Posttraumatic Stress Scores Research Articles

Risk and protective factors for post-traumatic stress among New Zealand military personnel: A cross sectional study.

Post-traumatic stress (PTS) is prevalent among military personnel. Knowledge of the risk and protective factors associated with PTS in this population may assist with identifying personnel who would benefit from increased or targeted support. To examine factors associated with PTS among New Zealand military personnel. For this cross-sectional study, currently serving and retired military personnel were invited to complete a questionnaire. The questionnaire included a measure of PTS (the Military Post-traumatic Stress Disorder Checklist; PCL-M), where scores ≥30 indicate the experience of significant PTS symptoms and scores ≥45 indicate a presumptive clinical diagnosis of post-traumatic stress. Potential risk and protective factors associated with PTS were examined using logistic regression modelling. 1817 military personnel completed the questionnaire. PCL-M scores were ≥30 for 549 (30%) participants and ≥45 for 179 (10%) participants. Factors associated with higher PCL-M scores were trauma exposure, older age, male sex, and Māori ethnicity. Factors associated with lower PCL-M scores were greater length of service, psychological flexibility, and better quality sleep. PTS was found to be prevalent among New Zealand military personnel. The experience of trauma was strongly associated with PTS. However, factors such as psychological flexibility (the ability to adapt to changes in circumstances) and good sleep were protective, suggesting that these factors could be key targets for interventions designed to reduce PTS among military personnel in New Zealand.

Surgical and Psychosocial Predictors of Mental Health in Parents of Children With Cardiac Admissions

This study investigated factors associated with long-term mental health outcomes of parents of children with a cardiac illness. The objective of the study was to investigate the hypothesis that acute mental health status and psychosocial risk factors (eg, acute stress reactions, quality of life) would be more strongly associated with long-term mental health outcomes than demographic, diagnostic, morphology, or procedure-related factors. Participants were 31 parents of children who underwent cardiac operations in a pediatric hospital. Acute mental health status, psychosocial risk, demographic information, morphology, and procedure-related data were collected within the first 4 weeks of the child's hospital admission. Mental health outcomes, including symptoms of posttraumatic stress, depression, anxiety, and general stress, were collected at a 2-year follow-up. Acute mental health status and psychosocial risk, specifically acute stress reactions, contributed significantly to parent mental health, explaining 44% of the variance in the parent posttraumatic stress scores (P< .001) and 40% in depression scores (P < .001). Morphology and procedure-related factors (eg, prolonged mechanical ventilation) explained a further 12% of the variance in parent posttraumatic stress scores (P= .015) and a further 13% in depression scores (P= .014). No associations were found with demographic factors. Results suggest that acute mental health status is more strongly related to parent mental health outcomes than morphology and procedure-related variables in children undergoing neonatal cardiac operations and that demographic variables are not associated with mental health outcomes.

