Total Trauma Score Research Articles

The effect of thoracic trauma scoring system in thoracic trauma patients with rib fracture

Objective Rib fractures are common in thoracic trauma patients. There are various factors, including flail chest, pulmonary contusion, and accompanying conditions, affecting morbidity and mortality. The study aimed to identify high-risk patients for morbidity and mortality with a scoring system that the authors created. Methods Cases over the age of 18 admitted due to trauma and diagnosed with rib fractures between 1 January 2019 and 1 March 2023, were included. Trauma scores were determined by applying the new trauma scoring system. Trauma scores and other variables regarding morbidity and mortality were evaluated. Results A total of 1023 cases were included in the study. The total trauma scores were higher in bilateral and multiple fractures. In those without respiratory failure, the total score was statistically significantly lower than in the groups with respiratory failure. The total score was significantly higher in those who needed surgery, those who were hospitalized, and those who needed intensive care compared to the non-surgical groups. However, there was no correlation between intensive care unit stay and total score. Trauma mechanism, presence of additional extrathoracic pathology, and thoracic trauma-age score were independent predictors of survival. Conclusion The present study demonstrated that the number of rib fractures and the presence of pulmonary contusion did not have an effect on mortality and morbidity. The presence of extrathoracic pathology and age significantly affect survival.

Deprem sonrası erken dönemde travma belirtileri, uyku kalitesi ve ilişkili faktörler

Aim: Traumatic life events such as earthquake are frequently encountered problems both in our country and all over the world. The aim of this study was to determine sleep quality, trauma level and related factors and to evaluate the effects of gender, damage status and losses in adults who were admitted to the psychiatry outpatient clinic among individuals who were placed in Kırıkkale University student dormitories immediately after the 6 February 2023 earthquakes that affected a wide geography in our country.
 Methods: 64 volunteers were included in the study between March 2023 and June 2023. After the participants' complaints and sociodemographic characteristics were questioned, the Pittsburgh Sleep Quality Index (PSQI) and the Scale That Determines the Level of the Trauma after the Earthquake (PETLDS) were applied to the participants to determine their sleep quality and trauma levels after the earthquake.
 Results: 
 The mean age of the participants was 45.5±15.5, and 75.0% of them were women. Fear/anxiety and insomnia were the most frequently reported complaints by the participants. The mean of the participants' PSQI scores was 10.5±4.4, and 43 participants (79.6%) had poor sleep quality in the last month. The mean score of the participants' PETLDS was determined as 76.6±17.9. When the subscales were examined, it was determined that the emotional limitation and cognitive restructuring scores were higher than the behavioral, affective and sleep problems. When the participants were compared in terms of damage in their homes, it was found that the participants with moderately or more damaged houses had statistically higher emotional, cognitive restructuring and sleep problems and total trauma scores compared to the participants with a solid or slightly damaged house (respectively; p=.017, p=.023, p=.010, p=.040). Individuals with moderately or more damaged houses had higher PSQI scores but this difference did not reach statistical significance (p=.061).
 Conclusion: The earthquakes that occurred in our country on and after 6 February 2023 affected a large area and resulted in millions of people being directly or indirectly affected. To minimize the physical and psychological damage that earthquakes may cause, post-disaster management should be carried out well, and it should be noted that it is a priority to support earthquake victims psychologically as well as their social and medical needs.

Mean comparisons of trauma symptoms between a reproductive trauma sample and a normative sample: Toward a trauma-informed practice.

