Traumatic Stress Disorder Research Articles

Empathy fatigue among physicians and its influencing factors: a cross-sectional survey from Southwest China

BackgroundEmpathy fatigue refers to the excessive empathy required of medical staff in the process of helping patients, which can produce traumatic experiences and emotional exhaustion. Severe empathy fatigue can even lead to medical disputes and errors, exacerbating increasingly tense doctor–patient relationships. Most studies on empathy fatigue focus on nurses, with few studies on physicians.MethodsA cross-sectional questionnaire was used to assess empathy fatigue among physicians in public tertiary general hospitals in southwest China using convenience sampling.ResultsA total of 562 physicians participated in the survey; average empathy satisfaction scores were 32.1 ± 6.85, 28.2 ± 5.30, and 26.2 ± 6.04 for empathy satisfaction disorder, job burnout, and secondary traumatic stress domains, respectively. We identified 291 (51.8%) physicians with severe empathy fatigue. Working two or three night shifts per week was associated with severe empathy fatigue. In total, 424 (75.4%) physicians had thoughts of resigning. Weekly rest time, empathic satisfaction disorder, job burnout, and secondary traumatic stress disorder influenced thoughts of resigning.ConclusionsThe majority of hospital physicians experience empathy fatigue and have considered resigning; this study provides reference data that demonstrate the extent of this issue. Efforts are urgently needed to address empathy fatigue in physicians and, therefore, increase physician retention.

Bibliometric Analysis: Acceptance and Commitment Therapy on Post Traumatic Stress Disorder

The study carried out a bibliometric analysis of Acceptance and Commitment Therapy on Post Traumatic Stress Disorder to know the effectiveness of the therapy. This bibliometric research focuses on looking at research activities around the world using publication data from the Scopus database. Bibliometric analysis uses a quantitative approach to analyze results and provide a representative picture. This research is recognized as a practical approach to assessing the output of publications, organization, writing, and characteristics of research topics between 2005 until 2023. There are Attempts to use Acceptance and Commitment Therapy to reduce trauma but the amount of effort did not increase significantly. Instead, the Acceptance and Commitment Therapy research is growing.

Impact of Trauma on the Lives of Black Men With Multiple Arrests

A mixed-methods study was carried out to better characterize the life course experiences, with a focus on trauma, of men who had perpetrated gun violence and other violent crime, and who had multiple arrests and incarcerations. A small sample of 13 men with a history of a minimum of 12 arrests each as well as histories of gun violence, other violent crime, and incarceration was drawn from a social program providing cognitive therapy and job skills training in a major urban center. Participants completed the Adverse Childhood Experiences Questionnaire and Post Traumatic Stress Disorder Checklist for DSM-5 and completed an in-depth interview. Results demonstrated that the participants had extraordinarily significant levels of trauma exposure but that they had minimal avowed trauma symptoms. The exception is that every participant demonstrated a clinically relevant score on the Arousal subscale (Criterion E). Participants in interviews discussed a number of characteristics of their developmental years. They described near constant exposure to traumatic events, in some cases starting from very young ages. Most participants described a personal experience of numbing or desensitization to their experiences. They described the impact of gangs on both protecting them from trauma and exposing them to trauma, and they described their subsequent experiences of incarceration. They offered recommendations for strategies to minimize violent crime in communities.

Partial Quantile Tensor Regression

Tensors, characterized as multidimensional arrays, are frequently encountered in modern scientific studies. Quantile regression has the unique capacity to explore how a tensor covariate influences different segments of the response distribution. In this work, we propose a partial quantile tensor regression (PQTR) framework, which novelly applies the core principle of the partial least squares technique to achieve effective dimension reduction for quantile regression with a tensor covariate. The proposed PQTR algorithm is computationally efficient and scalable to a large tensor covariate. Moreover, we uncover an appealing latent variable model representation for the PQTR algorithm, justifying a simple population interpretation of the resulting estimator. We further investigate the connection of the PQTR procedure with an envelope quantile tensor regression (EQTR) model, which defines a general set of sparsity conditions tailored to quantile tensor regression. We prove the root-n consistency of the PQTR estimator under the EQTR model, and demonstrate its superior finite-sample performance compared to benchmark methods through simulation studies. We demonstrate the practical utility of the proposed method via an application to a neuroimaging study of post traumatic stress disorder (PTSD). Results derived from the proposed method are more neurobiologically meaningful and interpretable as compared to those from existing methods.

