Probable Posttraumatic Stress Disorder Research Articles

Sexual Violence and Hazardous Drinking: Exploring Associations With PTSD Symptoms and Gender Among Adults With Probable PTSD and Hazardous Drinking.

Sexual violence is associated with posttraumatic stress disorder (PTSD), but relatively less research has explored whether it is associated with hazardous drinking. PTSD symptoms may indirectly influence the association between sexual violence and hazardous alcohol use. This association may be moderated by gender. The aim of the current study was to cross-sectionally test whether sexual violence is indirectly associated with hazardous drinking through PTSD symptoms and explore whether gender moderates this association. Hypotheses were tested among 631 adults (Mage = 38, 56% men, 78.6% White) with probable PTSD and hazardous drinking who completed online self-report surveys. Results indicated sexual violence, compared with other trauma types, was associated with more severe hazardous drinking. There was a significant indirect effect of PTSD symptoms in this association. There was no evidence of a moderating effect of gender. PTSD symptoms may drive hazardous drinking among sexual violence survivors. Results also underscore associations between sexual violence and alcohol use, regardless of gender. Future work should continue to investigate these associations prospectively.

Web-Based Intervention (SunnysideFlex) to Promote Resilience to Posttraumatic Stress Disorder Symptoms During Pregnancy: Development and Pilot Study.

Approximately 4% to 8% of pregnant individuals meet the criteria for current posttraumatic stress disorder (PTSD), a known risk factor for a multitude of adverse maternal and child health outcomes. However, PTSD is rarely detected or treated in obstetric settings. Moreover, available prenatal PTSD treatments require in-person services that are often inaccessible due to barriers to care. Thus, web-based interventions offer great potential in extending PTSD treatment to high-risk pregnant individuals by providing affordable, accessible care. However, there are currently no web-based interventions designed specifically for the treatment of PTSD symptoms during pregnancy. This study aims to develop and pilot a 6-week, web-based, cognitive behavioral therapy intervention for PTSD, SunnysideFlex, in a sample of 10 pregnant women with current probable PTSD. Consistent with established guidelines for developing and testing novel interventions, the focus of this pilot study was to evaluate the initial feasibility and acceptability of the SunnysideFlex intervention and preintervention to postintervention changes in PTSD and depression symptoms. This approach will allow for early refinement and optimization of the SunnysideFlex intervention to increase the odds of success in a larger-scale clinical trial. The SunnysideFlex intervention adapted an existing web-based platform for postpartum depression, Sunnyside for Moms, to include revised, trauma-focused content. A total of 10 pregnant women in weeks 16 to 28 of their pregnancy who reported lifetime interpersonal trauma exposure (ie, sexual or physical assault) and with current probable PTSD (scores ≥33 per the PTSD checklist for DSM-5) were enrolled in the SunnysideFlex intervention. Assessments took place at baseline and 6 weeks (postintervention). All participants were retained through the postintervention assessment period. Engagement was high; participants on average accessed 90% of their lessons, logged on to the platform at least weekly, and reported a generally positive user experience. Moreover, 80% (8/10) of participants demonstrated clinically meaningful reductions in PTSD symptoms from baseline to postintervention, and 50% (5/10) of participants no longer screened positive for probable PTSD at postintervention. Most (6/10, 60%) of the participants maintained subclinical depression symptoms from baseline to postintervention. Findings from this small pilot study indicate that SunnysideFlex may be a feasible and acceptable mechanism for delivering PTSD intervention to high-risk, trauma-exposed pregnant women who might otherwise not have opportunities for services. Larger-scale trials of the intervention are necessary to better understand the impact of SunnysideFlex on PTSD symptoms during pregnancy and the postpartum period.