Traditionally, adverse reproductive experiences have been described as stressful events for the individuals who experience them. However, a growing body of evidence suggests that the term "stress" minimizes this experience, and adverse reproductive experiences should be reconceptualized as reproductive trauma. Currently, there are few ways that clinicians have agreed are valid pathways to measure trauma symptoms within this population. The purpose of this study was to examine comparisons between a sample of individuals who have experienced reproductive trauma to a normative sample utilizing the Posttraumatic Checklist for the DSM-V (PCL-V). This study utilized a descriptive observational design. Participants indicated what form of adverse reproductive events they had experienced (with options including infertility, miscarriage, stillbirth, premature birth, complicated pregnancy, and distress during delivery), and then completed the PCL-V regarding their experience with this event. These data were compared with a PCL-V normative sample using multivariate analysis of variance (MANOVA) models. Significant mean differences between the reproductive trauma groups and the normative group were found for at least one subscale (intrusion, avoidance, arousal, or changes in mood and cognition) for the infertility group, multiple miscarriages, stillbirth, complicated pregnancy, premature birth, and distress during delivery. Premature birth, distress during pregnancy, and stillbirth groups also noted total trauma scores significantly higher than the normative group. Results validate the use of the term reproductive trauma, despite constraints presented by Criteria A of PTSD in the DSM-V. Results also present indications for clinical treatment and diagnosis for psychologists and health professionals working with this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The association of childhood trauma with depressive and negative symptoms in recent onset psychosis: a sex-specific analysis.

Childhood trauma may impact the course of schizophrenia spectrum disorders (SSD), specifically in relation to the increased severity of depressive or negative symptoms. The type and impact of trauma may differ between sexes. In a large sample of recent-onset patients, we investigated the associations of depressive and negative symptoms with childhood trauma and whether these are sex-specific. A total of 187 first-episode psychosis patients in remission (Handling Antipsychotic Medication: Long-term Evaluation of Targeted Treatment study) and 115 recent-onset SSD patients (Simvastatin study) were included in this cross-sectional study (men: n = 218; women: n = 84). Total trauma score and trauma subtypes were assessed using the Childhood Trauma Questionnaire Short Form; depressive and negative symptoms were rated using the Positive And Negative Symptoms Scale. Sex-specific regression analyses were performed. Women reported higher rates of sexual abuse than men (23.5% v. 7.8%). Depressive symptoms were associated with total trauma scores and emotional abuse ratings in men (β: 0.219-0.295; p ≤ 0.001). In women, depressive symptoms were associated with sexual abuse ratings (β: 0.271; p = 0.011). Negative symptoms were associated with total trauma score and emotional neglect ratings in men (β: 0.166-0.232; p ≤ 0.001). Negative symptoms in women were not linked to childhood trauma, potentially due to lack of statistical power. Depressive symptom severity was associated with different types of trauma in men and women with recent-onset SSD. Specifically, in women, depressive symptom severity was associated with childhood sexual abuse, which was reported three times as often as in men. Our results emphasize the importance of sex-specific analyses in SSD research.

Childhood trauma and neurocognitive functions in individuals with bipolar disorder and unaffected siblings of individuals with bipolar disorder

Previous studies have suggested a possible connection between childhood trauma, the course of illness, and neurocognitive impairment in individuals with bipolar disorder (BD). This cross-sectional study aimed to investigate the relationship between childhood trauma and neurocognitive functioning in a sample consisting of 41 euthymic individuals with BD, 37 individuals who have at least one sibling with BD, and 48 healthy controls (HCs). We assessed childhood trauma history using the Childhood Trauma Questionnaire (CTQ). Both the BD and Sibling groups showed higher rates of emotional abuse, neglect, and higher total trauma scores compared to the HCs. A principal component analysis of the neurocognitive test battery revealed a global cognition factor responsible for 49.40% of the variance and five subsequent neurocognitive components: working memory & response inhibition, verbal memory, visual copying, verbal fluency, and processing speed. Individuals with BD had lower scores in verbal memory, visual copying, processing speed, and global cognitive factor domains than the Siblings and HCs. The Siblings' performance was similar to that of the HC group. Correlation analyses showed significant correlations between physical neglect, sexual abuse, and neurocognitive domains like processing speed, verbal fluency, working memory, and the global cognitive factor. However, the linear regression analyses didn’t reveal a significant influence of childhood trauma on neurocognitive domains. Our findings indicate that both individuals with BD and their unaffected siblings have a high occurrence of childhood trauma, but presence of bipolar disorder itself appears to influence neurocognitive functioning independently of childhood traumatic experiences or familial predisposition to bipolar disorder.

