Risk For Posttraumatic Stress Disorder Research Articles

Clinical specificities of patients with substance use disorder and comorbid borderline personality disorder compared to patients with substance use disorder only: a retrospective study

Introduction Substance use disorder (SUD) is a common condition often associated with borderline personality disorder (BPD), and patients with both disorders (SUD + BPD) have more complex presentations and poorer outcomes in treatment. Thus, there is a need to identify more clearly the clinical differences between patients with SUD + BPD and those with SUD only to help clinicians in their diagnostic process. Methods Data from medical files of 92 patients with SUD (SUD only: n = 42; SUD + BPD: n = 50) treated in an outpatient psychiatry and addiction treatment center were extracted to compare the differences in terms of sociodemographic characteristics, substance used, psychopathological dimensions, comorbidity prevalence, and functional impairment. Results Compared to the SUD only group, patients in the SUD + BPD group were younger, more disabled, and less satisfied with their social life. Regarding substance used, the comorbid group had more frequently cannabis use disorder and poly nonalcoholic SUD. Regarding psychopathological dimensions, the comorbid group had higher levels of impulsivity, emotion regulation difficulties and alexithymia. Finally, regarding comorbidities, the comorbid group had a higher risk of comorbid anxiety, obsessive-compulsive, and post-traumatic stress disorders. Conclusion While being only exploratory, these results add evidence on the impact of the BPD comorbidity in patients with SUD and underline important dimensions that should be considered by clinicians working with this population.

Adherence to Gender Roles on PTSD Symptoms of Hurricane Harvey Survivors

The purpose of this study was to explore the relationships between trauma and adherence to gender roles among a sample of Hurricane Harvey survivors (N = 225). Posttraumatic stress disorder (PTSD) resulting from natural disasters has been associated with an increased risk of negative psychological outcomes. Previous studies have found increased risks of PTSD resulting from hurricane exposure, and there also appears to be a correlation between PTSD and gender. Specifically, women have been found to be more likely to endorse PTSD symptoms. However, this relationship has not yet been examined specifically among survivors of trauma from natural disasters. The Hayes Process Macro (v3.5) was utilized to test for the potential moderating effect of adherence to traditional gender roles on the relationship between trauma exposure and PTSD symptoms, as well as trauma exposure and depression. Results indicated that adherence to traditional female gender roles significantly moderated the relationships both between trauma severity and PTSD symptoms and between trauma severity and depression. Those with more androgynous gender roles have been found to have an increased ability to utilize more situation-specific coping skills. Future research could explore the specific aspects of traditional female and male gender roles that increase or decrease ability to cope with trauma.

Sex-dependent differences in vulnerability to early risk factors for posttraumatic stress disorder: results from the AURORA study.

Knowledge of sex differences in risk factors for posttraumatic stress disorder (PTSD) can contribute to the development of refined preventive interventions. Therefore, the aim of this study was to examine if women and men differ in their vulnerability to risk factors for PTSD. As part of the longitudinal AURORA study, 2924 patients seeking emergency department (ED) treatment in the acute aftermath of trauma provided self-report assessments of pre- peri- and post-traumatic risk factors, as well as 3-month PTSD severity. We systematically examined sex-dependent effects of 16 risk factors that have previously been hypothesized to show different associations with PTSD severity in women and men. Women reported higher PTSD severity at 3-months post-trauma. Z-score comparisons indicated that for five of the 16 examined risk factors the association with 3-month PTSD severity was stronger in men than in women. In multivariable models, interaction effects with sex were observed for pre-traumatic anxiety symptoms, and acute dissociative symptoms; both showed stronger associations with PTSD in men than in women. Subgroup analyses suggested trauma type-conditional effects. Our findings indicate mechanisms to which men might be particularly vulnerable, demonstrating that known PTSD risk factors might behave differently in women and men. Analyses did not identify any risk factors to which women were more vulnerable than men, pointing toward further mechanisms to explain women's higher PTSD risk. Our study illustrates the need for a more systematic examination of sex differences in contributors to PTSD severity after trauma, which may inform refined preventive interventions.

Longitudinal method comparison: modeling polygenic risk for post-traumatic stress disorder over time in individuals of African and European ancestry.

