Traumatic Events Research Articles

Cognitive causes of the mental state of terror and their link to mental health outcomes.

The mental state of terror is a dysphoric emotion, feeling of dread and sudden realisation that the outcomes of one's life events can take an extremely negative turn. The state represents the acute stage of fear, anxiety and trauma and generally occurs in mental disorders, such as trauma- and stress-related disorders, but it can also manifest in healthy individuals as the initial trigger response, the point of mental dysregulation. The mental state of terror can be specified with the following parameters: (1) perceived loss of safety, (2) unpredictability and uncertainty, (3) intense consequent emotional reaction, (4) hypersensitivity to the trigger stimuli, and consequentially, (5) the outcome that can be either negative, such as resulting in developing a mental disorder, or positive, such as developing post-traumatic growth and resilience. Behavioural biases are also a for factor the development of the mental state of terror. The aim of this theoretical contribution is to define the mental state of terror in terms of cognitive factors, such as exposure to traumatic events and uncertainty of the environment for understanding the development of mental disorders within stress and trauma domains; highlight the importance of psychological resilience and social support.

Long-term outcome of adult traumatic atlantoaxial rotatory fixation: a case series

BackgroundThis case series presents five cases of adult atlantoaxial rotatory subluxation (AARS) following traumatic events, focusing on treatment strategies and long-term outcomes.Case presentationThis paper includes four Iranian male patients and one Iranian female patient with ages ranging from 25 to 46 years old. Each case involved unique presentations and management approaches. Initial conservative treatments, including skull traction and orthoses, were attempted, but surgical intervention became necessary due to inadequate response. Surgical fixation significantly improved functional status and alleviated symptoms in all patients, leading to long-term relief. Radiological assessments demonstrated successful outcomes post-surgery.ConclusionsThis study underscores the importance of considering both conservative and surgical options in managing adult atlantoaxial rotatory subluxation to achieve optimal outcomes.

Examination of Congruity between Subjective and Objective Working Memory in Veterans with Mild TBI and Relation to Psychiatric Symptoms and Childhood Trauma.

There is conflicting evidence regarding congruence between subjective cognitive decline and objective cognitive performance for individuals with a history of mild traumatic brain injury (mTBI). The current study investigated the congruity between subjective and objective cognition, particularly working memory, among veterans with an mTBI history, accounting for post-traumatic stress disorder (PTSD) and childhood trauma. Participants included 35 veterans with a history of mTBI sustained during deployment. Participants completed measures of subjective [i.e., Behavioral Inventory Rating of Executive Functioning (BRIEF)] and objective working memory (i.e., WAIS-IV working memory index). Congruity between subjective and objective working memory was examined using linear regression. Bonferroni-corrected correlations were run to explore relationships among working memory, psychiatric symptoms, mTBI severity, and childhood trauma. Among Veterans with mTBI, subjective working memory and objective working memory performance were not significantly related (p > 0.05); however, the overall model was significant (p < 0.0001), and childhood trauma was a notable predictor (p = 0.02). Greater PTSD, depression, and sleep symptoms were significantly related to increased subjective working memory concerns, even after Bonferroni adjustments (ps < 0.0001). Better objective working memory was significantly related to a fewer number of childhood traumatic events; however, this did not sustain corrections. The majority of individuals (67%) endorsed significant working memory complaints, despite objectively performing within normal limits (within 1 SD and above). Subjective-objective working memory congruity among veterans with mTBI was limited. Subjective, but not objective, working memory concerns were associated with greater PTSD, depression, and sleep symptoms. Childhood trauma was a notable factor that contributed to both subjective and objective cognitive concerns. There remains clinical value in assessing subjective cognitive concerns given the strong relationships with psychiatric problems and, hence, a focus for intervention.