26 Brief Psychological Intervention for Distress Reduction in Inpatient Burn Survivors: A Pilot Study

Abstract Introduction It is estimated that 19–45% of hospitalized burns patients exhibit symptoms of posttraumatic stress (PTS) during hospitalization, and inpatient distress is linked with poorer functional, psychosocial, and medical prognosis. Despite this, research on psychological intervention for PTS during inpatient treatment for burns remains nascent. The current study developed and pilot-tested a six-session cognitive-behavioral therapy (CBT) for adult inpatients with acute burns. Methods After IRB approval, patients were enrolled in a single verified ABA burn center. Interventions consisted of 6, 50-minute CBT sessions over two weeks. Therapeutic techniques included mindfulness-focused relaxation training, titrated exposure, psychoeducation, and cognitive restructuring. Depression (Beck Depression Inventory II; [BDI]), anxiety (Beck Anxiety Inventory [BAI]), and PTS (Detailed Assessment of Posttraumatic Stress- PTS-T subscale) were assessed at baseline, 2 weeks, and 6 weeks post-intervention. All data were analyzed in SPSS using Student’s univariate t-tests and Last Observation Carried Forward analysis for missing data at T1. No missing data were imputed for T2 given the high drop-out rate. Results Seventeen adult participants were enrolled (13 female; Mage = 31.7 years, SD = 8.7, range 21–53 years; 35% Hispanic/Latinx; MTBSA = 21.6%, SD = 20.2). Analyses indicated no relation between demographic or study variables and drop-out. Average number of sessions was 4.8 (SD = 1.4). At baseline, participants reported moderate anxiety (M = 23, SD = 12.32), mild depression (M = 14.18, SD = 8.46), and clinically significant posttraumatic stress (M = 72.18, T score = 75, 99th percentile). Comparing baseline to post-intervention, BAI scores decreased, t(16) = 3.76, p = .002, Cohen’s d = .61, whereas BDI scores, t(16) = 1.06, ns, Cohen’s d = .19, and PTS scores, t(16) = 1.03, ns, Cohen’s d = .12, did not change. There were no changes from post-intervention to follow-up in BAI, t(5) = 1.48, ns, Cohen’s d = .43, BDI, t(5) = 1.06, ns, Cohen’s d = .54, or PTS scores (t(5) = .55, ns, Cohen’s d = .12) for the six participants who completed follow-up assessment. TBSA burn was not associated with anxiety, depression, or PTS symptoms at any timepoint. Conclusions Participants reported significant reductions in anxiety, but not PTS or depression symptoms, following a CBT distress-reduction intervention. More generally, the findings of this study point to the potential utility of implementing an early intervention of empirically-based treatment components to help burn survivors manage emotional symptoms following trauma. Applicability of Research to Practice Patients experiencing anxiety may benefit from short-term mindfulness or exposure interventions and more research is needed to understand the trajectory and heterogeneity of PTS symptom relief following acute burns.

The Psychological Impact of COVID-19 on Medical Care Workers in China

Background: Medical care workers experienced unprecedented levels of workload and pressure since the outbreak of COVID-19 started from the end of 2019. Little is known about its exact impact on medical care workers and related factors in China. Methods: A cross-sectional survey was conducted among 863 medical care workers from 7 provinces in China using standard questionnaires measuring adverse psychological outcomes including Impact of Event Scale-6 (IES-6), Depression, Anxiety and Stress Scale(DASS)and related psychosocial factors like perceived threat, social support and coping strategies. Exploratory Factor analysis was performed to identify the dimensions of perceived threat by study participants. Multivariate regression was used to examine the determinants of adverse psychological outcomes. Findings: Posttraumatic stress (PTS) were prevalent in this sample of health care professionals, and 40·21% indicated positive screens for significant posttraumatic stress disorder (PTSD) symptoms. The proportion of having mild to extremely severe symptoms of depression, anxiety and stress were 13·56%, 13·90% and 8·57%, respectively. Perceived threat and passive coping strategies were positively correlated to PTS and DASS scores, while perceived social support and active coping strategies were negatively correlated to DASS scores. Nurses were more likely to be anxious than others among medical care workers during the COVID-19 epidemic. Interpretation: Adverse psychological symptoms were prevalent among medical care workers in China during the COVID-19 epidemic. Screening for adverse psychological outcomes and developing corresponding preventive measures would be beneficial in decreasing negative psychological outcomes. Funding Statement: Asian Regional Special Cooperation Fund of National Health Commission of the People’s Republic of China and the Innovative Engineering Program on global health policy sponsored by Chinese Academy of Medical Sciences (2017-I2M-B&R-17). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: This study has been approved by the Ethics Committee of Jining Medical University of Shandong province on February 12th, 2020 (approval number: JNMC-2020-KY-001).

The Severity of Post-abortion Stress in Spontaneous, Induced and Forensic Medical Center Permitted Abortion in Shiraz, Iran, in 2018.

