PTSD Checklist-Civilian Version Research Articles

The Trauma Recovery Clinic: A Stepped Collaborative Care Model for Trauma Surgery Patients to Address Health Disparities.

Background: The Trauma Recovery Clinic (TRC) was developed to meet the psychiatric, psychological, and psychosocial needs of traumatically injured patients following discharge from a level-I trauma center. The objective of this study is to demonstrate the efficacy of the TRC as an application of the stepped collaborative care model in order to address health disparities.Methods: Patients with a history of inpatient treatment for a physically traumatic injury at this level-I trauma center were approached and enrolled at initial TRC outpatient appointments. Data was collected, including the PTSD Checklist-Civilian Version (PCL-C), the Patient Health Questionnaire (PHQ-9), the Attitudes towards Guns scale, and the Youth Behavior Risk Survey (questions about weapon carrying practices).Results: A total of 80 patients were included in this study. Patients expressed several social determinants of health risk factors, with 60% of the sample reporting witnessing someone being wounded or killed. Results demonstrated a significant decrease in trauma symptoms (T24 = 3.33; P = .001, d = 0.67) and depressive symptoms (T24 = 2.23, P = .02, d = 0.45) by their 6th clinic visit. Additionally, patients reported significant improvements in role limitations due to emotional problems (T25 = 1.74; P = .04; d = 0.34) and social functioning (T25 = 2.23; P = .02; d = 0.43). Interestingly, patients who reported carrying a weapon in the last 30 days reported significantly higher trauma symptoms (T64 = 3.21, P = .002) and depressive symptoms (T64 = 2.77, P = .007).Discussion: This evaluation of services at the recently implemented Trauma Recovery Clinic demonstrated that the clinic is successfully treating individuals who have experienced traumatic injuries. More specifically, the clinic services are effectively engaging a vulnerable, hard-to-reach patient population.

Posttraumatic stress symptoms during treatment in parents of children diagnosed with cancer

The study aimed to study the presence of PTSS in parents of children with cancer currently on treatment and the association of PTSS in parents with cancer during treatment with length of time since diagnosis and treatment intensity. The study was conducted on 360 parents at a Tertiary Care Government Medical College and Cancer Hospital. The participants were subjected to the questionnaire PTSD Checklist Civilian Version (PCL-C) scale, to assess PTSS and Oncologists rated the intensity of each child's treatment. The most common age group in the parents was of young adults 25-34years [255(71%)]. Majority of parents were male 288(80%). It was found that PTSD was present in majority of parents [235(65.27%]. On statistical analysis, no significant relationship was found between PTSS in mothers and fathers (p=0.1664). There was no significant relationship between PTSS and the length of time since diagnosis in both mothers (P=0.85) and fathers (P=0.32). No significant relationship was found between the intensity of treatment and PTSD in mothers on statistical analysis (p<0.3). While PTSD in fathers showed significant correlation with the intensity of treatment of the child (p<0.05). There are very few studies regarding examining emotional distress of parents of children with malignancies in our country. Hence, studying PTSS in parents of children with cancer seems to be significant and more research needs to be done in this area.

Posttraumatic Stress Disorder Symptoms and Cardiovascular and Brain Health in Women

Posttraumatic stress disorder (PTSD), cardiovascular disease (CVD), and Alzheimer disease are major public health issues, particularly for women. The implications of PTSD for cardiovascular and brain health for women is poorly understood. To assess whether PTSD symptoms among midlife women are associated with carotid intima media thickness (IMT), an indicator of carotid atherosclerosis; brain white matter hyperintensity volume (WMHV), an indicator of brain small vessel disease; and cognitive performance and to test a modifying role of the APOEε4 genotype. In this cross-sectional study, participants were enrolled between 2016 to 2021 and completed questionnaires (PTSD Checklist-Civilian Version), physical measures, phlebotomy, neuropsychological testing, a carotid ultrasonographic examination, and 3-Tesla brain magnetic resonance imaging. Participants included community-based women ages 45 to 67 years without a history of CVD, stroke, or dementia. Data were analyzed from July 2022 to September 2023. PTSD symptoms. Outcomes of interest were associations of PTSD symptoms with carotid IMT, brain WMHV, and cognition, assessed in linear regression models. Interactions by APOEε4 were tested. Covariates included age, race and ethnicity, education, and CVD risk factors. Among 274 participants (mean [SD] age, 59.03 [4.34] years; 6 Asian participants [2.2%]; 48 Black participants [17.5%]; 215 White participants [78.5%]; 5 multiracial participants [1.8%]), 64 participants (24.71%) were APOEε4 genotype carriers. Higher PTSD symptoms were associated with greater carotid IMT (multivariable β = 0.07 [95% CI, 0.01 to 0.13]; P = .03). Associations of PTSD symptoms with neurocognitive outcomes significantly varied by APOEε4 status. Among women with APOEε4, PTSD symptoms were associated with greater whole-brain WMHV (β = 0.96 [95% CI, 0.30 to 1.63]; P = .009), periventricular WMHV (β = 0.90 [95% CI, 0.24 to 1.56]; P = .02), deep WMHV (β = 1.21 [95% CI, 0.23 to 2.20]; P = .01), and frontal WMHV (β = 1.25 [95% CI, 0.05 to 2.45]; P = .04), as well as with poorer cognition, specifically attention and working memory (β = -3.37 [95% CI, -6.12 to -0.62]; P = .02), semantic fluency (β = -6.01 [95% CI, -10.70 to -1.31]; P = .01), perceptual speed (β = -12.73 [95% CI, -20.71 to -4.75]; P = .002), and processing speed (β = -11.05 [95% CI, -17.80 to -4.30]; P = .002) in multivariable models. In this cross-sectional study of midlife women, greater PTSD symptoms were associated with higher carotid atherosclerosis and, among women who were APOEε4 carriers, greater brain small vessel disease and poorer cognitive performance. These findings point to the adverse implications of PTSD symptoms for cardiovascular and neurocognitive health among women in midlife, particularly for women who are APOEε4 carriers.