Adverse Childhood Experiences and Health Conditions and Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18 years. Data on ACEs among adolescents in the United States have primarily been collected through parent report and have not included important violence-related ACEs, including physical, sexual, and emotional abuse. This report presents the first national prevalence of self-reported ACEs among U.S. high school students aged <18 years, estimates associations between ACEs and 16 health conditions and risk behaviors, and calculates population-attributable fractions of ACEs with these conditions and behaviors using cross-sectional, nationally representative 2023 Youth Risk Behavior Survey data. Exposures were lifetime prevalence of individual (emotional, physical, and sexual abuse; physical neglect; witnessed intimate partner violence; household substance use; household poor mental health; and incarcerated or detained parent or guardian) ACEs and cumulative ACEs count (zero, one, two or three, or four or more). Health conditions and risk behaviors included violence risk factors, substance use, sexual behaviors, weight and weight perceptions, mental health, and suicidal thoughts and behaviors. Bivariate analyses assessed associations between individual and cumulative ACEs and demographics. Adjusted prevalence ratios assessed associations between cumulative ACEs and health conditions and risk behaviors, accounting for demographics. Population-attributable fractions were calculated to determine the potential reduction in health conditions and risk behaviors associated with preventing ACEs. ACEs were common, with approximately three in four students (76.1%) experiencing one or more ACEs and approximately one in five students (18.5%) experiencing four or more ACEs. The most common ACEs were emotional abuse (61.5%), physical abuse (31.8%), and household poor mental health (28.4%). Students who identified as female; American Indian or Alaska Native; multiracial; or gay or lesbian, bisexual, questioning, or who describe their sexual identity in some other way experienced the highest number of ACEs. Population-attributable fractions associated with experiencing ACEs were highest for suicide attempts (89.4%), seriously considering attempting suicide (85.4%), and prescription opioid misuse (84.3%). ACEs are prevalent among students and contribute substantially to numerous health conditions and risk behaviors in adolescence. Policymakers and public health professionals can use these findings to understand the potential public health impact of ACEs prevention to reduce adolescent suicidal behaviors, substance use, sexual risk behaviors, and other negative health conditions and risk behaviors and to understand current effects of ACEs among U.S. high school students.

Exposure to Traumatic Events and Shame in Adolescent Surf Lifesavers: An Australian Perspective

Exposure to Traumatic Events and Shame in Adolescent Surf Lifesavers: An Australian Perspective

Tracing Dissent: A Study of Simulated Gendered Memories in V. V. Ganeshananthan’s Brotherless Night

This article critically examines the interplay of memory, gender, and political consciousness in V. V. Ganeshananthan’s Brotherless Night against the backdrop of the Sri Lankan Civil War in the 1980s. Focusing on the protagonist, Sashi, the study employs theories of memory and gender studies to illuminate how her gendered memories contribute to the formation of political consciousness during the conflict. Sashi’s gendered memories emerge as a crucial lens through which the traumatic events of the war are remembered. By navigating the complexity of war, Sashi’s memories function as a form of dissent against dominant narratives, carving out a representation of subversive forms of memory often marginalized in such turbulent conditions. The concept of “simulated memories” by Kourken Michaelian can be used to analyze the narrative, wherein Sashi reconstructs major historical events she did not directly witness. This act of imaginative reconstruction, combined with the violence she has witnessed, forms a cogent narrative that transforms readers into secondary witnesses of the war. By engaging with theoretical frameworks of memory and gender studies, the study contributes to a deeper understanding of the intricate dynamics between personal memory, gendered experiences, and the political landscape in times of conflict.

Associations among combat exposure, adverse childhood experiences, moral injury, and posttraumatic growth in a large cohort of post-9/11 veterans.

Post-9/11 veterans experienced more deployments, combat exposure, and disability than earlier military cohorts. Those in the military are also more likely to have experienced adverse childhood experiences. Despite these traumatic exposures, a substantial number of veterans report experiencing personal growth, development, and maturity from their military service. This longitudinal survey study (n = 5,245) examined the degree to which posttraumatic growth (PTG) was present among post-9/11 veterans. Several components of PTG were examined, including relating to others, seeing new possibilities, personal strength, spiritual growth, and appreciation for life. Respondents rated their degree of personal growth and new appreciation of life most highly, while spiritual growth and appreciation of others were the least highly rated. Female veterans reported greater PTG. Veterans who experienced traumatic events (i.e., combat exposure, adverse childhood experiences), screened positive for posttraumatic stress disorder, and moral injury reported greater PTG than those who had not experienced those events or screened positive for posttraumatic stress disorder. Veterans reporting higher levels of social support and personal resilience were less likely to experience PTG. Veterans with other protective factors were more likely to experience PTG. Post-9/11 veterans report PTG in the face of various traumatic exposures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Post-Traumatic Stress Disorder (PTSD) in Trauma Patients.