Background:Abortion and loss of pregnancy in the first trimester may affect maternal mortality and morbidity. This study aimed to determine the severity of post-abortion stress in spontaneous abortion, induced abortion, and Forensic Medical Center (FMC) referral abortions immediately after abortion and after 1 month of follow-up in Shiraz, Iran, in 2018.Materials and Methods:This cross-sectional study was conducted on 104 mothers selected through convenience sampling method in 2018. The data collection tools included a demographic characteristics questionnaire and the Mississippi Post-Traumatic Stress Disorder (M-PTSD) Scale that were filled out by mothers immediately and 1 month after the abortion. Data were analyzed using one-way ANOVA and post-hoc LSD test in SPSS software. Moreover, p < 0.05 was considered as statistically significant.Results:The mean (SD) of post-traumatic stress scores was 83.87 (18.35) and 77.40 (9.88) in spontaneous abortion, 82.28 (13.27) and 75.71 (14.73) in FMC permitted abortions, and 86.66 (10.10) and 74.98 (12.99) in induced abortions immediately and 1 month after abortion, respectively. Stress was reduced in the three groups of mothers, after one month of severe value. The score for frequency of stress was 3.10% in FMC-permitted abortions and 5.10% in induced abortions; moreover, no stress was observed in the spontaneous abortion cases.Conclusions:Stress was gradually reduced over time. The level of PTSD was lower after 1 month in women who had experienced spontaneous abortion. Given that 1 month after abortion, women are still often moderately stressed, follow-up care, and appropriate counseling for these women are necessary.

State-wide implementation and clinical outcomes associated with evidence-based psychotherapies for traumatized youth.

Highly efficacious evidence-based psychotherapies (EBPs) exist for children and youth exposed to trauma, yet very few who need the treatments in the community receive them. Research within real-world settings is needed to better understand what is required to translate treatments into the community. We aimed to examine the implementation and clinical outcomes of a multiyear project installing 2 EBPs for trauma-exposed youth in community agencies across the state of New Hampshire. We invited clinicians to 2 days of training plus weekly group consultation calls for 9 or 12 months in Trauma-Focused Cognitive Behavioral Therapy or Child Parent Psychotherapy. Implementation metrics included clinician adherence to training, consultation, and treatment delivery expectations. Clinical outcomes included treatment dropout, as well as posttraumatic stress (PTS) symptoms. Of the 292 clinicians meeting eligibility and agreeing to participate, 243 (83%) attended trainings, 168 (58%) began consultation calls, and 70 (24%) adhered to implementation expectations by attending 80% of consultation calls and beginning the treatment with 2 youths. According to (completing) clinicians' reports, of the 363 youths tracked over the 9 to 12 month consultation periods, 47% dropped out of treatment and 44% were ongoing. Pre-post PTS scores (n = 82) demonstrated clinically meaningful reductions for 59% of youth. Clinical outcomes were robust for those who completed treatment, rivaling those of highly controlled trials. However, implementation outcomes indicate an uphill battle in reaching youth who need the treatment. Implementation outcomes were mixed compared with those of more resource-intensive implementation models. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A group mental health randomized controlled trial for female refugees in Malaysia.

Forcibly displaced persons confront multiple stressors while awaiting permanent asylum or resettlement and often experience high levels of emotional distress. This study assessed an 8-week somatic-focused culturally adapted cognitive-behavioral therapy (CBT) group intervention with 39 female refugees from Afghanistan living in Kuala Lumpur, Malaysia. Twenty-nine participants were randomly assigned to treatment conditions, resulting in 20 participants in two separate treatment groups and 9 in a waitlist control group. An additional 10 participants were not randomly assigned and therefore were treated as an additional treatment group and analyzed separately. A three-group piecewise linear growth model was specified in Mplus using Bayesian estimation. Dependent variables included emotional distress, anxiety, depression, posttraumatic stress, and social support. From baseline to posttreatment assessments, initial intervention participants experienced significant declines in emotional distress (b = -16.90, p < .001), anxiety (b = -.80, p < .001), depression (b = -.59, p < .001), and posttraumatic stress (b = -.24, p < .05). Gains were maintained three months posttreatment, with similar trends observed among nonrandomized participants. Subsequent to receiving treatment, the waitlist control participants also showed significant declines in emotional distress (b = -20.88, p < .001), anxiety (b = -1.10, p < .001), depression (b = -.79, p < .001), and posttraumatic stress scores (b = -.82, p < .001). Comparing the treatment groups to the waitlist control group revealed large effect sizes: Cohen's d was 2.14 for emotional distress, 2.31 for anxiety, 2.42 for depression, and 2.07 for posttraumatic stress. Relevant public health findings include low drop out, group format, and facilitation by a trained community member. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Pilot Study Assessing the Impact of Bereavement Support on Families of Deceased Intensive Care Unit Patients.

