Psychological Trauma Symptoms Research Articles

Assessment of Narrative Exposure Therapy on the Psychological Trauma Symptoms of Victims of Violent Community Attacks

Assessment of Narrative Exposure Therapy on the Psychological Trauma Symptoms of Victims of Violent Community Attacks

Traumatic Brain Injury, Psychological Trauma Exposure, and Anxious and Depressive Symptoms in a Clinical Population.

Approximately 90% of adults endorse psychological trauma exposure. However, barriers to assessment of psychological trauma and sequelae include limited access to care, lack of standardized assessments in nonpsychiatric settings, and comorbid diagnoses, such as traumatic brain injury (TBI), that may mimic psychiatric syndromes. This study aims to assess the prevalence rates of psychological trauma exposure and TBI to understand the relationship of these experiences with current psychiatric symptoms. This is a cross-sectional study of a convenience sample of adult patients (age 18years and older) referred for outpatient evaluation at a neuropsychology clinic in the Western United States between September 2021 and October 2022. Patients completed a clinical interview to assess their history of psychological trauma, TBI, and current psychiatric symptoms. A total of 118 patients met inclusion criteria. Patients in the TBI group (n = 83) endorsed significantly higher rates of childhood trauma and prior physical, emotional, and sexual abuse compared with the No TBI group (n = 35). Psychological trauma exposure and TBI significantly predicted current anxiety and depressive symptoms, but there was no interaction between these experiences in predicting current psychiatric symptoms. Individuals with prior TBI experienced psychological trauma, particularly childhood trauma, at a significantly higher rate than those without TBI. Psychological trauma exposure and TBI independently predicted anxious and depressive symptoms, suggesting both may be viable treatment targets. Evaluation of prior psychological trauma exposure during evaluation of TBI may provide opportunities for trauma-informed care and may allow for improved outpatient treatment planning.

Psychological pathway to emotional exhaustion among nurses and midwives who provide perinatal bereavement care in China: a path analysis

BackgroundA lack of confidence in perinatal bereavement care (PBC) and the psychological trauma experienced by nurses and midwives during bereavement care leads to their strong need for sufficient organisational support. The current study intended to test a hypothesised model of the specific impact paths among organisational support, confidence in PBC, secondary traumatic stress, and emotional exhaustion among nurses and midwives.MethodsA descriptive, cross-sectional survey was conducted in sixteen maternity hospitals in Zhejiang Province, China, from August to October 2021. The sample (n = 779) consisted of obstetric nurses and midwives. A path analysis was used to test the relationships among study variables and assess model fit.ResultsOrganisational support directly and positively predicted confidence in PBC and demonstrated a direct, negative, and significant association with secondary traumatic stress and emotional exhaustion. Confidence in PBC had a positive direct effect on secondary traumatic stress and a positive indirect effect on emotional exhaustion via secondary traumatic stress. Secondary traumatic stress exhibited a significant, direct effect on emotional exhaustion.ConclusionsThis study shows that nurses' and midwives' confidence in PBC and mental health were leadingly influenced by organisational support in perinatal bereavement practice. It is worth noting that higher confidence in PBC may lead to more serious psychological trauma symptoms in nurses and midwives. Secondary traumatic stress plays an essential role in contributing to emotional exhaustion. The findings suggest that support from organisations and self-care interventions were required to improve confidence in PBC and reduce negative psychological outcomes among those providing PBC. The development of objective measures for assessing competence in PBC and organizational support are essential.

