Posttraumatic Depression Research Articles

Prevalence of Neuropsychiatric Symptoms in COVID-19 and Post-COVID-19 Patients in Southeast Asia: A Systematic Review

Objective: This systematic review aimed to determine the prevalence of neuropsychiatric symptoms in COVID-19 and post-COVID-19 patients in Southeast Asia and explore associated factors. Methods: Following PRISMA guidelines, a comprehensive literature search was conducted in relevant databases. Studies reporting on the prevalence of neuropsychiatric symptoms such as fatigue, anxiety, depression, sleep disturbances, cognitive impairment, and post-traumatic depression in COVID-19 and post-COVID-19 patients in Southeast Asia were included. Data were extracted and analysed to determine the prevalence rates and associated factors. Results: A total of 7 studies met the inclusion criteria. The findings revealed a high prevalence of neuropsychiatric symptoms among COVID-19 patients in Southeast Asia. Fatigue was reported by approximately 43.3% of patients during active COVID-19 infection and 45.1-54% in the post-COVID-19 phase. Anxiety affected 14.3-28.1% of COVID-19 patients, with comorbidities and severity being closely associated. Depression was prevalent in 3.6-38.7% of COVID-19 patients, with healthcare workers showing a higher prevalence. Sleep disturbances were reported in approximately 16.1% of post-COVID-19 individuals. Various factors such as age, gender, quarantine duration, and socioeconomic status were identified as potential contributors to these symptoms. Conclusion: Neuropsychiatric symptoms, including fatigue, anxiety, depression, sleep disturbances, cognitive impairment, and post-traumatic depression, are prevalent among COVID-19 and post-COVID-19 patients in Southeast Asia. These symptoms have a significant impact on patients' lives and warrant attention in clinical management. Further research is needed, particularly in the ASEAN region, to better understand these symptoms, explore gender differences, and develop effective management strategies. The findings of this study emphasize the importance of early detection and holistic treatment that addresses both physical and psychological symptoms in COVID-19 patients. Funding: This research is supported by the International Medical University Joint Committee on Ethics and Research (IMU-JC). Conflicts of Interest: No conflicts of interest.

Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study

BackgroundPrior sexual trauma (ST) is associated with greater risk for posttraumatic stress disorder after a subsequent traumatic event; however, the underlying neurobiological mechanisms remain opaque. We investigated longitudinal posttraumatic dysfunction and amygdala functional dynamics following admission to an emergency department for new primarily nonsexual trauma in participants with and without previous ST. MethodsParticipants (N = 2178) were recruited following acute trauma exposure (primarily motor vehicle collision). A subset (n = 242) completed magnetic resonance imaging that included a fearful faces task and a resting-state scan 2 weeks after the trauma. We investigated associations between prior ST and several dimensions of posttraumatic symptoms over 6 months. We further assessed amygdala activation and connectivity differences between groups with or without prior ST. ResultsPrior ST was associated with greater posttraumatic depression (F1,1120 = 28.35, p = 1.22 × 10−7, ηp2 = 0.06), anxiety (F1,1113 = 17.43, p = 3.21 × 10−5, ηp2 = 0.05), and posttraumatic stress disorder (F1,1027 = 11.34, p = 7.85 × 10−4, ηp2 = 0.04) severity and more maladaptive beliefs about pain (F1,1113 = 8.51, p = .004, ηp2 = 0.02) but was not related to amygdala reactivity to fearful versus neutral faces (all ps > .05). A secondary analysis revealed an interaction between ST and lifetime trauma load on the left amygdala to visual cortex connectivity (peak Z value: −4.41, corrected p < .02). ConclusionsFindings suggest that prior ST is associated with heightened posttraumatic dysfunction following a new trauma exposure but not increased amygdala activity. In addition, ST may interact with lifetime trauma load to alter neural circuitry in visual processing regions following acute trauma exposure. Further research should probe the relationship between trauma type and visual circuitry in the acute aftermath of trauma.

