Stress Disorder In Adults Research Articles

Predictors of study dropout in cognitive-behavioural therapy with a trauma focus for post-traumatic stress disorder in adults: An individual participant data meta-analysis

BackgroundAvailable empirical evidence on participant-level factors associated with dropout from psychotherapies for post-traumatic stress disorder (PTSD) is both limited and inconclusive. More comprehensive understanding of the various factors that contribute to study dropout from cognitive-behavioural therapy with a trauma focus (CBT-TF) is crucial for enhancing treatment outcomes.ObjectiveUsing an individual participant data meta-analysis (IPD-MA) design, we examined participant-level predictors of study dropout from CBT-TF interventions for PTSD.MethodsA comprehensive systematic literature search was undertaken to identify randomised controlled trials comparing CBT-TF with waitlist control, treatment-as-usual or another therapy. Academic databases were screened from conception until 11 January 2021. Eligible interventions were required to be individual and in-person delivered. Participants were considered dropouts if they did not complete the post-treatment assessment.FindingsThe systematic literature search identified 81 eligible studies (n=3330). Data were pooled from 25 available CBT-TF studies comprising 823 participants. Overall, 221 (27%) of the 823 dropped out. Of 581 civilians, 133 (23%) dropped out, as did 75 (42%) of 178 military personnel/veterans. Bivariate and multivariate analyses indicated that military personnel/veterans (RR 2.37) had a significantly greater risk of dropout than civilians. Furthermore, the chance of dropping out significantly decreased with advancing age (continuous; RR 0.98).ConclusionsThese findings underscore the risk of premature termination from CBT-TF among younger adults and military veterans/personnel.Clinical implicationUnderstanding predictors can inform the development of retention strategies tailored to at-risk subgroups, enhance engagement, improve adherence and yield better treatment outcomes.

Accelerated Resolution Therapy (ART) for the treatment of posttraumatic stress disorder in adults: A systematic review

Accelerated Resolution Therapy (ART), developed in 2008, uses techniques such as rapid eye movement, in vivo exposure, and image rescripting to recondition stressful memories, and reduce physical and emotional reactions to traumatic memories. There is considerable interest in evidence-based treatments for post-traumatic stress disorder (PTSD). This is the first systematic review examining the efficacy of ART for the treatment of PTSD among adults. We searched MEDLINE, PsycINFO, Embase, CINAHL, Scopus, trial registries, and government and private websites for citations published before October 2023. Studies that reported on the effect of ART for PTSD among adults were included. Meta-analyses could not be undertaken due to heterogeneity in study designs and an insufficient number of studies with a low risk of bias. Risk of bias was assessed, and findings synthesized following the synthesis without meta-analysis (SWiM) guidelines. Of the 112 records screened, five studies (Nenrolled = 337; Ncompleted = 250) and six reports of studies met criteria for inclusion. Included studies reported a significant reduction in symptoms of PTSD from pre- to post-intervention, d = 1.12 to 3.28. Significant reductions were also reported in symptoms of depression, mental distress, anxiety, and sleep dysfunction. ART shows some promise as a time-efficient clinical treatment for symptoms of PTSD in adults; however, more high-quality studies are needed.

Repetitive transcranial magnetic stimulation for post-traumatic stress disorder in adults.

Repetitive transcranial magnetic stimulation for post-traumatic stress disorder in adults.

Revue critique de la littérature sur l’efficacité des interventions en Eye Movement Desensitization and Reprocessing (EMDR) chez l’enfant et l’adolescent