An epigenetic association analysis of childhood trauma in psychosis reveals possible overlap with methylation changes associated with PTSD

Patients with a severe mental disorder report significantly higher levels of childhood trauma (CT) than healthy individuals. Studies have suggested that CT may affect brain plasticity through epigenetic mechanisms and contribute to developing various psychiatric disorders. We performed a blood-based epigenome-wide association study using the Childhood Trauma Questionnaire-short form in 602 patients with a current severe mental illness, investigating DNA methylation association separately for five trauma subtypes and the total trauma score. The median trauma score was set as the predefined cutoff for determining whether the trauma was present or not. Additionally, we compared our genome-wide results with methylation probes annotated to candidate genes previously associated with CT. Of the patients, 83.2% reported CT above the cutoff in one or more trauma subtypes, and emotional neglect was the trauma subtype most frequently reported. We identified one significant differently methylated position associated with the gene TANGO6 for physical neglect. Seventeen differentially methylated regions (DMRs) were associated with different trauma categories. Several of these DMRs were annotated to genes previously associated with neuropsychiatric disorders such as post-traumatic stress disorder and cognitive impairments. Our results support a biomolecular association between CT and severe mental disorders. Genes that were previously identified as differentially methylated in CT-exposed subjects with and without psychosis did not show methylation differences in our analysis. We discuss this inconsistency, the relevance of our findings, and the limitations of our study.

Impact of adverse childhood experiences on the symptom severity of different mental disorders: a cross-diagnostic study

BackgroundAdverse childhood experiences have a significant impact on different mental disorders.ObjectiveTo compare differences in adverse childhood experiences among those with different mental disorders and their relationships in a cross-disorder manner.MethodsThe...

F76. CHILDHOOD TRAUMA RELATED TO ABNORMAL SOCIAL COGNITION IN SCHIZOPHRENIA

BackgroundChildhood trauma has been proposed as a risk factor for schizophrenia. Moreover, it has been related to brain abnormalities associated with cognitive functions, including social cognition. Alterations in mentalizing skills are found in both schizophrenia patients and individuals exposed to childhood trauma. We hypothesize that childhood trauma might be related to emotional processing deficits in psychotic patients.MethodsThe present study is ongoing. To date, we have assessed social cognition and childhood trauma in 30 patients with schizophrenia. Social cognition is quantified using Mayer, Salovey and Caruso emotional intelligence test (MSCEIT) with five different categories: i) emotional perception, ii) emotional facilitation, iii) emotional comprehension, iii) emotional management and iv) emotional intellectual quotient dimensions. Early trauma data is collected using Childhood Trauma Questionnaire (CTQ), which yields physical, emotional, sexual abuse and neglect scores. We have assessed the correlation coefficients (Spearman′s rho) between childhood trauma and social cognition scores.ResultsAccording to our preliminary analyses, there are significant inverse correlation coefficients in the patients group between emotional neglect and total trauma scores and, on the other hand, social cognition scores for the facilitation, comprehension, management and emotional intellectual quotient dimensions. Thus, patients with higher scores reflecting more severe emotional neglect and total trauma performed lower in social cognition tests.DiscussionChildhood trauma experiences may contribute to social cognition deficits in schizophrenia.

Early trauma experiences, parenting styles, and personality patterns in individuals with depression from India

The study was carried out to understand the vulnerability factors for depression. The objectives were to, explore the early trauma experiences, parenting styles and personality patterns in depression and to examine relationship between the variables.The Sample composed of 30 individuals diagnosed with depression and 30 controls from the community in the age range of 18–45 years. The tools used were Socio demographic sheet, MINI-International Neuropsychiatric Interview Plus, Beck Depression Inventory- II, Early Trauma Inventory Self Report-Short Form, Parental Bonding Instrument, Sociotropy-Autonomy Scale, and General Health Questionnaire –12. Study group had significantly lower score on father care and higher overprotection from both parents along with higher scores on general punishment, emotional abuse, total trauma score and sociotropy compared to control group. Depression and early trauma experiences were positively correlated with mother’s overprotection and negatively correlated with mother ...

