Search

Researchers have identified university students and military personnel as highly susceptible to the stress and emotional challenges imposed by the Coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to compare the psychological impact of COVID-19 on soldiers and students based on risk factors identified in self reports. We recruited 258 students (male: female = 58: 204, average age = 19.73 ± 1.52 years) and 194 active soldiers (male: female = 172: 22, average age = 24.88 ± 4.11 years) from northern Taiwan. Analysis was performed on demographic data, history of COVID-19 infection, vaccinations, and the subjective psychological impact of the pandemic, as well as their current (within one month) anxiety levels, depression level, and symptoms of post-traumatic stress disorder (PTSD). Descriptive statistics and linear regression analysis models were used to compare soldier vs. student status and male vs. female. Overall, roughly 54% of the subjects had been infected by COVID-19 at least once, and the psychological impact of the pandemic was more pronounced in the infected group. The students reported more pronounced symptoms of PTSD (elevated anxiety and depression levels) than did the soldiers. All regression models other than those associated with age and sex revealed that the link between COVID-19 infection and the symptoms of PTSD was more salient among soldiers and males than among students and females. It appears that the psychological impact of COVID-19 is underreported by soldiers. These findings indirectly support previous research indicating that soldiers are less likely than students to disclose emotions related to trauma, indicating the need for psychological support for military personnel. [ABSTRACT FROM AUTHOR]

Background: Psychological repercussions resulting from coronavirus disease 2019 (COVID-19) have been encountered, such as anxiety, depression, insomnia, and post-traumatic stress disorder (PTSD). The study aimed to assess the frequency and severity of PTSD, depression, and anxiety in a sample of Egyptian patients with COVID-19 infection and analyze potential risk factors. The current study is a descriptive cross-sectional, hospital-based study, conducted from August 2020 to June 2021. The sample was selected from patients diagnosed with COVID-19 infection at Ain Shams University hospitals (outpatient clinics and inpatient units). Patients underwent a COVID severity criteria scoring system, structured clinical interview for DSM-IV (SCID-I), PTSD checklist–Civilian Version (PCLC), Beck depression inventory, and Taylor's manifest anxiety scale. Results: PTSD was observed in 79.29% of the study sample, 61.43% had depression, and 18.57% had anxiety. The severity of COVID-19 infection was significantly associated with PTSD severity mean scores (P value = 0.027). Furthermore, a significant relationship was observed between the severity of depression and COVID-19 infection severity (P value = 0.028). The number of comorbid medical risk factors demonstrated significance to PTSD severity (P value = 0.014). Conclusion: A significant portion of the study's patients experienced psychiatric consequences following COVID-19 infection, with 79.29% developing PTSD, 61.43% suffering from depression, and 18.57% experiencing anxiety. Various factors, such as the presence of chronic medical illnesses and the number of co-morbid medical risk factors, were observed to contribute to these psychiatric outcomes. Therefore, comprehensive psychiatric assessment and management in COVID-19 patients especially with severe forms of the disease and hospitalized patients are mandatory. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the effects of flexible intensive care unit (ICU) visitation on the 1-year prevalence of post-traumatic stress, anxiety and depression symptoms among family members of critically ill patients. Methods: This is a long-term outcome analysis of a cluster-crossover randomized clinical trial that evaluated a flexible visitation model in the ICU (12 h/day) compared to a restrictive visitation model (median 1.5 h/day) in 36 Brazilian ICUs. In this analysis, family members were assessed 12 months after patient discharge from the ICU for the following outcomes: post-traumatic stress symptoms measured by the Impact Event Scale-6 and anxiety and depression symptoms measured by the Hospital Anxiety and Depression Scale. Results: A total of 519 family members were analyzed (288 in the flexible visitation group and 231 in the restrictive visitation group). Three-hundred sixty-nine (71.1%) were women, and the mean age was 46.6 years. Compared to family members in the restrictive visitation group, family members in the flexible visitation group had a significantly lower prevalence of post-traumatic stress symptoms (21% vs. 30.5%; adjusted prevalence ratio [aPR], 0.91; 95% confidence interval [CI] 0.85–0.98; p = 0.01). The prevalence of anxiety (28.9% vs. 33.2%; aPR 0.93; 95% CI 0.72–1.21; p = 0.59) and depression symptoms (19.2% vs. 25%; aPR, 0.78; 95% CI 0.60–1.02; p = 0.07) did not differ significantly between the groups. Conclusion: Flexible ICU visitation, compared to the restrictive visitation, was associated with a significant reduction in the 1-year prevalence of post-traumatic stress symptoms in family members. [ABSTRACT FROM AUTHOR]

