Severe Posttraumatic Stress Research Articles

Pre-event attachment anxiety and avoidance predict posttraumatic stress symptom severity – Results from a longitudinal population-based study

Attachment-related anxiety and avoidance have been identified as risk factors for psychopathology following traumatic events. However, the predictive value of pre-event attachment orientations for PTSD symptoms in the general population remains unclear. Attachment anxiety and avoidance, as well as symptoms of anxiety and depression, were assessed in autumn 2010 (T0) in 270 adult members of a Dutch research panel. PTSD symptoms were assessed in April (T1), August (T2), and December (T3) 2012 for events occurring within one year before T1. The predictive value of attachment orientations for severity and remission of PTSD cluster and total scores was estimated by latent growth curve analyses controlling for gender, age, and pre-event psychopathology. Attachment anxiety predicted higher posttraumatic stress severity at T1, while attachment avoidance predicted lower initial posttraumatic stress levels, together adding 7.4 % independently explained variance. Higher attachment anxiety was related to more remission of PTSD total scores (6.0 % independently explained variance) which might be understood as an effect of regression to the mean. In conclusion, insecure attachment orientation predicts PTSD symptoms in the general population. Our results advocate the significance of pre-traumatic factors for the prediction of posttraumatic stress and the consideration of attachment orientations in clinical work with trauma survivors.

Change despite obstacles: A mixed-methods pilot study of a trauma-sensitive mindfulness and compassion intervention

This mixed-methods pilot study aimed to assess the symptomatic changes of post-traumatic stress disorder, complex post-traumatic stress disorder, dissociative symptoms, self-critique, and self-compassion following participation in a 16-week trauma-sensitive mindfulness and compassion intervention. The adverse experiences of participation were also explored explicitly. Seventeen predominantly female clients with severe post-traumatic stress disorder symptomatology participated in the trauma-sensitive mindfulness and compassion intervention. All clients completed questionnaires before (pre) and after (post) the intervention to gain information on symptom change, self-critique, and self-compassion. Second, a qualitative interview addressing clients’ experiences of participation, including an explicit focus on adverse experiences, was conducted. There was a significant decrease in PTSD, CPTSD, dissociative symptoms, self-hatred, and inadequate self before and after the intervention. All the clients reported having adverse experiences during participation but no lasting negative effects. The results point to the potential of the TMC intervention in helping reduce trauma symptoms and self-critique while also elucidating the tremendous stress that clients with trauma experience undergoing trauma treatment. However, no injurious adverse effects were reported. These preliminary results warrant further investigation via a randomized control trial to examine the efficacy of TMC. The study is registered in ClinicalTrials.gov ID: NCT05993468.

LONG-TERM HEALTH OUTCOMES OF PAEDIATRIC MULTIFOCAL MUSCULOSKELETAL SEPSIS: A 15-YEAR REVIEW

This study aimed to identify long-term physical and psychosocial health outcomes in children with overwhelming musculoskeletal sepsis.Children admitted to the Paediatric Intensive Care Unit (PICU) from 1st January 2002 to 31st December 2017 with a musculoskeletal focus of infection were identified. A medical notes review was completed to determine survival and morbidity. Present-day clinical assessment of the musculoskeletal and respiratory systems along with questionnaires on health-related quality of life, mental health and sleep were performed.70 patients were identified over 15 years. Seven children died acutely (five Pasifika and two Māori children) indicating 10% mortality. Recurrence/chronic infection affected 23%. Growth disturbance affected 18%. The hip joint and proximal femur suffered the worst long-term complications. Children under 2 years most at risk of long-term disability. No patients had chronic respiratory illness beyond 90 days. Fifteen children had symptoms of acute neurological impairment, three of whom had permanent acquired brain injury. Twenty-six survivors (41%) were assessed a mean of 8.2 years (SD 4.5, range 2– 18 years) after discharge. Health-related quality of life scores were on par with normative data. All patients who underwent pulmonary function tests had normal results. Six patients and eight parents screened positive for moderate to severe post-traumatic stress disorder.Paediatric multifocal musculoskeletal sepsis can result in complex illness with multi-organ complications for some children. Māori and Pasifika children are most at risk. Children under 2 years and those with proximal femur and/or hip involvement are most likely to have chronic musculoskeletal sequelae and permanent disability. Other outcomes are favourable with no evidence of chronic lung disease or mean reduced quality of life. A period of rehabilitation for children with identified acquired brain injury should be part of discharge planning.