Post-traumatic stress disorder (PTSD) was first introduced as a diagnosis by the American Psychiatric Association in 1980. This diagnosis, included in the 3rd edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III), was to be considered after someone was exposed to a traumatic event "outside the range of usual human experience and would be markedly distressing to almost anyone." Since then, trauma survivors have been identified as being at risk for the development of post-traumatic stress symptom (PTSS) and post-traumatic stress disorder (PTSD). Despite the recognition of this fact, the screening, recognition, and diagnosis of PTSD in these at-risk populations are inconsistent. In the following review, which is designed for the clinician who is unfamiliar with PTSD and its recognition, diagnosis, and treatment, we introduce the problem in the trauma patient and define its scope. In addition, we discuss the diagnosis of PTSD in trauma patients, special considerations relating to these patient populations, treatment options, and explore future directions for how best to define, study, recognize, and treat this challenging and potentially devastating condition.

Physical activity and psychosocial status among Egyptian healthcare professionals: a cross-sectional study

BackgroundThe Egyptian health system faces numerous challenges, including overpopulation, limited resources, and high patient load. Long working hours, inadequate sleep, and exposure to traumatic events further strain health care workers. This study aims to investigate the association between physical activity and psychosocial status of healthcare professionals in Egypt.MethodsThis cross-sectional study was conducted in Egypt from 20th March to 20th April 2023. An online self-administered survey was used to recruit 647 healthcare professionals. The International Physical Activity Questionnaire (IPAQ) and Psychosocial Index (PSI) were used to measure physical activity and psychosocial status, respectively.ResultsAmong the 647 participants, 82% were aged 24–30 years, with 49.9% females and 66.5% doctors. Only 41% engaged in physical activity, and among them, only 5.7% exercised more than three times per week. The median work hours per week were 36, and based on the Total Work MET, participants were classified into high (32%), moderate (40%), and low (28%) physical activity levels. Half of the participants experienced highly stressful lives, while only 40% reported good-to-excellent well-being. Physical activity correlated with psychological distress (r = 0.116, p = 0.003) and abnormal illness behaviors (r = 0.081, p = 0.038), while average working hours per week correlated with psychological distress (r = 0.084, p = 0.033) and sleep disturbance (r = 0.14, p < 0.001).ConclusionIn this study, physical activity levels varied among participants, and the majority of participants had a poor psychological status. Additionally, physical activity significantly correlated with psychological distress and abnormal illness behaviors, while average working hours per week correlated with psychological distress and sleep disturbance.

MDMA-assisted psychotherapy for the treatment of PTSD: A systematic review and meta-analysis of randomized controlled trials (RCTs).

Post-traumatic stress disorder (PTSD) is a mental health disorder resulting from exposure to traumatic events, manifesting in various debilitating symptoms. Despite available treatments, many individuals experience inadequate response or significant side effects. Previous reviews suggest promising outcomes with MDMA-assisted psychotherapy (MDMA-AT), but limitations prompt the need for a comprehensive evaluation. We searched various online databases and registries such as MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov to retrieve RCTs that fit our inclusion criteria. We performed meta-analyses using Review Manager by applying a random-effects model. Dichotomous and continuous outcomes were pooled as risk ratios (RR) and standard mean difference (SMD), respectively. Nine studies with a total of 297 participants with PTSD were included in our meta-analysis. The control group consisted of inactive doses of MDMA (25-40 mg) or placebo. Our meta-analysis showed that MDMA-AT led to a significant reduction in the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) severity scores as compared to the control group (SMD -1.10, 95% CI: -1.62 to -0.59). More patients in the MDMA-AT group exhibited significant response (RR 1.59, 95% CI: 1.22, 2.08) and remission (RR 2.32, 95% CI: 1.47 to 3.66) as compared to patients in the control group. There was no significant difference regarding the incidence of ≥1 treatment-emergent adverse events (TEAE), ≥1 severe TEAE, and suicidal ideation between the two groups. MDMA-AT demonstrates significant efficacy in improving PTSD symptoms, enhancing both response and remission rates in individuals with chronic, treatment-resistant PTSD, while maintaining a favorable safety profile.