Background: The trauma film paradigm (TFP) is the gold standard experimental psychopathology model of psychological trauma. However, different film clips with distinct effects on trauma-analogue symptoms are used across TFP studies, raising questions about the generalizability of study-specific results and the ecological validity of the TFP. Little is known about differences among film clips commonly used in the TFP regarding key features of psychological trauma (i.e., threat and anxiety) and their veridicality. Methods: Thirty healthy participants watched eight trauma film clips in randomized order and subsequently rated each in view of perceived threat, anxiety, and realism. In addition to descriptive statistics, variance analyses and pairwise comparisons were performed to test for differences on these outcomes. Results: The results indicated significant differences among the trauma film clips in terms of perceived threat and realism. However, nearly all trauma film clips evoked moderate anxiety levels. Conclusions: This study stressed the importance of perceived threat as a key feature in selecting film clips for the TFP, as highly threatening film clips were also perceived as more realistic. When replicated using delayed outcomes (e.g., intrusive memories), choosing trauma film clips in view of their perceived threat might improve the ecological validity of the TFP. [ABSTRACT FROM AUTHOR]

Mental health disorders and substance use disorders (SUDs) in particular, contribute greatly to the global burden of disease. Psychedelics, including entactogens and dissociative substances, are currently being explored for the treatment of SUDs, yet with less empirical clinical evidence than for other mental health disorders, such as depression or post-traumatic stress disorder (PTSD). In this narrative review, we discuss the current clinical research evidence, therapeutic potential and safety of psilocybin, lysergic acid diethylamide (LSD), ketamine, 3,4-methylenedioxymethamphetamine (MDMA) and ibogaine, particularly in the context of the SUD treatment. Our aim was to provide a balanced overview of the current research and findings on potential benefits and harms of psychedelics in clinical settings for SUD treatment. We highlight the need for more clinical research in this particular treatment area and point out some limitations and challenges to be addressed in future research. [ABSTRACT FROM AUTHOR]

The mental health of youth with chronic kidney disease (CKD) has been increasingly recognized as an area of clinical need. The development of mental health concerns is influenced by a range of physiological, psychological, and environmental factors. Some of these factors are common across child development, but some are more unique to youth with CKD. Mental health concerns are associated with increased risk for a range of poor medical outcomes (e.g., adherence, risk of transplant rejection) and quality of life concerns. In this educational review, we discuss the current evidence base regarding the development of mental health concerns in youth with CKD. The review covers multiple domains including mood and anxiety disorders, traumatic stress, and neurodevelopmental disorders. Estimated prevalence and hypothesized risk factors are outlined, and the potential impact of mental health on medical care and functional outcomes are reviewed. Finally, we introduce options for intervention to support positive mental health and offer recommendations for building access to mental health care and improving the mental health education/training of medical professionals. "A higher resolution version of the Graphical abstract is available as Supplementary information" [ABSTRACT FROM AUTHOR]

Background: The current study was aimed at constructing a questionnaire for evaluating the role of variant environmental factors on language acquisition in the three surrounding levels of communication that include familial level, preschool or nursery level, and surrounding social environmental level among children with delayed language development (DLD) due to environmental deprivation. The current study was a retrospective case–control study that was performed on 100 Egyptian Arabic-speaking children aged from 2 to 5 years. The study was carried out among preschool age children in the Mansoura governmental and private preschools (53 males and 47 females). They were divided into 2 groups: Group I (case group) consisted of 50 children with DLD due to environmental deprivation, and group II (control group) consisted of 50 typically developed children. Results: The present study demonstrated several factors for prediction of DLD due to environmental deprivation. Univariable analysis revealed multiple factors as number of hours that parents present at home, time of the mother's job, the relation between the child and the mother, the parents select certain time to talk and play with their child, joint attention of the mother, mother asking her child what he wants, long time using multimedia, divorce as a traumatic stress, bad social performance, and low socioeconomic status. Multivariate analysis revealed that longer time of the mother's job and less time the mother select to talk and play with her child were the environmental deprivation factors which had the most precipitating effect on predicting DLD. Conclusions: The constructed Arabic questionnaire was proved to be valid, reliable, and homogenous and is likely to produce consistent responses in evaluating the variant environmental factors on language development among children with DLD due to environmental deprivation in the three surrounding communications levels. [ABSTRACT FROM AUTHOR]