Online Experiences, Internet-Fostered Connection, Resilience, and Adjustment Among Adolescent Siblings of Children With Cancer.

Pediatric cancer disrupts the lives of siblings in many ways, including physical separations from family and friends that increase risk for distress. Research suggests that siblings use technology and social media to connect with friends and family and seek social support and interaction. However, this may expose siblings to negative online experiences that can erode self-esteem, reducing resilience. This study explored the relationship between online experiences, internet-fostered connection, resilience, and psychosocial health among siblings of children with cancer. Participants included adolescent siblings (N = 81; aged 12-17 years) of children with cancer. Most were female (56.8%), and 50.6% represented racially or ethnically minoritized groups. Online experiences, social media use, resilience, and psychosocial health were self-reported and analyzed using structural equation modeling. A majority of siblings reported moderate to severe posttraumatic stress symptoms (PTSSs) (59%) and elevated emotional and behavioral difficulties (EBDs) (53%). Experiencing more positive online experiences was associated with greater perceived connection to family and friends online, but not resilience, PTSSs, or EBDs. In contrast, higher negative online experience scores were significantly associated with more PTSSs and EBDs. In addition, the association between negative online experiences and EBDs was significantly mediated by a negative association between negative online experiences and resilience. Although social media may be a valuable tool for helping siblings of children with cancer garner social support, negative online experiences may be detrimental to their adjustment. Efforts should be made to preserve and foster resilience among siblings who use social media for support.

Severity of Post-traumatic Stress and Non-medical, Concomitant Opioid and Benzodiazepine Use in a Sample of Women at High Risk of Overdose

Severity of Post-traumatic Stress and Non-medical, Concomitant Opioid and Benzodiazepine Use in a Sample of Women at High Risk of Overdose

Comparing post-traumatic stress severity in professional and volunteer Australian firefighters.

While extensive research has highlighted increased risk for post-traumatic stress disorder (PTSD) in firefighters, previous research has yielded mixed results regarding the role of work status (professional versus volunteer) in the development of psychopathological symptoms. To explore the predictive strength of work status on PTSD or post-traumatic stress symptom severity in a large sample of professional (PFFs) and volunteer (VFFs) Australian firefighters exposed to operational work-related trauma. The stratified random sample comprised 1317 PFFs (n = 1148 (87%) males and 13%, n = 169 (13%) females) and 898 VFFs (n = 744 (83%) males and n = 154 (17%) females) who reported having experienced trauma while working or volunteering. Participants completed demographic, health and work-related questions and mental health measures of stress, trauma, PTSD, social support and use of mental health prevention programmes. The results revealed a significant relationship between work status and PTSD, with PFFs reporting higher levels of PTSD symptom severity compared to VFFs. This association persisted after controlling for demographics, health, stress away from work, social support and use of organizational mental health support programmes (debriefing and face-to-face training for mental and physical self-care). This study suggests the importance of work status in PTSD amongst Australian firefighters exposed to operational trauma. Future research is needed to substantiate our findings and examine why PFFs may be more prone to developing PTSD. Implications for the provision of mental health programmes offered by fire organizations to their members are discussed.

MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial

This multi-site, randomized, double-blind, confirmatory phase 3 study evaluated the efficacy and safety of 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) versus placebo with identical therapy in participants with moderate to severe post-traumatic stress disorder (PTSD). Changes in Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) total severity score (primary endpoint) and Sheehan Disability Scale (SDS) functional impairment score (key secondary endpoint) were assessed by blinded independent assessors. Participants were randomized to MDMA-AT (n = 53) or placebo with therapy (n = 51). Overall, 26.9% (28/104) of participants had moderate PTSD, and 73.1% (76/104) of participants had severe PTSD. Participants were ethnoracially diverse: 28 of 104 (26.9%) identified as Hispanic/Latino, and 35 of 104 (33.7%) identified as other than White. Least squares (LS) mean change in CAPS-5 score (95% confidence interval (CI)) was −23.7 (−26.94, −20.44) for MDMA-AT versus −14.8 (−18.28, −11.28) for placebo with therapy (P < 0.001, d = 0.7). LS mean change in SDS score (95% CI) was −3.3 (−4.03, −2.60) for MDMA-AT versus −2.1 (−2.89, −1.33) for placebo with therapy (P = 0.03, d = 0.4). Seven participants had a severe treatment emergent adverse event (TEAE) (MDMA-AT, n = 5 (9.4%); placebo with therapy, n = 2 (3.9%)). There were no deaths or serious TEAEs. These data suggest that MDMA-AT reduced PTSD symptoms and functional impairment in a diverse population with moderate to severe PTSD and was generally well tolerated. ClinicalTrials.gov identifier: NCT04077437.

Social support over time for men and women veterans with and without complex trauma histories.

Social support is closely linked to health, but little is known about United States (U.S.) veterans' social support over time and factors that may influence their support trajectories. This study investigates social support over time for U.S. men and women Post-9/11 veterans in relation to trauma history and gender. A secondary analysis of longitudinal cohort data from the Survey of Experiences of Returning Veterans (SERV), which employed a repeated-measures longitudinal design using five waves of data (baseline, 3, 6, 9, 12 months) with 672 combat veterans. Results from random intercept multilevel models found no significant gender differences in social support over time. Veterans with complex trauma histories were at risk for lower social support across waves. A stability trend was also observed; specifically, at baseline, veterans who started with high support maintained their level over time whereas veterans who started with deficits in social support remained low over time. Veterans identifying as African American or Latinx, and those with lower annual incomes, reported lower support compared to White and higher-income veterans. Furthermore, low social support was significantly associated with severe posttraumatic stress symptoms and active suicidal ideation across 12 months. SERV utilized a nonrandom sampling method that may reduce generalizability of findings. There is also potential for residual confounding by factors related to both social support levels and time since discharge that were not available in this data set. Findings have implications for developing clinical and community interventions intended to support veterans as they transition back to the community. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Challenges With Short-term Use of Intravenous Racemic Ketamine With Psychotherapy for a Hospitalized Patient With Severe Posttraumatic Stress Disorder and Depression.

Challenges With Short-term Use of Intravenous Racemic Ketamine With Psychotherapy for a Hospitalized Patient With Severe Posttraumatic Stress Disorder and Depression.

Effects of BPD tendencies and subjective well-being on NSSI in adolescents with PTSD.