The psychological impact of disaster on first responders in the aftermath of Bahanaga train tragedy: A mixed methods approach

Background: First responders are at high risk for adverse mental health outcomes following trauma exposure during disaster response. This mixed methods study aimed to quantify psychological impacts and explore personal experiences among first responders after the Bahanaga train accident that killed 294 passengers in the month of June 2023. Methods: For qualitative data, in-depth interviews (IDIs) were conducted, and quantitative data was collected using the PTSD checklist for DSM-5 (PCL-5), generalized anxiety disorder scale (GAD-7), and patient health questionnaire (PHQ-9) for symptoms of post-traumatic stress disorder (PTSD), depression, and anxiety. The study was conducted over one month during July 2023. Results: Among 225 responders, alarming rates of symptoms of probable PTSD (10.2%), anxiety (11.6%), and depression (24.9%) were noted. Those with no prior exposure to disasters and those with no formal training in disaster response scored higher in measures for PTSD. IDIs were conducted with 22 first responders, including various stakeholders. Qualitative analysis identified themes of preoccupation with witnessing trauma, feeling overwhelmed, scary and terrible emotions, avoidance, guilt, hypervigilance, intrusive memories, emotional numbing, unmet needs for mental health support, worsening physical health, re-emergence of past traumas, compounding impact of graphic images in the media, certain positive impact, including increased empathy, resilience and finding purpose, and the beneficial role of peer support. Conclusion: Significant psychological impacts are noted with elevated rates of probable PTSD, anxiety, and depressive symptoms among first responders one month after the Bahanaga train tragedy. These results underscore the vulnerability of first responders to mental health challenges following disaster response in India.

Pandemic-related PTSD and associated risk factors in the general adult population in the Netherlands

Abstract Introduction The COVID-19 pandemic introduced widespread stressors and shocking events, impacting mental well-being. Understanding posttraumatic stress disorder (PTSD) prevalence during the pandemic is crucial, yet existing studies on this topic vary widely in methodological quality. This study aims to fill this gap using a large-scale national survey study to examine PTSD prevalence during the pandemic and compare pandemic-related and traditional shocking events. Methods This study uses data from the Dutch Public Health Monitor Adults and Elderly 2022, consisting of 365,000 Dutch adults representative for the general adult population. Pandemic-related and traditional events were assessed and anchored to a screening instrument for PTSD: the Dutch version of the PCL-5. Results Two-thirds of participants reported experiencing a shocking event during the pandemic. Exposure to pandemic-related events was reported more frequently than traditional events. Overall probable PTSD prevalence due to these events was 2.4%, evenly split between pandemic-related and traditional events. Among exposed individuals, probable PTSD prevalence was 3.7%. This was higher for traditional than for pandemic-related events. Risk factors for developing probable PTSD after exposure to an event during the pandemic were younger age, financial difficulties, loneliness, low resilience and experiencing multiple events. Discussion Exposure to shocking events during the pandemic influenced the prevalence of probable PTSD. Despite the lower relative impact of pandemic-related shocking events compared to traditional events, exposure to pandemic-related shocking events accounted for the same amount of probable PTSD cases in the Dutch general population as 5 common traditional events. This emphasizes the need to address mental health consequences of prolonged crises and the demand for healthcare, and the importance of mitigation strategies based on risk and protective factors. Key messages • Exposure to pandemic-related events accounted for approximately the same amount of probable PTSD cases as 5 frequently occurring traditional events. • Despite pandemic-related events being reported more frequently, traditional events were associated with a relatively higher prevalence of PTSD.

Use of renin-angiotensin system blockers and posttraumatic stress disorder risk in the UK Biobank: a retrospective cohort study