Neurobiological effects of childhood trauma: A literature review

This article is a comprehensive review of past literature focusing on neurobiological effects of childhood trauma. Chronic interpersonal violence in children is common worldwide (De Bellis & Zisk, 2014). Exposure to continuous physical and emotional trauma in childhood undoubtedly has long lasting effects like developing post- traumatic stress disorder (PTSD), dysregulation of the hypothalamic–pituitary–adrenal axis (HPA) axis leading to hormonal issues, among other things, in an individual. A systematic review of these effects can prove beneficial in the field of psychiatry.

Post Traumatic Stress Disorder in E.M. Remarque's Works about the "Great War"

Considered one the most vivid writers about the horrors of first World War, E.M Remaque was also a good observer of the human nature in condition of extreme stress. His major books about the “Great War”, All quiet on the Western Front, The Road back and a series of eight short stories are not just about war itself but about human endurance, hope, failure….and about the description of a mental affliction considered “modern”: Post Traumatic Stress Disorder (PTSD). Present in ancient, medieval or modern literary sources, PTSD haunted soldiers for millennia. In Remarque’s case, the author gives well documented descriptions of the PTSD, these cases being the subject of the present paper.

The Correlates of Psychological Resilience in Turkish Adolescents During The COVID-19 Pandemic: A Systematic Review

Adolescents, already in a vulnerable state due to the challenges of adolescence, were among risk groups to develop psychosocial and emotional problems during the COVID-19 pandemic. Research conducted with adolescents identified psychological resilience as one of the protective factors which helped them cope better with pandemic-related adversities. The aim of this systematic review is to determine the correlates of Turkish adolescents’ psychological resilience to gain a better understanding of its protective role during the pandemic. Using the related keywords (Turkish adolescents, students, psychological resilience, COVID-19 Pandemic) and limiting the publication period as 2020-2024, a database search was conducted, in which 340 articles were identified. 10 articles that met the eligibility criteria were included in the systematic review. By reviewing the articles systematically, doing exercise, emotional flexibility, spirituality, hope, parental and peer support, financial support, psycho-education programs supporting pandemic-specific coping, and certain personality traits including openness to new experience, extraversion, conscientiousness, and agreeableness were identified as variables that are positively correlated with psychological resilience. On the other hand, fear of COVID-19, anxiety, depression, post traumatic stress disorder (PTSD), smartphone addiction, playing digital games, online education, exam anxiety and neuroticism are variables that have negative correlation with psychological resilience. Based on the results, it appears that during the COVID-19 pandemic, psychological resilience, in relation with other individual and social/contextual protective factors, functioned as a psychological buffer against psychological problems for Turkish adolescents.

Effectiveness of Ignatia Amara 200C in Post Traumatic Stress Disorder: A Case Study

Effectiveness of Ignatia Amara 200C in Post Traumatic Stress Disorder: A Case Study

Traumatised youth harbour feelings of revenge: investigating the association between PTSD symptomatology, vengeance, and willingness to forgive among the Congolese adolescent refugees in Uganda

ABSTRACT Background: Prolonged conflicts in the Democratic Republic of Congo (DRC) have caused widespread psychological trauma among civilians leading to maladaptive coping strategies across generations. Despite this occurrence, empirical studies on the prevalence of trauma and its impact on attitudes towards revenge and forgiveness, particularly among the youth, are scarce. This study aims to clarify the relationship between Post Traumatic Stress Disorder (PTSD) symptom severity and the desires for forgiveness and revenge among Congolese adolescents residing in Uganda. Methods: We analysed data from 269 adolescent refugees from the DRC living in the Nakivale refugee settlement in Southwestern Uganda. The assessment included exposure to war-related traumatic events and the MINI-KID for DSM-V PTSD symptom severity. The Heartland Forgiveness and Vengeance Scales measured willingness to forgive and feelings of vengeance. Results: Exposure to war-related traumatic events was notably high in our sample, with severe deprivation of food (260 [97%]), exposure to armed combat (249 [93%]), witnessing bombing, burning, or destruction of houses (245 [91%]), disappearance of family members (239 [89%]), and seeing dead bodies (236 [88%]). PTSD symptom severity was negatively associated with willingness to forgive (b = −0.48; 95% CI −0.71–−0.25; p < .001) and positively associated with vengeance (b = 0.18; 95% CI 0.04–0.32; p = .011). Conclusion: PTSD symptom severity reduces the willingness to forgive and increases the desire for vengeance among adolescent refugees. Mental health clinicians and policymakers should consider addressing maladaptive coping behaviours related to feelings of revenge and unwillingness to forgive in their support strategies for refugees.