Family members of patients who die in an intensive care unit (ICU) may experience negative outcomes. However, few studies have assessed the effectiveness of bereavement care for families. To evaluate the effectiveness of bereavement follow-up on family members' anxiety, depression, posttraumatic stress, prolonged grief, and satisfaction with care. A cross-sectional, prospective pilot study of 40 family members of patients who died in 2 tertiary care ICUs. Those in the medical-surgical ICU received bereavement follow-up (bereavement group); those in the cardiac ICU received standard care (nonbereavement group). Both groups completed surveys 13 months after the death. Surveys included the Hospital Anxiety and Depression Scale, Impact of Event Scale-Revised, Family Satisfaction With Care in the Intensive Care Unit, Prolonged Grief Disorder, and a bereavement survey. Of 30 family members in the bereavement group and 10 in the nonbereavement group, most were female and spouses, with a mean (SD) age of 60.1 (13.3) years. Significantly more participants in the nonbereavement group than in the bereavement group had prolonged grief. Posttraumatic stress, anxiety, depression, and satisfaction with care were not significantly different in the 2 groups. However, overall posttraumatic stress scores were higher in the nonbereavement group than the bereavement group, indicating a higher risk of posttraumatic stress disorder. Bereavement follow-up after an ICU death reduced family members' prolonged grief and may also reduce their risk of posttraumatic stress disorder. This type of support did not have a measurable effect on depression or satisfaction with ICU care.

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center

ObjectivesThe study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable...

437 Quality of Life and Behavioral Health Outcomes in Military Burn Survivors

Military burn survivors treated in the Military Burn Center are typically not included in other national burn studies. The purpose of this study was to examine the quality of life (QOL), post-traumatic stress, depression, and community integration outcomes of military burn survivors for a period of 18 months after burn center discharge. This study consisted of a descriptive longitudinal design. Data were collected using the Burn Specific Health Scale-Abbreviated (BSHS-A), the Short-Form -36, the Post-traumatic Stress Checklist-Military, the Centers for Epidemiologic Studies Depression Scale, the Community Integration Questionnaire (CIQ), and demographic/clinical questionnaires. Data were collected from the patients and their medical records at burn center discharge, 3, 6, 12, and 18 months post-discharge. Measures of central tendency and multilevel modeling were used to analyze the data. There were 77 participants; they were primarily active duty Army, Caucasian males, with at least a high school education and an average income between $20,000–40,000 per year. The burn survivors had a total body surface area burned of 24% (median = 17%) with full thickness burns accounting for 14% (median = 6%); their average length of stay in the burn center was 44 days (median = 17 days). The participants demonstrated improved QOL on most measures over time. The BSHS-A physical, mental, and general health domain scores showed statistically significant improvement over time but the affective and social domain scores did not significantly improve. The SF-36 PCS and MCS means scores were better than those of the normed scores for the U.S. healthy population and above the 75th percentile in both cases. The CIQ scores showed significant, albeit slight change over time and patients did not return to their pre-burn perceptions of their community integration. Post-traumatic stress and depression scores did not improve over time but none of the mean scores indicated positive screening for post-traumatic stress or depression, although scores did fluctuate slightly over time. Although the QOL and behavioral health outcomes of the military burn survivors did improve over time, there were fluctuations in some of the instrument scores that indicated a possible need for psychosocial interventions at various time points to facilitate continued rehabilitation. Psychiatric clinical nurse specialists and case managers should provide ongoing assessments. Longitudinal research with military burn survivors should continue in the outpatient setting. Return to work status should be included in subsequent research. Qualitative research should be integrated into the studies to better determine the patients’ perspectives about the quantitative results.

Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications

ObjectiveWe sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. Study designWe conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. ResultsWe analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, p<.0001), as were posttraumatic stress and grief scores (r=0.7, p<.0001). In the adjusted analysis, higher decision satisfaction was associated with lower grief and posttraumatic stress scores (p=.02 and p=.01, respectively) and higher shared decision making was associated with lower posttraumatic stress scores (p=.01). ConclusionsDecision satisfaction and shared decision making have a positive effect on psychological outcomes after second-trimester abortion for pregnancy complications. Counseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. ImplicationThese results highlight the importance of patient-centered counseling for women seeking pregnancy termination.

Feasibility and acceptability of a brief online self-compassion intervention for mothers of infants

To evaluate the acceptability and potential utility of a small package of online resources designed to improve self-compassion for mothers of infants. A within-groups repeated-measures study design was used. A community sample of 262 mothers who were ≤ 24months post-partum were given access to a set of online resources (two videos plus a tip sheet) that outlined simple techniques for increasing self-compassion drawn from compassion-focused therapy (CFT). Participants completed pre-intervention assessment, followed by post-intervention assessment 1month later. Assessment included self-report measures of self-compassion, psychological flexibility and shame in the mothering role; symptoms of post-traumatic stress (PTS) following childbirth; subjective breastfeeding experience; and satisfaction with infant feeding. Overall, 49.8% of participants accessed some or all of the resources, with lack of time the most common barrier to use. The vast majority (96%) agreed that self-compassion is helpful for women experiencing birth or breastfeeding difficulties. t tests examined change in scores from pre- to post-intervention, indicating increases in self-compassion, decreases in PTS symptoms (intrusion, hyperarousal and total PTS score) and improved subjective breastfeeding experience as well as overall satisfaction with breastfeeding. There were no changes in scores for psychological flexibility, shame, or satisfaction with general infant feeding. This pilot study supports the acceptability and potential utility of self-compassion resources, drawn from CFT, to support mothers' well-being in the first years of their baby's life. This novel approach to maternal health intervention warrants further exploration, development and testing in future research.

Feasibility and psychometric properties of the UCLA PTSD reaction index for DSM-5 in japanese youth: A multi-site study.

The purpose of this study was to determine the reliability and validity of the UCLA PTSD Reaction Index for DSM-5 (PTSD-RI-5) among Japanese youth. This is the first study to explore psychometrics of the DSM-5 version of the PTSD-RI-5, as well as the first multisite study of an Asian population. This article presents psychometric characteristics of the PTSD-RI-5 derived from a sample of Japanese children and adolescents (N = 318). The PTSD-RI-5 total scale displayed good internal consistency reliability (α = 0.85). Correlations of PTSD-RI scores with the posttraumatic stress scores on the TSCC-A for the entire sample provided evidence of convergent validity. The four-factor structure of the PTSD-RI-5 was supported through confirmatory factor analysis in this sample. In conclusion, a DSM-5 version of the PTSD-RI-5 can be regarded as an adequate instrument for clinical and research purposes in Japan.

Quality of life and posttraumatic growth after adult burn: A prospective, longitudinal study

Posttraumatic growth is positive psychological change that occurs beyond pre-trauma levels. Understanding the relationship between growth, stress and quality of life after burn improves understanding about the nature of postburn psychological growth and associated quality of life factors. This study aimed to determine the nature of these relationships, and whether posttraumatic growth changed over time in individuals. Two hundred and seventeen surveys were collected from 73 adult burn patients. The Posttraumatic Growth Inventory, Depression, Anxiety and Stress Score, SF-36 quality of life and Burns Specific Health Score − Brief surveys, together with demographic and clinical information was collected over a six month period. Acute and non-acute burns were equally represented. Growth and stress were positively correlated (p=0.004), but depression and growth had a curved relationship (p=0.050). Growth scores reduced as affect (p=0.008) and mental health improved (p<0.0001), and were highest at mid-levels of physical recovery (p=0.001). This supports the concept that PTG is linked to coping as higher growth is reported with more stress, and that depression is a barrier to growth. As patients recover both physically and mentally from burn, less growth is reported. Early identification and management of depression is important to optimise growth outcomes.

