PSTD Symptoms Research Articles

Posttraumatic Stress Disorder, Personal Identity, and Meaning in Life in U.S. Veterans

ABSTRACT We examined whether higher levels of posttraumatic stress disorder (PTSD) symptoms and gender were associated with three dimensions of identity (i.e., commitment, in-depth exploration, and reconsideration) and meaning in life (i.e., meaning in life and search for meaning) among recent-era veterans. Participants were 174 post-9/11 veterans (55.8% men; mean age = 36.4 years; SD = 10.1 years) who had experienced one or more deployments. After controlling for combat exposure, age, and time since military separation, more PTSD symptoms were associated with lower presence of meaning in life, lower commitment, lower in-depth exploration, and higher reconsideration. The PTSD symptoms by gender interaction, the association between PSTD symptoms and search for meaning, and direct effects of gender were not significant. These findings suggest the importance of developing a comprehensive conceptualization, which includes identity and meaning in life, for recent-era veterans with PTSD symptoms.

Psychological impact of COVID -19 pandemic on frontline health care workers in Bangladesh: A cross-sectional study

This study aimed to estimate the prevalence of depression, anxiety, post-traumatic stress disorder, and insomnia symptoms among frontline health workers during the corona virus disease 19 (COVID-19) pandemic in Bangladesh and to compare these between medical and allied health workers. We conducted a cross-sectional survey between June and August 2020. A total of 479 health care professionals participated in the study. Anxiety and depression were measured using Patient Health Questionnaire-4 (PHQ-4), post-traumatic stress disorder (PTSD) was measured by primary care post-traumatic stress disorder score (PC-PTSD score), and insomnia was measured by Insomnia Severity Index (ISI). We performed logistic regression to assess risk factors associated with psychological symptoms. Overall, prevalence of anxiety, depression, PTSD and insomnia symptoms were 17.6%, 15.5%, 7.6% and 5.9%, respectively. Compared to allied health workers, doctors had significantly higher prevalence of symptoms of anxiety: doctor versus allied health care worker; 21.1% vs 06%, (OR= 4.19; 95% CI= 1.88-9.35; p <0.001); depression: 18% vs 6.8%, (OR= 2.99; 95% CI= 1.40-6.42; p 0.005); PTSD: 9.4% vs 1.7%, (OR= 5.96; 95% CI= 1.41-25.11; p 0.015) and insomnia: 7.4% vs 0.9%, (OR= 9.22; 95% CI= 1.24-68.4; p 0.03),respectively. The logistic regression analysis showed pre-existing medical illness as a predictor of anxiety (OR= 2.85; 95% CI= 1.71-4.76; p <0.001) and depressive symptoms (OR= 2.29; 95% CI= 1.39-3.77; p 0.001). Working more than 6(six) weeks in COVID-19 dedicated hospitals was significantly associated with PSTD symptoms (OR= 2.83; 95% CI= 1.35-5.93; p 0.006) and insomnia (OR= 2.63; 95% CI= 1.15-6.02; p 0.022). Our study demonstrated a high prevalence of symptoms of depression, anxiety, PTSD, and insomnia among Bangladeshi frontline health workers during the COVID-19 pandemic. BSMMU J 2021; 14 (COVID -19 Supplement): 22-29

The impact of COVID-19 pandemic outbreak on education and mental health of Chinese children aged 7\u201315\u2009years: an online survey