Traumatic Brain Injury Can Affect Emotions and Behaviors

Proper brain functioning is responsible for our feelings, behavior, and thinking. However, an injury to the brain can disrupt brain function, which can affect our emotions and behaviors. A traumatic brain injury (TBI) can be a one-time severe injury to the brain, or repeated, milder injuries. Scientists have observed that, after TBI, people are frequently sad and have difficulty concentrating. These symptoms are referred to as post-traumatic depression (PTD). PTD can affect school performance and daily activities. It is therefore important to notice any signs of PTD. If signs of PTD are present, individuals should seek help from a professional. PTD is treatable and, with adequate treatment, individuals with PTD can gradually recover their normal functioning.

Implementasi Tele Psychological First Aid (PFA) pada Layanan Konseling

Psychological First Aid (PFA) or Initial Psychological Assistance assists individuals experiencing pressure or abnormal conditions such as trauma and disasters to feel calm and cope better with their situation. The Covid-19 pandemic is the latest crisis that underlies the importance of organizing PFA because the psychological impact it causes increases anxiety in the community. This study aims to reveal the application of PFA to telePFA in Counseling Services to deal with changing patterns in people's lives when the co-19 pandemic hit. The research was conducted in a qualitative descriptive manner. Research data was collected through the observation method of modules and the application of telePFA to the counseling service of Friends of Sehati UIN Prof. K.H. Saifuddin Zuhri Purwokerto. Data collected and analyzed accompanied by triangulation. The study results show that through the six steps of look, listen, comfort, link, protect and hope, the telePFA service of Teman Sehati UIN Prof. K.H. Saifuddin Zuhri Purwokerto helps clients overcome anxiety, frustration, and even post-traumatic depression or in abnormal mental health conditions

Trouble de stress post-traumatique et symptômes dépressifs : « comorbidités » ou formes cliniques du trauma ? Description de la dépression dissociative.

We investigate the epidemiology of depressive disorders, on the one hand, and post-traumatic disorders, on the other hand, in order to better understand the relationship between the two. The evolution of a semiological and a psychopathological understanding of post-traumatic psychic disorders, which cannot be reduced to post-traumatic stress disorder alone, allows us to understand the nosographic framework of post-traumatic depression. Over time, under the effect of traumatic dissociation, the cardinal symptoms of reliving, avoidance and hypervigilance can give way to various syndromes whose psychotraumatic origins remain unknown. This is no doubt the cause of many cases of resistant depression. These are neither depressive “comorbidities” nor “complications” but authentic clinical forms resulting from trauma and remaining linked to it by anamnestic, psychopathological and neurobiological factors. In this study, we enumerate the now classic post-traumatic depressions: (i) psychophysiological exhaustion in the face of the trauma and its consequences, (ii) mood-congruent psychotic characteristics, (iii) depressions masked by somatic suffering, (iv) those that involve post-traumatic grief. Also, we suggest that pathological dissociation creates depressogenic cognitive patterns to the point of leading to “dissociative depressions”. We then discuss the therapeutic perspectives of pharmacological and psychotherapeutic treatments, and finally address research strategies based on psycholinguistics, and in particular the description of traumatic psycholinguistic syndrome (SPLIT). We conclude with a discussion of the medico-legal issues.

Syndrome de détresse respiratoire aiguë (SDRA) : quel est le devenir à long terme de ces patients ?

In the last decades, improvements in acute respiratory distress syndrome (ARDS) management decreased in-hospital mortality. Most of the time, these young patients with ARDS suffer from post-intensive care syndrome (PICS) after discharge. The special features of PICS after ARDS include a similar global recovery for the most severe patients with ECMO, a good pulmonary function recovery but a high prevalence of physical and psychological dysfunction. Physical impairment concerns fatigue and fatigability. Half of the patients had cognitive impairment at one year and a third suffer from post-traumatic stress disorder (PTSD), anxiety, or depression during the first year. These symptoms persist later, associated with a reduced quality of life. As a witness to global dysfunction, only 50 % of patients return to their original work at one year. Being aware of the long-term impact of ARDS is crucial for intensivists to set up a multi-disciplinary and individual follow-up after intensive care unit discharge.