Victimization during the COVID-19 pandemic and symptoms of psychological trauma in early and late adolescents: the mediating role of loneliness

This study aims to analyze the effect of victimization suffered during the COVID-19 lockdown on psychological trauma in early and late adolescents. The sample of this study comprised of 933 Peruvian adolescents, 45.5% (n= 423) were males and (54.5%) (n= 506) were females. 44.5% (n=415) were in early adolescence (12 to 13 years) and 55.5 % (n=518) were in late adolescence (14 to 17 years). Data was collected online during the COVID-19 lockdown. Results show that early adolescents who have suffered victimization have higher probabilities of suffering psychological trauma than late adolescents compared to non- victims. In addition, loneliness is observed to play a significant role as a mediator in the relationship between victimization and psychological trauma in Early Adolescents (B = .69, SE = 0.08, CI [ .53, .86]) and late adolescents (B = .66, SE = 0.07, CI [.51, .81]). Results suggests that the cost-benefit of COVID 19 lockdown should be reconsidered. Social distance could had made difficult for adolescents to stablish interpersonal relationships and solve conflicts associated with victimization. Loneliness could be an expression of these difficulties and therefore explain symptoms of psychological trauma. Finally, results are discussed in order to prevent the harmful effects of the pandemic and the measures taken on adolescent mental health, especially in middle- and low-income countries.

Psychological Disclosure of a World within Human Mind: A Study of Eugene O’neill’s The Emperor Jones

The Emperor Jones is a psychological study of the mind, fears, visions, and dreams of Brutus Jones, the protagonist of the work. In the same piece, Tom-Tom symbolizes the last heartbeat and death of a person. Jones's awareness is expressed in his technique of cinematic flashbacks linking past and present. Symbolism and psychology merge here and the whole play becomes one long drama. Eugene O'Neill compresses the summary of an event of trauma into eight scenes, expressing the personal and collective trauma of an individual and a society caused by a distorted sense of self and one’s concept of identity with respect to political repression as well as cultural colonization. By externalizing the symptoms of psychological trauma in the reconstruction of Black identity together with nationalism, O'Neill’s play symbolically lets readers participate in perceptions of the evolution of trauma and the ongoing threat of psychosocial trauma.

The effects of trauma on feedback processing: an MEG study.

The cognitive impact of psychological trauma can manifest as a range of post-traumatic stress symptoms that are often attributed to impairments in learning from positive and negative outcomes, aka reinforcement learning. Research on the impact of trauma on reinforcement learning has mainly been inconclusive. This study aimed to circumscribe the impact of psychological trauma on reinforcement learning in the context of neural response in time and frequency domains. Two groups of participants were tested - those who had experienced psychological trauma and a control group who had not - while they performed a probabilistic classification task that dissociates learning from positive and negative feedback during a magnetoencephalography (MEG) examination. While the exposure to trauma did not exhibit any effects on learning accuracy or response time for positive or negative feedback, MEG cortical activity was modulated in response to positive feedback. In particular, the medial and lateral orbitofrontal cortices (mOFC and lOFC) exhibited increased activity, while the insular and supramarginal cortices showed decreased activity during positive feedback presentation. Furthermore, when receiving negative feedback, the trauma group displayed higher activity in the medial portion of the superior frontal cortex. The timing of these activity changes occurred between 160 and 600 ms post feedback presentation. Analysis of the time-frequency domain revealed heightened activity in theta and alpha frequency bands (4-10 Hz) in the lOFC in the trauma group. Moreover, dividing the two groups according to their learning performance, the activity for the non-learner subgroup was found to be lower in lOFC and higher in the supramarginal cortex. These differences were found in the trauma group only. The results highlight the localization and neural dynamics of feedback processing that could be affected by exposure to psychological trauma. This approach and associated findings provide a novel framework for understanding the cognitive correlates of psychological trauma in relation to neural dynamics in the space, time, and frequency domains. Subsequent work will focus on the stratification of cognitive and neural correlates as a function of various symptoms of psychological trauma. Clinically, the study findings and approach open the possibility for neuromodulation interventions that synchronize cognitive and psychological constructs for individualized treatment.