Black women living with HIV (BWLWH) face adversities associated with lower HIV medication adherence, viral non-suppression, and mental health symptoms (e.g., post-traumatic stress disorder) such as trauma/violence, racism, HIV-related discrimination/stigma, and gender-related stressors. We developed the first intervention based in cognitive behavioral therapy and culturally congruent coping for BWLWH to increase medication adherence and decrease PTSD symptoms by enhancing resilience, self-care, engagement in care, and coping for trauma, racism, HIV-related discrimination/stigma, and gender-related stressors. A pilot randomized control trial was conducted with BWLWH and histories of trauma who were at risk for their HIV viral load remaining or becoming detectable (i.e., below 80% medication adherence, detectable viral load in the past year, and/or missed HIV-related appointments). 119 BWLWH were assessed at baseline and 70 met inclusion criteria, completed one session of Life-Steps adherence counseling, and were randomized to either nine sessions of STEP-AD (Striving Towards EmPowerment and Medication Adherence) or ETAU (enhanced treatment as usual consisting of biweekly check-ins). Women completed a post intervention follow up assessment (3 months post baseline) and 3-month post intervention follow-up (6 months post baseline). Via STATA the difference-in-difference methodology with mixed models compared STEP-AD to ETAU on changes in outcomes over time. BWLWH in STEP-AD compared to E-TAU had significantly higher ART adherence (estimate = 9.36 p = 0.045) and lower likelihood of being clinically diagnosed with PTSD (OR =.07, estimate = − 2.66, p = 0.03) as well as borderline significance on higher CD4 count (estimate = 161.26, p = 0.05). Our findings suggest preliminary efficacy of STEP-AD in improving ART adherence, mental health, and immune function. [ABSTRACT FROM AUTHOR]

Although trauma centrality was positively associated with posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG), few studies have examined the factors that may influence the strength of these associations. This study aimed to investigate whether self-concealment would moderate the effects of trauma centrality on PTSD and PTG. A total of 211 Chinese college students (77.3% female; age: M = 19.86, SD = 1.85) participated in this cross-sectional study. These participants completed a battery of measures for trauma centrality, self-concealment, PTSD, and PTG. Trauma centrality was positively associated with both PTSD and PTG. The moderating role of self-concealment in the effect of trauma centrality on PTSD and PTG was statistically significant. Specifically, self-concealment was found to strengthen the relation between trauma centrality and PTSD, while mitigating the relation between trauma centrality and PTG. The extent to which trauma centrality contributes to PTSD and PTG might be determined by self-concealment among Chinese college students. The implications of these findings were discussed. [ABSTRACT FROM AUTHOR]

Adolescents exposed to natural disasters are among the most vulnerable groups to the devastating effects of these events, including experiencing mental health issues such as Post-Traumatic Stress Disorder (PTSD), depression, and anxiety disorders. The study aims to evaluate the impact of an early-term psychoeducational intervention (2 months after the disaster) on adolescents who were exposed to the February 6th earthquakes in Turkey regarding symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, and coping styles. The study employed AB experimental design with a single-group, pre-test, post-test, and follow-up test evaluation. The sample consisted of 8 individuals aged between 12 and 18, relocated to another city (Istanbul) with their families to a container camp after exposure to the earthquake. Participants underwent an 8-session (one session per week) psychoeducational program developed by researchers composed of psychologists 2 months after the earthquake. To assess the effectiveness of the psychoeducational intervention, the Child and Adolescent Post-Traumatic Stress Disorder Reaction Index, Brief Symptom Inventory, and Coping Styles Scale-Brief Form was employed at three different time points (pre-intervention, post-intervention, and 4-month follow-up). Percentage distribution and the Friedman Test for comparisons were done for the data to be analyzed. Following the psychoeducational intervention, a statistically non-significant decrease in depression symptoms was observed, but the effect of the intervention was maintained over the 4-month follow-up period. While no change in anxiety symptoms was noted after the intervention, a significant decrease was observed in the follow-up. However, no improvement was observed in PTSD symptoms. Participants showed a statistically significant increase in religious coping, whereas a non-significant increase in planning, using emotional social support, and positive reinterpretation coping styles were observed. After large-scale disasters affecting numerous individuals, early psychological interventions should be planned and tailored for specific groups and specific needs instead of including every member of the group would be more time and cost-efficient. [ABSTRACT FROM AUTHOR]