0642 Characterizing Actigraphy-Measured Sleep Disturbance in Veterans and Service Members with Post-traumatic Headache following Mild Traumatic Brain Injury

Abstract Introduction Post-traumatic headache (PTH) frequently occur following traumatic brain injury (TBI) is particularly prevalent in Veterans with deployment-related TBI. PTH is associated with a range of physical and mental health symptoms, including post-traumatic stress disorder (PTSD), depression, anxiety, post-concussive symptoms, and subjective sleep complaints. Subjective sleep disturbance is associated with greater pain severity, and headaches (HA) are associated with poorer sleep. Poor sleep may be a mechanism by which PTH exerts both direct and indirect effects on health outcomes Despite the high prevalence of sleep problems in individuals with PTH, we know little about sleep disturbance in Veterans and military personnel with PTH. This study sought to characterize the relationship between objective sleep disturbance and HA in Veterans and military personnel with chronic PTH following mild TBI. Methods Veterans and active-duty service members (N=39, Mage= 49.4, 89.7% male) were included from a larger study evaluating prazosin as prophylactic treatment for persistent PTH. Participants completed baseline measures of PTSD symptoms, insomnia, sleep quality, HA frequency and impairment, as well as 7-day actigraphy, sleep diary, and HA logs. Actigraphy-derived sleep parameters include sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO). Daily HA logs were used to assess HA severity and duration. Analyses were conducted in SPSS 26.0 using multilevel modeling, controlling for the effects of time. Results Preliminary results suggest number of HA days at baseline was significantly associated with self-reported sleep quality (r=-.398, p= .016), but not with subjective SOL, TST, or WASO. Number of HA days was significantly correlated with actigraphy-measured WASO (r=.178, p=.003). Actigraphy-measured SOL, SE, WASO, and TST were not significantly associated with same-day HA severity and duration. Conclusion This preliminary data suggest examination of sleep fragmentation may be important in enhancing our understanding of PTH and related impairment. Findings support the importance of using both subjective and objective measures in the assessment of sleep in Veterans and service members with PTH. Support (If Any) This project was supported by a VA Career Development Award 5IK2RX001136 from the United States Department of Veterans Affairs Rehabilitation Research and Development Service. The contents of this work do not represent the views of the Department of Veterans Affairs or the United States government.

Structural and Functional Alterations of Substantia Nigra and Associations With Anxiety and Depressive Symptoms Following Traumatic Brain Injury.

BackgroundsAlthough there are a certain number of studies dedicated to the disturbances of the dopaminergic system induced by traumatic brain injury (TBI), the associations of abnormal dopaminergic systems with post-traumatic anxiety and depressive disorders and their underlying mechanisms have not been clarified yet. In the midbrain, dopaminergic neurons are mainly situated in the substantia nigra (SN) and the ventral tegmental area (VTA). Thus, we selected SN and VTA as regions of interest and performed a seed-based global correlation to evaluate the altered functional connectivity throughout the dopaminergic system post-TBI.MethodsThirty-three individuals with TBI and 21 healthy controls were recruited in the study. Anxiety and depressive symptoms were examined by the Hospital Anxiety and Depression Scale. All MRI data were collected using a Siemens Prisma 3.0 Tesla MRI system. The volume of SN and the global functional connectivity of the SN and VTA were analyzed.ResultsIn the present study, patients with TBI reported more anxiety and depressive symptoms. More importantly, some structural and functional alterations, such as smaller SN and reduced functional connectivity in the left SN, were seen in individuals with TBI. Patients with TBI had smaller substantia nigra on both right and left sides, and the left substantia nigra was relatively small in contrast with the right one. Among these findings, functional connectivity between left SN and left angular gyrus was positively associated with post-traumatic anxiety symptoms and negatively associated with depressive symptoms.ConclusionsThe TBI causes leftward lateralization of structural and functional alterations in the substantia nigra. An impaired mesocortical functional connectivity might be implicated in post-traumatic anxiety and depression.