Tailoring Hospice Care to the Veteran Population.

United States Military Veterans are an increasingly elderly population, and more and more veterans are choosing hospice care at the end of life. These veterans, particularly if they served in combat, can bring unique management challenges and opportunities to a hospice team. This review highlights the physical and psychosocial traumas experienced by many veterans, and discusses how these issues can affect their hospice care. Traumatic injury-related issues such as chronic pain, neuropathic pain, insomnia, and chronic headaches can worsen for veterans at the end of life, and the psychological sequelae of these traumatic events such as Post-Traumatic Stress Disorder (PTSD), Chronic Anxiety, Substance Abuse, and increased risk of suicide can also be magnified during this time. This review details these and other commonly seen service-related comorbidities, and offers evidence-based recommendations regarding their diagnosis and treatment. In addition, it discusses what is important to veterans at the end of life, and provides suggestions on how hospice programs can individualize and optimize their care of this special population. Honoring their service and respecting their sacrifices are also important aspects of "Best Care" for veterans at the end of life, and this review provides suggestions on how to do so and includes a list of resources that can greatly assist hospice programs, veterans, and families in delivering the most respectful, comprehensive, and thoughtful care possible.

Psychological Distress Among Ethnically Diverse Participants From Eastern and Southern Africa

Psychological distress is characterized by anxiety and depressive symptoms. Although prior research has investigated the occurrence and factors associated with psychological distress in low- and middle-income countries, including those in Africa, these studies' findings are not very generalizable and have focused on different kinds of population groups. To investigate the prevalence and characteristics (sociodemographic, psychosocial, and clinical) associated with psychological distress among African participants. This case-control study analyzed data of participants in the Neuropsychiatric Genetics in African Populations-Psychosis (NeuroGAP-Psychosis) study, which recruited from general outpatient clinics in Eastern (Uganda, Kenya, and Ethiopia) and Southern (South Africa) Africa. Individuals who participated in the control group of NeuroGAP-Psychosis from 2018 to 2023 were analyzed as part of this study. Data were analyzed from May 2023 to January 2024. The prevalence of psychological distress was determined using the Kessler Psychological Distress Scale (K10), which measures distress on a scale of 10 to 50, with higher scores indicating more distress. Participants from the NeuroGAP-Psychosis study were categorized into cases as mild (score of 20-24), moderate (score of 25-29), and severe (score of 30-50), and participants with scores less than 20 were considered controls. Factors that were associated with psychological distress were examined using binomial logistic regression. From the data on 21 308 participants, the mean (SD) age was 36.5 (11.8) years, and 12 096 participants (56.8%) were male. The majority of the participants were married or cohabiting (10 279 participants [48.2%]), most had attained secondary education as their highest form of learning (9133 participants [42.9%]), and most lived with their families (17 231 participants [80.9%]). The prevalence of mild, moderate, and severe psychological distress was 4.2% (869 participants), 1.5% (308 participants), and 0.8% (170 participants), respectively. There were 19 961 participants (93.7%) who served as controls. Binomial logistic regression analyses indicated that the independent associations of psychological distress were experience of traumatic events, substance use (alcohol, tobacco, or cannabis), the physical comorbidity of arthritis, chronic neck or back pain, and frequent or severe headaches. In this case-control study among ethnically diverse African participants, psychological distress was associated with traumatic stress, substance use, and physical symptoms. These findings were observed to be consistent with previous research that emphasizes the importance of traumatic events as a factor associated with risk for psychopathology and notes the frequent co-occurrence of conditions such as physical symptoms, depression, and anxiety.

Mindfulness, work-family conflict, family-work conflict and depressive symptoms among nurses: A cross-sectional design.