Cross-sectional data allow the investigation of how genetics influence health at a single time point, but to understand how the genome impacts phenotype development, one must use repeated measures data. Ignoring the dependency inherent in repeated measures can exacerbate false positives and requires the utilization of methods other than general or generalized linear models. Many methods can accommodate longitudinal data, including the commonly used linear mixed model and generalized estimating equation, as well as the less popular fixed-effects model, cluster-robust standard error adjustment, and aggregate regression. We simulated longitudinal data and applied these five methods alongside naïve linear regression, which ignored the dependency and served as a baseline, to compare their power, false positive rate, estimation accuracy, and precision. The results showed that the naïve linear regression and fixed-effects models incurred high false positive rates when analyzing a predictor that is fixed over time, making them unviable for studying time-invariant genetic effects. The linear mixed models maintained low false positive rates and unbiased estimation. The generalized estimating equation was similar to the former in terms of power and estimation, but it had increased false positives when the sample size was low, as did cluster-robust standard error adjustment. Aggregate regression produced biased estimates when predictor effects varied over time. To show how the method choice affects downstream results, we performed longitudinal analyses in an adolescent cohort of African and European ancestry. We examined how developing post-traumatic stress symptoms were predicted by polygenic risk, traumatic events, exposure to sexual abuse, and income using four approaches-linear mixed models, generalized estimating equations, cluster-robust standard error adjustment, and aggregate regression. While the directions of effect were generally consistent, coefficient magnitudes and statistical significance differed across methods. Our in-depth comparison of longitudinal methods showed that linear mixed models and generalized estimating equations were applicable in most scenarios requiring longitudinal modeling, but no approach produced identical results even if fit to the same data. Since result discrepancies can result from methodological choices, it is crucial that researchers determine their model a priori, refrain from testing multiple approaches to obtain favorable results, and utilize as similar as possible methods when seeking to replicate results.

Mendelian randomization analyses reveal causal relationships between brain functional networks and risk of psychiatric disorders.

Dysfunction of brain resting-state functional networks has been widely reported in psychiatric disorders. However, the causal relationships between brain resting-state functional networks and psychiatric disorders remain largely unclear. Here we perform bidirectional two-sample Mendelian randomization (MR) analyses to investigate the causalities between 191 resting-state functional magnetic resonance imaging (rsfMRI) phenotypes (n = 34,691 individuals) and 12 psychiatric disorders (n = 14,307 to 698,672 individuals). Forward MR identified 8 rsfMRI phenotypes causally associated with the risk of psychiatric disorders. For example, the increase in the connectivity of motor, subcortical-cerebellum and limbic network was associated with lower risk of autism spectrum disorder. In adddition, increased connectivity in the default mode and central executive network was associated with lower risk of post-traumatic stress disorder and depression. Reverse MR analysis revealed significant associations between 4 psychiatric disorders and 6 rsfMRI phenotypes. For instance, the risk of attention-deficit/hyperactivity disorder increases the connectivity of the attention, salience, motor and subcortical-cerebellum network. The risk of schizophrenia mainly increases the connectivity of the default mode and central executive network and decreases the connectivity of the attention network. In summary, our findings reveal causal relationships between brain functional networks and psychiatric disorders, providing important interventional and therapeutic targets for psychiatric disorders at the brain functional network level.

The psychological implications of COVID-19 over the eighteen-month time span following the virus breakout in Italy.

In a short time, the COVID-19 pandemic has exerted a huge impact on many aspects of people's lives with a number of consequences, an increase in the risks of psychological diseases being one of them. The aim of this experimental study, based on an eighteen-month follow-up survey, is to assess the psychological effects of the COVID-19 pandemic, in particular, changes in stress, anxiety and depression levels, and the risks of developing Post-Traumatic Stress Disorder (PTSD). A follow-up survey was performed on a sample of 184 Italian individuals to collect relevant information about the psychological impact of COVID-19. Predictors of the components of the psychological impact were calculated based on the ANCOVA model. The analysis of the online questionnaires led to the conclusion that a high percentage of the participants suffer from levels of stress, anxiety and depression higher than normal as well as an increased risk of PTSD. The severity of such disorders significantly depends on gender, the loss of family members or acquaintances due to the pandemic, the amount of time spent searching for COVID-19 related information, the type of information sources and, in part, on the level of education and income. The time factor had a more severe effect on the low-income population. COVID-19 has entailed a very strong psychological impact on the Italian population also depending on the coping strategies adopted, the level of mindful awareness, socio-demographic variables, people's habits and the way individuals use the available means of communication and information.