Gender differences in post-traumatic stress disorder and depression among Iranian population with substance use disorder

ABSTRACT Background In a review of Iranian studies, no studies have yet to explore a relationship between substance use disorders (SUDs), depression and/or PTSD. In this paper, we report whether the Iranian women and men with SUDs exhibit differences in PTSD and depression. Methods A cross-sectional study was performed on 600 SUDs patients in treatment. Assessments included socio demographic questionnaire, the Beck Depression Inventory II, and the PTSD Checklist. Data were analyzed using descriptive, chi-square (χ2) and logistic regression analysis. Results PTSD was 61.5% in the study population. The mean PTSD score was 47.92 ± 12.07 for all men and women. The participants revealed mild, moderate, and severe depressive symptoms 19.7%, 24.3%, and 32.3%, respectively. Women were more likely than men to be diagnosed with PTSD (adjusted odds ratio (AOR) =1.82, 95%CI: 1.19, 2.80) and depression (AOR =1.65, 95%CI: 1.01, 2.77). In addition, marital status and job status were significantly associated with depression and PTSD. Conclusions This study shows remarkably higher prevalence of PTSD and depression in drug using women than their male counterparts. The results illustrate a number of gender differences that may shed light on etiologic models of co-morbid SUDs, PTSD, and depression.

Suicidal ideation among recently arrived refugees in Germany

BackgroundRefugees are considered a high-risk population for developing mental health disorders. Yet little research has been conducted on suicidal ideation among refugees resettled in Western high-income countries. In the present hstudy, suicidal ideation and its association with different socio-demographic, flight-related, and mental health-related factors were analyzed in recently arrived refugees in Germany.MethodsThe study was conducted in a reception facility for asylum-seekers in Leipzig, where 564 newly arrived adult residents participated. The questionnaire included socio-demographic and flight-related questions as well as standardized instruments for assessing suicidal ideation (item 9 from PHQ-9), a variety of traumatic experiences (LEC-5), posttraumatic stress disorder (PCL-5), depression (PHQ-8), and somatic symptoms (SSS-8). Multiple logistic regression models were run to predict suicidal ideation in relation to different socio-demographic, flight, and mental health-related factors.ResultsIn total, 171 (30.3%) participants who had just or very recently arrived in Germany reported having experienced suicidal ideation within the two weeks prior to being assessed. Those who reported suicidal ideation also reported higher prevalence of somatic symptoms, posttraumatic stress disorder, depression, and experiences of sexual violence, as well as worse self-rated mental and physical health. In addition, there were significant independent associations between suicidal ideation and (1) younger age, (2) longer flight duration, (3) experiences of sexual violence, (4) symptoms of posttraumatic stress disorder, and (5) symptoms of depression.ConclusionsThe results emphasize the association between suicidal ideation and different clinically relevant mental health symptoms among newly arrived refugees in Germany. Special attention should not only be given to refugees suffering from symptoms of poor mental health, but also to those of younger age as well as refugees who have experienced sexual violence, as they might be affected by suicidal ideation whether or not they suffer from other mental health problems.

A Scoping Review of Climate Change, Climate-Related Disasters, and Mental Disorders among Children in Low- and Middle-Income Countries.

Children, particularly those living in low- and middle-income countries (LMICs), are highly vulnerable to climate change and its impacts. Our main objective was to conduct a scoping literature review to determine how exposure to climate change and climate-related disasters influences the presence of mental disorders among children in LMICs. We also aimed to identify gaps in this area of scholarship. We included studies of children in LMICs that had a climate change or climate-related disaster exposure and mental disorder outcome. Twenty-three studies were included in the final synthesis. Fourteen studies were conducted in China, three in India, two each in Pakistan and the Philippines, and one each in Namibia and Dominica. All studies assessed the association between a climate-related disaster exposure and a mental disorder outcome, while none explored broader climate change-related exposures. Post-traumatic stress disorder (n = 21 studies) and depression (n = 8 studies) were the most common mental disorder outcomes. There was considerable between-study heterogeneity in terms of sample size, follow-up length, and outcome measurement. Overall, the literature in this area was sparse. Additional high-quality research is required to better understand the impacts of climate-related disasters and climate change on mental disorders within this population to ultimately inform future policies and interventions.