Background: COVID-19 disproportionately impacted marginalized populations early in the pandemic. Families of patients admitted to the intensive care unit (ICU) experienced significant psychological effects. Little is known about whether individual and patient psychological outcomes after a loved ones stay in the ICU differs by socioeconomic status, as measured by the area deprivation index (ADI). Methods: Family members of patients with COVID-19 respiratory failure admitted to the ICU at twelve hospitals in five US states were enrolled in a larger study looking at rates of symptoms of post-traumatic stress disorder (PTSD), anxiety, and depression in the months following their loved one's ICU stay. This secondary data analysis includes eight of the twelve hospitals in four of the five states. Each participant was assigned a number indicating a level of neighborhood disadvantage based on the patient's zip code. Patient and family level characteristics as well as symptoms of anxiety, depression, and PTSD were assessed among each neighborhood. Results: Patients from the most disadvantaged neighborhoods had the highest proportion of patients that needed to be intubated (p = 0.005). All the patients in the most disadvantaged neighborhoods were a race other than white (p = 0.17). At 12 months post-hospitalization, there was a statistically significant difference in the proportion of family members who experienced symptoms of PTSD, anxiety, and depression between the ADI groups. Conclusions: ADI may be a predictor of COVID-19 disease severity for patients on presentation to the ICU. Patients and family members experience psychological effects after a loved one's admission to the ICU, and these outcomes vary among individuals of different socioeconomic status', as measured by the ADI. A larger study of family members' incidence of anxiety, depression, and post-traumatic stress disorder is needed to understand the extent to which these symptoms are impacted by neighborhood level factors as measured by the ADI. [ABSTRACT FROM AUTHOR]

Background: Gaza war and the attack on the healthcare system and healthcare personnel influenced the Palestinian people's psychological status, especially healthcare professionals and university students. Aim: The study aims to explore the impact of Gaza war on nursing students of Palestine Polytechnique University (PPU). Method: In a cross-sectional design, 272 nursing students completed the Impact of Event Scale-Revised (IES-R). Chi-square test used to examine the association of PTSD severity with demographic variables; independent samples t-tests and ANOVA were used to compare means of PTSD subscales (intrusion, avoidance, and hyperarousal); relationships between subscale scores and the total IES-R score were assessed using Pearson correlation coefficients. Results: 71.3% of the Nursing students had high levels of PTSD symptoms, 14.7% were classified as having probable PTSD diagnosis, 10.7% had clinical concerns, and 3.3% with no clinical concern; hyperarousal and intrusion were the highest subscale scores; females showed higher levels of PTSD symptoms compared to males (p <.05); feelings of guilt when practicing happy events; negative impact on study significantly associated with higher PTSD severity (p <.05). Conclusion: The study highlighted the significant impact of Gaza war events on nursing students' mental health as evidenced by a high level of PSTD symptoms, despite the aggressive attack on health care system during war on Gaza students found to have high willingness to challenge and pursue in their future nursing career. Implications: Targeted supportive mental health programs, resiliency, and coping mechanisms are needed for nursing students in the Palestinian context. [ABSTRACT FROM AUTHOR]

The potent hallucinogen N,N-dimethyltryptamine (DMT) has garnered significant interest in recent years due to its profound effects on consciousness and its therapeutic psychopotential. DMT is an integral (but not exclusive) psychoactive alkaloid in the Amazonian plant-based brew ayahuasca, in which admixture of several β-carboline monoamine oxidase A (MAO-A) inhibitors potentiate the activity of oral DMT, while possibly contributing in other respects to the complex psychopharmacology of ayahuasca. Irrespective of the route of administration, DMT alters perception, mood, and cognition, presumably through agonism at serotonin (5-HT) 1A/2A/2C receptors in brain, with additional actions at other receptor types possibly contributing to its overall psychoactive effects. Due to rapid first pass metabolism, DMT is nearly inactive orally, but co-administration with β-carbolines or synthetic MAO-A inhibitors (MAOIs) greatly increase its bioavailability and duration of action. The synergistic effects of DMT and MAOIs in ayahuasca or synthetic formulations may promote neuroplasticity, which presumably underlies their promising therapeutic efficacy in clinical trials for neuropsychiatric disorders, including depression, addiction, and post-traumatic stress disorder. Advances in neuroimaging techniques are elucidating the neural correlates of DMT-induced altered states of consciousness, revealing alterations in brain activity, functional connectivity, and network dynamics. In this comprehensive narrative review, we present a synthesis of current knowledge on the pharmacology and neuroscience of DMT, β-carbolines, and ayahuasca, which should inform future research aiming to harness their full therapeutic potential. [ABSTRACT FROM AUTHOR]