Stress and influencing factors of public health and preventive medicine students in the post-pandemic period: a cross-sectional study in Changsha, China.

Little is known about the stress levels and associated factors of public health and preventive medicine students in the post-pandemic period. This study aims to investigate the stress levels of these students in the post-COVID-19 era and to determine the association of personal background, employment attitude, and psychological state with stress. A cross-sectional survey was conducted in March 2023 among 620 public health and preventive medicine students from two universities in Changsha, China. The survey included demographic characteristics, employment attitudes, perceived stress scale 10, general anxiety disorder 7, the University of California at Los Angeles loneliness scale 20, and the PTSD checklist-civilian version. Two-sided t-tests and ANOVA tests were used to compare the differences in PSS scores among variables, and multiple hierarchical regression analysis was used to evaluate the associated factors with stress. The survey was completed by 504 students (mean age: 21.5 ± 2.6 years, 69.2% female). 24.8% of the students were screened for a high level of stress. 69.0% thought the epidemic positively impacted employment while 18.5% believed it had a negative impact. The results of regression analysis showed that older age (B = 0.42, p = 0.001), higher grade (3.59, p < 0.001, 4.57, p < 0.001), having internship experiences (B = 1.16, p = 0.006), having anti-epidemic experiences (B = 1.77, p < 0.001), believing that COVID-19 has a negative impact on employment (B = 2.56, p < 0.001), and having higher GAD scores (B = 0.64, p < 0.001) and UCLA scores (B = 0.07, p = 0.002) were significantly associated with high-stress levels. Conversely, being female (B = -1.64, p < 0.001) and believing that the pandemic had a positive impact on employment (B = -1.98, p = 0.001) were associated with low-stress levels. Public health and preventive medicine students in Changsha, China, experienced a high-stress level in the post-pandemic period, which was influenced by age, gender, grade, employment attitude, internship experience, anxiety, and loneliness. As one of the main guardians of the epidemic, these students should be given more attention and psychological interventions in the future.

Impact of Meditation on the Level of Post-traumatic Stress in Flood Victims of Sindh

This study aimed to find whether meditation can be effective in terms of post-traumatic stress(PSTD) or not. The purpose of this current study was to analyse the flood victims specifically (IDPs) by the influence of meditation on state post-traumatic stress. Guided meditation is helpful in reduction of the stress. The study analyses how meditation reduces the post-traumatic stress of IDP flood victims. The study is experimental in nature. The survey was conducted from N= 100 participants IDPs by using convenience sampling. SPSS used to quantify the data. The measure used in the research was the 3.7 PTSD checklist civilian version of the flood exposure questionnaire to collect the data from Internally displaced persons. First, for the pre-test, it was provided before the meditation and the second time it was given after the guided meditation for the post-test. The result of the research supports that PTSD can be reduced by meditation.

Morally injurious combat events as an indirect risk factor for postconcussive symptoms among veterans: The mediating role of posttraumatic stress.