BackgroundPrevious research has shown that the use of renin-angiotensin system (RAS) blockers is linked to a lower prevalence of posttraumatic stress disorder (PTSD), but longitudinal studies are scarce. We aimed to estimate the association between the use of RAS blockers and the risk of PTSD among individuals taking antihypertensive medications.MethodsThis longitudinal study included participants aged 40–69 from the UK Biobank. Exposure data were obtained from the initial assessment (2006–10), while outcome data were obtained from the online mental health questionnaire administered 6–11 years later (2016–17). We included participants who were under antihypertensive treatment and did not have a prior diagnosis of PTSD before the initial assessment. Use of RAS blockers was defined as self-reported regular use, at the initial assessment, of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB). Among participants who experienced adverse life experiences, cases of probable PTSD were defined with the six-item PTSD Checklist-Civilian version score ≥ 14. Logistic regression with inverse probability of treatment weighting was used to estimate the odds ratios (ORs) and 95% confidence interval (CI) for the association between RAS blocker use and the risk of probable PTSD.ResultsOf the 15,954 participants (mean age = 59.9 years; 42.6% women) under antihypertensive treatment with no prior history of PTSD at the initial assessment, 64.5% were taking RAS blockers. After a mean follow-up of 7.5 years, 1,249 (7.8%) were newly identified with probable PTSD. RAS blocker users had a lower risk of probable PTSD than RAS blocker non-users (OR = 0.84 [95% CI: 0.75–0.94]), whereas the use of other antihypertensive medications showed no such association (users vs. non-users; calcium channel blockers, OR = 0.99 [95% CI: 0.88–1.11]; beta-blockers, 1.20 [1.08–1.34]; and thiazide-related diuretics, 1.15 [1.03–1.29]). The association between probable PTSD risk and the use of ACEi vs. ARB showed no significant difference (p = 0.96).ConclusionsAmong individuals under antihypertensive treatment, the use of RAS blockers was associated with a decreased risk of probable PTSD. This added benefit of RAS blockers should be considered in the selection of antihypertensive medications.

Prevalence and Risk Factors of PTSD, Depression, and Grief Among Survivors of 2023 Türkiye Earthquake.

This study investigated the prevalence and risk factors of probable posttraumatic stress disorder (PTSD), depression, and complicated grief among 529 adults residing in a container city, 4 months after the 2023 earthquakes in Türkiye. Participants were assessed using the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, the Hamilton Depression Scale, and the Inventory of Complicated Grief. The prevalence rates of probable PTSD, depression, and complicated grief were 21.4%, 15.9%, and 64.7%, respectively. Logistic regression analyses indicated that PTSD was significantly associated with the loss of a loved one, fear of future earthquakes, and decreased perceived life control. Similarly, depression was associated with being trapped under debris, experiencing fear during the earthquake, and reduced perceived life control. These findings suggest that individuals presenting these risk factors warrant closer follow-up for potential psychological issues. Additionally, the impact of fear related to the earthquake and the role of perceived life control emerge as crucial considerations for psychological interventions.

Trauma reactivation 50 years later: Yom Kippur war veterans after the October 7 attack

Fifty years after the Yom Kippur War began with a surprise attack, the October 7 terror attack caught Israelis off guard in yet another surprise attack. The current study assessed the extent to which Yom Kippur War veterans thought about the linkage between the two wars, and whether such thoughts were associated with trauma reactivation and exacerbation of distress. A web-based random sample of 297 Yom Kippur War veterans (age range 68–88) completed questionnaires five months before (T1) and two months after the October 7 attack (T2). The results showed an increase in probable posttraumatic stress disorder (PTSD) rates due to the Yom Kippur War, rising from 5.4 % in T1 to 13.1 % in T2. Rates of clinical depression and anxiety also rose. The study found that a significant number of veterans experienced intrusive thoughts linking the two wars. These intrusive thoughts increased the risk for probable PTSD and clinical levels of depression and anxiety, even after accounting for pre-attack symptoms. The study is among the first to show that intrusive linkage is quite frequent among older veterans who confronted another event that resonates with their focal trauma. Supporting the stress resolution perspective, this linkage increased the risk for trauma reactivation.

