Risk For Posttraumatic Stress Disorder Research Articles

2873 Post traumatic stress disorder in older adults after delirium: a systematic review

Abstract Introduction Post-traumatic stress disorder (PTSD) is an anxiety disorder caused by frightening or traumatic events. Delirium is a state of acute confusion associated with acute illness, surgery, and hospitalisation. Delirium is known to be associated with a risk of PTSD in patients in the Intensive Care (ICU) setting. However, there is limited information on the prevalence of delirium in older adults outside of Intensive Care. We therefore undertook a systematic review to ascertain the prevalence of PTSD in elderly patients after an episode of delirium on a general ward. Methods The systematic review was conducted using MEDLINE (1946–10/01/2024), Embase (1974–10/01/2024), and PsycINFO (1806–10/01/2024) to identify studies. Studies were eligible if they included adults aged ≥65 years, admitted to an acute hospital, diagnosed with delirium using a validated screening tool, (e.g. 4AT, CAM-ICU) and subsequently screened for PTSD at any point following discharge with a validated screening tool (e.g. the PTSS-14). The exclusion criteria excluded ICU cohorts and terminal illness with <3 months life expectancy. Two researchers (SM, NM) independently reviewed all studies with any disparities resolved through a 3rd researcher (AM). Results After removal of duplicates, the search identified 1042 titles from which only 3 eligible studies were identified. All 3 studies were in older patients after surgical procedures (n = 132 participants in total). Two of the studies reported no association between delirium and the subsequent risk of PTSD. However, the largest study (n = 77) reported a significant independent association between delirium and the 3-month risk of PTSD. Conclusion The current body of research on the prevalence of PTSD following episodes of in-patient delirium in older adults is limited. The findings of this review highlight the need for further research. A prospective cohort study on Geriatric Medicine wards is being planned.

Assessment of risks of post-traumatic stress disorder among Ukrainian military personnel as a component of public health preservation

The paper is focused on exploring the potential impact of Post-Traumatic Stress Disorder (PTSD) among combatants on the national public health system. It utilizes scientific statistical data on the prevalence of PTSD symptoms among military personnel who have participated in armed conflicts worldwide over the past 50 years. For a deeper analysis of PTSD's potential influence on Ukraine's public health system, the research examines scientific data on major somatic and mental health disorders triggered by PTSD among military personnel. The study highlights the association between PTSD in combatants and the development of comorbid conditions such as depression, substance dependency, diabetes, and cardiovascular diseases. PTSD is identified as a key risk factor that should be accounted for when planning medical and preventive measures for Ukraine's Defense Forces. The article also analyzes global trends in the declining quality of life among military personnel due to reduced material and functional capabilities. It provides data on the direct and indirect costs of treatment and rehabilitation for PTSD and its associated comorbidities. Furthermore, the article discusses PTSD's impact on self-actualization abilities, such as education, employment, job retention, and interpersonal communication. These effects, resulting from PTSD's disruption of various aspects of life, inevitably lead to negative consequences and a sharp decline in the quality of life for affected individuals.

Identifying ICU survivors and relatives with post-traumatic stress disorder using text mining: An explorative study.

A quarter of ICU-patients develop post-traumatic stress disorder (PTSD) after discharge. These patients could benefit from early detection of PTSD. Therefore, we explored the accuracy of text mining with self-narratives to identify intensive care unit (ICU) patients and surviving relatives at risk of PTSD in a pilot study. In this prospective cohort study with self-administered questionnaires, discharged ICU-patients and surviving relatives participated. In a single centre study at a 32-bed ICU of a large teaching hospital, we used an online screening tool with self-narratives, to identify ICU-patients and surviving relatives at risk of PTSD using text mining. Study variables were Trauma Screening Questionnaire (TSQ) and self-narratives, administered 3 to 6months after ICU discharge. Of the participants 15% had an indication of PTSD based on TSQ. The median length of the self-narratives was 101 words. Using self-narratives, PTSD was predictable with a reasonable performance (AUROC of 0.67), compared to TSQ as gold standard. The most important words of the prediction model were 'happen' 'again' and 'done'. These words are difficult to interpret without context. It is possible to predict risk of PTSD for ICU-patients and surviving relatives using text mining applied on self-narratives, 3 to 6months after ICU discharge. The model performance is reasonable and helps to identify patients and surviving relatives at risk. Based on the large proportion of participants with an indication for PTSD, it remains important to persuade patients and surviving relatives to seek help when experiencing mental health problems after discharge.