Psychosocial factors, including combat-related distress (e.g., posttraumatic stress disorder [PTSD]), contribute to postconcussive symptoms (PCS) among veterans with mild traumatic brain injury (mTBI). However, research on risk factors for PCS has focused solely on life-threatening combat experiences, neglecting the morally injurious dimension of combat-related trauma and associated implications for treatment. Morally injurious events (MIEs) are associated with PTSD symptoms among veterans, a robust risk factor of PCS. Nonetheless, the interplay between MIEs, PTSD symptoms, and PCS remains poorly understood. We sought to investigate MIEs as an indirect risk factor for PCS among Veterans with mTBI. This cross-sectional study of 145 veterans with mTBI used path analysis to investigate whether PTSD symptoms mediated the relationship between MIEs (transgressions and betrayals) and PCS (mood-behavioral, vestibular-sensory, and cognitive domains) among 145 veterans with mTBI. We used the Moral Injury Event Scale, PTSD Checklist-Civilian Version, and Neurobehavioral Symptom Inventory to measure MIEs, PTSD, and PCS, respectively. Perceived transgressions were indirectly associated with mood-behavioral (β = .21, p = .005), vestibular-sensory (β = .17, p = .005), and cognitive PCS (β = .20, p = .005), as mediated by PTSD. Greater transgressions were associated with more severe PTSD (β = .27, p = .003), and greater PTSD was associated with more severe mood-behavioral (β = .79, p < .001), vestibular-sensory (β = .64, p < .001), and cognitive PCS (β = .73, p < .001). Betrayals were not indirectly associated with PCS. Findings offer preliminary support for responses to MIEs being a modifiable risk factor for PCS among veterans. Interventions designed to foster veterans' recovery by targeting the unique emotions and beliefs associated with MIEs may be indicated. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Landslide disasters in eastern Uganda: post-traumatic stress disorder and its correlates among survivors in Bududa district

BackgroundPost-traumatic stress disorder is the commonly reported psychiatric morbidity among the survivors of natural disasters. However, its prevalence particularly in Bududa, Eastern Uganda is largely unknown.Aims and objectivesTo assess the prevalence and correlates of post-traumatic stress disorder among Bududa landslide survivors.MethodsA community-based cross-sectional study was conducted on a sample of 587 participants. The study setting was the Bududa district, with a multistage sampling method. Pre-tested, administered interviewer PTSD Checklist–civilian version was used as screening tools between 4th and April 29th 2022. Data were analyzed using descriptive and binary logistic approaches at a 5% level of significance.ResultsOf the study participants, 276 (46.8%) had PTSD symptoms. Among the respondents, 250 (42.6%) were in the age range of 40 and above, 396 (67.3%) were female, 284 (48.4%) had no formal education, and 333 (56.7%) were married. Results showed that male gender (AOR: 0.47; 95% CI 0.31–0.73; p = 0.001), widowhood (AOR: 0.44; 95% CI 0.21–0.94; p = 0.034), lack of counseling (AOR: 0.44; 95% CI 0.21–0.94; p = 0.001), and duration since the landslide (AOR: 0.35; 95% CI 0.23–0.52; p = 0.001) were associated with an increased likelihood of screening for PTSD in landslide survivors.ConclusionLandslides pose significant effects on the mental health of survivors. In the present study, the extent of PTSD among survivors is substantially high. male gender,, widowhood, lack of counselling, low social support, and duration since the landslide were significantly associated with PTSD. Effective screening and awareness programs among survivors should be strengthened for the prevention and treatment of psychiatric morbidity among the survivors of landslides.

The impact of social quarantine on the living status and mental health of the elderly in the Wuhan community: one year after Wuhan COVID-19 blockade

PurposeIn order to control the corona virus disease-2019 (COVID-19) pandemic, many countries have adopted social quarantine policies, with older adults in Wuhan suffering the longest and most severe conditions. But few studies have explored the impact of this on the mental health of older adults in Wuhan. The purpose of this paper is to examine changes in the residential status and mental health of this group when 1 year after the social isolation policies in Wuhan.MethodA cross-sectional study with convenience sampling was conducted to assess the questionnaire of older adults in a total of 21 streets in 5 central and 2 distant urban districts of Wuhan. Using a self-compiled living status questionnaire, the Patient Health Questionnaire-9, the General Anxiety Disorder-7, the PTSD Checklist-Civilian Version, the UCLA Loneliness Scale and the Social Support Rating Scale, our survey evaluated the living status, depression, anxiety, post-traumatic stress symptoms, loneliness and social support of all the participants.ResultsA total of 400 valid samples were obtained. One year after experiencing social isolation, older adults had not changed much from their pre-epidemic living status and mostly lived with their partners. They had satisfactory social support (33.86 ± 6.92) and low levels of depression (3.12 ± 4.30), anxiety (1.52 ± 3.19) and post-traumatic stress symptoms (21.41 ± 7.39), but there were moderate levels of loneliness (38.27 ± 9.31). Among them, depression, anxiety and post-traumatic stress symptoms were significantly higher (ps < 0.05) in older adults who were COVID-19 close contacts while experiencing social isolation.ConclusionOne year after experiencing Wuhan’s harsh social isolation, older adults in the Wuhan community did not experience significant symptoms of depression, anxiety or post-traumatic stress, but loneliness has increased and the mental health of older adults who were COVID-19 close contacts needs attention.