Responding to Symptoms of Psychological Trauma

Responding to Symptoms of Psychological Trauma

Effect of COVID-19 Pandemic on the Mental Health of Healthcare Workers

Background: The novel coronavirus 2019, or COVID-19, has gripped all corners of the world and has created a crisis that significantly affected people's mental health around the globe, including healthcare workers (HCWs). Purpose: This study aimed to bring the results to the attention of healthcare systems' policymakers and managers so as to fully recognize the severity of the situation and set the groundwork for appropriate interventions to address the condition of HCWs. Methods: This systematic review searched PubMed, Google, Google Scholar, and Scopus for literature relevant to mental health conditions among healthcare workers during this pandemic. This review includes the searches from March to October 2020. Results: The main findings were symptoms of anxiety, depression, stress, psychological trauma, insomnia and sleep problems, burnout and fatigue, and distress. Most studies suggest that social and family support, hygiene measures, and physical activity are safeguards for mental health and are among the recommended protective interventions for promoting mental health. Limitations: The researcher has reservations about the findings' generalizability as the samples may not represent the population. Conclusion: This review highlights the existing burden of mental health conditions reported by HCWs during the COVID-19 pandemic. It revealed consistent reports of stress, anxiety, and depressive symptoms resulting from COVID-19. Implications: Longitudinal data will be helpful through surveys of representative samples of the general population. More relevant and recent data in Asian countries could inform understanding of challenges concerning COVID-19 and the impacts on healthcare workers' mental health and well-being, particularly those in the Philippines.

Organizational Change Strategies to Support High-Quality Behavioral Health Care for LGBTQ Individuals.

There is growing recognition of the need to provide high quality behavioral health care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ) individuals. Research suggests that the LGBTQ community experiences high levels of psychological distress, psychological trauma, and other mental health symptoms as a result of minority stress. Despite these findings, the LGBTQ community continues to face barriers when seeking affirming behavioral health treatment. Using an established framework, this commentary highlights one behavioral health managed care organization's (BHMCO) work towards organizational change in the hopes of creating an affirming and inclusive environment for individuals influenced by the BHMCO (e.g., staff, members, behavioral health providers). In this commentary, we: (1) discuss the importance and role of insurers in promoting strategies to increase and deliver high quality care for LBGTQ individuals, (2) outline the steps our organization took to implement changes, (3) highlight the lessons learned throughout this process, and (4) provide recommendations for future efforts.

Prospective examination of psychological trauma among adolescents during the COVID-19 pandemic.

This longitudinal study investigated the predictors of and changes in psychological trauma during the COVID-19 pandemic. Participants included 236 adolescents (130 males; Mage = 16.74 years in spring 2020; 49.6% diagnosed with attention-deficit hyperactivity disorder; 16.1% diagnosed with an anxiety or depressive disorder) in the United States who completed online questionnaires at four timepoints (spring 2020, summer 2020, fall 2020, spring 2021). Repeated measures ANOVA showed that psychological trauma was highest during stay-at-home orders in spring 2020, and decreased for a majority of adolescents by the summer of 2020. However, ~20% of adolescents exhibited moderate-to-clinical levels of psychological trauma at each timepoint. Four groups were identified based on the presence of psychological trauma symptoms: (a) resilient group (normal range across all timepoints; 60.6%); (b) moderate fluctuating group (moderate range at 1 or more timepoints; 18.2%); (c) severe fluctuating group (clinical range at 1 or more timepoints; 14.0%); and (d) chronic psychological trauma group (moderate or clinical range across all timepoints; 7.2%). Females, adolescents with preexisting internalizing disorders, and participants whose families were most impacted by the pandemic were more susceptible to experiencing psychological trauma symptoms. Findings highlight at-risk populations and suggest that the COVID-19 pandemic resulted in psychological trauma symptoms for approximately 20% of adolescents at some point during the first year of the pandemic. There is critical need to provide mental health services to adolescents, such as through school-based services, to reduce the negative long-term psychological impact of the pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Correlates of Psychological Stress and Trauma Symptoms with COVID-19 Exposure among Healthcare Workers in a Tertiary Hospital