ObjectivesOver three decades, EMDR therapy became a gold standard treatment for post-traumatic stress disorder in adults. While a pediatric adaptation of EMDR therapy has been developed and disseminated in specialized trauma centers, its place in the management of psychotrauma in children and adolescents remains unclear. Patients and methodA literature search was conducted using PubMed and Cochrane databases to identify controlled trials evaluating the benefit of EMDR therapy in subjects under 18 years of age. ResultsFourteen studies were found (non-randomized k=3, randomized k=11) in which EMDR therapy was consistently more effective for trauma-related symptoms in children and adolescents compared to no intervention (waiting list) or non-specific interventions. None of the studies comparing EMDR to psychotrauma-focused psychotherapy (CBT-trauma-focused or writing-based) showed a significant difference on the primary outcomes. Two meta-analyses reported a medium effect size, d=0.49–0.66, i.e., in the same range as other psycho-trauma focused psychotherapies. DiscussionAlthough encouraging, one may regret the lack of studies evaluating the benefit EMDR therapy for youths with more complex trauma-related disorders (e.g., chronic form, association with suicidal behaviors, and/or developmental disabilities). ConclusionFurther research would help to assess the benefit of EMDR therapy in children and adolescents, not only in terms of efficacy but also in terms of acceptability and effectiveness compared to other interventions.

Antidepressants in the acute treatment of post-traumatic stress disorder in adults: a systematic review and meta-analysis.

Currently, there are few pharmacotherapy options for clinicians treating post-traumatic stress disorder (PTSD), and antidepressants are usually the medication of choice. This meta-analysis aimed to review the efficacy of antidepressants in the acute treatment of PTSD in adults while investigating the contribution of study design and placebo response to the findings of these studies. Randomized, double-blind, placebo-controlled clinical trials that compared antidepressants with placebo for acute treatment of PTSD were selected. Standardized mean difference (SMD) in change in Clinician-Administered PTSD Scale scores were pooled after examining for heterogeneity. A random-effects meta-analysis was performed. Twenty-nine antidepressant-placebo comparisons, involving 4575 subjects, were analyzed. The SMD among all studies was 0.25, a small to medium effect size, lower than that in studies of antidepressants in adult major depressive disorder. The SMDs for low and high mean placebo responses, were 0.27 and 0.22, respectively. The overall SMD for paroxetine studies was in the moderate range (0.43) and that for sertraline studies was in the small range (0.12). Our findings suggest that antidepressants have modest efficacy in alleviating PTSD symptoms. Patient-level meta-analyses are required to further explore the potential clinical relevance of sertraline for PTSD.

Acute stress disorder and associated factors among adult trauma patients in Ethiopia: a multi-institutional study

IntroductionAcute stress disorder (ASD) is a mental disorder that happens after someone experienced traumatic event within duration of less than a month. Other studies conducted in different countries revealed that adults with a trauma had experienced acute stress disorder. This results in substantial distress and interferes with social and day to day activities. Despite the high burden of this problem, very little is known about the prevalence and risk factors for acute stress disorder in adults with traumatic injuries in Ethiopia.ObjectiveThis study was aimed to assess the prevalence of acute stress disorder and associated factors among adult trauma patients attending in northwest Amhara Comprehensive Specialized Hospitals, Ethiopia 2022.MethodsAn institutional based cross-sectional study design was employed among 422 adult trauma patients from May– June 2022. Systematic sampling technique was applied to recruit study participants. Data were collected through interviewer administered questionnaires using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, acute stress disorder measurement tools. Then, it was entered into Epi-Data version 4 and exported to STATA version 14 for analysis. Bivariate and multivariable binary logistic regressions model were carried out to identify factors significantly associated acute stress disorder.ResultThe prevalence of acute stress disorder among adult trauma patients in northwest Amhara comprehensive specialized hospitals was found to be 44.15% (95% CI: 39.4%, 49.0%) with 99% of response rate. In multivariate logistic analysis younger age (21–29) (AOR = 0.33 95% CI: 0.14–0.77), (30–39) (AOR = 0.35 95% CI: 0.15–0.85), (40–49) (AOR = 0.28 95% CI: 0.10–0.76) respectively, presence of complication (AOR = 2.22 95% CI: 1.36–3.60), prolonged length of hospital stay (AOR = 1.89 95% CI: 1.21–2.95) and having low (AOR = 3.21, 95% CI: 1.66–6.19) and moderate (AOR = 1.99, 95%, CI: 1.14–3.48) social support were factors significantly associated with acute stress disorder.Conclusion and recommendationThis study showed that the prevalence of acute stress disorder among the adult study participants who experienced traumatic events was high as compared to other literatures. Age, complication, prolonged hospital stay and social support were factors significantly associated with ASD at p-value < 0.05. This indicates the need for early identification and interventions or ASD care services from health workers of psychiatric ward.