BackgroundThe emerging of psychological problems triggered by COVID-19 particularly in children have been extensively highlighted and emphasized, but original research in this respect is still lagging behind. Therefore, we designed this study to evaluate the impact of COVID-19 pandemic on mental health and the effectiveness and attitudes towards online education among Chinese children aged 7–15 years.MethodsA detailed questionnaire, comprising of 62 questions was designed and parents or caretakers of 7 to 15 years old children were invited to participate via WeChat, a multi-purpose messaging, social media and mobile payment app, which is widely used by the Chinese population. A total of 668 parents across different regions of China were included.ResultsDuring COVID-19 pandemic, 20.7 and 7.2% children report experiencing post-traumatic stress disorder (PTSD) and depressive symptoms due to the COVID-19 pandemic. PTSD and SMFQ-P scores are significantly higher in middle school and boarding school students compared to primary and day school students. Multiple logistic regression analysis revealed that school system and province of origin are factors significantly associated with developing PSTD symptoms. 44.3% respondents feel online education is effective in gaining knowledge and improving practical and communications skills. 78.0% believe the online education system is efficient. Overall 79.8% respondents are satisfied and children can adapt to this new education system. During the COVID-19 pandemic, we found 1 in five children have PTSD and 1 in 14 children have depressive symptoms.ConclusionIn summary, COVID-19 epidemic has caused PTSD and depression symptoms among Chinese children aged 7 to 15 years. In general, a large proportion of respondents are satisfied with online education, but still a substantial proportion of students are not comfortable with this new form of learning. Authorities should optimize online education systems and implement effective interventions to cope with the psychological effects of COVID-19 on children, as it is affecting the global population and remains uncertain when it will end.

Prevalence of Post-traumatic stress symptoms in recovered patients of COVID-19 in Pakistan

This investigation aims to scrutinize prevalence of Post-Traumatic Stress (PTSD) symptoms in recovered patients of COVID-19. The study implemented a quantitative approach through circulation of an online google survey with nonprobability purposive convenient sampling strategy. The chosen assessment measure of PTSD Checklist for DSM-5 (PCL-5) was administered on 200 participants on 07th day of recovery during period of observation. In addition, Regression statistical analysis was performed for data analysis and results indicated a moderate prevalence of PSTD symptoms in females as compared to Male. Overall proneness towards PTSD is calculated as 45.6% among the respondents (R-square = 0.456). Thorough consideration of ethical parameters is enforced by several procedures comprising informed consent, right to withdraw, disposal of data, and confidentiality. The current study would act as a basis for future researches to reduce the prevalence of psychological issues that patients face during this period of pandemic and would help in catering suitable interventions for the patients.

Pilot exploration of post-traumatic stress symptoms in intensive care unit survivors in Cyprus.

Approximately, 20% of intensive care unit (ICU) survivors develop post-traumatic stress disorder (PTSD) symptoms. Although Davidson Trauma Scale (DTS) provides a comprehensive approach to PSTD symptoms, there is no evidence on DTS-I-M use in ICU survivors. To validate the modified intensity Davidson Trauma Scale (DTS-I-M) (wherein the frequency and severity subscales are combined to express symptoms intensity) in a convenience sample of ICU survivors in Cyprus, and to explore the prevalence of PTSD symptoms and related predictors. An instrument validation design, along with a cross-sectional, correlational study design was employed. Translation and cultural adaptation of the instrument were achieved through a group of experts and pilot testing. The DTS-I-M was administered via telephone. Participants' clinical data (length of ICU stay [LOS], mechanical ventilation duration [MVD], admission diagnosis, medication history) and demographics (age, gender) were collected. Non-parametric comparisons, and regression analyses to identify predictors of DTS-I-M scores and PTSD symptoms were employed. The Cypriot DTS-I-M version demonstrated high test-retest (Pearson's r = 0.928, P < .001) and internal consistency (Cronbach's [α] alpha = .97) reliability in a sample of 69 ICU survivors (62.7% response). About 36.2% of participants reported PTSD symptoms. Factor analysis confirmed the construct validity of the DTS-I-M, and a 3-factor structure (encompassing intrusive, avoidance, hyperarousal, mood, and cognitive symptoms). In a multiple regression, MVD (B = -3.11, OR [95% CI] = 22.58 [3.07-166.09, P = .002]) and LOS (r2 = 0.302, P = .002) were statistically significant predictors of DTS-I-M score. We confirm the applicability of the DTS-I-M for the assessment of PTSD symptoms in ICU survivors; and offer preliminary evidence on the prevalence and predictors of post-ICU PTSD symptoms in Cyprus. DTS-I-M is an appropriate screening tool for PTSD symptoms after ICU hospitalization. Patients with longer MVD and LOS are at higher risk for post-ICU PTSD symptoms and seem to experience more intense relevant symptoms.