Abstract Background: During the Coronavirus (COVID-19) pandemic, Healthcare workers (HCWs) have been at the frontline of the healthcare and have reported higher risk of infection along with higher stress levels. This study aims to understand the association of the stress and trauma related symptoms in HCWs in relation to the COVID 19 exposure. Methods: A prospective follow up study was conducted in HCWs working at two obstetric centers in India from July to August 2020. HCWs who had been exposed to COVID 19 patients were assessed for stress and trauma related symptoms before the RTPCR test and once after the RTPCR test results were out. The Self Reporting Questionnaire (SRQ-20), Perceived Stress scale (PSS) and Impact of Event Scale – Revised (IES-R) were used to assess the stress and trauma related symptoms in HCWs. Results: A total of 151 HCWs participated in the study. 120 (79.4%) of the participants were female. 95 out of the 151 (62.5%) participants belonged to the 20-40 years age group. There was a significant reduction in stress related scores of HCWs in both SRQ-20 and PSS after the RTPCR results. Conclusion: There is increased psychological distress in HCWs after exposure to COVID infection, which significantly decreases once their COVID test is done. This indicates that the fear of infection itself is a stressful and traumatic process affecting the HCWs. The results highlight the importance of screening HCWs for stress related symptoms after exposure. Providing immediate psychological support to the HCWs will improve mental status and working capacity at the earliest.

Le temps d’une chanson : abord médiatisé de la blessure de guerre en thérapie de groupe

Post-traumatic stress disorders are a major concern for the armed forces. Certain pathognomonic symptoms of psychological trauma are expressed by isolation and avoidance behavior that are antithetical to the principle of group unity and cohesion that is so fundamental in the military. The Robert Picqué military hospital is located in the heart of a region where many operational regiments are stationed. For the past 20 years, the French army has been deployed in different countries at war, on foreign missions or OPEX (Afghanistan, Lybia, Mali) and interior operations or OPINT. The Robert Picqué psychiatric department has adapted its clinical activity to admit and treat the many soldiers who have been injured and has developed a multidisciplinary and integrative approach, which includes group therapy, to treat PTSD. In this context, the combination of two health professionals, one an occupational therapist and the other a psychomotor therapist, has resulted in the creation of an original therapeutic approach using musical and creative mediation in group activities. The benefits of therapeutic synergy help to build a framework for free expression and includes the use of songs and personal creative exercises using a variety of media. From the patients’ artistic creations, their drawings and writing, we can see how this double mediation favors social bonding and makes it possible to understand the personal, family, and professional repercussions of PTSD. Thus, the time of a song provides the patients with a space of relief, of security and the development of a collective elaboration of their suffering.

The journey to becoming trauma-informed - using pilot trauma training data to highlight the role of dental services in supporting patients affected by psychological trauma.

Rates of psychological trauma are increasing in the community. Psychological trauma symptoms may prevent patients from being able to access or tolerate dental treatment. The importance of dental teams providing equitable person-centred care by adopting a trauma-informed approach is discussed. One way to support dental services to be trauma-informed is through training staff in psychological trauma. An example from a Scottish Dental Hospital is provided. Directions for future research are discussed and the next steps in the journey to develop trauma-informed dental services are outlined.

Mechanisms of heightened pain-related disability in Canadian Armed Forces members and Veterans with comorbid chronic pain and PTSD

LAY SUMMARY Canadian Armed Forces (CAF) members and Veterans with chronic pain and posttraumatic stress disorder (PTSD) symptoms were surveyed. Participants with a high number of PTSD symptoms had a higher vulnerability to becoming psychologically traumatized by their chronic pain than participants with a low number of PTSD symptoms. In turn, participants with this high vulnerability reported experiencing more disability from their chronic pain than participants with a low vulnerability. In addition, participants with a high number of PTSD symptoms tended to have many catastrophic thoughts about their pain. In turn, these participants reported experiencing more disability from their chronic pain than participants with few catastrophic thoughts about their pain. PTSD may lead servicemembers and Veterans to experience high disability from their chronic pain by increasing how traumatized they feel by their pain and by increasing the number of catastrophic thoughts they have about their pain. Targeting pain-related psychological trauma symptoms and catastrophic thoughts when treating servicemembers and Veterans with chronic pain and PTSD may be effective at reducing disability from chronic pain.

Smartphone addiction risk, technology-related behaviors and attitudes, and psychological well-being during the COVID-19 pandemic.