Prediction models for post-traumatic stress disorder in family members of ICU patients: A systematic review.

Several predictive models have been developed for post-traumatic stress disorder (PTSD) in intensive care unit (ICU) family members. However, significant differences persist across related studies in terms of literature quality, model performance, predictor variables and scope of applicability. This study aimed to systematically review risk prediction models for PTSD in family members of ICU patients, to make recommendations for health care professionals in selecting appropriate predictive models. China National Knowledge Infrastructure, VIP database, Wanfang database, SinoMed, PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Embase and OVID were searched from inception to 1 May 2024. Two independent researchers conducted literature screening, data extraction and applied a risk of bias assessment tool for predictive models to evaluate included studies. The systematic review was registered on PROSPERO (registration number: CRD42024560815). Seventeen studies were included, with sample sizes ranging from 32 to 2734. Incidence rates of outcomes ranged from 1.6% to 63.6%. The most frequently used predictors were relative's female sex, longer duration of ICU stay, patient's death in the ICU and type of relationship with the patient. Two models reported area under the receiver operating characteristic curve (AUC) values ranging from 0.73 to 0.74; only three models reported calibration, and one study conducted internal validation. Overall, the 17 studies showed good applicability but exhibited a high risk of bias, particularly in data analysis. Research on predictive models for PTSD risk in family members of ICU patients is in the developmental stage. Future studies should validate existing models or develop high-performance localized predictive models. PTSD can have a significant impact on the families of ICU patients, making early identification of high-risk populations essential for health care professionals to implement timely interventions.

Firearm injury survivors report extreme high risk for poor physical and mental health outcomes early after hospital discharge necessitating multidisciplinary care

BackgroundUp to 20–40% of survivors of any traumatic injury develop post-traumatic stress disorder (PTSD) or depression after injury. Firearm injury survivors may be at even higher risk for adverse outcomes....

Cardiovascular risk and allostatic load in PTSD: The role of cumulative trauma and resilience in affected and trauma-exposed adults.

The pathophysiology of posttraumatic stress disorder (PTSD) involves dysregulation of stress-sensitive biological systems due to repeated trauma exposure, predisposing individuals to the development of cardiovascular disease (CVD). Allostatic load (AL), an indicator of maladaptive stress responses, could shed light on the underlying biological mechanisms. We determined whether CVD risk and AL were associated with trauma load and resilience in women with PTSD and trauma-exposed controls (TEC). Adults with PTSD N=114 and TEC N=95 were administered the Clinician Administered Posttraumatic Stress Disorder Scale for DSM-5, to assess for current PTSD diagnosis and severity, the Life Events Checklist for DSM-5 for lifetime exposure to potentially traumatic events (cumulative trauma) and the Connor-Davidson Resilience Scale. An AL score was calculated as a sum of dichotomous variables from four physiological systems (neuroendocrine, metabolic, cardiovascular, and inflammatory). CVD risk was assessed with the South African Framingham risk score. In patients with PTSD, cumulative trauma was associated with higher AL (p=0.04) and CVD risk (p=0.02). In TEC, AL was inversely associated with resilience (p=0.04). There was a significant interaction between cumulative trauma and resilience on AL (p=0.009) in PTSD cases, with a stronger association between cumulative trauma and AL in those with higher resilience. Resilience may have differential detrimental and protective effects on AL in individuals with PTSD and TEC. Cumulative trauma exposure may, independently, increase the likelihood of high AL and CVD risk in PTSD, with resilience moderating this effect. Remaining resilient while experiencing PTSD symptoms may impose a biological strain that could have long-term harmful effects.

Prognostic models for depression and post-traumatic stress disorder symptoms following traumatic brain injury: a CENTER-TBI study

BackgroundTraumatic brain injury (TBI) is associated with an increased risk of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). We aimed to identify predictors and develop models for the...