Design Thinking of Smart School Emergency Tents Modular Based as Post-Disaster Recovery

Abstract Indonesia’s geological location has a significant impact on disasters in Indonesia. This disaster caused economic losses, casualties, and psychosocial disorders, namely post-traumatic stress disorder, especially at vulnerable ages, one of which was students. This research aims to develop innovations related to post-disaster recovery efforts for learning activities that were hampered by damage to school buildings by paying more attention to healing Post Traumatic Stress Disorder (PTSD) in students. The method used is the Design Thinking Framework which consists of Emphatize, Define, Ideate, Prototype, and Testing. Data collection techniques use literature study, indirect observation, and Forum Group Discussion. Data analysis uses descriptive qualitative by describing the results of observations, literature studies, and focus group discussions. The results is Modular-Based Smart School Emergency Tents prototype. The originality or value of this research lies in the idea of an emergency school tent that has a personal energy source, portable tables, and is modular based. The module that accompanies this tent guides teachers in carrying out trauma healing for students who are indicated to be experiencing post-traumatic stress disorder.

Возможности применения рефлексотерапии в реабилитации военнослужащих

The rehabilitation of military personnel who are injured or suffer from the psychological and physical consequences of hostilities is one of the key tasks of military medicine. Recently, reflexology methods attract more and more attention as an effective addition to traditional approaches. The purpose of the review is to consider the main mechanisms of action and the possibility of applying reflexology methods in the rehabilitation of military personnel. The article presents scientific research and sources confirming the effectiveness of acupuncture in the comprehensive restoration of the physical performance of conscripts, when stopping acute and chronic pain syndromes, including acupuncture on the battlefield (Battlefield Acupuncture), clinical manifestations of post -traumatic stress disorders, as well as in military surgery and traumatology. Reflexotherapy methods have a wide range of opportunities in the rehabilitation of military personnel and can have a significant impact on the well -being and quality of life of veterans and in military service.

Psychometric properties of the farsi version of the international trauma questionnaire -child and adolescent version (ITQ-CA) in a sample of iranian children and adolescents exposed to trauma

BackgroundThe International Trauma Questionnaire-Child and Adolescent Version (ITQ-CA) is a self-report measure for post- traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD), corresponding to the diagnostic criteria in the International Classification of Diseases, 11th Revision (ICD-11). While in the meantime the original English version of the ITQ-CA is available in different languages such as traditional and simplified Chinese, German, or Spanish, the Farsi was missing so far. ObjectiveThe purpose of this study was to evaluate the psychometric properties of the Farsi International Trauma Questionnaire-Child and Adolescent version (ITQ-CA) in a sample of Iranian children and adolescents objectively exposed to a traumatic event. MethodA total of 130 participants completed the Farsi form of the ITQ-CA and the Farsi Child and Adolescent Trauma Screen (CATS) for comparison. For the psychometric evaluation, we used confirmatory factor analysis (CFA) and bivariate correlations. ResultsThe Farsi version of ITQ-CA self-report form yielded scores with robust reliability (internal consistency ranging from 0.83 to 0.91, and the Intraclass correlation coefficients (ICC) varied from 0.74 to 0.92 with moderate, good, and excellent results) and adequate convergent validity (correlations with the CATS ranging from 0.49 to 0.77). CFA supported ICD-11 CPTSD symptom structure as a two-factor higher order model with PTSD. We found that the two-factor model fit the data better than the other measurement models (χ2/df = 43.492/37=1.175, RMSEA = 0.038, CFI = 0.994, TLI = 0.989, SRMR = 0.04.( ConclusionThe Farsi version of the ITQ-CA showed very good and satisfactory psychometric properties. As such, the Farsi ITQ-CA appears to be a valid and reliable self-rating measure to assess PTSD and DSO in Farsi-speaking children and adolescents exposed to traumas.