Can apparently transient life events trigger long-term lower urinary tract symptoms?

One-time life events such as neurological injury can result in lifelong lower urinary tract symptoms (LUTS). However, it is unclear whether an apparently transient life event can also trigger long-term LUTS. This review examines the possibility of an association and hypothesizes the pathogenesis. A pubmed search was conducted using the MeSH words "life change events," "child abuse," or "stress disorders, Posttraumatic", and LUTS. Additional manuscripts were identified by a hand and citation search. Long-term LUTS was noted following temporally remote childhood sexual abuse, adverse childhood experiences, and stressful experiences in adults. There was evidence for an association of childhood sexual abuse and adverse childhood events with both storage as well as voiding LUTS. There was limited evidence that the number of adverse childhood events might increase the risk and severity of LUTS. There was evidence of an association between post-traumatic stress disorder in adults and LUTS. The finding of mental health disorders in such patients could explain some but not all of the observed association suggesting that other factors might also be important. There is an association noted between apparently transient lifetime events and the subsequent reporting of LUTS. The timing of these adverse experiences might be important in determining the propensity for clinical manifestation. There is a need to explore this association, establish causality, and determine the underlying etiopathogenesis.

Supplemental Material for Eye Movement Desensitization and Reprocessing (EMDR) Therapy Compared to Usual Treatment for Posttraumatic Stress Disorder in Adults With Psychosis in Forensic Settings: Randomized Controlled Trial

Supplemental Material for Eye Movement Desensitization and Reprocessing (EMDR) Therapy Compared to Usual Treatment for Posttraumatic Stress Disorder in Adults With Psychosis in Forensic Settings: Randomized Controlled Trial

Eye movement desensitization and reprocessing (EMDR) therapy compared to usual treatment for posttraumatic stress disorder in adults with psychosis in forensic settings: Randomized controlled trial.

Little direct evidence supports any particular treatment for posttraumatic stress disorder (PTSD) in people with schizophrenia, forensic histories, and/or multiple comorbidities. This trial assesses the efficacy and risks of eye movement desensitization and reprocessing (EMDR) for people with PTSD and psychotic disorders receiving forensic care, including inpatients and prisoners. Single-blind randomized controlled trial comparing EMDR therapy to wait-list (routine care) in forensic-treated adults with psychotic disorders and PTSD. The primary outcome was clinician-rated PTSD symptoms. Secondary outcomes included participant-rated PTSD symptoms, psychotic symptoms, social functioning, disability level, self-esteem, depressive symptoms, posttraumatic cognitions, complex posttraumatic difficulties, and adverse events. Blinded investigators assessed outcomes at baseline, and after 10 weeks and 6 months. Analysis of the primary outcome was by a mixed linear model. Twenty-four participants were randomized, recruitment being hindered by COVID-19 restrictions. Clinician Administered PTSD Scale mean (SD) scores after 6 months were lower (better) in the EMDR group, 21.3 (13.3), compared with the control group, 31.5 (20.7). The point estimate [95% CI] difference, averaged over two measurement times, was 11.4 [1.3, 21.4], p = .028, favoring EMDR. Self-esteem increased in the EMDR group and depressive symptoms and disability reduced. There were no statistically significant differences in psychotic symptoms or adverse events, although point estimates favored EMDR. This is the first EMDR trial in mental health inpatient, forensic, or custodial settings, where PTSD is common. There were improvements in PTSD and other symptomatology consistent with EMDR being a safe and effective treatment for PTSD in these settings. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Assessment of Posttraumatic Stress Disorder in Adults with Severe or Moderate Intellectual Disability: A Pilot Study Using the Diagnostic Interview Trauma and Stressors – Severe Intellectual Disability