A latent profile analysis of emotional expression among patients with unintentional injuries

BackgroundEmotional expression has been suggested to affect the well-being of individuals with unintentional injuries. However, few studies have investigated it as a heterogeneous phenomenon. The purpose of this study was to characterize the patterns of emotional expression among patients with unintentional injuries using latent profile analysis, and to examine the relationship among these latent profiles and cognitive processing, posttraumatic growth, and posttraumatic stress disorder.MethodsA cross-sectional study was carried out at two general hospitals in Wenzhou, China. In total, 352 patients with unintentional injuries completed the socio-demographic questionnaire, Berkeley Expressivity Questionnaire, Ambivalence Over Emotional Expression Questionnaire, Event-Related Rumination Inventory, the Posttraumatic Growth Inventory, and PTSD Checklist-Civilian Version. ResultsThree unique profiles were identified: high emotional expressivity (n = 238, 67.6%), moderate emotional expressivity (n = 45, 12.8%), and low emotional expressivity (n = 69, 19.6%). The ANOVA and chi-square tests demonstrated significant differences among the three groups concerning deliberate rumination and posttraumatic growth. Multinomial logistic regression analysis indicated that monthly income and time since injury significantly predicted profile membership.ConclusionsMost patients showed high emotional expressivity after an unintentional injury. Emotional expression profiles were associated with deliberate rumination and posttraumatic growth. Emotional expression interventions tailored for different profiles are warranted after an unintentional injury.

The Role of Mental Adjustment in Mediating Post-Traumatic Stress Disorder Symptoms and Social Support in Chinese Ovarian Cancer Patients: A Cross-Sectional Study.

BackgroundPost-traumatic stress disorder (PTSD) can manifest in individuals following a traumatic event. There is a paucity of studies focusing on PTSD symptoms in ovarian cancer (OC) patients. This study aimed to investigate the association of social support, mental adjustment and PTSD symptoms in Chinese OC patients with a view to exploring whether mental adjustment could mediate the relationship.MethodsA cross-sectional study was conducted from January 2015 to December 2016. A total of 171 OC subjects were recruited and the effective response rate was 81.3%. The PTSD Checklist-Civilian Version (PCL-C), Mini-Mental Adjustment to Cancer scale (Mini-MAC) and Duke-UNC Functional Social Support Questionnaire were disseminated to the patients. The Chinese Mini-MAC was used in this study focusing on three components, namely negative emotion, positive attitude, and cognitive avoidance. Hierarchical linear regression analyses were employed to investigate the association of social support and PTSD symptoms, and the role of mental adjustment in their mediation.ResultsThe prevalence of PTSD symptoms was 17.3% in OC patients. PTSD symptoms were negatively related with both social support and positive attitude, and positively associated with negative emotion and cognitive avoidance. Social support was negatively associated with negative emotion and cognitive avoidance, and positively related with positive attitude. In addition, negative emotion and positive attitude mediated the association between social support and PTSD symptoms.ConclusionPTSD symptoms in OC patients should be paid attention to. Social support and mental adjustment were positive resources associated with PTSD symptoms. Moreover, mental adjustment could mediate the relation between social support and PTSD symptoms in OC patients. Therefore, intervention management that focusing on improving perceived social support as well as strengthening mental adjustment, especially negative emotion and positive attitude, may be useful for reducing PTSD symptoms in this context.

The Influence of Family-Oriented Enabling Psychological Nursing on Posttraumatic Stress and Fear of Recurrence in Patients with Cervical Cancer.

Objective. The incidence of cervical cancer is high, which seriously threatens the life and health of women. At present, there were few studies on the application of family-oriented enabling psychological nursing in patients with cervical cancer. So, the purpose of this study was to explore the effect of family-oriented enabling psychological nursing on posttraumatic stress and fear of recurrence in patients with cervical cancer. The clinical data of 236 patients with cervical cancer treated in our hospital from January 2020 to December 2021 was retrospectively analyzed. According to different nursing methods, they were assigned to convention group (105 cases accepted the conventional nursing) and psychology group (131 cases accepted the family-oriented enabling psychological nursing). The PTSD Checklist-Civilian Version (PCL-C) scores, Fear of Progression Questionnaire-Short Form (FoP-Q-SF) scores, Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) scores, and satisfaction rates of the two groups were compared. It turned out that the PCL-C score, FoP-Q-SF score, and CARES-SF score decreased in the psychology group and the convention group (P < 0.05) and the decreases of those three scores were more obvious in the psychology group. In comparison with the convention group, the nursing satisfaction rate of psychology group was higher (96.18% vs. 76.19%, P < 0.05). It could be concluded that family-oriented enabling psychological nursing had definite clinical application value in patients with cervical cancer, which could alleviate the symptoms of posttraumatic stress disorder and reduce the fear of recurrence, stabilize the perioperative psychological state, facilitate treatment, and improve the quality of life and satisfaction rate of patients and was worthy of promotion and application.