Mental health and perceived consequences in a clinical sample of women featured in video-based pornography

ContextSeveral reports have shed light on the potentially traumatic filming conditions, and violence experienced by women featured in pornography (WP). However, there is a scarcity of research on the mental health of these women, as well as the perceived consequences of participation in Video-based Pornography (VbP). MethodsThirty-six women, recruited through collaboration with WP support groups, completed an online questionnaire covering socio-demographics, pre-VbP violence experiences, and perceived consequences of their participation in VbP. Additionally, participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES-II), and the 13-item Beck Depression Inventory (BDI-13). ResultsThe participants had a mean age of 31.2 years (SD = 7), and the median age at first participation in VbP was 21. A majority (77.8%) reported a lifetime experience of sexual violence before featuring in VbP. All participants reported at least one negative effect of participating in VbP, with three in four women citing cyberbullying following VbP dissemination. Additionally, participants reported a range of physical consequences such as vaginal lesions and sexually transmitted diseases. Thirty women (83%) had a PCL-5 score over 33, indicative of probable PTSD, and 28 women (78%) had a DES-II score of 30 or more, indicating high levels of dissociative symptoms. Furthermore, 19 women (53%) reported a BDI-13 score over 13, suggesting potential severe depression. ConclusionThis study underscores psychosocial vulnerabilities and the presence of severe psychopathology among WP. It also documents their perceptions of negative consequences of participation in VbP, such as cyberbullying, physical injuries, and emotional distress. Further, large-scale studies are needed to substantiate these results and better understand the scale of the problem, as well as to optimize care interventions.

Types and timing of trauma exposure across the life course and maternal hypertension.

Exposure to trauma across the life course may be associated with cardio-metabolic dysfunction during pregnancy; however, previous research has been inconsistent, particularly in highly exposed populations. To estimate associations between types and timing (first occurrence) of trauma exposure and hypertension experienced during pregnancy in a safety-net hospital in Atlanta, Georgia, 2011-2022. Participants completed a 14-item trauma screener. We linked that information to data from the medical record on hypertension (including chronic hypertension, gestational hypertension or preeclampsia). We fit logistic regression models and used the estimates to calculate risk ratios for each trauma type and each critical window (0-9 years, 10-19 and 20+). We fit unadjusted models and adjusted for age, parity and education. We included 704 individuals with a delivery within 12 months following screening. The majority (94%, 661) reported at least one traumatic event, most commonly witnessing violence (79.4%). Overall, 18% experienced gestational hypertension, 10.8% chronic hypertension and 11.9% preeclampsia. Among individuals who reported trauma, 31.5% screened positive for probable posttraumatic stress disorder and 30.9% for probable depression, compared to 0 and 2.3% among those without reported trauma. No trauma type (violence, witnessing violence, non-interpersonal or sexual assault) was associated with increased hypertensive risk, regardless of timing. In this sample with a high trauma and hypertension burden, trauma was not associated with an elevated risk of hypertension during pregnancy, despite a high burden of PTSD and depressive symptoms among people with trauma exposure.

Resilience as a protective factor in the development of post-traumatic stress disorder in patients hospitalised for COVID-19

Introduction and objective: Both the illness itself and hospitalisation due to COVID-19 are potentially traumatic experiences, especially when the course of the disease is severe. Resilience has been identified as a crucial factor in the process of successfully coping with traumatic events and may protect against the development of symptoms of post-traumatic stress disorder. The aim of this study was to determine the role of resilience in the prevention of post-traumatic stress disorder symptoms in patients requiring hospitalisation due to COVID-19. Materials and methods: A total of 138 patients (59 women, 79 men; mean age: 52.34 years; standard deviation, SD = 12.46) hospitalised at the University Hospital in Krakow were included in the study, which was conducted 7–8 months after their COVID-19 diagnosis. The PTSD Checklist for DSM-5 (PCL-5) and the Resilience Measurement Scale (SPP-25) were administered, and stepwise multiple regression analysis was used in the predictive models. Results: A total of 31 participants (22.5%) met the criteria for probable post-traumatic stress disorder symptoms. The study participants were characterised by a moderate level of resilience (5th sten), with women exhibiting lower levels than men. Higher levels of resilience were associated with lower severity of PTSD symptoms. A significant predictor of post-traumatic stress disorder symptoms was “Tolerance for failure and treating life as a challenge”. Conclusions: Resilience has an impact on the severity of symptoms of post-traumatic stress disorder. Specifically, the dimension of “Tolerance” within resilience appears to be an important protective factor against post-traumatic stress disorder symptoms after hospitalisation for COVID-19. Patients hospitalised with severe course of COVID-19 exhibit a moderate level of resilience, with men demonstrating higher resilience levels than women.