Imagery rescripting for the treatment of trauma in voice hearers: a case series

High rates of trauma and post-traumatic stress disorder (PTSD) are reported in people who hear voices (auditory hallucinations). A recent meta-analysis of trauma interventions in psychosis showed only small improvements in PSTD symptoms and voices. Imagery Rescripting (ImRs) may be a therapy that is more effective in this population because it generalizes over memories, which is ideal in this population with typically repeated traumas. The primary aims of this study were to investigate whether ImR reduces (1) PTSD symptoms, and (2) voice frequency and distress in voice hearers. We used a single arm open trial study, case-series design. Twelve voice hearers with previous traumas that were thematically related to their voices participated. Brief weekly assessments (administered in sessions 1-8, post-intervention, and at 3-month follow-up) and longer measures (administered pre-, mid- and post-intervention) were administered. Mixed regression analysis was used to analyse the results. There was one treatment drop-out. Results of the weekly measure showed significant linear reductions over time in all three primary variables - voice distress, voice frequency, and trauma intrusions - all with large effect sizes. These effects were maintained (and continued to improve for trauma intrusions) at 3-month follow-up. On the full assessment tools, all measures showed improvement over time, with five outcomes showing significant time effects: trauma, voice frequency, voice distress, voice malevolence and stress. The findings of the current study suggest that ImRs for PTSD symptoms is generally well tolerated and can be therapeutically beneficial among individuals who hear voices.

Correlates of Post-Traumatic Stress Disorder diagnosis among rape survivors: Results and implications of a South African study

This study aimed to describe factors associated with the experience of Post-Traumatic Stress Disorder (PTSD) among rape survivors. Participants were female survivors attending a treatment centre in South Africa (black = 85%, coloured = 15%; age range = 18 to 55 years). Data were collected through interviewing all rape survivors who agreed to participate in this study, using the Post Traumatic Diagnostic Scale-5 (PDS-5). Descriptive statistics, chi-square, phi-crammer, and regression analysis were used to determine the relationship of PTSD and the demographic data. About 74.5% of rape survivors had high PSTD, and PSTD symptoms were most elevated among those with high religiosity. These results show that PTSD is a reality for the majority of rape survivors, and that those with a strong religious belief system are at elevated risk for PTSD.

The application of bundle care prevention in preventing postoperative posttraumatic stress disorder of adult patients undergoing cardiac surgery

Objective To explore the effect of bundle of care on the prevention of the postoperative posttraumatic stress disorder(PTSD) symptoms of patients undergoing cardiac surgery. Methods A total of 95 patients treated in our hospital from January 2013 to July 2014 were chosen as the control group, and 95 patients treated in our hospital from August 2014 to December 2015 were selected as the observation group.Patients of the control group received roution nursing care and others in the observation group received bundle of care.Then the PLC-C was used to evaluate the positive incidence(recovery phase, 3 months and 6 months) and level of PSTD symptoms of the two groups.The positive incidence, the average scores of PTSD symptoms at different phases (recovery phase, 3 months and 6 months) and the occurance rate of 3 symptoms of PTSD was analyed and compared. Results The positive incidence of PTSD symptoms of the observation group was significantly lower than that of the control group(P<0.05), and the scores of PTSD symptoms of the observation group were lower than that of the control group(P<0.05). Conclusions The application of bundle care prevention in preventing postoperative posttraumatic stress disorder of adult patients undergoing cardiac surgery at ICU period can effectively reduce the positive incidence of PTSD symptoms and keep the symptoms at a low level, thus to ensure the nuring quality. Key words: Cardiac surgery; PTSD(posttraumatic stress disorder); Bundle of care

Modeling the Indirect Association of Combat Exposure With Anger and Aggression During Combat Deployment: The Moderating Role of Perceived Unit Morale

Anger and aggression are common combat-related behavioral health problems. The impact of combat on anger and aggression appears to be largely attributable to symptoms of posttraumatic stress disorder (PTSD). Factors that moderate the purported pathway from combat to anger and aggression are poorly understood. We examined the conditional direct and indirect associations of combat exposure with self-reported anger and aggression using survey data collected from 592 U.S. Soldiers during a combat deployment in Afghanistan. Unit morale was examined as a moderator between combat exposure and PSTD symptoms, as well as the indirect association of combat exposure with anger and aggression via PTSD symptoms, controlling for depression symptoms. Results indicated that unit morale was negatively correlated with PTSD symptoms and self-reported anger and aggressive behaviors. Perceptions of unit morale moderated the direct association of combat exposure with PTSD symptoms. Unit morale also moderated the indirect association of combat exposure with anger and aggression through PTSD symptoms. Unit morale moderated the association of combat exposure with anger and aggression during combat operations by putatively mitigating the deleterious effect of combat on stress-related symptoms. The impact of policy and leadership on soldier and unit morale should be carefully considered given its protective role during combat operations.