B - 39 Resilience in Active Duty US Military Service Members: Factor Analysis and Prediction of Psychological Symptoms in a Mild Traumatic Brain Injury Sample

Abstract Objective The factor structure of the Connor-Davidson Resilience Scale (CD-RISC) varies between cultures, settings, and samples, yet has not been assessed in an active-duty United States (US) military sample. We used factor analysis to characterize resilience in a generalizable sample of active-duty service members (ADSMs) and explored its associations with self-reported psychological outcomes in ADSMs with a history of mild traumatic brain injury (mTBI). Method Exploratory factor analysis (EFA) of the 25-item CD-RISC was performed on a non-clinical convenience sample of 212 active duty SMs followed by a confirmatory factor analysis (CFA) for model validation. Hierarchical regressions compared the relationships among the resulting factors and total scores on the Post Traumatic Stress Disorder Checklist (PCL-5), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) between subgroups with self-reported history of mTBI (n = 60) and TBI-negative controls (n = 54). Results EFA returned a 4-factor, 19-item solution. After modifications to improve model fit, CFA validated a 4-factor, 17-item solution: Fortitude, Resoluteness, Decisiveness, and Dedication. The interaction of TBI history with the Decisiveness and Dedication factors significantly predicted BDI and PCL-5 total scores (p &amp;lt; 0.05), but not BAI total scores. Fortitude and Resoluteness did not differentially predict any psychological outcomes between groups. Conclusion Four latent factors of resilience that are unique to ADSMs were identified and validated from the 25-item CD-RISC. Decisiveness and Dedication more strongly predicted depressive and PTSD symptoms in ADSMs with a history of mTBI than in controls, suggesting these factors of resilience are especially critical for better psychological outcomes following mTBI in military populations.

B - 15 Symptom Presentation on the Neurobehavioral Symptom Inventory and Post Traumatic Stress Disorder Checklist for DSM-5 in a Cohort of Explosive Ordnance Disposal Veterans

Abstract Objective This preliminary research examined symptom differences on the Neurobehavioral Symptom Inventory (NSI) and Post Traumatic Stress Disorder Checklist DSM-5 (PCL-5) for Explosive Ordnance Disposal (EOD) and Non-EOD Veterans receiving care at the Washington DC-War Related Illness and Injury Study Center (DC-WRIISC) Veterans Administration Medical Center. EOD Veterans have extensive repetitive blast-exposure histories, exposure to environmental toxins, and operated under high-stress/allostatic load throughout their careers. Therefore, we aim to understand how these unique occupational exposures influence long-term health outcomes for EOD Veterans. Method Eligible participants (N = 39, Mage = 51 years (SD = 9.5 years); EOD, n = 21) completed comprehensive interdisciplinary evaluations, self-report questionnaires, were combat deployed, and experienced traumatic brain injury. Total and component scores for the NSI (affective, cognitive, somatic, vestibular, and validity-10) and PCL-5 (criterion B-E symptom clusters), and total score for the Holmes-Rahe Life Stress Inventory, (HRLSI) were included. Results Regression analysis revealed overall NSI severity was positively correlated to PCL-5 total scores for both groups (EOD: F(1,19) = 25.30, p &amp;lt; 0.001); (Non-EOD: F(1,16) = 25.48, p &amp;lt; 0.001). However, significant differences in symptom presentation were noted between groups. NSI Cognitive scores were positively correlated with PCL-5 component scores for Criterion B for EOD (F(3,17) = 8.40, p &amp;lt; 0.001) and Criterion E for Non-EOD (F(3,14) = 24.32, p &amp;lt; 0.001). Post-hoc analysis suggested stress/resiliency may further contribute to group differences (HRLSI; Non-EOD, F(2,12) = 33.96, p &amp;lt; 0.001). Conclusion DC-WRIISC Veterans often present with cognitive concerns and complex medical presentations. Our findings suggest the presence of unique symptom presentations that may improve diagnostic formulation, treatment planning, and engagement. These findings highlight the need for continued research examining the influence occupational exposures have on Veteran health.