The Development and Effectiveness of an Integrated Management Program for PTSD among Firefighters

본 연구는 최근 우리나라에서 중요성이 부각되고 있는 소방공무원의 외상후 스트레스 예방 및 관리를 위하여 1차 예방교육, 2차 조기발견 및 치료를 위한 개인상담과 집단요법 및 3차 추후관리를 위한 사례관리 프로그램의 3단계로 구성되어진 통합 프로그램을 개발하고 이 프로그램을 실시한 후, 소방공무원들의 외상후 스트레스, 우울 및 수면장애에 미치는 효과를 검정하고자 하였다. Y시의 소방공무원 170명을 대상으로 한 본 연구에서 개발된 프로그램 시행 후 외상후 스트레스, 우울 및 수면장애의 점수가 유의하게 감소하여 프로그램의 효과가 검정되었다. 따라서 일선 현장에 본 연구에서 개발된 외상후 스트레스 통합관리 프로그램을 통한 개인적, 집단적 접근을 통하여 지속적이고 체계적인 심리지원서비스를 제공함으로써 소방공무원의 외상후 스트레스, 우울 및 수면장애를 경감시키는 중재 프로그램으로 활용할 수 있을 것이다. 향후 이 프로그램이 소방공무원의 실무에서 확대 보급되어지고, 중재기간에 따른 효과와 지속성을 검정하는 종단적인 연구가 지속되어져, 소방공무원들의 외상후 스트레스 관리를 위한 체계적인 정책수립이 수반되기를 제언한다.This study intends to develop an integrated program to prevent and manage post-traumatic stress disorder (PTSD) firefighters may suffer, which enhances their mental health based on their working level (individual or group). It examines the effect of this program on post-traumatic stress, depression and sleep disorder of 170 firefighters working at a fire station in Y city in Korea. The data were analyzed with SPSS (Win 18.0) utilizing frequency, percentage, average and a paired t-test. The results of the study showed that the post-traumatic stress, depression and sleep disorder scores were significantly decreased after the program. Therefore, the integrated management program for PTSD among firefighters can effectively maintain psychological stability through systematic and continuous engagement with psychological support activities. Firefighters can also be useful in maintaining a healthy lifestyle, preventing progression to PTSD, be useful in alleviating the secondary pathologies, and prevent the ripple effect of your organization through systematic management.

Post-traumatic stress disorder after terrorist attack in healthcare professionals

INTRODUCTION: On the date of 15 July 2016 a terrorist organization launched a terrorist attack using helicopters and heavy combat weapons in the city centers of Istanbul and Ankara simultaneously. Numerous civilian were hurt and many of them lost their lives during the attacks. Terrorism is a form of combat designed to cause the highest psychological influence on the masses. Post-traumatic stress disorder (PTSD) is one of the most common psychological disorders after such disasters. The aim of this study is to determine the associated risk factors and PTSD rates in healthcare professionals who were on call during the 15 July 2016 terrorist attacks. METHOD: Since the hospital is in a neighbouring the street to where terror attacks occurred, all healthcare professionals ≥ 18 years of age who were on duty that night in the Dr. Ridvan Ege Training and Research Hospital and were auditory or visual witnesses of the event were included in the study as the first group while healthcare professionals who work in the same hospital but were not on duty that night were included as the control group. RESULTS: The mean post-traumatic diagnostic scale stress score of the control group was 11.87. The mean post-traumatic diagnostic scale stress score of the Group 1 was 21.91. There was a significant difference between the groups in terms of posttraumatic diagnostic scale stress score (p < 0.05). While the healthcare professionals on duty on July 15, 2016 (Group 1) had moderate-severe (21.91 ± 5.11) stress disorder, the healthcare professionals who were not at the hospital on July 15, 2016 (Control Group) had moderate stress disorder (11.87 ± 6.86). CONCLUSION: Our country is at risk from the fact that such attacks may be experienced again because of its unique conditions. The results of our work support the data on the high level of exposure to PTSD when exposed to a terrorist attack. For this reason, the identification of the characteristics of pre-traumatic health individuals at risk is useful in planning the presentation of preventive and curative health services. At the same time, there is a need for longer-term work and wider samples to reveal the psychological consequences of such attacks.