Lower Perceived Social Support During Hospitalization by Close Family Members may have Significant Associations with Psychological Distress 1 Month After Cardiac Arrest.

The perception of having poor social support is associated with worse symptoms of psychological distress in close family members of critically ill patients, yet this has never been tested after cardiac arrest. Close family members of consecutive patients with cardiac arrest hospitalized at an academic tertiary care center participated in a prospective study. The validated Multidimensional Scale of Perceived Social Support (MSPSS) cued to index hospitalization was administered before discharge. Multivariate linear regressions estimated the associations between the total MSPSS score and total scores on the Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder 2-item (GAD-2), and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), assessed 1month after cardiac arrest. In 102 participants (mean age 52 ± 15years, 70% female, 21% Black, 33% Hispanic) with complete data, the prevalence of depression, generalized anxiety, and probable posttraumatic stress disorder at a median duration of 28.5days (interquartile range 10-63days) from cardiac arrest was 61%, 34%, and 13%, respectively. A lower MSPSS score was significantly associated with higher PHQ-8 scores (β = - 0.11 [95% confidence interval - 0.04 to - 0.18]; p < 0.01), even after adjusting for family members' age, sex, prior psychiatric condition, and witnessing of cardiopulmonary resuscitation and patient's discharge disposition (β = - 0.11 [95% confidence interval - 0.02 to - 0.15]; p < 0.01). Similarly, significant inverse associations of total MSPSS scores were seen with 1-month GAD-2 and PCL-5 scores. Poor social support during hospitalization, as perceived by close family members of cardiac arrest survivors, is associated with worse depressive symptoms at 1month. Temporal changes in social networks and psychological distress warrant further investigation.

Prevalence of probable post-traumatic stress disorder among survivors of the 2023 earthquakes in Türkiye

Background: Post-traumatic stress disorder (PTSD) is one of the most prevalent conditions following a devastating earthquake or disaster. Aim: To explore the prevalence of probable PTSD and its risk factors among earthquake survivors in Türkiye. Methods: This cross-sectional study examined 1100 survivors, aged ≥ 18 years, in 11 provinces of Türkiye affected by the 2 June 2023 earthquakes. We collected the data 5 months after the earthquakes and measured PTSD using the PTSD checklist for the diagnostic and statistical manual of mental disorders fifth edition (DSM-5), the Connor-Davidson resilience scale, and multidimensional scale of perceived social support. We analysed the data using SPSS version 28. Results: The earthquake survivors were aged 18–89 years, mean age 35.59 years, and more than half of them were female (58.8%). Prevalence of probable PTSD was 55.2%. Multiple logistic regression analysis revealed that prevalence of probable PTSD was predicted by female gender, current smoking, sleep disturbance, chronic disease, being trapped under the rubble, loss of a first-degree relative, post-earthquake sheltering in a tent or container or someone else’s house, high postearthquake anxiety, and low socioeconomic status. Survivors with high psychological resilience had lower probable PTSD prevalence. Conclusion: Prevalence of PTSD was high among our participants and psychological resilience seemed to be a mitigating factor for PTSD. There is therefore a need to focus on improving psychological resilience among earthquake survivors to prevent or minimise PTSD.