Let’s Get “REAL”: A Collaborative Group Therapy for Moral Injury

Moral injury is a particular response to profoundly distressing life events that manifests in damage to basic human/relational capacities, such as trust, autonomy, initiative, competence, identity, and intimacy. This paper describes and presents preliminary outcomes of “Reclaiming Experiences And Loss,” or “REAL,” which is an innovative moral injury group therapy that was developed collaboratively by Veterans Affairs mental health and spiritual care providers. Clinical outcome measures collected pre- and post-group indicates that REAL is effective at reducing symptoms of post-traumatic stress disorder and depression. Additionally, a cohort case example demonstrates the impact of REAL as told through individual stories as well as the intersectionality and interactions that comprise a typical REAL cohort and are considered central to care. Implications for ongoing care and future research are discussed.

Prior differences in previous trauma exposure primarily drive the observed racial/ethnic differences in posttrauma depression and anxiety following a recent trauma.

Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, suggesting that such differences in chronic PTSD rates may be related to differences in recovery over time. As part of the multisite, longitudinal AURORA study, we investigated racial/ethnic differences in PTSD and related outcomes within 3 months after trauma. Participants (n = 930) were recruited from emergency departments across the USA and provided periodic (2 weeks, 8 weeks, and 3 months after trauma) self-report assessments of PTSD, depression, dissociation, anxiety, and resilience. Linear models were completed to investigate racial/ethnic differences in posttraumatic dysfunction with subsequent follow-up models assessing potential effects of prior life stressors. Racial/ethnic groups did not differ in symptoms over time; however, Black participants showed reduced posttraumatic depression and anxiety symptoms overall compared to Hispanic participants and White participants. Racial/ethnic differences were not attenuated after accounting for differences in sociodemographic factors. However, racial/ethnic differences in depression and anxiety were no longer significant after accounting for greater prior trauma exposure and childhood emotional abuse in White participants. The present findings suggest prior differences in previous trauma exposure partially mediate the observed racial/ethnic differences in posttraumatic depression and anxiety symptoms following a recent trauma. Our findings further demonstrate that racial/ethnic groups show similar rates of symptom recovery over time. Future work utilizing longer time-scale data is needed to elucidate potential racial/ethnic differences in long-term symptom trajectories.

A cross-sectional study of mental health-, posttraumatic stress symptoms and post exposure changes in Norwegian ambulance personnel

BackgroundPosttraumatic stress disorder (PTSD) has been shown to be elevated among first responders (Emergency Medical Services, fire service, police force) compared to the general population. Examining the prevalence of mental health issues in a work force with an elevated occupational risk is fundamental towards ensuring their wellbeing and implementing safeguard measures. The goal of this study is therefore to report the prevalence of depression, anxiety, posttraumatic development, and PTSD in Norwegian ambulance personnel.MethodsThis study is a cross-sectional, anonymous, web-based survey (Questback®), performed among operative personnel employed in the Emergency Medical Services in the Regional Health Trust of Central Norway between 18. February and 9. April 2021. The study was sent to 1052 eligible participants. Questions reported demographic data, a traumatic events exposure index, Patient Health Questionnaire-9 (Depression), Generalized Anxiety Disorder-7 scale, Posttraumatic symptom scale (PTSD) and Posttraumatic change scale.ResultsThe response rate in this study was 45.5% (n = 479/1052). The mean age of respondents was 37.1 years (std. 11.1) and 52.8% (n = 253) were male. Of the respondents, 80.6% (n = 386) were married or had a partner, and 91.6% (n = 439) reported having access to a peer support programme, with 34.9% (n = 167) reporting that they had utilized peer support. In this study, 5% (n = 24) showed a prevalence of manifest posttraumatic stress disorder symptoms, while 8.6% (n = 41) reported moderate to severe depression and 2.9% (n = 14) presented moderate to severe symptoms of general anxiety. Of the respondents, 77.2% (n = 370) reported personal growth because of their work experiences.ConclusionsThis study indicates that Norwegian ambulance personnel report a prevalence of posttraumatic stress symptoms and depression, which is slightly higher for men, and lower for the female proportion in this study, when compared to an adult Norwegian population. The vast majority of respondents reported personal growth because of their work experience, and both the degree of peer support and having a partner seem to influence levels of posttraumatic stress and -development.