Work and family role conflict is a common source of stressors that affect nurses, leading to negative outcomes on their mental health, such as depressive symptoms, which affect nurses' job performance and patients' health outcomes. Mindfulness positively affected mental health, but its role in the relationship between role conflict and depressive symptoms was not previously examined. To examine the mediating role of mindfulness in the relationship between work-family conflict and family-work conflict with depressive symptoms among nurses. A descriptive cross-sectional design was used to collect data from a sample of 188 nurses from two large referral hospitals in northern and central Jordan. Data analysis was performed using Pearson correlation and macro PROCESS. The mean score of depressive symptoms in our sample indicated that our sample is at risk for clinical depression. The bivariate correlation showed that depressive symptoms were significantly and negatively associated with work-family and family-work conflicts and significantly and positively associated with mindfulness. Both regression models explained 52% of the variance in depressive symptoms (F [6, 181] = 35.38, p< .001). The models also showed that mindfulness had a significant negative effect on depressive symptoms (t= -8.98, p< .001). The results of macro PROCESS indicated that mindfulness mediated the relationship between work-family conflict and family-work conflict with depressive symptoms. Nurses are exposed to a number of stressors in their work environment, including long work hours and frequent exposure to traumatic events. The current study showed that mindfulness might play a role in mediating the relationship between family-work conflict and family-work conflict with depressive symptoms. Nurses, nurse managers and policymakers can work with healthcare organizations to promote nurses' work quality by controlling risk factors, such as depressive symptoms, and implementing strategies to mitigate these risks.

The link between childhood traumatic events and the continuum of premenstrual disorders.

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD), collectively known as Premenstrual Disorders (PMDs), cause significant distress and functional impairment, and premenstrual exacerbation (PME) affects a large proportion of women with psychiatric diagnoses. Childhood trauma is one factor that may contribute to PMD/PME risk. This study examines the relationship between childhood trauma and PMDs, PME, and non-PMD psychiatric illness. This study is a secondary analysis of data from a prospective cohort. Participants completed self-assessments on childhood trauma using the Childhood Traumatic Event Scale (CTE-S) and on premenstrual symptoms using the Premenstrual Symptoms Screening Tool (PSST). Psychiatric diagnoses were assessed through structured clinical interviews. Participants were divided into four groups based on their PSST scores and psychiatric illness status: (1) Premenstrual Disorders (PMDs; moderate to severe PMS and PMDD), (2) PME, (3) psychiatric controls (PC; individuals with psychiatric illness but no significant premenstrual symptoms), and (4) healthy controls (HC; individuals with no psychiatric illness and no significant premenstrual symptoms). Statistical analyses, including ANOVA, Tukey's HSD test, Fisher's exact test, and logistic regression, were conducted to examine differences among the groups. Data from 391 participants were analyzed. Participants with PME and PC reported a higher quantity and severity of childhood traumatic events compared to HCs (p <.05). There was a weak but significant correlation between childhood trauma and premenstrual symptom burden across all groups (R = .18, p <.001). Within-group analysis revealed moderate correlations between childhood trauma and premenstrual symptoms driven by the PMD group (R = .42, p = .01). The findings underscore the impact of childhood traumatic events on mental health and premenstrual symptoms and highlight the need for additional research to explore the underlying mechanisms linking childhood trauma to the continuum of premenstrual disorders, to improve the efficacy of trauma-focused interventions for affected individuals.

Emergency surgery for traumatic brain injury in geriatric patients

Objectives: Verify the sociodemographic profile of an elderly victim of trauma due to a fall who is admitted to the ICU of a public reference hospital to determine whether there are relationships between his age, comorbidities, length of stay, complications and clinical results. A retrospective analytical study with a quantitative approach was carried out between April and October 2014 in the Intensive Care Unit (ICU) of the Hospital de Base do Distrito Federal, administered by the State Department of Health of the Federal District, DF. Using the TrakCare® computerized medical record, sociodemographic data were found on elderly people hospitalized between the fall of July 2012 and July 2014, including mechanisms of trauma, comorbidities, length of stay, use of invasive devices, vasoactive and sedative drugs, complications and clinical internships. Results: The sample was made up of 52 elderly people, the majority of whom were men and the injury was a fall in height. Lung infection, septic shock, use of blood products and acute renal failure were the main complications. Despite the high mortality observed in the study, the majority of elderly people survived the traumatic event. Male sex, traumatic brain injury (TBI), pulmonary septic shock and dialysis were the main causes of mortality. Conclusion: Falling in height, fractures and severe TBI were extremely common, and most patients had more than one complication during hospitalization. No significant difference was found between age and mortality.