Posttraumatic stress disorder is characterized by functional dysregulation of dermal fibroblasts

Incidence of mental health disorders are rising in modernity, with psychological stress linked to a propensity for developing various chronic diseases due to a relative inability of the body to counter the allostatic load on cellular level. Despite these high rates of comorbidities associated with posttraumatic stress disorder (PTSD), there is still a lack of understanding in terms of the peripheral effects of PTSD on tissue level. Therefore, the purpose of this study was to profile basal dermal fibroblast functional status in PTSD using a wide range of markers involved in the cell-to-cell communication facilitated by fibroblasts. Primary dermal fibroblasts derived from patients diagnosed with PTSD (n = 11) and matched trauma exposed controls (i.e. who did not develop PTSD, n = 10) were cultured using standard techniques. The patients and controls were matched based on age, sex, body-mass index (BMI) and lifestyle. The growth rate, population doubling time, cell surface marker expression (CD31, FNDC5) (flow cytometry), secretome (TIMP-2, MMP-9) (ELISAs), intracellular signalling capacity (Fluo-4 Ca2+ flux) and gene expression (IL-6, IL-10, PTX-3, iNOS, Arg1) were compared between groups. The data illustrated significant PTSD-associated fibroblast conditioning resulting in a blunted signalling capacity. This observation highlights the importance of including tissue-specific investigations in future studies focused on elucidating the association between PTSD and subsequent risk for somatic disease.

Stress and Trauma Among Nurses in Development (STAND): A Descriptive Study

Background Mental health conditions related to traumatic stress exposure are common in practicing nurses. Less is known about the impact of trauma on nursing students and how it affects their transition to practice. Objectives The purpose of this study is to understand the experience of trauma exposure and resulting symptoms in undergraduate nursing students. Design This is an analysis of baseline data from a longitudinal study. Students in an undergraduate nursing program completed a survey with validated instruments to measure trauma exposure, risk and protective factors, and trauma symptoms. Settings The study took place in an undergraduate nursing program in the United States. Participants A total of 248 nursing students participated in the study. Results The nursing students reported a higher number of adverse childhood experiences and post-traumatic stress disorder (PTSD) symptoms than the general population. Additionally, mental health symptoms and burnout symptoms increased over time. Conclusions Nursing students are at high risk for PTSD and other mental health conditions due to cumulative trauma. Interventions are needed to address trauma in developing nurses.

Psychological outcomes in patients with rare cancers: a systematic review and meta-analysis

Rare cancers are those that exhibit an incidence of less than six per 100,000 in a year. On average, the five-year relative survival for patients with rare cancers is worse than those with common cancers. The traumatic experience of cancer can be further intensified in patients with rare cancers due to the limited clinical evidence and the lack of empirical evidence for informed decision-making. With rare cancers cumulatively accounting for up to 25% of all cancers, coupled with the rising burden of rare cancers on societies globally, it is necessary to determine the psychological outcomes of patients with rare cancers. This PRISMA-adherent systematic review (PROSPERO: CRD42023475748) involved a systematic search of PubMed, Embase, Cochrane and PsycINFO for all peer-reviewed English language studies published since 2000 to 30th January 2024 that evaluated the prevalence, incidence and risk of depression, anxiety, suicide, and post-traumatic stress disorder (PTSD) in patients with rare cancers. Two independent reviewers appraised and extracted the summary data from published studies. Random effects meta-analyses and meta-regression were used for primary analysis. We included 32 studies with 57,470 patients with rare cancers. Meta-analyses indicated a statistically significant increased risk-ratio (RR) of depression (RR=2.61, 95% CI: 1.43-4.77, I2=97%) and anxiety (RR=2.66, 95% CI: 1.27-5.55, I2=92%) in patients with rare cancers compared to healthy controls. We identified a high suicide incidence (315 per 100,000 person-years, 95% CI: 162-609, I2=95%), prevalence of depression (17%, 95% CI: 14-22, I2=88%), anxiety (20%, 95% CI: 15-25, I2=96%) and PTSD (18%, 95% CI: 9-32, I2=25%). When compared to patients with common cancer types, suicide incidence, and PTSD prevalence were significantly higher in patients with rare cancers. Systematic review found that having advanced disease, chemotherapy treatment, lower income, and social status were risk factors for negative psychological outcomes. We highlight the need for early identification of psychological maladjustment in patients with rare cancers. Additionally, studies to identify effective interventions are imperative. This study was supported by the National Medical Research Council Transition Award, SingHealth Duke-NUS Oncology Academic Clinical Programme, the Khoo Pilot Collaborative Award, the National Medical Research Council Clinician Scientist-Individual Research Grant-New Investigator Grant, the Terry Fox Grant and the Khoo Bridge Funding Award.