All wounds speak – performing trauma/witnessing grief

While ‘trauma' has become a buzzword encompassing any distressing event, its definition as an unassimilated psychological wound, unresolved and recurrent, also means that it cannot ever be completely known. Trauma therapy seeks to reintegrate experiences, breaking the cycle of perpetual suffering through fragmentary recollection. Drama and performance art offer a platform for this reintegration, potentially facilitating healing. However, the fine line between therapeutic confrontation and re-traumatization necessitates careful navigation, avoiding triggering negative emotions. Crucially, not all traumatic events lead to PTSD; resilience and communal support can mitigate the effects of distressing experiences, as seen in instances of shared acceptance and forgiveness. Theatre's role in addressing trauma lies in its ability to bear witness, creating spaces for communal acknowledgment and shared grieving. While contemporary performances often revel in discomfort, embracing unresolved narratives, they prompt reflection on the limitations of representation. Art's transformative potential lies not in explicit curative intent but in its expression of unresolved complexities of human experience. Through patience, acceptance, and a refusal to impose meaning, creative arts can serve as a site for healing, fostering empathy and connection amidst the fragmentary experience of what Freud called ‘traumatic neurosis,’ what has since come to be called Post Traumatic Stress Disorder.

The psychometric properties of the Swahili version of the Primary Care Post Traumatic Stress Disorder screen for DSM-5 among adults in Kenya.

The psychometric properties of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are undocumented in Kenya and sub-Saharan Africa (SSA) at large. This study aimed to evaluate the psychometric properties of the Swahili version of the tool, S-PC-PTSD-5, in a community sample of adults 18 years and older drawn from Nairobi, Mombasa and Kwale counties in Kenya. Analysis of cross-sectional data from 1431 adults from the community was conducted, examining the reliability, factorial structure, measurement invariance, and convergent and divergent validity of the interviewer-administered S-PC-PTSD-5. Out of 1431 adults who completed the S-PC-PTSD-5, 666 (46.5%) reported experiencing at least one traumatic event. Internal consistency of the S-PC-PTSD-5 was good overall, with alpha and omega values above 0.7. Confirmatory factor analysis (CFA) results indicated a one-factor structure of the S-PC-PTSD-5 for the overall sample. Multigroup CFA also demonstrated factorial invariance for sex for the one-factor structure of S-PC-PTSD-5. Scores for S-PC-PTSD-5 significantly correlated (positively) with those of generalized anxiety disorder (GAD7) and depressive symptoms (PHQ9), indicating convergent validity. S-PC-PTSD-5 scores also significantly correlated (negatively) with the WHO-5 wellbeing index, supporting divergent validity. The S-PC-PTSD-5 is a reliable and valid unidimensional measure. It appears to be a valuable screening measure for probable PTSD in both urban and rural community settings in Kenya. Nonetheless, to confidently identify those who may need treatment/additional support, further research on the reliability and validity of S-PC-PTSD-5 is required, especially its diagnostic accuracy at different cutoff scores.

Overcoming Rape: A Mixed-Methods Approach to Understanding Psychological and Physical Health Functioning of Male Survivors.

When examining sexual assault, men are often hidden from the literature. The current study employed a mixed-methods, convergent parallel design to examine the experiences of 22 male survivors of sexual assault (mean age = 44.19, SD = 13.28, range 18-65; 91% European American; 50% heterosexual). Survivors were administered an online survey using quantitative and qualitative questions to assess rape myths, gender roles, self-esteem, self-efficacy, resiliency, coping, overall mental and physical health, and diagnostic criteria for alcohol abuse, post traumatic stress disorder (PTSD), and sexual dysfunction. Three key themes emerged from the integration of quantitative and qualitative data: (a) Help is Elusive, (b) Internal Struggles and External Strengths, and (c) Living with Clinical Diagnoses. This study adds to an important area of the literature that increases understanding of men's experiences with sexual violence and honors the voices of these survivors.