A symptom-level perspective on irritability, PTSD, and depression in children and adults

BackgroundAlthough irritability is a prominent clinical manifestation among traumatized populations, its relationships with other psychopathologies are rarely studied. Adopting a symptom-level perspective, this study aimed to explore how symptoms of irritability, posttraumatic stress disorder (PTSD), and depression are associated. MethodThe Brief Irritability Test, the PTSD Checklist for DSM-5, and the Patient Health Questionnaire-9 were used to measure irritability, PTSD, and depression, respectively, in a large sample of trauma-exposed children and adolescents (n = 5454), trauma-exposed adults (n = 4718), and children and adolescents with probable PTSD (n = 556). Exploratory graph analysis (EGA) and network analysis were conducted to examine potential communities and significant relations. ResultsAlthough irritability, PTSD, and depression were highly correlated at the disorder level, EGA results indicated that, at the symptom level, they formed highly stable and dense communities, respectively. Relations across disorders mainly emerged at symptoms related to negative cognition, dysphoria, and suicidal thoughts. Especially, strong transdiagnostic relations across all samples were “negative beliefs” and “suicidal thoughts”, “numbing” and “suicidal thoughts”, “startle” and “moving slowly or restless”, “bothering” and “moving slowly or restless”. Furthermore, irritability symptoms seem more central than PTSD and depression symptoms, with “snap” being the most central node across all networks, especially in the child and adolescent sample. ConclusionIrritability, PTSD, and depression are relatively independent constructs when analyzed at the symptom level. Irritability symptoms emerged as core symptoms in trauma-exposed populations. Our findings highlight the importance of independent assessment of irritability in the diagnosis and treatment of PTSD.

Clinical correlates of irritability, anger, hostility, and aggression in posttraumatic stress disorder.

Although irritability, anger, and aggression are diagnostic symptoms of posttraumatic stress disorder (PTSD), their clinical significance and associations with psychopathology remain unclear. In a sample of community adults with probable PTSD (n = 151), we measured irritability, physical aggression, verbal aggression, anger, and hostility with the Brief Irritability Test and the Brief Aggression Questionnaire. Participants' psychopathology, including depression, attention deficit and hyperactivity disorder (ADHD), psychotic-like experiences, insomnia, as well as suicidal behaviors were also assessed. Correlation analysis showed that irritability and anger were modestly related to all PTSD dimensions; physical aggression was related to avoidance, negative alterations in cognitions and mood (NACM), and hyperarousal; hostility was related to reexperiencing, NACM, and hyperarousal; while verbal aggression was not significantly related to any PTSD dimensions. After adjustment for trauma exposure and PTSD symptoms, irritability was associated with almost all psychopathology and suicidal behaviors, however, anger, hostility, and aggression were sparsely related to some psychopathology or suicidal behaviors. Particularly, anger was only related to ADHD and insomnia. Latent profile analysis based on PTSD, irritability, anger, hostility, and aggression indicated two discrete subgroups: the high severity group (33.8%) and the low severity group (66.2%), with high severity group reporting higher rates of comorbidity and suicidal behaviors. The findings support irritability, aggression, anger, and hostility as separate constructs; moreover, irritability, anger, and aggression should be independently measured in PTSD. Our findings also suggest the significance of irritability as a separate hallmark of PTSD and the need to incorporate PTSD dimensions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Surviving the storm: Wave-wise comparison of the pandemic's impact on mental health dynamics, sleep patterns, and preventive behaviors among coronavirus patients in Northern India.

Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear. It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales. The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives. The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.

Response styles to positive affect during a positive psychology intervention for veterans with PTSD and moral injury: Preliminary results from a moral elevation intervention pilot trial.