COVID-19 pandemic-related perceived risk of infection, illness fears, acute stress, emotional anxiety, exhaustion, and fatigue, psychological trauma and depressive symptoms, and sustained psychological distress can cause smartphone addiction risk and lead to technology-related cognitive, emotional, and behavioral disorders, thus impacting psychological well-being. Behavioral addiction of smartphone users can result in anxiety symptom severity, psychiatric symptoms, and depressive stress. We carried out a quantitative literature review of the Web of Science, Scopus, and ProQuest throughout June 2022, with search terms including “smartphone addiction + COVID-19” + “stress,” “anxiety,” “depression,” “psychological distress,” “screen time,” and “fear.” As we analyzed only articles published between 2020 and 2022, 288 papers met the eligibility criteria. By excluding sources with similar titles, having unclear findings or unsupported by replication, or displaying inconsistent content, we selected 64, mainly empirical, sources. We used layout algorithms (VOSviewer) and bibliometric mapping (Dimensions) as data visualization tools. Assessing the Methodological Quality of Systematic Reviews (AMSTAR), a systematic review and literature review software (Distiller SR), Mixed Methods Appraisal Tool (MMAT), and Systematic Review Data Repository (SRDR) were employed as methodological quality assessment tools. As limitations, we analyzed only articles published between 2020 and 2022 in scholarly outlets indexed in the Web of Science, Scopus, and ProQuest databases. The scope of our study also does not advance the inspection of sources covering vulnerable individuals suffering from certain diseases or specific generations. Subsequent analyses should develop on smartphone use and addiction among children and adolescents. Future research should thus investigate problematic smartphone use and addiction across generations Z and Alpha. Attention should be directed to their personality traits and psychopathological symptoms.

Impact of Dialectical Behavior Therapy Prolonged Exposure protocol on trauma-related symptoms in Egyptian women with Borderline Personality Disorder

IntroductionAlthough around 50% of individuals with borderline personality disorder (BPD) suffer from trauma-related disorders, literature lacks a specific treatment for these serious co-occurring problems. Dialectical Behavior Therapy Prolonged Exposure (DBT PE) is a recent protocol developed by Melanie Harned, integrating (PE) into standard (DBT). The protocol has showed promising results in treating comorbid PTSD in BPD patients. The current study, however, was the first trial to apply DBT PE protocol in Egypt.ObjectivesTo investigate the efficacy of (DBT PE) protocol in reducing trauma-related symptoms (psychological trauma symptoms and trauma-related cognitions) among Egyptian women with BPD.MethodsSixteen women diagnosed with BPD and trauma-related symptoms, were recruited from “DBT clinic”, a private outpatient clinic in Alexandria, Egypt and randomly divided into equivalent (Therapeutic & Control) groups. The therapeutic group received DBT PE protocol while the control group received Treatment as usual (TAU). Participants were assessed pre and post-intervention using: The short version of the Borderline Symptom list, The Trauma Symptom Checklist-40, and The Posttraumatic Cognitions Inventory. The therapeutic group started treatment with standard comprehensive DBT concurrently with DBT PE protocol (14 individual sessions, 120 minutes/ week), according to readiness criteria suggested by the treatment developer.ResultsPatients who received DBT PE protocol showed significantly lower degrees of psychological trauma symptoms and trauma-related cognitions compared to patients in control group.ConclusionsDespite being applied for the first time in Egypt, DBT PE protocol proved to be an effective intervention in reducing trauma-related symptoms in a sample of Egyptian BPD patients without any need to modify the original protocol.DisclosureNo significant relationships.