Sex Differences in the Comorbidity between Attention Deficit-Hyperactivity Disorder and Posttraumatic Stress Disorder: A Systematic Literature Review and Meta-Analysis.

Attention Deficit-Hyperactivity Disorder (ADHD) and Posttraumatic Stress Disorder (PTSD) are often comorbid and share a common core of symptoms. However, sex and gender-related factors significantly influence their prevalence, clinical presentation, and diagnosis. Here, we conducted a systematic literature review and meta-analysis to examine sex differences in ADHD/PTSD comorbidity during childhood and adulthood. A scoping review of PsycINFO and PubMed yielded 13 eligible studies with complete outcome data. We conducted fixed-effects meta-analyses of the sex-stratified prevalence of ADHD/PTSD using pooled odds ratios (OR) with a 95% confidence interval (CI). Fixed-effects subgroup analyses were performed using age as a subgroup. Effect size heterogeneity was assessed using the I 2 index and Cochran's Q test. In the whole sample (N= 13,585; F= 7005, M= 6580), the diagnosis of ADHD/PTSD was significantly higher in females than in males (OR = 1.32, p = 0.02). Between-study heterogeneity was low-to-moderate and not significant (I 2 = 41%; p = 0.06), validating the fixed-effects model. Age-stratified subgroup analyses revealed higher ADHD/PTSD odds in females compared to males only in adult populations (OR=1.41; p = 0.01). Additionally, females were more likely to be diagnosed with both disorders in studies where ADHD was the primary diagnosis (OR = 1.60; p = 0.002), and in studies employing structured clinical interviews as diagnostic tools (OR = 1.46; p = 0.009). Our study is the first to show that the association between ADHD and PTSD is stronger in females, suggesting that ADHD may increase risk for PTSD in a sex-specific manner.

A Brief Intervention for Injury-Related Traumatic Stress: Results From a Feasibility Study.

Post-traumatic stress disorder (PTSD) significantly impacts post-injury quality of life; however, many injured patients struggle to access necessary psychosocial care. A brief intervention, Talk, Listen, Communicate to Recover (TLC to Recover), may facilitate access to psychosocial care in low resource trauma centers. This study assessed staff and patient perceptions regarding the feasibility and acceptability of implementing TLC to Recover at a Level I trauma center. This study used a mixed methods approach to examine the implementation of a brief dyadic intervention intended to mitigate the effect of potential post-injury mental health sequelae. The study took place from April 2021 to April 2024. Participants included adult patients who received post-injury care and were at risk for post-injury PTSD and/or depression. Outpatient trauma clinic staff participated in formative and summative evaluations of the intervention. Recruitment, retention rates, and engagement were assessed. Symptom measurements were administered to patients at baseline, two week follow-up, and one month to measure the effectiveness of TLC to Recover. Semistructured interviews and focus groups explored the acceptability of TLC to Recover among staff and patients. Summative template analysis was utilized to analyze qualitative data and integrated with the theoretical framework of acceptability. A total of N=26 participants were included in the summative and formative evaluations, of which n=15 were patients and n=11 were clinic staff. The surgical clinic was an acceptable and feasible context to deliver a brief intervention to patients at risk for post-injury PTSD and/or depression. This study offers insight into opportunities for implementation of brief post-injury psychosocial interventions in a surgical context.