Prevalence Of Psychosocial Issues Among Internally Displaced Children by Military Wars in District Khyber

Internally Displaced Persons (IDPs) are those who have been forced to leave their homes to avoid the impacts of armed war, violence, and other forms of violence. Human rights violations or natural or man-made calamities have occurred, but they have not passed an internationally recognized state border. Objective: To identify the psychosocial effects created by military wars on the internally displaced children of District Khyber, Khyber Pakhtunkhwa, Pakistan Methods: For this purpose, 300 children were selected randomly, out of which 150 were males and 150 were females. These 300 children belonged to the middle and the secondary school of the same District and were internally displaced because of military wars. Data was collected using PTSD Checklist-Civilian Version (PCL-C) questionnaire and demographic information sheet and responses were recorded and analyzed using a SPSS version 24 software. Results: The p-value of less than 0.001 indicated that children belonging to year 2002 were victimized of war the most and had severe psychosocial effects. The factors such as loss of housing, family, finances, employment and the lack of accessibility to health care services had direct correlation with the increase in psychosocial impacts. Conclusion: It is concluded that females and children of middle and secondary schools were most affected

The protective role of parental involvement at home in negative psychological outcomes among Chinese adolescents during the COVID-19 epidemic

BackgroundThe COVID-19 outbreak has generated many negative psychological outcomes, such as depression, in adolescents. Exploration of protective factors for adolescent mental health is urgently needed, and no research has examined the role of parental involvement. MethodsFrom March to April 2020, valid data were collected from 1663 Chinese adolescents through online demographic and other questionnaires. Parental involvement at home was assessed by an adapted questionnaire on parental support in learning at home, stress since the COVID-19 outbreak was measured by the Perceived Stress Scale, and three negative psychological outcomes (i.e., depression, anxiety, and posttraumatic stress symptoms (PTSS)) were measured by the Center for Epidemiologic Studies Depression Scale, Zung Self-rating Anxiety Scale, and PTSD Check List-Civilian Version, respectively. ResultsIn total, 35.4%, 21% and 25% of adolescents had depression symptoms, anxiety symptoms, and PTSS, respectively. Three moderated mediation models consistently showed the following: a. Parental involvement indirectly reduced the three psychological problems by alleviating perceived stress, and the indirect effects were not moderated by sex. b. There were negative direct effects of parental involvement on the three psychological problems, and the links were not moderated by sex. c. Sex moderated the associations between perceived stress and the three psychological problems. LimitationsThe cross-sectional design and the sampling of all participants from one junior high school impeded causal inferences and the generalization of our findings, respectively. ConclusionsWe found similar indirect and direct protective roles of parental involvement in boys' and girls' mental health, and girls were more vulnerable to stress.

Psychiatric reactions among the non-exposed population who viewed disaster-related short videos: Evidence from the 2021 Henan floods

Media-triggered mental disorders are common when people experience traumatic events. However, few studies have examined the underlying mechanism of how viewing disaster-related short videos triggers psychiatric reactions among non-exposed populations in the context of today's media ecology. Moreover, limited studies have employed psychological network analysis to comprehensively disentangle the associations between diverse forms of media exposure and psychological symptoms. To fill these research gaps, we conducted a survey on a non-exposed population (N = 516) during the 2021 Henan floods to test the effects of short video exposure on its mental status. Short video exposure behaviors were measured under 12 different scenarios, and the participants' mental status (i.e., depression, anxiety, and post-traumatic stress disorder [PTSD]) was measured using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder (GAD-7) scale, and PTSD Check List-Civilian version (PCL-C). We employed both correlation and psychological network analyses to make estimations. The descriptive results revealed that short video exposure behaviors among almost all scenarios were positively associated with the scores of PHQ-9, GAD-7, and PCL-C. The network analysis revealed that both depression and anxiety were associated with the “Support (SVP)” scenario, whereas PTSD was directly linked to the “Help Seeking (SVP)” scenario. Among the three networks, “Help Seeking (SVP)” was the most central among the 12 scenarios of short video exposure. The central symptoms for depression, anxiety, and PTSD were “Concentration,” “Relax,” and “Reliving Trauma,” respectively. The shortest paths between the central short video exposure item and central symptom among the three networks consisted of only two or three steps. This study's findings could assist researchers and policymakers in undertaking novel disaster-related practical activities worldwide.