Understanding nightmares after traumatic events in Detroit (UNiTED): prospective associations with interpersonal violence and posttraumatic stress disorder symptoms

ABSTRACT Background: Research suggests trauma-related nightmares (TRNs) during the acute aftermath of trauma may contribute to posttraumatic stress disorder (PTSD). However, it is unknown who is most vulnerable to TRNs, which is critical to identify at-risk patients toward whom early nightmare-focused treatments can be targeted to prevent PTSD. Objective: We tested trauma type (interpersonal violence [e.g. assault] vs non-interpersonal trauma [e.g. motor vehicle collision]) as a risk factor for TRNs in a predominantly low-income, Black, urban sample in Detroit, MI, USA. Method: We recruited patients from the intensive care unit following traumatic injury (N = 88; M age = 39.53 ± SD 14.31 years, 67.0% male, 67.0% Black, 47.7% annual income ≤ $20,000) and administered surveys at three post trauma timepoints: one week (T1), one month (T2; n = 61), and two months (T3; n = 59). Trauma type was assessed at T1 via electronic medical records. Participants reported the extent to which their dreams’ content was similar to the trauma for which they were hospitalized across T1-T3. Participants then completed the PTSD Checklist for DSM-5 at T3. Results: TRNs were more prevalent over time among patients exposed to interpersonal violence (80%) vs non-interpersonal trauma (48.7%, p = .005). Patients hospitalized for interpersonal violence faced greater odds for TRNs across timepoints relative to non-interpersonal trauma patients (Odds Ratio = 4.95, p = .021). TRNs, in turn, prospectively predicted PTSD symptoms such that TRNs at T2 presaged more severe PTSD at T3 (p = .040, η p 2 = .31), above and beyond T1 PTSD status. Conclusions: This prospective study provides first evidence that interpersonal violence exposure is a robust risk factor for TRNs, which prospectively contribute to PTSD symptom development. Early intervention on TRNs after interpersonal violence exposure may decrease PTSD risk. Future studies are encouraged to use ambulatory methods to capture nightmares sooner after they occur.

Crisis – Challenge – Coherence: Combining Universal Design for Learning and Sense of Coherence

The study investigates the effectiveness of using the Universal Design for Learning (UDL) approach as a trauma-sensitive pedagogy strategy in higher education. By integrating the concepts of UDL and Salutogenesis, we aimed to develop a tool that promotes healthy learning, problem-solving, and motivation among students. Salutogenesis emphasizes the development of a Sense of Coherence (SoC), which serves as a tool for stress resilience and restoration. To assess the impact of UDL practices on SoC levels, we administered a Sense of Coherence-13 questionnaire before and after implementing UDL practices in English language classes at a polytechnic university. All the students in the study had experienced traumatic events caused by the current crisis in Ukraine. The study focused on demonstrating that UDL practices can serve as a restorative and inclusive tool. The results indicate that the application of UDL practices led to an increase in SoC levels, demonstrating their potential for promoting restoration. Additionally, teacher interviews were conducted to identify the challenges and benefits of implementing UDL practices.

Cortical morphological changes and associated transcriptional signatures in post-traumatic stress disorder and psychological resilience.