Veterans with posttraumatic stress disorder (PTSD) or moral injury are at risk of maladaptive response styles to positive emotions, such as emotional numbing. A potential pathway to target problematic responses to positive affect is a positive psychology intervention that elicits moral elevation-feeling inspired after witnessing someone perform a virtuous act. This study aims to examine responses to positive affect in a pilot trial of a web-based moral elevation intervention titled, MOVED: Moral Elevation Online Intervention for Veterans Experiencing Distress Related to PTSD and Moral Injury. Method: Veterans who reported moral injury distress and probable PTSD were randomized into an intervention or control condition (n = 48). We examined repeated measures data during the trial and focused on three subscales of the Response to Positive Affect Questionnaire: rumination on positive mood and somatic experiences (emotion-focus), rumination on positive aspects of the self and pursuit of relevant goals (self-focus), and efforts to dampen positive moods (dampening). Three multilevel models were fitted with time and condition as predictors and subscale scores as outcomes. Qualitative data reported at intervention sessions was also reviewed and coded based on the three subscales. Veterans in the MOVED condition reported more positive rumination than the control condition for both emotion-focus (b = 2.70, p = .023) and self-focus styles (b = 2.90, p = .003). There was no group difference in the dampening style. Qualitative responses after elevation-eliciting exercises and session-based goals were most frequently coded as including emotion-focused positive rumination, followed by dampening, then self-focused rumination. These results provide preliminary evidence that a moral elevation intervention might contribute to positive responses to positive affect in a sample predisposed to emotional numbing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Validation of the PCL-5 in Dutch trauma-exposed adults

BackgroundThe PTSD Checklist for DSM-5 (PCL-5) is an internationally widely used self-report questionnaire that can be used to screen for probable diagnosis of posttraumatic stress disorder (PTSD). Information on the psychometric properties of the Dutch PCL-5 is currently lacking.ObjectiveWe aimed to validate the Dutch PCL-5 in a sample of Dutch adults with prior (suspected) serious injury and establish the optimal cut-off for probable PTSD diagnosis herein.MethodsData for the current study were collected as part of a long-term follow-up measurement of the TraumaTIPS cohort, where adults admitted to an emergency department following (suspected) serious injury completed a follow-up measurement 12–15 years post-trauma. Of N = 333 eligible participants, n = 192 (57.7%) consented and completed the PCL-5 alongside self-report instruments measuring depression (QIDS), PTSD (IES-R), and quality of life (WHO-QOL and EQ-6D). In total, n = 185 participants also completed a clinician administered interview for PTSD (CAPS-5). Most participants were men (66%) and on average 54 years old (SD = 12.41). We evaluated the diagnostic utility of the PCL-5 using Youden index and tested reliability and convergent validity.ResultsThe PCL-5 demonstrated excellent diagnostic accuracy with a cut-off point of 16 resulting in an optimal Youden index (0.90) for screening purposes with a high sensitivity (1.00) and specificity (0.90). A cut-off of 22 yielded a slightly lower Youden index (0.84) but better positive predictive value (0.50 instead of 0.33) than the cut-off of 16. A cut-off of 29 resulted in the most accurate prevalence estimates. The PCL-5 showed a high internal consistency (Cronbach’s α = 0.94), excellent inter-item and item-total correlations and good convergent validity (r > .5 for CAPS-5, IES-R and QIDS).ConclusionsThe PCL-5 is a reliable and valid measurement for PTSD symptoms and probable diagnosis and shows excellent screening abilities in Dutch adults with prior (suspected) serious injury, with a lower optimal cut-off compared to previously found in clinical populations. We recommend a cut-off of 22 for screening purposes and a cut-off of 29 for prevalence estimates in Dutch trauma-exposed adults.

Co-occurring experiences of traumatic events and substance use among young people