Self-Injury and Suicide Attempt in Relation with Trauma and Dissociation among Adolescents with Dissociative and Non-Dissociative Disorders

ObjectiveTo explore the role of trauma and dissociation over self-injurious behaviors (SIB) and suicide attempts (SA) in adolescents.MethodsA total of 207 adolescents participated in the study. After conducting diagnostic interview, participants were divided into five groups as subjects with dissociative disorders (DD), attention deficit hyperactivity disorder (ADHD), major depressive disorder (MDD) and anxiety disorders (AD), and a control group (CG) without any psychiatric disorder. ADHD, MDD and AD groups were considered as non-dissociative disorders (non-DD group) in the present study.ResultsThere is no significant difference between groups in terms of number and age of the subjects (p>0.05). Among all participants SIB was reported in 32.2% of females (n=37) and 25% of males (n=23) while SA was reported in 29.6% of females (n=34) and 4.4% of males (n=4). Adolescents with DD were found to experience higher rates of SIB and SA than the other groups. Dissociation was the most important variable contributing to SIB and female gender was the most efficient variable for SA. Total trauma scores were also found to be significantly higher in DD group followed by non-DD and CG respectively.ConclusionSIB and SA are complex behavioral problems which may be associated with many psychiatric factors. However higher level dissociation seems as an important mediating factor, even regardless of psychiatric diagnosis, in the development of SIB and SA. More research is needed to further explore the factors effective over SIB and SA in adolescents.

A History of Childhood Trauma and Response to Treatment With Antipsychotics in First-Episode Schizophrenia Patients: Preliminary Results.

In this study, we aimed to investigate whether a history of childhood trauma (CT) can help predict early response to antipsychotic treatment in patients with first-episode schizophrenia (FES). We recruited 64 FES patients who were followed up after 12 weeks of treatment with second-generation antipsychotics. Symptomatic manifestation was examined using the Positive and Negative Syndrome Scale (PANSS). Childhood adversities were assessed using the Early Trauma Inventory Self-Report-Short Form. Nonresponders had significantly higher general trauma score, emotional abuse score, total trauma score, and baseline PANSS negative factor score. A history of CT was significantly more frequent among nonresponders. Logistic regression analysis revealed that positive history of CT, higher emotional abuse score, and higher baseline PANSS negative factor score are significant predictors of poor response to treatment. Our results indicate that a history of CT, especially emotional abuse, and higher severity of negative symptoms are independent predictors of poor response to treatment with antipsychotics.

Childhood maltreatment increases the risk of suicide attempt in schizophrenia

ObjectivesIn this study, we evaluated the effect of several types of childhood trauma on lifetime suicide attempt in patients with schizophrenia spectrum disorders. MethodsWe interviewed 361 participants with schizophrenia. Childhood trauma was collected using the Childhood Trauma Questionnaire (CTQ). Suicidal attempts were confirmed using subjective and objective validated scales. We applied an observational study design using propensity scores to match individuals with history of childhood trauma to those without past history of trauma. We used logistic regression models to estimate the effect of each type of childhood maltreatment on suicidal attempts controlling for demographics and known suicidal risk factors. ResultsIn our sample, 39.1% of the subjects had lifetime suicide attempt. After matching the two groups and controlling for demographics and clinical confounders, total trauma score and the majority of childhood maltreatment subtypes predicted suicide attempt (odds ratios ranged from 1.74 to 2.49 with p-values ranging from 0.001 to 0.02). Physical neglect was not significantly associated with suicide attempt in our sample (p=0.94). ConclusionChildhood maltreatment is confirmed to be a strong independent risk factor for suicidal attempts in schizophrenia. The risk is probably aggravated by the development of depressive symptoms and feeling of hopelessness in the adult life. Early screening and modified psychosocial treatment are recommended for psychotic individuals with trauma history.

Lower LINE-1 methylation in first-episode schizophrenia patients with the history of childhood trauma.