Explanatory models of post-traumatic stress disorder (PTSD) and depression among Afghan refugees in Norway

BackgroundThe current situation in Afghanistan makes it likely that we are facing a new wave of Afghan refugees, warranting more knowledge about how to deal with mental health problems among them. This study aims to gain more knowledge on Explanatory Models (EM) of depression and post-traumatic stress disorders (PTSD) among Afghan refugees resettled in Norway.MethodsWe conducted six gender-separated, semi-structured focusgroup interviews based on vignettes with Afghan refugees (total N = 27). The vignettes described a fictional character with symptoms of either depression or PTSD symptoms in line with DSM-5 and ICD-10 criteria.ResultsThe findings showed that EM varied with gender, age, generation, and migration stories. Participants suggested different potential causes, risk factors, and ways of managing symptoms of depression and PTSD depending on the context (e.g., in Norway vs. Afghanistan). In describing the causes of the depression/PTSD in the vignettes, females tended to emphasize domestic problems and gender issues while males focused more on acculturation challenges. The younger males discussed mostly traumatic experiences before and during flight as possible causes.ConclusionThe practice of condensing a single set of EMs within a group may not only be analytically challenging in a time-pressed clinical setting but also misleading. Rather, we advocate asking empathic questions and roughly mapping individual refugee patients’ perceptions on causes and treatment as a better starting point for building trusting relationships and inviting patients to share and put into practice their expertise about their own lives.

Posttraumatic Treatment Interventions for Refugee Children Residing in the Middle East and North Africa (MENA) Region: A Brief Review

ABSTRACT Despite the tremendous burden of refugees on regional and global health care financial systems, the current tools set into place to deal with the worsening conditions of asylum seekers have failed to address the significant challenges facing the Middle East, which in turn affected the capability of host countries to provide the necessary care for incoming population groups. One of the main health risks refugees in the Middle East and North Africa (MENA) region suffer from is mental health disorders, mainly posttraumatic stress disorder (PTSD), depression, and anxiety. Due to the limited accessibility of mental health services and the shortage of mental health professionals in host communities, refugees end up neglecting their conditions and subsequent consequences, which result in a long-term social, psychological, and economic impact. The following scoping review aims to evaluate PTSD interventions implemented for refugee children in developing nations within the MENA region. The York methodology was used to ensure transparency, enable replication of the search strategy, and increase the reliability of study findings. The results indicate that several strategies such as art therapy, cognitive-behavioral therapy, digital-based educational games, writing for recovery, group theraplay, and profound stress attunement framework deemed effective in decreasing PTSD symptoms on a short-term basis. However, future interventions should apply more sustainable strategies to help refugee children in the long-term management of the chronic mental illness. Additional research regarding this topic is needed in the MENA region.

Improving the Quality of Life towards Healing Long Haul Symptoms of COVID- 19 Survivors through Online Video Booklets and Gymnastics and Education

Background: COVID-19 is a global pandemic health problem that is getting a lot of attention around the world today. It is a serious illness that can significantly affect the daily lives of patients and their families in terms of mental health problems, such as post-traumatic stress, depression, anxiety, and insomnia, as well as negatively impacting the quality of patients. Purpose: This study aims to determine the impact of long haulers on the quality of life of COVID-19 survivors in East Java, Indonesia. Methods: Researchers conduct detailed the solution to overcome the problem by using educational videos and sports or routine gymnastics to change the attitude of COVID-19 survivors towards long haul healing is done through the distribution of the two facilities via the google drive link. The drafting team has 2 program plans as a solution to the problems carried out. Results: The prevalence of COVID-19 survivors with long haulers was slightly higher than that of non-long haulers. The results of the knowledge and attitude scores on the pre-test and post-test after viewing the media booklet and educational video showed a significant difference and improvement of quality of life in the result. Conclusion: The level of knowledge, attitudes, and quality of life including the physical health of long haul COVID-19 survivors in East Java experienced a significant increase after being given counseling through online booklets andeducational videos.