The Effects of Intimate Partner Violence Exposure on the Maternal Bond and PTSD Symptoms of Children.

The quality of the maternal bond can be disrupted in women exposed to intimate partner violence (IPV), causing them to be less available to their children. The aim of this study was to examine difficulties in emotional regulation in women exposed to IPV and the impact of IPV on both the maternal bond and posttraumatic symptoms among children. A cross-sectional study was carried out with two groups: IPV dyads ( n = 36) comprising mothers who had been exposed to IPV and their children, and control dyads ( n = 27) comprising non-abused mothers and their children. Information was obtained via structured interviews including scales regarding IPV, posttraumatic stress disorder (PTSD) symptoms, maternal bond, and difficulties in emotional regulation. Correlation analyses showed a positive association between the severity of IPV, PTSD symptom severity in children, and difficulties of emotional regulation in mothers. They also showed a negative association between IPV and the quality of the maternal bond. Regression models demonstrated that exposure to sexual IPV, maternal difficulties in emotion regulation, and younger age of the mother are important predictors of lower quality of the maternal bond. Difficulties in emotional regulation and sexual IPV disrupted the quality of the maternal bond among women and their children. In addition, lower quality of maternal bond was associated with higher PSTD symptoms among children.

Wounds that can't be seen: Implicit Trauma Associations predict posttraumatic stress disorder symptoms

Background and objectivesProminent theories suggest that explicit and implicit cognitive biases are critical in the development and maintenance of posttraumatic stress disorder (PTSD). However, studies evaluating implicit PTSD-related cognitive biases are rare, and findings are mixed. We developed two adaptions of the Implicit Association Test (IAT), the “traumatized self” IAT (evaluations of the self as traumatized vs. healthy) and the “dangerous memory” IAT (evaluations of remembering as dangerous vs. safe), and investigated their psychometric properties and relations to PTSD symptoms and trauma exposure. MethodsParticipants were visitors to the Project Implicit research website (Study 1: N = 347, Study 2: N = 501). They completed the IATs (Study 1: both IATs; Study 2: traumatized self IAT only), a trauma exposure measure, a PTSD symptom inventory, and explicit cognitive bias measures (Study 2 only). ResultsBoth IATs had good internal consistency, but only the traumatized self IAT was correlated with PSTD symptoms and identified participants meeting clinical cutoffs for PTSD symptoms. Study 2 focused on the traumatized self IAT and included explicit cognitive bias measures. The IAT correlated with PTSD symptoms and explicit cognitions, and predicted variance in PSTD symptoms above and beyond trauma exposure and explicit cognitions. LimitationsStudy designs were cross-sectional; samples were unselected; and PTSD symptoms were self-reported. ConclusionsDespite these limitations, these studies provide preliminary validation of an implicit measure of PTSD-related cognitive bias – the traumatized self IAT – that is consistent with PTSD theories and may ultimately improve the identification and treatment of individuals with PTSD.