Prazosin Treatment of Sleep Problems in Youth with PTSD

Post traumatic stress disorder (PTSD) is a condition characterized by reexperiencing symptoms, persistent avoidance, negative alterations in cognition and mood, and changes in arousal and reactivity in response to a traumatic event (American Psychiatric Association, 2013). The pathophysiology of PTSD is not fully understood but likely related to dysregulation of fear‐processing. Currently, the gold standard of treatment is trauma‐focused cognitive behavioral therapy (TF‐CBT). SSRIs are the only FDA‐approved pharmacologic treatments for PTSD in adults and there are no FDA approved medications to treat pediatric PTSD. Unlike studies in adults, double‐blinded randomized control trials (RCTs) did not show any efficacy for SSRIs in pediatric patients diagnosed with PTSD (Hudson et al., 2021). While estimates of pediatric PTSD prevalence varies, the prevalence of PTSD at age 18 is 7.8% (Rolling et al., 2023). Sleep disturbances such as insomnia, night‐time awakenings, and nightmares often persist despite treatment with TF‐CBT or SSRIs. Left untreated, sleep disturbances are predictive of PTSD persistence and comorbid psychiatric complications (Rolling et al., 2023). There is evidence supporting the use of the medication prazosin in alleviating pediatric PTSD sleep disturbances including nightmares and insomnia. Anywhere from 20–80% of children with PTSD report nightmares compared to a prevalence of 10–20% in the general pediatric population (Kovachy et al., 2013). There is a growing need for pharmacologic therapy given the paucity of providers trained in TF‐CBT and a need for symptomatic management. In this review, we will examine sleep disturbances in pediatric PTSD patients and discuss the feasibility of prazosin as an adjunct treatment option.

What I was thinking/what I would do differently: Clinical research.

At the 2023 International Society for Traumatic Stress Studies annual meeting, a panel of three distinguished investigators and clinicians convened to reflect on their careers, their contributions to the field of traumatic stress disorders, and the lessons learned over the years. Dr. Terence M. Keane has guided the development and deployment of evidence-based care, shaping evaluation guidelines and best treatment practices for traumatic stress pathology. Dr. Sheila Rauch, a pioneer in the development of prolonged exposure therapy, has significantly contributed to the treatment of posttraumatic stress disorder (PTSD) and other traumatic stress disorders. Dr. Richard Bryant has developed targeted psychological treatments for traumatic stress and prolonged grief, adapting to the diverse needs, mechanisms, and cultural contexts of patients. These individuals' collective experiences span from the establishment of the PTSD diagnosis to the current proliferation of scientific knowledge on its epidemiology, assessment, and treatment. Their unique yet overlapping contributions have provided invaluable guidelines for the next generation of clinicians and investigators. This panel discussion offers a retrospective look at their careers and a forward-looking perspective on the future of traumatic stress treatment.

THE PSYCHOLOGICAL IMPACT OF SURVIVORS OF THE EARTHQUAKE, TSUNAMI, AND LIQUEFACTION: A QUALITATIVE STUDY

Introduction: Natural disasters in the form of earthquakes, tsunamis, and liquefactions in Central Sulawesi in 2018 had several impacts on disaster survivors' psychology. These psychological problems have developed as an effect from serious injuries or loss of family members of the survivors. Psychological disorders, such as anxiety, depression, to Post traumatic stress disorder, can affect long-term quality of life. This study aims to explore the psychological impacts experienced by survivors of the earthquake, tsunami, and liquefaction in Central Sulawesi. Method: A qualitative study with a phenomenological approach. In-depth interviews were conducted using semi-structured guideline, observation and voice recording of 18 survivors of the earthquake, tsunami, and liquefaction disasters. The determination of the sample is using a purposive sampling technique based on inclusion criteria. The results of the interviews were transcribed, member checking, and analyzed using the Van Mannen method. Results: This study produced four themes and fifteen sub-themes. The research themes consist of the grieving phase, post-traumatic stress disorder, social support and health services support. Conclusions: Further screening of disaster survivors who experienced psychological disorders is needed, not only as a preventive measure but also as a psychological support to improve their quality of life.