Trauma exposure and ICD-11 PTSD and CPTSD in a Greenlandic adolescent population

ABSTRACT Background: Little peer-reviewed research has been done on trauma exposure, Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) prevalence among Greenlandic children and adolescents. There is a need for a validated Greenlandic version of the International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) to assess symptoms of ICD-11 PTSD and CPTSD, as well as investigations of the prevalence of these disorders. This information is imperative in a Greenlandic context, where general epidemiological knowledge on traumatic exposure and reactions is lacking. Objective: The present study examined the factor structure of the Greenlandic ITQ-CA, estimated the prevalence of trauma exposure, ICD-11 PTSD and CPTSD, and examined the relationship between potentially traumatic events (PTEs), PTSD, CPTSD, and demographic variables in a Greenlandic adolescent population. Method: Confirmatory factor analysis of competing models of the dimensionality of the ITQ-CA was tested among Greenlandic adolescents (N = 704) aged 11–17 years (M = 13.4, SD = 1.77). Using the ITQ-CA, PTSD and CPTSD was assessed. Results: Findings supported the factorial validity of the Greenlandic ITQ-CA although factor structure differed across boys and girls. A total of 82.8% of the adolescents had been directly exposed to at least 1 PTE (M = 3.2), and 57.0% had been indirectly exposed (M = 3.1). The estimated prevalence of PTSD and CPTSD was 7.8% and 8.5%, while an additional 13.9% and 7% reached subclinical levels. Older age, female gender, several different and cumulative PTEs significantly elevated the risk of PTSD and CPTSD. Conclusion: ITQ-CA is a valid tool for identifying symptoms of ICD-11 PTSD and CPTSD. Results indicate that type and quantity of direct traumatic exposure are important predictors of PTSD and CPTSD. Events not normally considered traumatic as well as non-interpersonal events are significantly associated with CPTSD symptoms.

The association between social support and postpartum post-traumatic stress disorder

BackgroundPostpartum post-traumatic stress disorder (PTSD) is a debilitating condition that can arise following childbirth. Despite a growing body of research on postpartum mental health, the relationship between social support and postpartum PTSD remains unclear. This study aimed to assess the association between social support and postpartum PTSD.MethodsA prospective cohort study was conducted at a tertiary hospital in Guangdong province of China between November 2022 and April 2023. Eligible mothers were assessed for social support using the Social Support Rating Scale (SSRS) at three days postpartum and for PTSD using the Perinatal Post-Traumatic Stress Disorder Questionnaire (PPQ) at 42 days postpartum. The association between social support and postpartum PTSD was analyzed using multiple linear and log-binomial regression, with adjustments for potential confounders.ResultsForty-six of 560 (8.2%) mothers developed PTSD within 42 days postpartum. Scores for subjective support (β=-0.319, P < 0.001), objective support (β=-0.327, P < 0.001), support availability (β=-0.285, P < 0.001), and overall social support score (β=-0.428, P < 0.001) were inversely associated with PTSD scores. Compared to mothers in the 1st quartile of the overall social support score, those in the 2nd, 3rd, and 4th quartiles had adjusted relative risks of 0.39 (95% confidence interval [CI]: 0.21–0.74), 0.20 (95% CI: 0.09–0.45), and 0.10 (95% CI: 0.03–0.33), respectively, of developing PTSD. An inverse linear trend in the risk of PTSD was observed with increasing social support (P-trend < 0.001).ConclusionsSocial support may have a protective effect against postpartum PTSD, with practical implications for interventions targeting various dimensions of support.

The PAC1 receptor risk genotype does not influence fear acquisition, extinction, or generalization in women with no trauma/low trauma.

Women are known to have twice as much lifetime prevalence of post-traumatic stress disorder (PTSD) as men do. It has been reported that the risk genotype (CC) of a single nucleotide polymorphism (SNP) (rs2267735) in the pituitary adenylate cyclase-activating polypeptide (PACAP-PAC1R) system is associated with PTSD risk and altered fear conditioning and fear extinction in women. Surprisingly, no previous work has studied the effect of this SNP on fear conditioning, extinction, or generalization in non-traumatized/low trauma load women. Here, two separate groups of women underwent either a two-day fear conditioning and fear extinction paradigm, or a one-day fear conditioning and fear generalization paradigm. Results showed no significant differences between genotypes in conditioned stimulus discrimination, during fear acquisition, extinction, or generalization. These findings suggest that the previously reported fear processing impairments in traumatized CC women are not a consequence of this genotype alone, but likely dependent on the interaction between this genetic risk and the exposure to traumatic stressors.