Severe posttraumatic stress disorder (PTSD) may lead to non-suicidal self-injury (NSSI), and borderline personality disorder (BPD) tendencies may play a role in this process. Secondary vocational students experience more social, familial and other pressures and are more vulnerable to psychological problems. Thus, we explored the effect of BPD tendencies and subjective well-being (SWB) on NSSI in secondary vocational students with PTSD. A total of 2,160 Chinese secondary vocational students in Wuhan participated in our cross-sectional investigation. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), criteria for PTSD, NSSI Questionnaire, Personality Diagnostic Questionnaire-4+, subjective well-being scale, and family adaptation, partnership, growth, affection, and resolve (APGAR) Index were used. We conducted a binary logistic regression model and linear regression analysis. Sex (odds ratio [OR] = 0.354, 95% confidence interval [CI] = 0.171-0.733), BPD tendencies (OR = 1.192, 95% CI = 1.066-1.333) and SWB (OR = 0.652, 95% CI = 0.516-0.824) were independent factors that predicted NSSI in secondary vocational students with PTSD. Spearman's correlation analysis showed that BPD tendencies were positively correlated with NSSI frequency (r = 0.282, P < 0.01). SWB was negatively correlated with NSSI frequency (r = -0.301, P < 0.01). The linear regression showed that BPD tendencies (β = 0.137, P < 0.05 and β = -0.230, P < 0.001) were significantly correlated with NSSI frequency. Spearman's correlation analysis showed that family functioning was positively correlated with SWB (r = 0.486, P < 0.01) and negatively correlated with BPD tendencies (r = -0.296, P < 0.01). In adolescents, PTSD in response to stressful events could lead to NSSI, and BPD tendencies promote the intensity of NSSI, while SWB diminishes its intensity. Improvement in family functioning may actively guide the development of mental health and improve SWB; such steps may constitute interventions to prevent or treat NSSI.

Youth Dually-Involved in the child welfare and juvenile justice systems: Varying definitions and their associations with trauma exposure, posttraumatic stress, & offending

Recently, scholars have placed increasing effort on better understanding the unique needs of youth involved in both the child welfare and juvenile justice systems. This study drew from the Developmental Cascade of Multisystem Involvement Framework to examine group differences in trauma exposure, posttraumatic stress symptoms, and offending among youth solely involved in the juvenile justice system and youth with varying degrees of dual-system involvement, including crossover youth (i.e., youth with a history of maltreatment and offending regardless of system involvement), dual-contact youth (i.e., youth who had a history of a substantiated CW maltreatment petition prior to their involvement in the current study), and dually-involved youth (i.e., youth under the care and custody of the state's child welfare system at the time of study participation). Four-hundred adolescents (25% girls, Mage = 15.97) who were recruited from a detention center and completed self-report measures assessing trauma exposure, posttraumatic stress, and offending. Juvenile justice and child welfare records also were collected. Results indicated that, compared to youth solely involved in the juvenile justice system, crossover youth reported significantly more exposure to traumatic events, more severe posttraumatic stress symptoms, and more self-reported offending. In contrast, results indicated few differences between dual-contact youth and youth solely involved in the juvenile justice system; these groups only differed in age and in recidivism charges. There also were few differences between dually-involved youth and youth solely involved in the juvenile justice system; these groups only differed in age and exposure to non-Criterion A traumatic events. The current results suggest that categorizing youth as crossover youth based on their own self-reported history of child maltreatment exposure resulted in more observed differences between dual-system youth and youth solely involved in juvenile justice. The present results have valuable implications for how we operationalize youth’s system involvement and highlight the importance of examining child maltreatment as a point of prevention and intervention efforts for these youth.

Advancing the Measurement of Trauma-Related Shame Among Women With Histories of Interpersonal Trauma.

Shame is a predominant emotion for many interpersonal trauma (IPT) survivors and is associated with more severe posttraumatic stress disorder (PTSD) symptoms. Measurement challenges have led to difficulties in understanding the impact of trauma-related shame. The Trauma-Related Shame Inventory (TRSI) was developed to address this limitation, yet additional psychometric support is needed. The present study evaluated and provided psychometric support for the TRSI among women with IPT histories, although recommendations for improvement are discussed. The impact of trauma-related shame, relative to trait shame and trauma-related guilt, on PTSD symptoms was also studied, with results suggesting that trauma-related shame had the strongest association.

Associations of polygenic risk scores with posttraumatic stress symptom trajectories following combat deployment.