Psychological Impact and Posttraumatic Stress Disorder Symptomatology After Ulnar Collateral Ligament Injuries in Baseball Players.

Significant psychological impact and prevalence of posttraumatic stress disorder (PTSD) have been well documented in patients sustaining anterior cruciate ligament injury. To examine PTSD symptomatology in baseball players after sustaining elbow ulnar collateral ligament (UCL) injury. Cross-sectional study; Level of evidence, 3. Male baseball players of various competition levels (high school through Minor League Baseball [MiLB]) who underwent surgery for a UCL injury between April 2019 and June 2022 participated in the study. Before surgery, patients completed the Impact of Event Scale-Revised (IES-R) to assess PTSD symptomatology. Subgroup analysis was conducted according to level of play and player position. A total of 104 male baseball players with a mean age of 19.4 years (range, 15-29 years) were included in the study; 32 players (30.8%) were in high school, 65 (62.5%) were in college, and 7 (6.7%) were in MiLB. There were 64 (61.5%) pitchers, 18 (17.3%) position players, and 22 (21.2%) 2-way players (both pitching and playing on the field). A total of 30 (28.8%) patients scored high enough on the IES-R to support PTSD as a probable diagnosis, and another 22 patients (21.2%) scored high enough to support PTSD as a clinical concern. Nineteen patients (18.3%) had potentially severe PTSD. Only 4 players (3.8%) were completely asymptomatic. Subgroup analysis revealed college players as significantly more symptomatic than high school players (P = .02), and 2-way players were found to be significantly less susceptible to developing symptoms of PTSD compared with pitchers (P = .04). Nearly 30% of baseball players who sustained a UCL injury qualified for a probable diagnosis of PTSD based on the IES-R. Pitchers and college athletes were at increased risk for PTSD after UCL injury compared with 2-way players and high school athletes, respectively.

Psychometric Evaluation of the Persian Version of the Post-Traumatic Symptom Scale: Exploratory and Confirmatory Factor Analysis

Background: Iranian youth encounter numerous stressors, including accidents, suicide, and unemployment, heightening their risk for posttraumatic stress disorder (PTSD). It's crucial to assess, diagnose, and treat PTSD in this demographic. Objectives: This study aimed to evaluate the factor structure and validate the Post-Traumatic Symptom Scale (PTSS). Methods: A cross-sectional approach was employed for the validation of the PTSS in Bandar Abbas, 2022, with a sample of 901 young residents selected via random cluster sampling. Data were gathered using the PTSS and the Mississippi Scale for Posttraumatic Stress Disorder (MSPSS). Validation of the scale encompassed content validity, concurrent validity, and factor analysis. Reliability assessments included internal consistency, test-retest, and split-half reliability. The optimal cut-off point was identified through receiver operating characteristic (ROC) curve analysis and the Youden Index. Results: The PTSS demonstrated robust face and content validity, evidenced by impact factor (1.6 < impact factor < 3.6), content validity ratio (CVR = 0.68 to 0.91), and Content Validity Index (CVI = 0.70 to 0.94). The PTSS's concurrent validity with the MSPSS was positively strong (r = 0.64, P < 0.001). Factor analyses, both exploratory (EFA) and confirmatory (CFA), substantiated a four-factor model of the PTSS, accounting for 56.288% of the variance (19% for arousal and reactivity, 14% for negative alterations in cognitions and mood, 11% for avoidance, and 11% for intrusion). The scale's overall Cronbach's alpha was 0.87, with subscales ranging from 0.77 to 0.88. Test-retest reliability stood at 0.81 (P < 0.01), and split-half reliability at 0.81. The PTSS's optimal cut-off for PTSD diagnosis was 60, delivering a sensitivity of 0.70, specificity of 0.99, and Youden Index of 0.69. Conclusions: The PTSS proves to be a reliable and valid instrument for assessing posttraumatic stress symptoms among young Iranians, offering a useful resource for researchers and practitioners in the prevention and treatment of PTSD.