Impact of middle- and long-distance running on mental health in college students in Guangzhou during COVID-19 outbreak

To investigate the impact of middle- and long-distance running on mental health of students in a college in Guangzhou during the COVID-19 outbreak. We collected data using online questionnaires from the college students selected via snowball sampling. After exclusion of invalid questionnaires and matching the data of running exercise with physical test scores of the participants, 1022 questionnaires were deemed valid for analysis. Of the 1022 students, 869 completed at least a 60-km running distance each semester as required and 153 students did not complete the task. The mental health status of the students was evaluated using PTSD Checklist-Civilian Version (PCL-C), Zung Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The scale scores were compared between the students who completed the running task and those who did not, and the factors affecting anxiety and depression were analyzed using univariate analysis and binary logistic regression. The students who completed the running task had significantly higher physical test scores than those who did not complete the task (P < 0.05). The PCL-C, SDS, SAS scale scores or the conditions of PTSD, anxiety, and depression did not differ significantly between two groups (P>0.05). Binary logistic regression analysis indicated that completing the running task or not did not affect the condition of PTSD, anxiety, or depression of the students; a higher physical test score was associated with a decreased risk of PTSD (OR=0.98, 95%CI: 0.97-0.99) and depression (OR=0.99, 95%CI: 0.97-1.00) but an increased risk of anxiety (OR=1.02, 95%CI: 1.01-1.04) during COVID-19 outbreak. Regular middleand long-distance running exercise may enhance the physical health to indirectly promote the mental health of the college students during COVID-19 outbreak.

The Associations between Coping Strategy Use and Patient-Reported Outcomes in Patients with Acute Myeloid Leukemia

Background: Patients with acute myeloid leukemia (AML) who receive intensive chemotherapy must cope with immense physical and psychological symptoms associated with a variety of patient-reported outcomes (PROs) such as quality of life (QOL). Although coping is critical to the management of an AML diagnosis and its treatment, data characterizing the use of coping strategies and its associations with PROs in the AML population are limited. Hence, we characterize coping strategy use among patients with AML and examine the associations between coping strategy use, psychological distress, and QOL.Methods: We used cross-sectional secondary data analyses to describe coping in 160 patients with newly diagnosed high-risk AML enrolled in a multi-site randomized supportive care trial. We used the Brief COPE, Hospital Anxiety and Depression Scale (HADS), PTSD Checklist-Civilian Version (PCL-C), and Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) within 72 hours of patient initiation of chemotherapy, to measure coping strategies, psychological distress and QOL, respectively. We grouped coping strategies into two higher-order domains of coping based on prior literature: approach-oriented coping (i.e., use of emotional support, active coping, positive reframing, acceptance) or avoidant coping (i.e., self-blame, denial, behavioral disengagement). We used the median split method for the distribution of coping domains. We used multivariate regression models adjusting for age, gender and diagnosis type (newly diagnosed vs. relapsed/refractory AML) to assess the relationship between coping and PROs.Results: Participants (median age of 64.4 years) were mostly non-Hispanic White (86.3%), male (60.0%), and married (73.8%). Most (51.9%) reported high utilization of approach-oriented coping strategies (e.g., emotional support) whereas 38.8% reported high utilization of avoidant coping strategies (e.g., denial) (Figure 1). At the time of AML diagnosis, use of approach-oriented coping was associated with less psychological distress and better QOL (Table 1). Use of avoidant coping was associated with more psychological distress and worse QOL. Additionally, patients who used multiple approach-oriented coping strategies had less psychological distress and better QOL (Table 2). In contrast, patients who used multiple avoidant coping strategies had more psychological distress, and worse QOL.Conclusions: Our study illustrates that most patients with high-risk AML utilize both approach-oriented and avoidant coping strategies. Our results also reveal links between approach-oriented coping strategies, less psychological distress, and better QOL. These findings underscore the need for early integration of supportive oncology interventions that help patients to cultivate approach-oriented coping strategies. [Display omitted] DisclosuresBrunner: Novartis: Consultancy, Research Funding; BMS/Celgene: Consultancy, Research Funding; Takeda: Consultancy, Research Funding; Acceleron: Consultancy; Agios: Consultancy; Keros Therapeutics: Consultancy; GSK: Research Funding; Aprea: Research Funding; AstraZeneca: Research Funding; Janssen: Research Funding. Fathi: AbbVie: Consultancy, Honoraria, Research Funding; Takeda: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; Blueprint: Consultancy, Honoraria; Seattle Genetics: Consultancy, Honoraria; Astellas: Consultancy, Honoraria; Daiichi Sankyo: Consultancy, Honoraria; Genentech: Consultancy, Honoraria; Trillium: Consultancy, Honoraria; Kura: Consultancy, Honoraria; Foghorn: Consultancy, Honoraria; Kite: Consultancy, Honoraria; Morphosys: Consultancy, Honoraria; Ipsen: Consultancy, Honoraria; Agios: Consultancy, Honoraria, Research Funding; Servier: Research Funding; Celgene/BMS: Consultancy, Honoraria, Research Funding. LeBlanc: Seattle Genetics: Consultancy, Other: Advisory board, Research Funding; Pfizer: Consultancy, Other: Advisory Board; AstraZeneca: Consultancy, Honoraria, Other: Advisory board, Research Funding; UpToDate: Patents & Royalties; American Cancer Society: Research Funding; Agios: Consultancy, Honoraria, Other: Advisory board; Travel fees, Speakers Bureau; BMS/Celgene: Consultancy, Honoraria, Other: Travel fees, Research Funding, Speakers Bureau; Daiichi-Sankyo: Consultancy, Honoraria, Other: Advisory board; Flatiron: Consultancy, Other: Advisory board; Astellas: Consultancy, Honoraria, Other: Advisory board; AbbVie: Consultancy, Honoraria, Other: Advisory board; Travel fees, Speakers Bureau; Otsuka: Consultancy, Honoraria, Other; Jazz Pharmaceuticals: Research Funding; Duke University: Research Funding; Helsinn: Consultancy, Research Funding; Heron: Consultancy, Honoraria, Other: advisory board; CareVive: Consultancy, Other, Research Funding; NINR/NIH: Research Funding; Amgen: Consultancy, Other: travel.