Assessing the Post-Traumatic Stress Among Survivors of Motor Vehicle Accidents in Hoshiarpur (Punjab)

Motor vehicle accidents are one of the leading causes of deaths, disabilities and hospitalisations. The present non-experimental descriptive research study, undertaken to assess post-traumatic stress among survivors of motor vehicle accidents, had sample size of 60 survivors of motor vehicle accidents after one month of accident attending OPD on follow-up basis. Assessment of posttraumatic stress was done with the help of standardised rating scale Impact Event Scale- Revised (IES-R) and assessment of severity of injury was done with Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Analysis showed that subjects had mild level of post-traumatic stress and as per subscales of post-traumatic stress, patients had highest mean percentage of posttraumatic stress score in hyper arousal subscale.

General Anesthesia Versus Local Anesthesia in Stereotactic Biopsies of Brain Lesions: A Prospective Randomized Study

Stereotactic biopsy of brain lesions with unknown entities is a common neurosurgical procedure to obtain tumor tissue. Pathologists can then provide an exact diagnosis on which further therapy, such as resection, radiotherapy, or chemotherapy, can be based. These procedures can be performed under local or general anesthesia. In this prospective study, we aim to show whether stress levels are higher for patients who undergo stereotactic biopsy under local or general anesthesia. Between January 2013 and December 2014, we screened 157 patients. Of these, 43 were included and evaluated in this study. Twenty-one patients gave their written consent and were randomized for either local or general anesthesia. A Post Traumatic Stress Score (PTSS) questionnaire was filled out by the patients preoperatively and postoperatively. Also, patients who did not agree to randomization had an opportunity to fill out the PTSS questionnaire. Twenty-two patients agreed only to fill out the stress-level questionnaire but refused randomization. These patients were evaluated as a subgroup. Scores achieved in the PTSS were compared by using the Fisher exact test. Among the randomized patients, 9 underwent the procedure under local anesthesia and 12 under general anesthesia. Median PTSS was 24 preoperatively in the patients who received local anesthesia versus 20 among the patients with general anesthesia (P= 0.37; Fisher exact test). Postoperatively, PTSS was 29.5 in median for patients with local anesthesia versus 23 for patients with general anesthesia (P= 0.30; Fisher exact test). Postoperatively, the PTSS showed a median increase of 5.5 points in the LA and 3 points in the GA group (P= 0.87; Fisher exact test). P values of 0.05 and lower were considered statistically significant. The willingness of patients to undergo randomization in this setting was low (13.3%). Within this highly selective group of patients, there was no significant difference for stress levels in patients who underwent stereotactic biopsy under local anesthesia versus general anesthesia. However, median values indicate a trend for higher stress-level values for patients undergoing local anesthesia.

What can we learn from critical periods of weight gain in military personnel?

What can we learn from critical periods of weight gain in military personnel?

Parent–Child Interaction Therapy for sexual concerns of maltreated children: A preliminary investigation

The current study examines whether an evidence-based treatment for externalizing behavior problems may reduce sexual concerns among children with maltreatment histories. An archival analysis identified 44 children between the ages of 3 and 8 exhibiting externalizing problems and co-morbid sexual concerns who were treated using Parent–Child Interaction Therapy (PCIT). A second group of children receiving PCIT for externalizing behaviors without sexual concerns was included for comparison purposes (n=143). Wilcoxon Signed-Ranks Tests indicated significant improvement among the group with sexual concerns, with 63.6% of children no longer displaying clinically significant sexual concerns at post-treatment. In addition, these children showed a decline in general externalizing problems comparable to that observed among the group of children receiving PCIT and not displaying sexual concerns. Lastly, logistic regression analyses showed that pre-treatment posttraumatic stress scores did not moderate improvement of sexual concerns, suggesting that posttraumatic stress-related sexual concerns may improve from PCIT treatment. These findings suggest that evidence-based parent training interventions, specifically PCIT, may successfully reduce sexual concerns among children who experienced maltreatment.