We investigated methylation of DNA repetitive sequences (LINE-1 and BAGE) in peripheral blood leukocytes from first-episode schizophrenia (FES) patients and healthy controls (HCs) with respect to childhood adversities. Patients were divided into two subgroups based on the history of childhood trauma - FES(+) and FES(-) subjects. The majority of HCs had a negative history of childhood trauma - HCs(-) subjects. FES(+) patients had significantly lower LINE-1 methylation in comparison with FES(-) patients or HC(-) subjects. Emotional abuse and total trauma score predicted lower LINE-1 methylation in FES patients, while general trauma score was associated with lower BAGE methylation in HCs. Childhood adversities might be associated with global DNA hypomethylation in adult FES patients.

Hypomethylation of Line-1 is Associated with Lifetime Experience of Traumatic Events in First-episode Schizophrenia Patients

Introduction Accumulating evidence indicates concordant epigenetic dysregulation in the brain and peripheral blood leukocytes in schizophrenia. It has also been found that stressful and traumatic events may alter DNA methylation; however, such studies have not been performed in schizophrenia patients. Objectives This study aimed at comparing LINE-1 methylation in first-episode schizophrenia (FES) patients and healthy control (HC) subjects with respect to the history of trauma. Methods We recruited 40 FES patients and 49 HC subjects matched for age, gender and body mass index (BMI). The early trauma self-report – short form (ETISR-SF) was administered to assess traumatic events. In addition to assessment of LINE-1 methylation, serum levels of homocysteine, folate and vitamin B12 were measured in all subjects. Results There was no significant difference in LINE-1 methylation between FES patients and HC subjects. However, LINE-1 methylation was significantly lower in FES patients with positive history of trauma when compared with FES patients and HC subjects with negative history of trauma (58.08±3.27% vs. 61.28±4.12%, p = 0.022 and 58.08±3.27% vs. 61.12±4.73%, p = 0.038, respectively). There was no significant difference in LINE-1 methylation between FES patients and HC subjects with negative history of trauma. There was a negative correlation between total trauma score and LINE-1 methylation (r = −0.390, p = 0.012). After controlling for confounding variables (age, gender, treatment duration, pack-year index, metabolic parameters), LINE-1 methylation was associated with total trauma score (p = 0.011). Conclusions Traumatic events might be associated with lower global DNA methylation in FES patients.

What doesn't kill you makes you stronger and weaker: How childhood trauma relates to temperament traits

Childhood trauma arises from damaging experiences and the absence of a secure and reliable environment for child development. Despite many studies on the risk for developing psychiatric disorders, much less is known on the relationship between traumatic experiences and personality traits. A total of 10,800 participants (mean age 27.7 ± 7.8 years old, 69.8% women) anonymously answered the Childhood Trauma Questionnaire (CTQ) and the Affective and Emotional Composite Temperament Scale (AFECTS) in the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP). The results showed that total trauma score was associated with lower levels of positive traits (volition, control, coping, and stability), higher scores of negative traits (sensitivity, anger, anxiety) and a higher frequency of depressive and cyclothymic temperaments. Linear regression analysis showed similar findings for emotional abuse and neglect, whereas physical abuse and neglect were positively associated with more volition and coping as well as less fear, sensitivity and anxiety traits, especially in men. This study has a cross-sectional design and the sole use of self-reporting as the main limitations. In conclusion, dysfunctional temperament profiles were associated mainly with emotional trauma and sexual abuse. Some adaptive traits were associated with physical abuse and neglect, especially in men. These results reinforce the negative impact of emotional trauma and people's resilience to physical trauma, which may even translate into adaptive trait expression in males particularly. We propose that the “context-dependent nature” of stress should be further studied to break down the influence of specific types and contexts of adversity on psychological and psychiatric outcomes.