ABSTRACT Introduction In persons with severe to moderate intellectual disability (SID), no valid and reliable diagnostic instrument is available to determine PTSD. In this study, a new instrument was evaluated: the Diagnostic Interview Trauma and Stressors – Severe Intellectual Disability (DITS-SID). Methods DITS-SID, Aberrant Behavior Checklist and Child and Adolescent Trauma Screener were administered to relatives and caregivers of 26 adults with SID. Results Inter-rater reliability and convergent validity of the DITS-SID are good. There is a moderate to strong correlation between PTSD symptoms and challenging behaviors. PTSD prevalence is high at 13%−19%. Differences in results between relatives and caregivers were found. Conclusion PTSD may be overlooked in individuals with SID, preventing them from receiving appropriate treatment. This study endorses the importance of using information from both relatives and caregivers when determining PTSD and provides a first step for a PTSD assessment. Follow-up research in a larger sample is needed to further validate the DITS-SID.

Exposure-based treatments for childhood abuse-related post-traumatic stress disorder in adults: a health-economic evaluation

ABSTRACT Background: Prolonged exposure (PE) is an effective treatment for post-traumatic stress disorder (PTSD). Objective: This study aimed to analyse the cost-effectiveness of three exposure-based treatments in patients with childhood abuse-related PTSD. Method: A net–benefit analysis was conducted alongside a pragmatic randomized controlled trial with participants (N = 149) randomized to three conditions: PE (n = 48), intensified PE (i-PE, n = 51), and phase-based PE [Skills Training in Affective and Interpersonal Regulation (STAIR) + PE, n = 50]. Assessments took place at baseline (T0), post-treatment (T3), 6 month follow-up (T4), and 12 month follow-up (T5). Costs stemming from healthcare utilization and productivity losses were estimated using the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness. Quality-adjusted life-years (QALYs) were based on the 5-level EuroQoL 5 Dimensions (EQ-5D-5L) using the Dutch tariff. Missing values of costs and utilities were multiply imputed. To compare i-PE to PE and STAIR + PE to PE, pair-wise unequal-variance t-tests were conducted. Net–benefit analysis was used to relate costs to QALYs and to draw acceptability curves. Results: Intervention costs did not differ across the three treatment conditions. Total medical costs, productivity losses, total societal costs, and EQ-5D-5L-based QALYs did not differ between treatment conditions either (all p > .10). At the relevant €50,000/QALY threshold, the probability of one treatment being more cost-effective than another was 32%, 28%, and 40% for PE, i-PE, and STAIR-PE, respectively. Conclusion: Three equally effective treatments were compared and no differences in cost-effectiveness between treatments were found. Therefore, we advocate the implementation and adoption of any of the treatments and endorse shared decision making.

Adapting the protocol for narrative exposure therapy for adults with mild intellectual disabilities

BackgroundNarrative exposure therapy (NET) is a trauma-focused cognitive behavioural therapy, recommended by the National Institute for Health and Care Excellence in 2018, to treat posttraumatic stress disorder in adults. There is a lack of research exploring the effectiveness of NET with adults with intellectual disabilities. The aim of this study is to develop an adapted version of the NET protocol (IDNET) for use with adults with mild intellectual disability.MethodsA qualitative research design was employed. Stage one involved systematically adapting the NET protocol for adults with mild intellectual disabilities in collaboration with a service user group comprising eight consultants. Stage two involved gaining professionals’ views on the adapted protocol and on the use of NET in intellectual disability services. This comprised a focus group of eight clinical psychologists specialising in intellectual disabilities and an expert panel of three NET clinicians. The framework approach was conducted on the focus group data only following guidance from a previous study.FindingsAn adapted NET protocol and collection of ‘easy read’ therapy materials were developed (IDNET), which incorporated feedback from the three stakeholder groups. Key concepts of ‘Optimism and motivation to adapt NET for people with mild intellectual disabilities’ and ‘Factors related to NET in practice’ were developed to describe the views of clinical psychologists. A number of issues were raised by professionals regarding the delivery of IDNET.ConclusionsProfessionals were optimistic about IDNET; however, issues raised regarding the delivery of IDNET require exploration when IDNET is trialled in practice. Specific implications for clinical practice and future research are discussed.