ObjectiveHarmful substance use among young people is concerningly prevalent. Substance use disorder (SUD) and post-traumatic stress disorder (PTSD) frequently co-occur in treatment settings and are well researched among adults but lacking among young community cohorts. The aim of this study was to explore the prevalence and relationship between substance use, SUD, trauma, and PTSD among a community sample of young people in Australia. MethodA cross-sectional examination of data collected from participants (n = 1007, 48.9 % male) aged 18–22 years (M = 20 years, SD = 0.44), who took part in the 7-year follow-up of a cluster RCT of school-based substance use prevention interventions: The Climate and Preventure (CAP) study. A series of regressions were conducted to examine the relationship between trauma-related variables and substance use outcomes. Results48.3 % experienced a traumatic event (median = 2, range = 1–11) and of those 10.9 % met a probable PTSD diagnosis. Median age of first trauma exposure was 14 years (range = 0–21). 89.9 % used substances; 73.1 % reported binge drinking, and 35.6 % met a probable diagnosis of SUD (alcohol/cannabis). Those who experienced any traumatic event had almost 1.5 times greater odds of binge drinking. Cannabis use was significantly associated with most trauma-related variables. Sexual trauma exposure was the only trauma type significantly associated with all substance use variables. ConclusionsThis study demonstrated that substance use/SUD and experiences of trauma/PTSD are prevalent among a community sample of young people. Importantly, substance use among young people is associated with experiencing a traumatic event, particularly sexual and physical types of traumatic events, and developing PTSD.

Experiences of attending prenatal ultrasounds during the COVID-19 pandemic in Australia: A cross-sectional survey.

Prenatal ultrasounds form an important part of routine maternity care in Australia and indeed internationally. The COVID-19 pandemic necessitated rapid changes in society and healthcare to curb transmission, with evidence demonstrating detrimental impacts on childbearing women associated with these restrictions. However, experiences with pandemic restrictions for prenatal ultrasounds in relation to distress, patient expectations, and satisfaction are largely unknown. This study aimed to explore the experiences of pregnant women attending prenatal ultrasound during the pandemic in Australia. A cross-sectional online survey of people in Australia who had undergone at least one prenatal ultrasound during the period of maternity care restrictions was performed. The survey included validated tools for assessing post-traumatic stress, satisfaction, and expectations with maternity care. A total of 1280 responses were obtained. Almost 37% of respondents returned a PCL-C score consistent with probable post-traumatic stress disorder. Unexpected ultrasound findings or a high PCL-C score were more likely to have higher expectations and lower levels of satisfaction with their maternity care experience. Having an ultrasound for pregnancy loss, fetal abnormality, and/or a prior post-traumatic stress disorder diagnosis were the strongest factors correlating with a high PCL-C score. The prevalence of post-traumatic stress symptoms in the study population is concerning and elucidates the distress experienced in association with prenatal ultrasounds during pandemic restrictions in Australia. Maternity services should acknowledge the high levels of service consumers with post-trauma symptoms and consider trauma-responsive maternity care adaptations in response to adverse perinatal outcomes for those afflicted with post-trauma and distress-related symptoms.

The effects of potentially traumatic events on the recovery from pre-existing anxiety and depression symptomatology and the risk of PTSD.

The extent to which recent potentially traumatic events (PTEs) hinder the recovery from pre-existing mental health problems is largely unknown. The same applies to the extent to which non-recovery from pre-existing mental health problems increases the risk of posttraumatic stress disorder (PTSD). The aim of the present study is to gain insight in these effects. Data were extracted from six annual surveys of the Dutch population-based Victims in Modern Society (VICTIMS) study. Of the adult respondents who participated in two subsequent surveys (labeled T1 and T2, n = 6942), those with severe anxiety and depression symptoms (ADS) at T1 (n = 487) were selected. We distinguished respondents exposed to PTEs (PTE-group, n = 162) and not exposed to PTEs (comparison group, n = 325) between T1 and T2. We applied five indicators of recovery [based on the Reliable Change Index (RCI), degrees of symptom reduction, and the cut-off score at T2]. Differences in the recovery from ADS and probable PTSD at T2 were examined using multivariate logistic regression. The PTE group less often recovered from severe ADS between T1 and T2 than the comparison group according to all five indicators of recovery, while controlling for 11 different variables (0.40 ≤ adjusted OR's ≤ 0.66). Those in the PTE group who did not recover, considerably more often suffered from probable PTSD at T2 (63%-82%) than those who did recover (0%-29%; 8.96 ≤ adjusted OR ≤ 26.33). Recent potentially traumatic events hinder the recovery from pre-existing anxiety and depression symptomatology and thereby increase the risk of probable PTSD.