Mechanism of olfactory deficit in neurotrauma and its related affective distress: A narrative review.

Traumatic brain injury (TBI) is among the leading causes of death and disability all over the globe. TBI is also commonly associated with clinical sequelae of posttraumatic depression, and reports of other subsequent affective distress are common. Similarly, posttraumatic changes in chemoreceptive sensory functions, primarily due to coup-contrecoup injury induced shearing of the olfactory nerve fibers, leading to anosmia and ageusia are also well documented in the literature. However, the current literature is limited in addressing the intersections between said variables. The aim of this study was to provide a focused narrative review of the literature, to address these intersections found in clinical sequelae of TBI. As chemoreceptive sensory deficits are also linked to significant affective distress of their own, this review addresses the bidirectionality between sensory deficit and affective distress. Prevalence, demographics, mechanisms, and clinical implications are presented. Previous research is presented and discussed, in an effort to highlight the importance of consideration for all factors in TBI patient care and future research.

Association Between Post-Traumatic Stress and Depression Among Older Puerto Ricans: How Does Loneliness Matter?

Puerto Ricans have a significantly higher prevalence of post-traumatic stress disorder (PTSD) than other racial and ethnic groups. PTSD can lead to co-morbid depression, which exacerbates the risk for compromised mental and physical health among older adults. Loneliness, a robust indicator of poor social support, is likely to worsen the dysphoric symptoms of PTSD and increase the risks of depression. However, few studies have focused on the moderating role of loneliness on the association between post-traumatic stress and depression. This study examines the association between post-traumatic stress and depression and whether such an association differs by loneliness among older Puerto Ricans. Data were collected from 304 Puerto Ricans aged 60-81 living in the Greater Boston area who responded to questionnaires in a survey. We used ordinary least squares regression to examine the association between post-traumatic stress, loneliness, and depression. We found that post-traumatic stress was significantly associated with higher levels of depression; however, the association was contingent on experiences of loneliness. The association between post-traumatic stress and depression was stronger for those experiencing a higher degree of loneliness. Findings underscored the role that loneliness plays in exacerbating the risk of developing co-morbid PTSD and depression among older Puerto Ricans. In working with older Puerto Ricans experiencing post-traumatic stress, it is important for mental health professionals to incorporate the assessment of loneliness and to prevent and reduce co-morbid depression by addressing loneliness through improving social skills, enhancing social support, and reducing maladaptive social cognition.

Binge Drinking and Heavy Drinking Among Older Military Veterans: Applying the Theory of Intersectionality

The post-service impact of military experiences include post-traumatic stress disorder, depression, substance misuse and several other adverse outcomes that persist well into older adulthood. As such, older military veterans are at risk of developing alcohol dependency and those with existing stressors from other identities are at the highest risk of engaging in binge drinking or heavy drinking. This study used the theory of intersectionality to examine alcohol misuse by veteran status and age, veteran status and race and veteran status and sex. Data were derived from the 2016, 2017 and 2018 Brief Risk Factor Surveillance System (BRFSS) from the Centers for Disease Control and Prevention (CDC). The BRFSS is an annual survey conducted over the phone in all 50 states and territories. Survey-weighted logistic regression models were used to examine alcohol misuse among adults aged 65+ by veteran status and the intersection between age, race, and sex. Results showed no interaction between veteran status and age, and no interaction between veteran status and sex. However, there was a significant interaction between veteran status and race, in that Black/Other race veterans were more likely to engage in both binge drinking and heavy drinking compared to White veterans, White nonveterans and nonveterans of the same race. Interventions geared towards this population should therefore engage culturally sensitive approaches that consider the historical and systemic factors that contribute to these disparities in rates of alcohol misuse among older military veterans.