Identification of genetic risk factors may inform the prevention and treatment of posttraumatic stress disorder (PTSD). This study evaluates the associations of polygenic risk scores (PRS) with patterns of posttraumatic stress symptoms following combat deployment. US Army soldiers of European ancestry (n = 4900) provided genomic data and ratings of posttraumatic stress symptoms before and after deployment to Afghanistan in 2012. Latent growth mixture modeling was used to model posttraumatic stress symptom trajectories among participants who provided post-deployment data (n = 4353). Multinomial logistic regression models tested independent associations between trajectory membership and PRS for PTSD, major depressive disorder (MDD), schizophrenia, neuroticism, alcohol use disorder, and suicide attempt, controlling for age, sex, ancestry, and exposure to potentially traumatic events, and weighted to account for uncertainty in trajectory classification and missing data. Participants were classified into low-severity (77.2%), increasing-severity (10.5%), decreasing-severity (8.0%), and high-severity (4.3%) posttraumatic stress symptom trajectories. Standardized PTSD-PRS and MDD-PRS were associated with greater odds of membership in the high-severity v. low-severity trajectory [adjusted odds ratios and 95% confidence intervals, 1.23 (1.06-1.43) and 1.18 (1.02-1.37), respectively] and the increasing-severity v. low-severity trajectory [1.12 (1.01-1.25) and 1.16 (1.04-1.28), respectively]. Additionally, MDD-PRS was associated with greater odds of membership in the decreasing-severity v. low-severity trajectory [1.16 (1.03-1.31)]. No other associations were statistically significant. Higher polygenic risk for PTSD or MDD is associated with more severe posttraumatic stress symptom trajectories following combat deployment. PRS may help stratify at-risk individuals, enabling more precise targeting of treatment and prevention programs.

Severity and Longitudinal Course of Depression, Anxiety and Post-Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis.

A diagnosis of cancer and treatment may constitute a highly traumatic period for paediatric cancer patients (PYACPs). However, no review has comprehensively analysed how the mental health of PYACPs is acutely affected and the longitudinal course. This systematic review followed PRISMA guidelines. Comprehensive searches of databases were conducted to identify studies of depression, anxiety and post-traumatic stress symptoms in PYACPs. Random effects meta-analyses were used for the primary analysis. From 4898 records, 13 studies were included. Acutely after diagnosis, depressive and anxiety symptoms were significantly elevated in PYACPs. Depressive symptoms only significantly decreased after 12 months (standardised mean difference, SMD = -0.88; 95% CI: -0.92, -0.84). This downward trajectory persisted to 18 months (SMD = -1.862; 95% CI: -1.29, -1.09). Anxiety symptoms similarly only decreased after 12 (SMD = -0.34; 95% CI: -0.42, -0.27) up to 18 months (SMD = -0.49; 95% CI: -0.60, -0.39) after the cancer diagnosis. Post-traumatic stress symptoms showed protracted elevations throughout follow-up. Overall, significant predictors of poorer psychological outcomes included unhealthy family functioning, concomitant depression or anxiety, poor cancer prognosis or experiencing cancer and treatment-related side effects. While depression and anxiety may improve over time with a favourable environment, post-traumatic stress may have a protracted course. Timely identification and psycho-oncological intervention are critical.

Prevalence of medically induced psychological trauma and its influence on women's health.

The aim of the present study was three-fold. One, to assess the prevalence of medical traumatization in outpatients of a gynecologic department; two, to analyze the relationship of medical traumatization with adverse childhood events; and three, to investigate the extent to which medical traumatization affects the health outcomes of woman. Between January and September 2022, a prospective cross-sectional study recruited patients of a gynecologic outpatient clinic at St. Gallen Cantonal Hospital in Switzerland. Medical trauma was a self-reported item. The presence of adverse childhood events was assessed using the Childhood Trauma Questionnaire. The severity of post-traumatic stress was evaluated using the Impact of Event Scale Revised questionnaire. In total, 227 patients were recruited. Medical trauma was reported by 20% of the interviewees and it was strongly associated with obesity (A= 0.005). Undergoing surgery was most commonly the source of psychological distress (5.7%) followed by delivery (4.8%), pregnancy loss (4.8%), and cancer diagnosis (4.0%). Yet, fewer than 1% of the patients reached the threshold suggesting post-traumatic stress disorder. We found no relationship between the medical trauma, adverse childhood events, cardiovascular disease, or substance abuse. The presence of medical trauma was associated with the patient's body mass index (calculated as weight in kilograms divided by the square of height in meters).