A-176 Regional Cerebral Blood Flow in Self-Reported Post-Traumatic Stress Disorder in Adults

Abstract Objective: The aim of this study is to identify regional cerebral blood flow (rCBF) differences between adults who self-reported high symptoms of Post-Traumatic Stress Disorder. Method: Subjects were selected from a de-identified database for adult SPECT scans. Scores were standardized to T-scores for each database. Twenty percent of the sample from each database were selected on the basis of self-reported levels of PTSD symptoms using the Amen Adult General Symptom Checklist (Amen, 1997). The final sample consisted of 350 Adults [Mage=36.70, majority-white (65.4%) and female (56.9%)]. Significant differences existed between groups for age. A MANOVA was utilized to test the difference in concentration rCBF between adults controlling for age. Results: Groups were compared across 17 variables representing different areas of the brain. Significant differences (p&amp;lt;.05) in rCBF were found in high levels of self-reported PTSD. Specifically, significant differences were noted in the left and right limbic areas with adults reporting high levels of PTSD having increased rCBF in these regions. Differences were also significant in the left and right basal ganglia regions with those reporting higher levels of PTSD having increased rCBF. Conclusion: Results indicate that there are significant differences in rCBF between adults with high self-reported levels of symptoms of PTSD. This suggests that adults with PTSD experience increased rCBF in the limbic and basal ganglia which both play a role in memory, emotions, and anxiety. Clinicians can use this information in the future to identify individuals that are at a high-risk for developing PTSD.

Adapting the protocol for narrative exposure therapy for adults with mild intellectual disabilities

AbstractBackgroundNarrative exposure therapy (NET) is a trauma‐focused cognitive behavioural therapy, recommended by the National Institute for Health and Care Excellence in 2018, to treat posttraumatic stress disorder in adults. There is a lack of research exploring the effectiveness of NET with adults with intellectual disabilities. The aim of this study is to develop an adapted version of the NET protocol (IDNET) for use with adults with mild intellectual disability.MethodsA qualitative research design was employed. Stage one involved systematically adapting the NET protocol for adults with mild intellectual disabilities in collaboration with a service user group comprising eight consultants. Stage two involved gaining professionals' views on the adapted protocol and on the use of NET in intellectual disability services. This comprised a focus group of eight clinical psychologists specialising in intellectual disabilities and an expert panel of three NET clinicians. The framework approach was conducted on the focus group data only following guidance from a previous study.FindingsAn adapted NET protocol and collection of ‘easy read’ therapy materials were developed (IDNET), which incorporated feedback from the three stakeholder groups. Key concepts of ‘Optimism and motivation to adapt NET for people with mild intellectual disabilities’ and ‘Factors related to NET in practice’ were developed to describe the views of clinical psychologists. A number of issues were raised by professionals regarding the delivery of IDNET.ConclusionsProfessionals were optimistic about IDNET; however, issues raised regarding the delivery of IDNET require exploration when IDNET is trialled in practice. Specific implications for clinical practice and future research are discussed.

Trauma exposure and co-occurring ICD-11 post-traumatic stress disorder and complex post-traumatic stress disorder in adults with lived experience of psychiatric disorder.