Disentangling sex differences in PTSD risk factors.

Despite extensive research on sex/gender differences in posttraumatic stress disorder (PTSD), underlying mechanisms are still not fully understood. Here we present a systematic overview of three sex/gender-related risk pathways. We assessed 16 risk factors as well as 3-month PTSD severity in a prospective cohort study (n=2924) of acutely traumatized individuals and investigated potential mediators in the pathway between sex assigned at birth and PTSD severity using multiple mediation analysis with regularization. Six risk factors were more prevalent/severe in women, and none were more pronounced in men. Analyses showed that acute stress disorder, neuroticism, lifetime sexual assault exposure, anxiety sensitivity, and pre-trauma anxiety symptoms fully mediated and uniquely contributed to the relationship between sex assigned at birth and PTSD severity. Our results demonstrate different risk mechanisms for women and men. Such knowledge can inform targeted interventions. Our systematic approach to differential risk pathways can be transferred to other mental disorders to guide sex- and gender-sensitive mental health research.

Availability and use of institutional support programs for emergency department healthcare personnel during the COVID-19 pandemic.

The COVID-19 pandemic placed health care personnel (HCP) at risk for stress, anxiety, burnout, and post-traumatic stress disorder (PTSD). To address this, hospitals developed programs to mitigate risk. The objectives of the current study were to measure the availability and use of these programs in a cohort of academic emergency departments (EDs) in the United States early in the pandemic and identify factors associated with program use. Cross-sectional survey of ED HCP in 21 academic EDs in 15 states between June and September 2020. Site investigators provided data on the availability of 28 programs grouped into 9 categories. Individual support programs included: financial, workload mitigation, individual COVID-19 testing, emotional (e.g., mental health hotline), and instrumental (e.g., childcare) Clinical work support programs included: COVID-19 team communication (e.g., debriefing critical incident), patient-family communication facilitation, patient services (e.g., social work, ethics consultation), and system-level exposure reduction. Participants provided corresponding data on whether they used the programs. We used generalized linear mixed models clustered on site to measure the association between demographic and facility characteristics and program use. We received 1,541 survey responses (96% response rate) from emergency physicians or advanced practice providers, nurses, and nonclinical staff. Program availability in each of the 9 categories was high (>95% of hospitals). Program use was variable, with clinical work support programs used more frequently (28-50% of eligible HCP across categories) than individual employee support programs (6-13% of eligible HCP across categories). Fifty-seven percent of respondents reported that the COVID-19 pandemic had affected their stress and anxiety, and 12% were at elevated risk for PTSD. Program use did not significantly differ for HCP who reported symptoms of anxiety and/or stress compared to those who did not. Early in the pandemic, support programs were widely available to ED HCP, but program use was low. Future work will focus on identifying barriers and facilitators to use and specific programs most likely to be effective during periods of highest occupational stress.

A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers

BackgroundLaw enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs.MethodsThis multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes.ResultsWe observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures.ConclusionsResults of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve.Trial registrationClinicalTrials.gov, NCT03784846. Registered on December 24th, 2018.

Posttraumatic stress disorder and psychosocial risk factors in first response workers to emergencies mixed method

First responders to emergencies are exposed to various risks, including psychosocial risk factors. Caring for patients in critical situations, experiencing traumatic events, and working under highly complex conditions increase their probability of developing mental disorders, such as posttraumatic stress disorder (PTSD). The objective of the study was to determine the relationship between PTSD and psychosocial risk factors and to understand the experiences of the disorder in this population. An explanatory sequential mixed method research design was used. The quantitative phase was an analytical cross-sectional observational study (n = 193), and the qualitative phase was phenomenological (n = 5). The psychosocial risk factors that best explained the presence of PTSD symptoms were the influence of non-work conditions on work, religion, emotional avoidance, and professional support as individual factors related to coping strategies. Individual factors such as coping strategies were determining factors that explained the symptoms of PTSD, and the influence of non-work conditions on work. It was identified that the demands of the job and the organizational factors, such as leadership style and lack of institutional support, generate anguish in workers and affect their ability to regulate their emotions when exposed to critical incidents.