PAEDIATRIC MULTIFOCAL MUSCULOSKELETAL SEPSIS: A 15-YEAR REVIEW OF OUTCOMES

Survival of sepsis has been documented worldwide, but little is documented about the long-term health outcomes of multifocal sepsis from acute musculoskeletal infection - the first study of its kind in New Zealand.Children admitted to the Paediatric Intensive Care Unit (PICU) from 1st January 2002 to 31st December 2017 with a musculoskeletal focus of infection were identified from hospital coding data. Notes review from discharge to present day determined survival and morbidity. Present-day clinical assessment of the musculoskeletal and respiratory systems along with questionnaires on health-related quality of life, mental health and sleep were performed.Seventy patients were studied. Seven children died acutely (five Pasifika and two Māori children) indicating 10% mortality. Long-term survival was favourable with no recorded deaths after discharge. Recurrence/chronic infection occurred in 23%, a mean of 1.1 year after discharge. Growth disturbance occurred in 18%, a mean of 3 years after discharge. The hip joint and proximal femur have the worst complications. Children under 2 years are most at risk of long-term disability. No patients had chronic respiratory illness beyond 90 days. Fifteen children had symptoms of acute neurological impairment, three of whom had permanent brain injury. Twenty-six survivors (41%) were assessed a mean of 8.2 years after discharge. Health-related quality of life scores were on par with normative data. Six patients and eight parents screened positive for moderate to severe post-traumatic stress disorder.Paediatric multifocal musculoskeletal sepsis can result in complex illness with long hospital stay and multi-organ complications. Māori and Pasifika children, those under two and those involving the proximal femur/or hip are most at risk. Other outcomes are favourable with no evidence of chronic lung disease or poor quality of life. A period of rehabilitation for children with identified acquired brain injury should be part of discharge planning.

Actigraphic Wake after Sleep Onset and Symptom Severity Correspond with Rumination in Trauma-Exposed Individuals.

Rumination and worry are forms of repetitive negative thinking (RNT) commonly associated with internalizing psychopathologies, although less is known about RNT in trauma-exposed individuals with internalizing psychopathologies. Separate lines of research show RNT also plays a role in problematic sleep, which is frequently experienced after trauma exposure. To address gaps in the literature, the current study examines the impact of sleep and symptoms on RNT in trauma-exposed participants. A transdiagnostic sample of 46 unmedicated treatment-seeking trauma-exposed participants completed standard measures of rumination and worry, as well as clinical measures that assessed posttraumatic stress, depression, and anxiety severity. Actigraphic sleep variables were sleep duration, wake after sleep onset (WASO), and sleep efficiency. Sleep and clinical measures were submitted to multiple regression analyses with rumination and worry as dependent variables. The regression results showed that rumination was significantly explained by WASO and posttraumatic stress symptom (PTSS) severity, and the omnibus test was significant. Depression, anxiety, and other estimates of sleep were not significant. No significant results emerged for worry. Preliminary findings suggest that PTSS and WASO, an index of fragmented sleep, may contribute to rumination, but not worry, in trauma-exposed individuals. Longitudinal studies are needed to determine potential causal relationships.

Clinical supervision approach predicts evidence-based trauma treatment delivery in children's mental health.

