but gender did not influence the longitudinal trajectory of PTSS. The pre-migration trauma load and daily stressors at baseline did not have a significant effect on PTSS at baseline or on the longitudinal trajectory.ConclusionsThis is the first study to document not only the high numbers of traumatic events for unaccompanied young refugees pre- and peri- migration, but also the continued traumatization during flight, as well as high rates of daily stressors and PTSS. Humanitarian and political assistance is urgently needed to curb the often life-threatening conditions unaccompanied young refugees face during migration.

Optimism as a protective factor against the psychological impact of COVID-19 pandemic through its effects on perceived stress and infection stress anticipation.

The 2019 coronavirus disease (COVID-19) and the recommended social isolation presented a challenge to people’s mental health status. Optimism is a psychological factor that plays a key role in the evaluation of stressful situations. The purpose of this study was to investigate the mediating role of perceived stress and Covid-19-related stress anticipation in the relationship between optimism and post-traumatic stress symptoms. Our sample included 1015 participants ranging in age from 18 to 79 years, 80% of whom were Spaniards. At the beginning of the worldwide pandemic, participants were confined to their homes for at least seven days and completed an online survey measuring various sociodemographic and psychological variables. We found an indirect effect of optimism on intrusion and hyperarousal through perceived stress and stress anticipation. In addition, we observed an indirect effect of optimism on avoidance through perceived stress. Finally, the results showed a significant indirect effect of optimism on the total post-traumatic stress symptoms score through perceived stress and stress anticipation. Our results indicate that positive beliefs inherent to optimism are related to less psychological impact of the COVID-19 outbreak.

From the First to the Second Wave of COVID-19: Anxiety, De-Pressive, and Post-Traumatic Stress Symptoms in the Italian Population.

In the early stages of the COVID-19 outbreak, high rates of clinically relevant anxiety, depression, and post-traumatic stress symptoms (PTSS) have been reported in the Italian population. The persistence of the pandemic and related restrictive measures highlight the need for a reassessment of psychopathological symptoms. The present longitudinal study consisted of two evaluations conducted during the two waves of infection. Participants were asked to complete the State-Trait Anxiety Inventory-Form Y1 (STAI Y1), the Beck Depression Inventory (BDI-II), and the PTSD Checklist for DSM-5 (PCL-5). There were no significant differences in depressive symptoms and PTSS scores reported by participants between T0 and T1, with single-case analysis revealing that in 71% and 69% of the participants, depressive symptoms and PTSS symptoms, respectively, remained stable during this period. On the contrary, mean scores comparison showed a significant decrease in anxiety levels, with 19% of participants in whom anxiety symptoms improved at single-case analysis. Taken together, these results suggest that depressive symptoms and PTSS not only occurred in a high percentage of participants but also tended to remain stable over time, thus warranting the importance of large-scale psychological screening and interventions to prevent the chronicization of these symptoms and their evolution to psychopathological disorders.

Media Exposure Related to the PTSS During COVID-19 Pandemic: The Mediating Role of Risk Perception.

Objectives: The objectives of this study are to assess the relationship between media exposure and post-traumatic stress symptoms (PTSS) and to highlight the underlying mechanisms mediated by risk perception.Methods: This survey was conducted online in China from February 1st to February 10th, 2020. A total of 2,858 Chinese citizens aged ≥18 years from 31 provinces and autonomous regions were recruited to participate in a cross-sectional study. Self-report questionnaires were used to assess media exposure, PTSS, and risk perception.Results: The prevalence of respondents with heightened PTSS scores was 22.2%. After controlling for covariates, media exposure (more than five times a day) was significantly and positively associated with a high level of PTSS (B = 4.11, p < 0.001), and risk perception (worry and severity) significantly mediated the relationship between media exposure and PTSS (all 95% CIs did not include 0).Conclusions: Based on these findings, the frequency of media exposure was associated with PTSS. Risk perception (worry and severity) mediated the relationship between media exposure and PTSS. The mental health, particularly PTSS, of the general population should be closely monitored and “infodemics” should be combatted while addressing the COVID-19 outbreak; cognitive interventions may be promising.

Who Reports What? A Comparison of Child and Caregivers\xb4 Reports of Child Trauma Exposure and Associations to Post-Traumatic Stress Symptoms and Functional Impairment in Child and Adolescent Mental Health Clinics

Identifying trauma-related symptoms is important for treatment planning at child and adolescent mental health services (CAMHS), and routine trauma screening may be a first step to ensure appropriate treatment. Studies with community samples have found modest agreement between children’s and caregivers´ report of exposure to potentially traumatizing events (PTEs). However, studies from clinical populations are scarce and the evidence base for screening recommendations is insufficient. The current study explores child and caregiver agreement on the child’s exposure to PTEs and its relationship with the child’s post-traumatic stress symptoms (PTSS) and functional impairment. The sample consist of 6653 caregiver-child dyads referred to Norwegian CAMHS between 2012–2017. The children were 6 to 18 years of age (M = 12.03, SD = 3.14) and 47% were boys and 45% were girls (8% missing). Children reported significantly more exposure to accidents or illness, community violence, and sexual abuse than their caregiver, but there were no differences for reports of domestic violence. Kappa results were fair to moderate, with the highest agreement rate for reports of sexual abuse, followed by domestic violence, community violence, and lowest agreement for accidents or illnesses. There were higher agreement rates among caregivers and older children, and caregivers and girls. In general, the child had higher PTSS and functional impairment scores when child exposure to PTEs were reported by both the caregiver and the child. Both children and caregivers should be included in trauma screening procedures at CAMHS to collect a more complete picture of the child’s experiences and treatment needs.

Use of EMDR-Derived Self-Help Intervention in Children in the Period of COVID-19: A Randomized-Controlled Study

Self-help treatments are an important intervention tool, with high accessibility and ease of application. To our knowledge, no research has previously been conducted on any self-help intervention derived from eye movement desensitization and reprocessing (EMDR) therapy. In this study, we evaluated the mental health status of children not directly affected by the pandemic and investigated the effects of using an EMDR-derived self-help intervention in children as a low-intensity treatment. The mental health status of 178 children was evaluated online via the State-Trait Anxiety Inventory for Children (STAIC) and Childhood Posttraumatic Stress Reaction Index (CPTS-RI). Then, children were randomly assigned to intervention and waitlist. A booklet containing EMDR-derived techniques was sent via the school online portal and the intervention was conducted. Posttests were administered 4 weeks later. The attrition rate was 45.5%, with 97 children completing the trial (intervention: 52; waitlist: 45). At baseline, 76.4% of children showed posttraumatic stress symptoms (PTSS) above threshold. Results showed a statistically significant decrease in the posttest PTSS scores for the intervention group compared to waitlist. The intervention group had significant pre–post improvement on all but one subscale, while the waitlist group showed a significant increase in state anxiety on the STAIC. In conclusion, posttraumatic stress was found to be high in children during the COVID-19 outbreak period, and EMDR-derived self-help intervention appeared to be an effective psychosocial intervention tool.