Individuals who have experienced severe traumatic events are estimated to have a post-traumatic stress disorder (PTSD) prevalence rate ranging from 10 to 50%, while those not affected by trauma exposure are often considered to possess psychological resilience. However, the neural mechanisms underlying the development of PTSD, especially resilience after trauma, remain unclear. This study aims to investigate changes of cortical morphometric similarity network (MSN) in PTSD and trauma-exposed healthy individuals (TEHI), as well as the associated molecular alterations in gene expression, providing potential targets for the prevention and intervention of PTSD. We recruited PTSD patients and TEHI who had experienced severe earthquakes, and healthy controls who had not experienced earthquakes. We identified alterations in the whole-brain MSN changes in PTSD and TEHI, and established associations between these changes and brain-wide gene expression patterns from the Allen Human Brain Atlas microarray dataset using partial least squares regression. At the neuroimaging level, we found not only trauma-susceptible changes in TEHI same as those in PTSD, but also unique neurobiological alterations to counteract the deleterious impact of severe trauma. We identified 1444 and 2214 genes transcriptionally related to MSN changes in PTSD and TEHI, respectively. Functional enrichment analysis of weighted gene expression for PTSD and TEHI revealed distinct enrichments in Gene Ontology biological processes and Kyoto Encyclopedia of Genes and Genomes pathways. Furthermore, gene expression profiles of astrocytes, excitatory neurons, and microglial cells are highly related to MSN abnormalities in PTSD. The formation of resilience may be by an active compensatory process of the brain. The combination of macroscopic neuroimaging changes and microscopic human brain transcriptomics could offer a more direct and in-depth understanding of the pathogenesis of PTSD and psychological resilience, shedding light on new targets for the prevention and treatment of PTSD.

Association between Adverse Childhood Experiences and Internalizing Symptoms in Adults at a Wellness Centre in India

Abstract Background: Adverse childhood experiences (ACE or childhood trauma) include very stressful and potentially traumatic events linked to a higher risk of mental health challenges and chronic conditions. India has an opportunity to study the association between ACE exposure and internalizing symptoms (depression and anxiety). To evaluate the association between exposure to ACE and internalizing symptoms (depression and anxiety) at a wellness centre in India. Methods and Material: This cross-sectional study studied a convenience sample of 909 individuals who self-assessed ACE exposure, depression (Major Depression Inventory: MDI), and anxiety levels (Generalized Anxiety Disorder: GAD-7). Logistic regression models evaluated the association between ACE and depression and anxiety levels. Results: The results show a strong association between ACE levels and depression as well as anxiety. Individuals with medium (1-3 ACEs), high (4-6 ACEs), and very high (&gt; =7 ACEs) exposure to childhood trauma are at 2–7 odds of having major depression and 1–3 odds of having anxiety. Moreover, both Gen Z and Gen Y are at a higher risk of depression and anxiety compared with Gen X. Conclusions: The research extends the findings from global research on ACE and mental health (depression, anxiety) in India, highlighting the strong association. Future work should expand the samples across the geography to enhance the insights.

Extracorporeal pediatric renal replacement therapy: diversifying application beyond kidney failure.

The utilization of extracorporeal renal replacement therapy (RRT), including continuous renal replacement therapy (CRRT) and hemodialysis (HD), beyond the treatment of volume overload and acute kidney injury (AKI) has witnessed a significant shift, demonstrating the potential to improve patient outcomes for a range of diseases. This comprehensive review explores the non-kidney applications for RRT platforms in critically ill children, focusing on diverse clinical scenarios such as sepsis, inborn errors of metabolism, liver failure, drug overdose, tumor lysis syndrome, and rhabdomyolysis. In the context of sepsis and septic shock, RRT not only facilitates fluid, electrolyte, and acid/base homeostasis, but may offer benefits in cytokine regulation, endotoxin clearance, and immunomodulation which may improve multi-organ dysfunction as well as hemodynamic challenges posed by this life-threatening condition. RRT modalities also have an important role in caring for children with inborn errors of metabolism, liver failure, and tumor lysis syndrome as they can control metabolic derangements with the efficient clearance of endogenous toxins in affected children. In cases of drug overdose, RRT is a crucial tool for rapid extracorporeal clearance of exogenous toxins, mitigating potential organ damage. The intricate interplay between liver failure and kidney function is examined, elucidating the role of RRT and plasma exchange in maintaining fluid and electrolyte balance when hepatic dysfunction complicates the clinical picture. Furthermore, RRT and HD are explored in the context of rhabdomyolysis, highlighting their utility in addressing AKI secondary to traumatic events and crush syndrome.