Posttraumatic stress disorder and its cross-generational familial relationship with drug use disorder and alcohol use disorder: an extended Swedish adoption study

ABSTRACT Objective: Information on how parental risk for posttraumatic stress disorder (PTSD) relates to their children’s risk for drug use disorder (DUD) and alcohol use disorder (AUD) is limited. This study is the first to utilize an extended adoption design which can address questions about the degree of, and sources of, cross-generational and cross-disorder transmission of PTSD and substance use disorders. Method: We examined diagnoses using Swedish National registries for parents and their adult offspring (n = 2,194,171, born 1960–1992) from six types of families (intact (1), not lived with biological father (2) or mother (3), step father (4), step mother (5), and adoptive (6)). Parent–child resemblance was assessed by tetrachoric correlation. Results: PTSD and DUD showed an approximately symmetrical cross-generational cross-disorder relationship. Conversely, AUD in parents was more related to the risk for PTSD in offspring compared to the reverse direction. The cross-disorder cross-generation transmission correlations for PTSD to DUD were higher than those for PTSD to AUD. Genetic and rearing correlations for PTSD-DUD were estimated at + .79 (CI: .66, .91) and + .49 (CI: .33, .65), significantly higher than those for PTSD-AUD + .59 (CI: .48, .71) and + .28 (CI: .12, .44). Conclusions: PTSD and the substance use disorders demonstrated cross-transmission, but more so for DUD. PTSD and DUD demonstrated highly correlated genetic effects, and moderately correlated rearing effects. Correlations of genetic and rearing effects between PTSD and AUD were lower than those for PTSD and DUD.

Prevalence and correlates of post-traumatic stress disorder and depression among welfare- and justice-involved adolescents in Nigeria

ABSTRACT Background: Childhood maltreatment (CM) is higher among welfare- and justice-involved youth than in those not involved in these systems, which increases the risk of depression and post-traumatic stress disorder (PTSD). However, the mechanisms underlying the link between CM and these two psychiatric conditions are less well understood among at-risk populations in low- and middle-income countries. Objective: This study attempts to fill this gap by examining the prevalence of and risk factors for depression and PTSD among at-risk groups in Nigeria. Method: A cross-sectional research design using multistage sampling was adopted. The sample comprised 205 adolescents: justice-involved [102 (49.8%)] and welfare-involved [103 (50.2%)]. In total, 151 (73.7%) were males, while 54 (26.3%) were females. Multivariate logistic regression analysis and multivariate analysis of variance were applied. Results: The results showed that 66.1% of welfare-involved adolescents and 69.6% of justice-involved adolescents reported PTSD, while 68.9% of welfare-involved adolescents and 75.5% of justice-detained adolescents reported depression. Neglect (OR = 0.253; 95% CI 0.146–0.571; p < .001) and witnessing violence (OR = 0.230; 95% CI 0.114–0.597; p < .004) predicted depression. Emotional abuse (OR = 0.186; 95% CI 0.090–0.80; p < .015), witnessing violence (OR = 0.147; 95% CI 0.014–0.876; p < .043), neglect (OR = 0.187; 95% CI 0.14–0.90; p < .008), and physical abuse (OR = 0.27; 95% CI 0.254–0.937; p < .001) predicted PTSD. Also, PTSD significantly differed based on type of placement (F = 6.08, p < .014, η 2 = .029), but depression did not differ based on type of placement (F = 2.46, p > .118, η 2 = .012). Conclusions: CM profiles are risk factors in PTSD and depression among at-risk groups. CM screening should be included in mental health services of out-of-home placements to prevent the cycle of mental health problems and reoffending. Trauma-focused and cognitive–behavioural therapies have the potential to alleviate the suffering of traumatized adolescents.

Does Trauma Change the Way Individuals with Post-Traumatic Stress Disorder (PTSD) Deal with Positive Stimuli?