Negative emotions, childbirth pain, perinatal dissociation and self-efficacy as predictors of postpartum posttraumatic stress symptoms

Objective: The aim of the study was to assess the contribution of negative emotions, childbirth pain, perinatal dissociation, and feelings of self-efficacy to the development of posttraumatic stress disorder (PTSD) symptoms following childbirth. Patients and methods: A prospective longitudinal study was carried out on 98 women from the south of France area. Four questionnaires were completed at 2–3 days postpartum: the Peritraumatic Emotions List (PEL), the French version of the McGill Pain Questionnaire, the Peritraumatic Dissociative Experience Questionnaire (PDEQ) and the Childbirth Self-efficacy Inventory (CBSEI). The Impact of Event Scale-Revised (IES-R) assessing posttraumatic stress symptoms was also completed 6 weeks after delivery. Results: Pain and negative emotions were significant predictors of the intensity of posttraumatic stress symptoms at 6 weeks postpartum. Although higher levels of pain contribute to increased PSTD symptoms, and higher negative emotion also contributes to PTSD symptoms, the effect of pain on PSTD is stronger when there are high levels of negative emotion. Discussion and conclusion: Our findings highlight that pain, negative emotions and their interaction were significant predictors of posttraumatic stress symptoms and confirm the importance of developing more specific treatments focusing on support and prevention.

Suicide and War: The Mediating Effects of Negative Mood, Posttraumatic Stress Disorder Symptoms, and Social Support among Army National Guard Soldiers

The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard soldiers (N=4,546). Results from structural equation modeling suggested that war experiences may precipitate a sequence of psychological consequences leading to suicidality. However, suicidality may be an enduring behavioral health condition. War experiences showed no direct effects on postdeployment suicidality, rather its effect was indirect through PTSD symptoms and negative mood. War experiences were, however, predictive of PTSD symptoms, as would be expected. PSTD symptoms showed no direct effect on postdeployment suicidality, but showed indirect effects through negative mood. Results also suggested that suicidality is relatively persistent, at least during deployment and postdeployment. The percentage of those at risk for suicide was low both during and after deployment, with little association between suicidality and time since returning from deployment. Additionally, few soldiers were initially nonsuicidal and then reported such symptoms at postdeployment. Implications of relationships of both negative mood and combat trauma to suicidality are discussed, as well as possible mediating effects of both personal dispositions and social support on relationships of war experiences to PTSD, negative mood, and suicidality.

Eye tracking and visual attention to threating stimuli in veterans of the Iraq war

Theoretical and clinical characterizations of attention in PTSD acknowledge the possibility for both hypervigilance and avoidance of trauma-relevant stimuli. This study used eye tracking technology to investigate visual orientation and attention to traumatic and neutral stimuli in nineteen veterans of the Iraq war. Veterans saw slides in which half the screen had a negatively valenced image and half had a neutral image. Negatively valenced stimuli were further divided into stimuli that varied in trauma relevance (either Iraq war or civilian motor vehicle accidents). Veterans reporting relatively higher levels of PSTD symptoms had larger pupils to all negatively valenced pictures and spent more time looking at them than did veterans lower in PTSD symptoms. Veterans higher in PTSD symptoms also showed a trend towards looking first at Iraq images. The findings suggest that post-traumatic pathology is associated with vigilance rather than avoidance when visually processing negatively valenced and trauma-relevant stimuli.

Is tonic immobility the core sign among conventional peritraumatic signs and symptoms listed for PTSD?

BackgroundPrevious studies suggested the importance of peritraumatic reactions as predictors of PSTD symptoms severity. Despite mounting evidence that tonic immobility occurs under intense life threats its role as predictor of PTSD severity remains by and large understudied. The objective of this study was to investigate the role of peritraumatic reactions (tonic immobility, panic and dissociation) as predictors of PTSD symptoms severity. MethodsParticipants were 32 victims of urban violence with PTSD diagnosed through the SCID-I. In order to evaluate PTSD symptoms at baseline, we used the Post-Traumatic Stress Disorder Checklist — Civilian Version. To assess peritraumatic reactions we employed the Physical Reactions Scale, the Peritraumatic Dissociative Experiences Questionnaire and Tonic Immobility questions. As confounding variables, we considered negative affect (measured by the Positive and Negative Affect Schedule — Trait Version), sex and time elapsed since trauma. ResultsTonic immobility was the only predictor of PTSD symptoms severity that kept the statistical significance after controlling for potential confounders. LimitationsThis study was based on a relatively small sample recruited in a tertiary clinic, a fact that may limit the generalizability of its findings. The retrospective design may have predisposed to recall bias. ConclusionsOur study provides good reason to conduct more research on tonic immobility in PTSD with other samples and with different time frames in an attempt to replicate these stimulating results.