Observational studies of practices used in clinical supervision-as-usual can be leveraged to advance the limited research on workplace-based supervision as an evidence-based treatment (EBT) implementation strategy. This exploratory observational study examined the presence of supervision approaches (comprised of supervision techniques) and whether these predicted clinicians' EBT technique delivery. Participants included 28 supervisors, 70 clinician supervisees, and 60 youth clients and guardians from 17 public mental health organizations. Data included audio recorded supervision-as-usual sessions over 1 year, audio recorded Trauma-focused Cognitive Behavioral Therapy (TF-CBT) treatment sessions with youth for 6 months, and youth-reported post-traumatic stress severity scores. Audio recordings of 438 supervision sessions were coded for session duration and the presence of 13 supervision techniques and intensity of their coverage. Audio recordings of 465 treatment sessions were coded for presence and intensity of coverage of TF-CBT practice elements. Agglomerative hierarchical cluster analysis examined the presence of clusters of supervision technique use, termed supervision approaches. Generalized estimating equations estimated the relation between supervision approaches and delivery of TF-CBT elements. Two supervision approaches were identified- Supportive-Directive and Supportive- that discriminated between use of five supervision techniques. Clinicians who received a higher proportion of supportive-directive supervision sessions had greater odds of delivering the trauma narrative with a client. Findings suggest that patterns of supervision techniques can be identified and may shape EBT delivery. Supervision approaches show some evidence of being tailored to individual clinicians. Implications for the development of supervision implementation strategies and future directions are discussed.

RESILIENCE AS A MEDIATOR IN RELATIONSHIP BETWEEN ANXIETY AND PERSONALITY AMONG PHYSIOTHERAPISTS-A CROSS-SECTIONAL STUDY

Background and Aims: The COVID-19 outbreak is the biggest global crisis in generations having severe and far-reaching repercussions for the health system, creating high prevalence of severe posttraumatic stress symptoms for physical therapists, highlighting the need for psychological help. Therefore, this study aimed to investigate how resilience functions as a mediator in the relationship between anxiety and personality among Karachi based physiotherapists. Methodology: A cross-sectional study was conducted among physiotherapists of Karachi using a convenience sampling technique from August to December 2021. The data was collected using a 10-Item Personality Inventory, Brief Resilience Scale, and Hamilton Anxiety Rating Scale questionnaire. Results: Among 70 participants, the emotional stability trait (7.6±1.4) had higher mean values on the TIPI. On the HAM-A scale, 81.4% physiotherapists had moderate to severe anxiety followed by 15.7% mild to moderate anxiety whereas 92.9% were shown to have normal resilience. Despite all correlations being negligible, only the association between agreeableness and resilience was non-significantly higher (r=0.83). Conclusion: It was concluded that there was no association between the anxiety state and resilience among physiotherapists, although there was a non-significantly higher relationship between agreeableness and openness to experiences personality traits. A high prevalence of moderate to severe anxiety was noted while using a standard resilience strategy.

The Posttraumatic Impact of Recurrent Pregnancy Loss in Both Women and Men.

Introduction Recurrent pregnancy loss is usually associated with significant psychological distress for both partners of the couple. It may act as a traumatic experience resulting in a posttraumatic stress disorder. The object of this study is to examine the posttraumatic impact of recurrent pregnancy loss on men and women and their interdependencies. Methods Cross-sectional study. All couples referred to the special unit for recurrent pregnancy loss between March 2019 and October 2020 were asked to participate with a sample size of 105 couples and 17 women. They were invited to complete a questionnaire package estimating the prevalence of posttraumatic stress, with anxiety, depression, lack of social support and dysfunctional coping strategies as contributing risk factors. Couple data were analysed with the Actor Partner Interdependence Model, taking the couple as a dyad. Results The response rate was 82.3 percent, with posttraumatic stress being measured in 13.7% of the women versus 3.9% of the men (p=0.017). For women, number of curettages, controlled for the number of losses, correlated with the severity of posttraumatic stress (p<0.05). Higher levels of anxiety, depression and lack of social support in women correlated positively with posttraumatic stress in their partners. The men's coping strategy "trivialization and wishful thinking" as well as "avoidance" correlated with more severe posttraumatic stress in the female partners (both p<0.05). Conclusion The posttraumatic risks within a couple with recurrent pregnancy loss are interdependent. Recurrent pregnancy loss clinics should assess posttraumatic risks of both partners in their routine diagnostic process.