Post-Traumatic Stress Disorder (PTSD) is a highly prevalent disorder and a highly debilitating condition. Although current theories focused on depressed mood and intrusion as critical dimensions, the mechanism through which depression increases the risk of PTSD remains unclear. Research usually concentrates on the hyperactive negative valence system (NVS) (e.g., increased fear and threat responses), but some evidence suggests a significant role for the hypoactive positive valence system (PVS) (e.g., less neural activation towards rewards). The main aim of the present research was to investigate whether probable PTSD leads to a different evaluation of the implicit processing in a refugee's sample. Ratings of arousal, dominance, and valence from 60 International Affective Picture System (IAPS) pictures (positive, neutral, and negative) were collected from 42 individuals with probable PTSD, and a group of 26 trauma-exposed individuals (Mage = 28.49 years, SD = ±7.78). ANOVA results revealed a main group effect (η2p = 0.379) on arousal, dominance, valence dimensions, and pictures' categories (η2p = 0.620), confirming evidence according to which PTSD origins a state of maladaptive hyperarousal and troubles the regulation of emotions, and not supporting the view that such difficulties arise only with negative stimuli. Participants with probable PTSD deemed negative stimuli as more threatening than they really are, reacting to unpleasant images with greater negative emotionality (i.e., enhanced arousal and lower valence ratings) compared with individuals without PTSD. Moreover, they rated positive stimuli as less pleasant. Furthermore, arousal ratings were negatively correlated with valence (r = -0.709, p < 0.01) indicating that pictures with high arousal (negative) were associated with lower valence. Our findings supported evidence according to which PTSD caused a constant state of hyperarousal and difficulties in regulating emotions facing environmental stimuli. Positive stimuli are considered less pleasant, and this inhibits from completely benefiting from them. Our study provides evidence for a differential and potentially complementary involvement of NVS and PVS in PTSD development. Intervention for PTSD may, thus, target both negative and positive valence processing.

Pandemic-Related Stress Increases PTSD and Depression Risk in Traumatic Injury Patients: A Comparative Study of Pre- and Peri-Pandemic Trauma Cases.

The COVID-19 pandemic significantly impacted the psychological well-being of the general population. However, there are limited studies that examine its mental health effects on patients who have experienced traumatic injuries and tracked their recovery over time. This study aimed to: (1) compare the rates and severity of post-traumatic stress disorder (PTSD) and depression between patients who sustained traumatic injuries before the COVID-19 pandemic (pre-pandemic) and those injured during the pandemic (peri-pandemic); and (2) assess whether the degree of pandemic-related stress (e.g., worry about infection, social isolation, loss of home/job) predicted the severity of PTSD or depression symptoms. Participants (N=198) were recruited from a Level 1 Trauma Centre in Southeastern Wisconsin following admission for a single-incident traumatic injury. Symptoms of PTSD and depression were assessed during hospitalisation and at three additional points within the subsequent 6months. Self-report measures were used to evaluate PTSD and depression severity among patients injured before (pre-pandemic; n=126) and during (peri-pandemic; n=73) the pandemic. Peri-pandemic participants also completed a modified version of the COVID-19 Family Stress Screener to measure pandemic-related stress. Exploratory factor analysis was conducted to identify the dimensions of pandemic-related stress in our sample. The findings indicated that participants injured during the pandemic exhibited higher symptoms of PTSD and depression compared to those injured before the pandemic. Additionally, greater pandemic-related stress correlated with elevated levels of depression and PTSD at baseline. Our results highlight that the broader context in which patients recover from injuries can intensify the negative mental health consequences of traumatic injury. This underscores the need for enhanced access to psychological services for trauma patients, particularly during major societal stressors like a global pandemic.

Symptoms of PTSD and depression in newly diagnosed people with multiple sclerosis during the outbreak Oct.7th war on Gaza: A case-control study from Jordan

The present study examined the severity and the correlates of post-traumatic stress disorder (PTSD) and depression symptoms severity in newly diagnosed people with multiple sclerosis (PwMS) compared to healthy people during the outbreak of the Oct.7th war on Gaza.This is a cross-sectional case-control study recruiting 63 PwMS and 79 controls. The severity of PTSD and depression were measured using validated scales.There was no significant (p>0.05) difference in PTSD and depression scores between the PwMS and the controls. In addition, PwMS who experienced one or more relapses since diagnosis were at a significantly higher risk (B=9.29, t=2.06, p=0.04) for severe PTSD and severe depressive (OR=5.50, 95% CI=1.32–22.92, p=0.01).The study of the mental health of PwMS during times of crisis is emerging in developing countries, future larger-scale and follow-up studies are yet required.

Latent classes of acute grief reactions in the shadow of collective trauma and its predictors in bereaved adults.