ObjectiveTo establish factors associated with ICD‐11 post‐traumatic stress disorder (PTSD) and complex PTSD (CPTSD) in a large sample of adults with lived experience of psychiatric disorder and examine the psychiatric burden associated with the two disorders.MethodsOne thousand three hundred and five adults were recruited from the National Centre for Mental Health (NCMH) cohort. ICD‐11 PTSD/CPTSD were assessed with the International Trauma Questionnaire (ITQ). Binary logistic regression was used to determine factors associated with both PTSD and CPTSD. One‐way between‐groups analysis of variance was conducted to examine the burden associated with the two disorders in terms of symptoms of anxiety, depression, and psychological wellbeing. For post‐hoc pairwise comparisons, the Tukey HSD test was used, and the magnitude of between‐group differences assessed using Cohen's d.ResultsProbable ICD‐11 CPTSD was more common than PTSD within the sample (PTSD 2.68%; CPTSD 12.72%). We found evidence that PTSD was associated with interpersonal trauma and household income under £20,000 a year. CPTSD was also associated with interpersonal trauma, higher rates of personality disorder, and lower rates of bipolar disorder. Those with probable‐CPTSD had higher levels of current anxiety and depressive symptoms and lower psychological wellbeing in comparison to those with probable‐PTSD and those with neither disorder.ConclusionsCPTSD was more prevalent than PTSD in our sample of people with lived experience of psychiatric disorder. Our findings indicate a need for routine screening for trauma histories and PTSD/CPTSD in clinical settings and a greater focus on the need for interventions to treat CPTSD.

COVID-19-related posttraumatic stress disorder in adults with lived experience of psychiatric disorder.

BackgroundPrevalence estimates of COVID‐19‐related posttraumatic stress disorder (PTSD) have ranged from 1% to over 60% in the general population. Individuals with lived experience of a psychiatric disorder may be particularly vulnerable to COVID‐19‐related PTSD but this has received inadequate attention.MethodsParticipants were 1571 adults with lived experience of psychiatric disorder who took part in a longitudinal study of mental health during the COVID‐19 pandemic. PTSD was assessed by the International Trauma Questionnaire (ITQ) anchored to the participant's most troubling COVID‐19‐related experiencevent. Factors hypothesised to be associated with traumatic stress symptoms were investigated by linear regression.Results40.10% of participants perceived some aspect of the pandemic as traumatic. 5.28% reported an ICD‐11 PTSD qualifying COVID‐19 related traumatic exposure and 0.83% met criteria for probable ICD‐11 COVID‐19‐related PTSD. Traumatic stress symptoms were associated with younger age, lower income, lower social support, and financial worries, and lived experience of PTSD/complex PTSD. Depression and anxiety measured in June 2020 predicted traumatic stress symptoms at follow‐up approximately 20 weeks later in November 2020.ConclusionsWe did not find evidence of widespread COVID‐19‐related PTSD among individuals with lived experience of a psychiatric disorder. There is a need for future research to derive valid prevalence estimates of COVID‐19‐related PTSD.

Repetitive transcranial magnetic stimulation for post-traumatic stress disorder in adults

Repetitive transcranial magnetic stimulation for post-traumatic stress disorder in adults

The Relationship Between Cognitive Functioning and Symptoms of Depression, Anxiety, and Post-Traumatic Stress Disorder in Adults with a Traumatic Brain Injury: a Meta-Analysis.

A thorough understanding of the relationship between cognitive test performance and symptoms of depression, anxiety, or post-traumatic stress disorder (PTSD) in people with traumatic brain injury (TBI) is important given the high prevalence of these emotional symptoms following injury. It is also important to understand whether these relationships are affected by TBI severity, and the validity of test performance and symptom report. This meta-analysis was conducted to investigate whether these symptoms are associated with cognitive test performance alterations in adults with a TBI. This meta-analysis was prospectively registered on the PROSPERO International Prospective Register of Systematic Reviews website (registration number: CRD42018089194). The electronic databases Medline, PsycINFO, and CINAHL were searched for journal articles published up until May 2020. In total, 61 studies were included, which enabled calculation of pooled effect sizes for the cognitive domains of immediate memory (verbal and visual), recent memory (verbal and visual), attention, executive function, processing speed, and language. Depression had a small, negative relationship with most cognitive domains. These relationships remained, for the most part, when samples with mild TBI (mTBI)-only were analysed separately, but not for samples with more severe TBI (sTBI)-only. A similar pattern of results was found in the anxiety analysis. PTSD had a small, negative relationship with verbal memory, in samples with mTBI-only. No data were available for the PTSD analysis with sTBI samples. Moderator analyses indicated that the relationships between emotional symptoms and cognitive test performance may be impacted to some degree by exclusion of participants with atypical performance on performance validity tests (PVTs) or symptom validity tests (SVTs), however there were small study numbers and changes in effect size were not statistically significant. These findings are useful in synthesising what is currently known about the relationship between cognitive test performance and emotional symptoms in adults with TBI, demonstrating significant, albeit small, relationships between emotional symptoms and cognitive test performance in multiple domains, in non-military samples. Some of these relationships appeared to be mildly impacted by controlling for performance validity or symptom validity, however this was based on the relatively few studies using validity tests. More research including PVTs and SVTs whilst examining the relationship between emotional symptoms and cognitive outcomes is needed.

