Trauma-specific Factors Research Articles

Application of artificial intelligence systems in the emergency room : Do the communication patterns give indications for possible starting points? An observational study

High expectations are currently attached to the application of artificial intelligence (AI) in the resuscitation room treatment of trauma patients with respect to the development of decision support systems. No data are available regarding possible starting points for AI-controlled interventions in resuscitation room treatment. Do information request behavior and quality of communication indicate possible starting points for AI applications in the emergency room? A 2‑stage qualitative observational study: 1.Development of an observation sheet based on expert interviews that depicts the following six relevant topics: situational factors (course of accident, environment), vital parameters, treatment-specific Information (treatment carried out). trauma-specific factors (injury patterns), medication, special features of the patient (anamnesis, etc.) 2.Observational study Which topics were inquired about during emergency room treatment? Was the exchange of information complete? There were 40consecutive observations in the emergency room. A total of 130 questions: 57/130 inquiries about medication/treatment-specific Information and vital parameters, 19/28 of which were inquiries about medication. Questions about injury-related parameters 31/130 with 18/31 regarding injury patterns, course of accident (8/31) and type of accident (5/31). Questions about medical or demographic background 42/130. Within this group, pre-existing illnesses (14/42) and demographic background (10/42) were the most frequently asked questions. Incomplete exchange of information was found in all six subject areas. Questioning behavior and incomplete communication indicate acognitive overload. Assistance systems that prevent cognitive overload can maintain decision-making abilities and communication skills. Which AI methods can be used requires further research.

Race differences in depression vulnerability following Hurricane Katrina.

This study investigated whether racial disparities in depression were present after Hurricane Katrina. Data were gathered from 932 New Orleans residents who were present when Hurricane Katrina struck, and who returned to New Orleans the following year. Multiple logistic regression models evaluated racial differences in screening positive for depression (a score ≥16 on the Center for Epidemiologic Studies Depression Scale), and explored whether differential vulnerability (prehurricane physical and mental health functioning and education level), differential exposure to hurricane-related stressors, and loss of social support moderated and/or reduced the association of race with depression. A univariate logistic regression analysis showed the odds for screening positive for depression were 86% higher for African Americans than for Caucasians (odds ratio [OR] = 1.86 [1.28-2.71], p = .0012). However, after controlling simultaneously for sociodemographic characteristics, preexisting vulnerabilities, social support, and trauma-specific factors, race was no longer a significant correlate for screening positive for depression (OR = 1.54 [0.95-2.48], p = .0771). The racial disparity in postdisaster depression seems to be confounded by sociodemographic characteristics, preexisting vulnerabilities, social support, and trauma-specific factors. Nonetheless, even after adjusting for these factors, there was a nonsignificant trend effect for race, which could suggest race played an important role in depression outcomes following Hurricane Katrina. Future studies should examine these associations prospectively, using stronger assessments for depression, and incorporate measures for discrimination and segregation, to further understand possible racial disparities in depression after Hurricane Katrina. (PsycINFO Database Record

Sixteen-year follow-up of childhood avalanche survivors

BackgroundEvery year a substantial number of children are affected by natural disasters worldwide. However, data are scarce on long-term psychological impact of natural disasters on children's health. Identifying risk factors and outcomes associated with the long-term sequelae of posttraumatic stress disorder (PTSD) can provide a gateway to recovery as well as enhancement of preventive measures.ObjectiveAmong childhood avalanche survivors, we aimed to investigate risk factors for PTSD symptoms and the relationship between socioeconomic status (SES) and PTSD symptoms in adulthood.MethodsChildhood survivors (aged 2–19 at the time of exposure) of two avalanches were identified through nationwide registers 16 years later. The Posttraumatic Diagnostic Scale was used to assess current PTSD symptoms. One-way ANOVA was used to explore PTSD symptoms by background and trauma-specific factors, as well as associations with current SES. Predictors of PTSD symptoms were examined by multivariable regression analysis.ResultsResponse rate was 66% (108/163). Results from univariate ANOVA analysis revealed that female sex was associated with PTSD symptoms (F=5.96, p<0.05). When adjusted for age and sex, PTSD symptoms were associated with lower education (F=7.62, p<0.001), poor financial status (F=12.21, p<0.001), and unemployment and/or disability (F=3.04, p<0.05). In a multivariable regression model, when adjusting for age and sex, lack of social support (t=4.22, p<0.001) and traumatic reactions of caregivers (t=2.49, p<0.05) in the aftermath of the disaster independently predicted PTSD 16 years post-trauma.ConclusionsLingering PTSD symptoms after childhood exposure to a disaster may negatively influence socioeconomic development in adulthood. Strengthening children's support systems post-disaster may prevent the long-term sequelae of symptoms.Highlights of the articlePTSD symptoms following avalanche exposure during childhood were associated with poorer socioeconomic status in adulthood.Lack of social support and traumatic reactions of caregivers in the aftermath of avalanches predicted PTSD symptoms among childhood survivors 16 years later.Findings underscore the importance of strengthening children's support systems in the aftermath of disasters.

Mediators and Treatment Factors in Intervention for Children Exposed to Interparental Violence

Changes in children's emotion differentiation, coping skills, parenting stress, parental psychopathology, and parent–child interaction were explored as mediators of treatment factors in two selective preventive group interventions for children exposed to interparental violence (IPV) and their parents. One hundred thirty-four IPV-exposed children (ages 6–12 years, 52% boys) and their parents were randomized to an IPV-focused or common factors community-based group intervention and completed baseline, posttest, and follow-up assessments for posttraumatic stress (PTS). A multilevel model tested mediators that included children's ability to differentiate emotions and coping skills, parenting stress, parental psychopathology, and parent–child interactions. In both conditions, exposure to nonspecific factors, specific factors unrelated to IPV and trauma-specific intervention factors was coded from videotaped child and parent sessions. Improved parental mental health mediated the link between greater exposure to nonspecific treatment factors and decreases in PTS symptoms. In addition, an increase in emotion differentiation and a decrease in parenting stress were associated with a decrease in PTS symptoms. Greater exposure to trauma-specific factors in child sessions was associated with a small decrease in emotion differentiation, an increase in coping skills, and a decrease in PTS symptoms over time. Greater exposure to nonspecific treatment factors in child and parent sessions was associated with more positive parent–child interaction. Parental mental health appears to be an important mechanism of change that can be promoted through exposure to nonspecific factors in parent intervention. For children, the effect of greater exposure to trauma-specific factors in intervention is less clear and may not have clear benefits.

Trauma exposure and child abuse potential: Investigating the cycle of violence.

This study was designed to ascertain the relationship between trauma exposure and child abuse potential, considering a number of demographic and trauma-specific factors. The sample consisted of 1,680 caregivers with open, substantiated cases of abuse or neglect who were evaluated at a university-based outpatient assessment and treatment center. As part of a larger battery of instruments, the participants completed the Child Abuse Potential Inventory (CAPI) and a trauma history screen. In partial support of the proposed hypotheses, univariate and multivariate analyses revealed important differences in CAPI scores between the no-trauma-exposure group and the child-only, adult-only, and child-adult exposure groups. In addition, the type of trauma, age, and gender proved to be powerful predictors of elevated CAPI scores. These findings advance understanding of the developmental and cumulative effects of trauma exposure and suggest a profile of individuals who may be at risk for developing characteristics similar to known physical abusers.