The current study explored grief reaction profiles after the October 7th, 2023, Israeli massacre regarding the loss of significant others. It investigated factors worsening pre-existing grief in 2,028 adult civilians, with 1,263 reporting pre- or post-massacre loss. Participants completed self-reports on prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), cognitive emotional regulation (CER), and assumptive worldviews. Latent class analysis identified four classes of probable PGD among those with lifetime loss: "high PGD-both core and emotional pain" (35.9 %); "Medium PGD-emotional pain" (6.9 %); "medium to high PGD-high core, medium emotional pain" (23 %); and "low PGD-both core and emotional pain" (34.5 %). The subsample analysis of individuals experiencing lifetime loss with concurrent October 7th loss indicated three classes of probable PGD: "high PGD symptoms" (47.9 %), "high to medium PGD-high core with medium emotional pain symptoms" (15.9 %), and "low PGD symptoms" (36.2 %). The subsample analysis of those who experienced concurrent recent loss related to the October 7th attack showed two classes related to indicative of acute grief: "high PGD symptoms" (69 %), and "low PGD symptoms" (31 %). Negative CER coping strategies were associated significantly with the high PGD in all three groups, and with increased risk of PTSD and CPTSD symptoms compared to the "low PGD symptoms" group. Collective bereavement amid collective trauma can activate prior individual grief reactions, even without current losses from the traumatic event. Those experiencing loss tied to severe traumatic events may face higher susceptibility to developing pathological grief.

Long-term psychopathology rates of children and adolescents and associated factors in the worst-sticken area of 2023 Kahramanmaras earthquake

Introduction Earthquakes are natural disasters that can have significant psychological impacts on individuals, particularly children. While physical injuries are often the immediate focus following an earthquake, the psychological effects can be long-lasting and profound. Understanding the psychiatric effects of traumatic experiences in children following earthquakes is crucial for developing effective interventions and support systems. Method One hundred fifty three children and adolescents who experienced the earthquake were evaluated in the first year of the earthquake. Depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms were measured using standardized assessment tools. Factors that may be related to psychopathology, such as sleep disturbance, the extent of trauma, and where one lived after the earthquake, were also evaluated. The anxiety, depression and stress levels of the mother and father separately and their relationship with the child’s psychopathology were evaluated. Results The frequency of depression risk among participants was found to be 24.8%, while the frequency of anxiety risk was 62.8%. The frequency of PTSD risk was 97.4%. Children who migrated to another province after the earthquake had higher scale scores. Parental depression anxiety stress level was positively correlated with children’s scale scores. Disruption in sleep patterns increased the risk of depression by 2.38 times. Experiencing the loss of friends in the earthquake increased PTSD score by 6.27. Discussion The findings of this study highlight the importance of addressing the psychiatric needs of children following earthquakes. Psychosocial support and access to appropriate treatment should be prioritized to mitigate the long-term psychological effects of traumatic experiences in children.

Interplay of serum BDNF levels and childhood adversity in predicting earlier-onset post-traumatic stress disorder: A two-year longitudinal study

This longitudinal study explored the intricate relationships between serum Brain-Derived Neurotrophic Factor (sBDNF) levels, exposure to childhood adversities, and the subsequent development of Post-Traumatic Stress Disorder (PTSD), distinguishing between earlier- and delayed-onset forms over a two-year follow-up period in individuals sustaining physical injuries. We recruited patients presenting with moderate to severe physical injuries at a trauma center, conducting baseline assessments of sBDNF levels and childhood adversities through the Adverse Childhood Experiences (ACE) questionnaire. Additionally, detailed socio-demographic and clinical data were compiled. The Clinician-Administered PTSD Scale for DSM-5 was employed to diagnose PTSD at 3, 6, 12, and 24 months post-injury. Binary and multinomial logistic regression analyses were applied to elucidate the interactions between sBDNF levels, childhood adversities, and PTSD onset patterns. Among 895 participants, PTSD was diagnosed in 107 individuals (11.9 %), with 76 (8.4 %) exhibiting symptoms indicative of earlier-onset PTSD and 31 (3.5 %) demonstrating delayed-onset PTSD. Significantly, lower sBDNF levels were associated with a higher risk of earlier-onset PTSD specifically in the context of childhood adversities. This association was not observed in individuals without childhood adversities or in those with delayed-onset PTSD. The findings suggest a complex and critical interplay between neurobiological factors, specifically sBDNF levels, and early life adversities in influencing the timing of PTSD onset, potentially deepening the understanding of PTSD etiology.