Full and partial posttraumatic stress disorders in adults exposed to super typhoon Lekima: a cross-sectional investigation

BackgroundSuper typhoon Lekima had a maximum wind force of 16 (52 m/s) and hit Wenling city, Zhejiang province in China on August 10, 2019. The typhoon left many victims showing symptoms of posttraumatic stress disorder (PTSD).ObjectiveThis study aimed to assess the prevalence of full and partial PTSD to inform targeted interventions for adult victims.MethodIn total, four thousand seven hundred and forty-six adults who are parents of students in local primary and middle schools were recruited to participate in this study. Participants completed a trauma exposure scale and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition PTSD Checklist. Logistic regression analysis was used to examine the factors of full and partial PTSD.ResultsNine hundred and ten (19.2%) adults had full PTSD and 1775 (37.4%) had partial PTSD. Adults with a monthly income > 10,000 RMB (about 1530 dollars) and a high education level (bachelor’s degree or above) were less likely to have full or partial PTSD than those with lower income and lower education levels. In addition, married adults were less likely to have full PTSD than divorced or widowed ones. Higher rates of PTSD were observed among those aged ≥40 years, who were injured/trapped, whose family members/friends were injured/trapped, and who lost property.ConclusionsPartial and full PTSD were common among adults following super typhoon Lekima, and high income, high education level, and married status were protective factors, whereas trauma exposure was a risk factor of PTSD. Target psychological intervention should be provided to these victims who are in low income and education level, divorced and widowed, and experienced more serious trauma.

The impact of childhood maltreatment on the severity of childhood-related posttraumatic stress disorder in adults

BackgroundChildhood maltreatment is relatively common and is related to a range of negative consequences, such as Posttraumatic Stress Disorder (PTSD). There are indications that various maltreatment types are related to PTSD severity, although not all types, such as emotional abuse, meet the PTSD Criterion-A. ObjectiveThe aim of the present study was to examine the relationship between 5 types of childhood maltreatment (i.e., sexual, physical, and emotional abuse, and physical and emotional neglect) and the severity of adult PTSD and PTSD symptoms. Participants and settingAdult participants (N = 147) with Childhood-related PTSD (Ch-PTSD) recruited from clinical sites completed the Childhood Trauma Questionnaire-short form (CTQ-sf) and 2 PTSD measures: The Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and the PTSD Checklist for DSM-5 (PCL-5). MethodsChildhood maltreatment predictors and 2 covariates, age and gender, were analysed in multivariate multilevel models as participants were nested within sites. A model selection procedure, in which all combinations of predictors were examined, was used to select a final set of predictors. ResultsThe results indicated that emotional abuse was the only trauma type that was significantly related to severity of PTSD and to the severity of specific PTSD symptom clusters (r between 0.130 and 0.338). The final models explained between 6.5% and 16.7% of the variance in PTSD severity. ConclusionsThe findings suggest that emotional abuse plays a more important role in Ch-PTSD than hitherto assumed, and that treatment should not neglect processing of childhood emotional abuse.