Revisiting the Child and Adolescent Survivors of 2004 Tsunami: A Follow-up Study

82 adolescent survivors of December 26, 2004 tsunami waves were assessed for their current level of posttraumatic stress (PTS) and posttraumatic growth (PTG). The intrusive and avoidance reactions were compared against their baseline level measured in 2006. The effect of death of family members and rehabilitation experiences (stay in rehabilitation camp and receiving relief material) on the posttraumatic outcomes was examined. Further, the mediating effect of schema changes, coping, and cognitive-emotional regulation strategies on the relationship between baseline trauma and posttraumatic outcomes was also explored. The findings suggested an overall reduction in trauma level with significant decline in intrusion, avoidance, and total trauma in males. However, the intrusion level had increased in females. The findings also indicated significant sex difference with females scoring high on PTS as well as PTG. Self-blame mediated the relationship between baseline and current levels of avoidance as well as baseline avoidance and spiritual change. Reflective coping significantly mediated the relationship between baseline intrusion and relating to others and personal strength. It also mediated the relationship between baseline total trauma score and relating to others, personal strength, and spiritual change. Preventive coping mediated the relationship between intrusion and appreciation of life, whereas instrumental support seeking mediated the relationship between baseline avoidance and new possibilities and appreciation of life.

The prevalence and impact of early childhood trauma in Chronic Fatigue Syndrome

BackgroundAlthough some studies have found high rates of early childhood trauma in Chronic Fatigue Syndrome (CFS), the role of early trauma in this condition remains controversial. MethodsThis study examined the prevalence of early childhood trauma and its impact on daily fatigue and pain levels over a 14-day period in a sample of 90 carefully screened CFS patients using a diary method approach. Data were analyzed using multilevel analysis. ResultsMore than half of the patients (54.4%) had experienced at least one type of early trauma, with the majority of these patients reporting multiple traumas. Prevalence rates were particularly high for emotional trauma (i.e., emotional abuse and/or emotional neglect) (46.7%). Moreover, total trauma scores and emotional abuse significantly predicted higher levels of daily fatigue and pain over the 14-day period, even when controlling for demographic features and depressed mood. ConclusionsThis is the first study to demonstrate that early childhood trauma predicts increasing levels of core symptoms of CFS in the daily flow of life. Moreover, findings of this study suggest that emotional trauma may be particularly important in CFS.

Persecutory delusions and childhood emotional abuse in people with a diagnosis of schizophrenia

The present research assesses the frequency of self-reported childhood trauma in individuals with and without persecutory delusions. Comparisons are made between reported childhood emotional, physical and sexual trauma in adults with a diagnosis of schizophrenia, with (n = 36) and without (n = 23) persecutory delusions. Those with persecutory delusions reported significantly higher levels of emotional abuse and there was a trend towards higher levels of emotional neglect. No differences emerged on total trauma score, physical abuse, physical neglect and sexual abuse. The study suggests that over and above a general association between childhood trauma and positive symptoms of psychosis, there may exist a specific link between persecutory delusions and childhood emotional abuse.

P01-379 - Childhood trauma, dissociation in patients with fibromyalgia and rheumatoid arthritis

IntroductionThe contribution of childhood trauma and dissociation to the unknown pathophysiology of fibromyalgia has been the subject of considerable debate.ObjectivesTo assess and compare the relationship of childhood trauma and somatoform dissociation between patients with fibromyalgia and rheumatoid arthritis both of which are characterized by chronic pain and disability.AimsEarly life and prolonged trauma may affect brain modulatory circuitry of pain and emotions. The findings of relationship between traumatic events, dissociation and fibromyalgia can lead to a better understanding of the etiology and suggest new treatment modalities.MethodsThirty-one patients with fibromyalgia and 19 patients with rheumatoid arthritis were enrolled in the study. All participants were asked to fill in the Childhood Trauma Questionnaire, Somatoform Dissociation Questionnaire and Dissociation Questionnaire.ResultsPhysical neglect score was higher in fibromyalgia group than rheumatoid arthritis group (p < 0.05) although there was no significant difference between two groups in other subscores of childhood trauma and the rest of the dissociation scores. Total trauma scores were positively correlated with dissociation scores in fibromyalgia group whereas this correlation was not seen in rheumatoid group.ConclusionsAmong childhood trauma types, physical neglect seems to have a more important role in fibromyalgia than rheumatoid arthritis. Fibromyalgia may be related to early life stress or prolonged trauma, affecting brain modulatory circuitry of pain and emotions in genetically susceptible individuals.