Causal Associations between Posttraumatic Stress Disorder and COVID-19.

We aimed to evaluate bidirectional genetic relationships between posttraumatic stress disorder (PTSD) and COVID-19. We investigated potential causal associations between PTSD and two COVID-19 conditions (COVID-19 hospitalization and SARS-CoV-2 infection) via Mendelian randomization (MR) analyses. Three genome-wide association study (GWAS) summary datasets were used in the study, including PTSD (N = 174,659), SARS-CoV-2 infection (N = 2,597,856), and COVID-19 hospitalization (N = 2,095,324). We performed a literature-based analysis to uncover molecular pathways connecting PTSD and COVID-19. We found that PTSD exerts a causal effect on SARS-CoV-2 infection (odds ratio (OR): 1.10, 95% confidence interval (CI): 1.00-1.21, p = 0.048) and hospitalized COVID-19 (OR: 1.34, 95% CI: 1.07-1.67, p = 0.001). However, both SARS-CoV-2 infection and hospitalized COVID-19 were not associated with the risk of PTSD. Pathway analysis revealed that several immunity-related genes may link PTSD to COVID-19. Our study suggests that PTSD was associated with increased risks for COVID-19 susceptibility and severity. Early diagnosis and effective treatment of PTSD in individuals infected with the coronavirus may improve the management of the outcomes of COVID-19.

Reducing posttraumatic stress disorder symptom severity among depressed women with childhood sexual abuse histories in interpersonal psychotherapy-trauma: The role of improved social functioning.

Childhood sexual abuse (CSA) increases risk for posttraumatic stress disorder (PTSD), and both CSA and PTSD are strongly associated with impaired social functioning. Interpersonal psychotherapy (IPT) has demonstrated promise for adults with PTSD and has been shown to be effective for women with PTSD and histories of CSA, but the mechanisms by which IPT might improve PTSD are unknown. The current secondary analysis tested whether the ameliorative effect of IPT-trauma (IPT-T) on PTSD, demonstrated in a randomized effectiveness trial, was mediated by improved social function. The randomized effectiveness trial compared IPT-T to clinic psychotherapy in a publicly funded community mental health center. Women with CSA histories and major depression (n = 162; Mage = 36.3; 54% White, 38% Black, 8% other race) were randomly assigned to IPT-T or CP, and 16 free sessions of IPT-T or CP were offered within a 32-week treatment period. Eighty-eight percent of the sample met diagnostic criteria for PTSD. Mediation models confirmed hypotheses, showing that the effect of IPT-T on improved PTSD symptoms at Week 32 (end of treatment) was partially mediated by better social functioning at Week 16 (middle of treatment period; path c¹: B = 12.25, p = .04, 95% confidence interval [.44, 24.05]). Findings support that a non-exposure-based therapy can reduce PTSD symptoms via improved social functioning. Given extensive literature showing the importance of social functioning in mental health generally and PTSD specifically, integrating a focus on social functioning (e.g., building social skills, expanding support networks) into treatments, including exposure-based treatments, may enhance outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Post-traumatic stress disorder in parents of schizophrenic patients at the Arrazi Psychiatric Hospital in Salé following familial violence