Understanding risk and protective factors to UK railway workers' mental wellbeing during the COVID-19 pandemic: a cross-sectional survey

BackgroundFrontline railway workers have provided an essential service throughout the COVID-19 pandemic. Although railway workers are known to be at risk of developing traumatic stress-related conditions, little is known about the effects of COVID-19 on the mental wellbeing of railway workers in the UK. We tested two hypotheses: (1) increased scores in COVID-19-related risk factors will predict decreased mental wellbeing and (2) protective factors will mediate the relationship between COVID-19-related risk factors and mental wellbeing. MethodsThe study consisted of a cross-sectional online survey exploring the effects of COVID-19 on the mental wellbeing of railway workers (n=906) in the UK, using data collected during third lockdown (between Dec 1, 2020, and March 24, 2021). The survey, advertised on social media and internal platforms of the Associated Society of Locomotive Engineers and Firemen, included measures of COVID-19-related risk factors (COVID-19 Perceived Risk Scale, COVID-19 Stress Measure, COVID-19 Burnout Scale, and PTSD Checklist–Civilian Version) and protective factors (brief resilience coping, team resilience, general help-seeking questionnaire) associated with mental wellbeing (Warwick Edinburgh Mental Wellbeing Scale–Short Form). We analysed responses via multiple regression and parallel mediation analyses. Open-ended questions, exploring railway workers' views of risks and protective factors for their mental wellbeing, were analysed using content analysis. The institutional ethics committee granted ethical approval and participants gave informed consent. FindingsCOVID-19 related risk factors negatively predicted wellbeing (r2=0·50, F=273·556 [3 variables, n=813], p<0·0001). Protective factors significantly mediated the relationship between wellbeing and burnout (indirect effect [IE] –0·0252, 95% CI –0·0364 to –0·0152), stress (IE –0·0252, –0·0364 to –0·0152), post-traumatic stress disorder (IE –0·0311, –0·0493 to –0·0145), and risk perception (IE –0·0244, –0·0411 to –0·0089). Content analysis found self-reported mental health decline throughout the COVID-19 pandemic, perceived loss of workplace supports, need for psychological support, and concerns for the future. InterpretationThese findings emphasise the importance of adaptive coping and team-based resilience in alleviating the negative impact that COVID-19 has on railway workers' mental wellbeing and in preventing burnout. Work-based supports and access to psychological input for railway workers who need it is highlighted. Building a resilient railway workforce moving forward requires attention to staff mental wellbeing and to ensuring that support systems are robust and accessible. FundingNone.

The importance of adaptive coping, peer support, psychological input, team resilience, and supportive management among fire and rescue service workers in maintaining wellbeing throughout the COVID-19 pandemic: a cross-sectional survey