COVID-19 one year on: identification of at-risk groups for psychological trauma and poor health-protective behaviour using a telephone survey

BackgroundThis study examined the profiles and correlates of psychological trauma, compliance with preventative measures, vaccine acceptance and participation in voluntary testing during the novel coronavirus disease 2019 (COVID-19) pandemic among the adult population in Hong Kong (n = 3,011).MethodsData were collected through a telephone survey between December 2020 and February 2021, using measures of psychological trauma, compliance with preventative measures, reading news reports on COVID-19, vaccine acceptance and willingness to participate in voluntary testing.ResultsThe prevalence of possible post-traumatic stress disorder was found to be 12.4%. Respondents were generally compliant with routine preventative measures, and approximately half had accepted vaccination and voluntary testing. Participants who had lower levels of education, were unemployed or had no income showed greater psychological trauma symptoms, whereas female, older and more educated participants showed greater compliance with preventative measures. Participants who spent more time watching news reports of COVID-19 had greater psychological trauma, but also greater compliance. Participants who were male, older, had lower education levels or were married showed greater acceptance of vaccination and participation in voluntary testing.ConclusionsSocio-demographic factors affected both psychological trauma and engagement in health-protective measures at one year after the onset of the pandemic. The theoretical and practical implications of these findings are discussed.

Piloting the feasibility of delivering Cognitive-Behavioral Conjoint Therapy online to military veterans and partners

ABSTRACT Cognitive-Behavior Conjoint Therapy (CBCT) for PTSD has demonstrated efficacy among military couples in which the veteran is experiencing PTSD. Yet, no studies to date have investigated delivering CBCT online. This brief report aims to describe the feasibility of delivering CBCT online to UK military couples. Six military veterans and their partners received CBCT, delivered using an online video platform. They completed mental health measures at the start and end of treatment as well as 12-weeks follow-up. Data trends suggested reduced psychological distress and trauma symptoms as well as increased wellbeing of veterans and partners. On the individual level, most veterans (83.3%) demonstrated clinically significant reductions in PTSD symptoms. Therapist reflections suggested client acceptability of treatment and highlighted considerations for delivering CBCT online. Clinical implications and the need for further empirical investigation of online-delivered CBCT are discussed.

The moderation of maternal parenting on the association of trauma, dissociation, and psychosis in depressive inpatients

ABSTRACT Background The effect of dissociation and parenting style on the relationship between psychological trauma and psychotic symptoms has not previously been investigated. Objective The aim of this study was to develop a moderated mediation model to assess whether the association between psychological trauma and psychotic symptoms is mediated by dissociation and moderated by parental maltreatment. Methods Inpatients with major depressive disorder (MDD) and bipolar depression (BP) were recruited. Self-reported and clinical rating scales were used to measure the level of dissociation, psychotic symptoms, history of psychological trauma and parental maltreatment. The PROCESS macro in SPSS was used to estimate path coefficients and adequacy of the moderated mediation model. High betrayal trauma (HBT), low betrayal trauma (LBT), paternal maltreatment, and maternal maltreatment were alternatively entered into the conceptual model to test the adequacy. Results A total of 91 patients (59 with MDD and 32 with BP) were recruited, with a mean age of 40.59 ± 7.5 years. After testing with different variables, the moderated mediation model showed that the association between LBT and psychotic symptoms was mediated by dissociation and moderated by maternal maltreatment. A higher level of maternal maltreatment enhanced the effect of LBT on dissociation. Conclusions Healthcare workers should be aware of the risk of developing psychotic symptoms among depressive patients with a history of LBT and maternal maltreatment.

Moral Injury, Traumatic Stress, and Threats to Core Human Needs in Health-Care Workers: The COVID-19 Pandemic as a Dehumanizing Experience

The pandemic has threatened core human needs. The pandemic provides a context to study psychological injury as it relates to unmet basic human needs and traumatic stressors, including moral incongruence. We surveyed 1,122 health-care workers from across the United States between May 2020 and August 2020. Using a mixed-methods design, we examined moral injury and unmet basic human needs in relation to traumatic stress and suicidality. Nearly one third of respondents reported elevated symptoms of psychological trauma, and the prevalence of suicidal ideation among health-care workers in our sample was roughly 3 times higher than in the general population. Moral injury and loneliness predict greater symptoms of traumatic stress and suicidality. We conclude that dehumanization is a driving force behind the psychological injury resulting from moral incongruence in the context of the pandemic. The pandemic most frequently threatened basic human motivations at the foundational level of safety and security relative to other higher order needs.