IntroductionParents whose adult child has a serious mental illness are at risk of serious violence from their child. One of the reasons for the high risk of PTSD is violence in the home [1,2]. The high risk of PTSD in parents of patients with schizophrenia is an issue of great concern because parents are likely to fear repeated violence and, therefore, to object to patients being discharged from hospital.Objectives To assess the existence of post-traumatic stress disorder in relatives of patients with schizophrenia treated at the Arrazi University Psychiatric Hospital in Salé following familial violence.MethodsThis was a descriptive cross-sectional study using a questionnaire including sociodemographic criteria, clinical criteria, questions about domestic violence and an “IES-R” post-traumatic stress symptom assessment questionnaire to investigate the existence of post-traumatic stress disorder in relatives of patients with schizophrenia followed up at Arrazi University Psychiatric Hospital in Salé following familial violence.ResultsThe response of 72 relatives of schizophrenic patients was collected. About 70% of the participants were mothers. The average age of the participants was 58. All lived with children who had been treated for schizophrenia for more than 18 years (57% of participants). Around 20% of these children were in hospital at the time of completing this questionnaire. About 80% of the children with schizophrenia spent all their time at home, and about 89% of the participants had already been victims of violence from their sick children. 90% had been sworn at and insulted, the majority blamed themselves for the illness, about 56% had already been kicked or punched, and 36% had already received death threats and 12% serious injuries/. For all items, parents with a high IES-R score had significantly more experiences of violence than parents with a low IES-R score. The percentage of parents with a high IES-R score was 45%.Conclusions The experience of severe violence and hospitalisation of a patient was related to a high risk of post-traumatic stress disorder in parents. These two factors can be considered as traumatic events arising from crisis situations and can have harmful consequences for parents and their schizophrenic children, who are sometimes rejected. There seems to be a need to create crisis intervention programmes that offer a multidisciplinary approach capable of rapidly detecting the exacerbation of a serious mental illness and providing rapid and intensive treatment as quickly as possible. Finally, the provision of support, education or treatment for parents during their child’s hospitalisation is essential.Disclosure of InterestNone Declared

Higher risk-less data: A systematic review and meta-analysis on the role of sex and gender in trauma research.

Women and men are at different risk for posttraumatic stress disorder (PTSD). It is unclear, however, how studies on PTSD risk factors integrate this knowledge into their research. Moreover, the temporal development of women's higher PTSD risk is unknown. In this systematic review and meta-analysis, we examine how prospective studies on PTSD development (k = 47) consider sex and gender across four domains (samples, terminology, analyses, and reporting). Further, we differentially analyze sex/gender differences within five time intervals from 1 month to 5 years posttrauma. PTSD prevalence (OR = 1.72 [1.27-2.34]) and severity (g = 0.31 [0.09, 0.53]) were increased for women relative to men at 1 month posttrauma already, that is, at the first timepoint of a possible PTSD diagnosis. PTSD severity was elevated for women compared to men across all time intervals, but evidence for increased PTSD prevalence for women relative to men was less stable with longer follow-ups. Despite women's higher PTSD burdens, they were clearly underrepresented in samples (68.3% male, 31.7% female participants). Only 5.0% of studies explained or described their understanding of sex and gender, and only 2.6% used sex as discovery variable, that is, investigating sex-dependent risk mechanisms. Sex and gender aspects in design, data, and discussion were considered by only one-third of studies each. Trauma research falls short of its potential to adequately consider sex and gender. Sex- and gender-sensitive practices can advance rigor, innovation, and equity in psychopathology research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Predicting DSM-5 PTSD symptomatology 6 months to 2 years after burn: The role of early psychological risk factors

BackgroundMajor burn injuries may have long-term mental health consequences, such as posttraumatic stress disorder (PTSD). This study extended prior work to investigate DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn as well as the contribution of two sets of early psychological risk factors to DSM-5 PTSD symptoms: Established PTSD risk factors (prior adjustment problems, past trauma, perception of life threat, peritraumatic emotions and dissociation) and theory-derived cognitive factors (negative appraisals of the trauma and its sequelae, memory disorganization, trauma-related rumination, and thought suppression). MethodThe current study recruited a sample of 118 adult burn patients (75.4% men, mean age 41.8, mean TBSA 18.3%) consecutively admitted to a large regional burn center in Northern Taiwan, who were assessed at 6, 12, and 24 months following their burn injury. ResultsA total of 11.0%, 5.9%, and 7.6% met probable DSM-5 PTSD at 6 months, 1 year, and 2 years post-burn, respectively. The rates rose to 15.3%, 10.2%, and 11.0% using the cutoff method. After controlling for covariates, the regression model with theory-derived cognitive factors explained an additional significant 15.9%, 17.2%, and 17.7% of the variance in DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn, respectively. In contrast, the regression model with established PTSD risk factors explained an additional significant 7.2%, 14.4%, and 10.5% of the variance in DSM-5 PTSD symptoms at 6 months, 1 year, and 2 years post-burn, respectively. Of all predictors, negative appraisals of intrusions was consistently and strongly predictive of DSM-5 PTSD symptomatology post-burn across time, followed by prior depression. ConclusionsThe results underscore the role of early cognitive risk factors in the development and persistence of DSM-5 PTSD symptomatology following burn injury.