BackgroundIdentifying wellbeing concerns among fire and rescue service workers (FRSWs) during COVID-19 is crucial to ensuring a safe and effective service is provided by these keyworkers. FRSWs are known to be at risk of developing traumatic stress-related conditions; however, little is known about the effects of COVID-19 stressors on the mental wellbeing of FRSWs. We tested two hypotheses: (1) COVID-19-related stressors (ie, risk perception, stress, burnout, and post-traumatic stress disorder [PTSD]) will predict decreased mental wellbeing and (2) protective factors will mediate the relationship between COVID-19 stressors and mental wellbeing. MethodsThe study consisted of a cross-sectional online survey exploring the effects of COVID-19 on the mental wellbeing of FRSWs (n=555) in the UK, using data collected during third lockdown (between Jan 25 and March 31, 2021). The survey, advertised on social media and fire and rescue service intranets, included the COVID-19 Perceived Risk Scale, Stress Measure, Burnout Scale, PTSD Checklist–Civilian Version, and the Warwick Edinburgh Mental Wellbeing Scale. FRSWs' perspectives on what they found helpful in maintaining their wellbeing throughout the pandemic were also explored. Quantitative data were assessed via a regression model and mediation analysis, and content analysis was done on the qualitative data collected through open-ended questions asking FRSWs about the effects on COVID-19 on their mental wellbeing and their support needs. The institutional ethics committee granted ethical approval and participants gave informed consent. FindingsNegative associations between lower scores on mental wellbeing and higher scores on COVID-19 risk factors were found for COVID-19-related stress (r=−0·49, p<0·0001) and burnout (r=−0·62, p<0·0001) scores. The independent variables, COVID-19 risk perception, stress, burnout, and PTSD outcomes, accounted for 50·90% of variance (F=118·00 [5–543], p<0·0001) and were each significant in contributing to the model. The overall mediation model was significant (F=341·14 [1–553], p<0·001) explaining 38·50% of the variance, with team resilience and adaptive coping significantly contributing towards the model. Qualitative data analysis showed that FRSWs' emphasised the need for psychological input, peer support, supportive management, and visible leadership when adapting to the challenges of the pandemic and maintaining wellbeing. InterpretationRisks to FRSWs' mental wellbeing associated with COVID-19 stressors might be buffered by fostering team-based resilience, adaptive coping, and peer support. Offering psychological input for FRSWs who need it and adopting a trauma-informed work environment is encouraged. Supportive management and visible leadership could help FRSWs to adapt to the constant change and challenges associated with COVID-19 and in preparedness for transitioning from the response to the recovery phase of the pandemic. FundingNone.

IL-10: A possible immunobiological component of positive mental health in refugees

ObjectiveAs the number of refugees continues to rise, there is growing concern about the impact from trauma exposures on their mental health. However, there is a limited understanding of possible biological mechanisms contributing to the substantial inter-individual differences in trauma-related outcomes, especially as it relates to positive mental health. Only sparse work has focused on the biology of positive mental health, including energy and sleep, in trauma-exposed persons. In this study, we analyzed cytokines in blood from newly arrived refugees with differential trauma exposures in relationship to self-reported energy, as a key marker of positive mental health. MethodsWithin the first month of arrival in the USA, 64 refugees from Iraq and Syria were interviewed. Refugees completed the clinical DSM-IV PTSD-Checklist Civilian Version (PCL-C), the Beck Anxiety Inventory (BAI), and the Hospital Anxiety and Depression Scale (HADS). Ten psychiatrically healthy non-refugee persons were used as healthy controls to compare levels of cytokines. Blood samples were collected at the time of the interview and subsequently analyzed for IL-1β, IL-6, IL-8, IL-10, and TNF-α concentrations. ResultsEnergy correlated positively with current concentration ability and sleep quality, and negatively with stress, PCL-C, BAI and HADS scores (Spearman correlations, all p<0.05). Refugees had lower levels of IL-10 compared to controls (p<0.05). IL-10 levels in refugees correlated with higher energy levels (p<0.01). ConclusionsResults suggest that self-reported energy is a key component of positive mental health in newly arrived traumatized refugees. Additionally, the anti-inflammatory cytokine IL-10 could be a marker of, or causally associated with positive mental health. A better understanding of the balance between pro- and anti-inflammatory states in highly traumatized individuals has the potential to create more targeted and effective treatments with implications for long-term health outcomes.

Psychological Sequelae of Covid 19 Calamity on Medical Personnel in Pakistan

Aim: To gauge the physiological sequelae of covid-19 pandemic on medical personnel in Pakistan. Place &amp; duration: An online cross sectional study was conducted from May, 2020 to August, 2020 in Lahore. Methodology: 17 score PTSD check list civilian version was used to assess the symptoms of post-traumatic stress disorder in medical personnel. Results: Mean post-traumatic stress score (PTSS) was 39±15 with a range of 18-89. 66% (n=240) of the participants experienced moderate to extreme stress level. Chi Square test was used to determine an association between higher stress level and age, gender and staff category. Higher stress scores were associated with females (p&lt;0.01). Conclusion: Rewarding the health personnel with gratitude, acknowledgement, financial compensations and provision of personal protective equipments (PPEs) can halt the psychological sequelae and is a promise to win this battle. Keywords: SARS coV2, Covid 19, PTSD, Health personnel