Violence across Latin America is an increasingly important factor influencing migration to the US. A particular form of violence that is experienced by many Latinx migrants is extortion. This research analyzes the extortion experiences of Latinx immigrant adults arriving at the US southern border and the impact these experiences have on mental health. We find that on average, participants paid $804 in extortion during their migration. The most common perpetrators of extortion in our study were police followed by immigration officials throughout Latin America. Pregnant participants were less likely to experience extortion and adults traveling with children were more likely to be extorted. Participants who were extorted for money reported significantly greater severity of post-traumatic stress disorder (PTSD) symptoms compared to those who were not extorted. This research is the first of its kind to analyze extortion experiences among Latinx immigrants to the US, quantifying the prevalence, amounts paid, countries where extortion occurs, and perpetrators of extortion. In addition, extortion experiences are associated with negative effects on the mental health of newly arrived Latinx immigrants to the US. Based upon these findings, we recommend that extortion should be considered a significant stressor in the migrant experience, particularly for those adults traveling with children. [ABSTRACT FROM AUTHOR]

The October 29, 2022, Seoul Halloween Crowd Crush (SHCC) caused the loss of 159 lives, making it the deadliest global mass-gathering disaster between 2018 and 2022. Despite the fact that years have passed since the incident, there remains a significant gap in research addressing the mental health of citizens to evaluate their recovery progress. Therefore, in this study, a survey was conducted to assess citizens' anxiety, depression, post-traumatic stress disorder (PTSD), and well-being after the SHCC. The data were analyzed using t-tests, analysis of variance (ANOVA), correlations, a Kruskal–Wallis test, and post hoc tests. The citizens' well-being differed significantly by victimization status, with direct victims showing languishing well-being (p =.036). PTSD severity level was higher in victims and direct witnesses (p <.001). Victims and direct witnesses exhibited worse outcomes in subjective, social, and psychological well-being as well as in PTSD (p <.001). Well-being exhibited a significant negative correlation with PTSD (r = −.247, p <.001). The results of the analysis suggest the SHCC's psychological impact has endured not only for victims and direct witnesses but also for media-exposed citizens. Offering continuous psychological support and fostering positive self-perceptions and social interactions are crucial for their recovery and well-being enhancement. [ABSTRACT FROM AUTHOR]

Background: Care in the intensive care unit (ICU) often introduces symptoms of post-traumatic stress disorder (post-ICU PTSD) in individuals with prior adverse experiences. General practitioners play an important role in follow-up care. Case report: A 58-year-old woman developed post-ICU PTSD symptoms after she experienced sepsis. She received brief narrative exposure therapy (NET) from her general practitioner and experienced significant improvement of symptoms. Conclusion: A brief version of NET might be appropriate for the treatment of patients with mild to moderate post-ICU PTSD symptoms. [ABSTRACT FROM AUTHOR]

Repetitive negative thinking and intolerance of uncertainty are risk and maintenance factors for emotional disorders. Although emerging evidence suggests that intolerance of uncertainty predicts increases in distress through repetitive negative thinking, these relationships have yet to be investigated among veterans. The present study examines if repetitive negative thinking mediates the relationships of intolerance of uncertainty with stress, disordered symptoms and impairment among a mixed clinical sample of veterans. Two hundred and forty-four treatment-seeking veterans with diagnoses of major depressive disorder, panic disorder, or posttraumatic stress disorder completed measures of intolerance of uncertainty, repetitive negative thinking, stress, impairment, depression, panic, and posttraumatic stress prior to receiving treatment. Mediation models revealed indirect effects of intolerance of uncertainty through repetitive negative thinking on stress and impairment in the full sample, and on disordered symptoms in subsamples with major depressive disorder and posttraumatic stress disorder. Conversely, intolerance of uncertainty did not have direct or indirect effects on disordered symptoms in a panic disorder subsample. Findings suggest that repetitive negative thinking and intolerance of uncertainty uniquely contribute to stress, impairment, and disordered symptoms, but repetitive negative thinking, may, in part, drive intolerance of uncertainty's contribution to emotional disorders. Interventions for repetitive negative thinking might improve the efficacy of existing transdiagnostic treatment protocols. Cross-sectional data is a limitation of the present study. Prospective designs in civilian samples can better establish the temporality of these relationships and if they are generalizable to the larger population. [ABSTRACT FROM AUTHOR]

Substantial concerns have been raised about the lack of an empirical basis for revisions made to the criteria for posttraumatic stress disorder (PTSD) in the DSM-5. Although researchers have examined the broader impact of these revisions on diagnostic prevalence, no study to date has examined the contribution of each individual revision. The current study sought to explore how each change in criteria and cluster structure affect frequency of PTSD diagnosis. Between July 2012 and October 2021, PTSD symptoms were collected at intake from child/parent reports (n = 65) at a pediatric mental health clinic and from adult patient reports (n = 322) at an outpatient mental health clinic. Compared to the frequency of PTSD diagnosis for adults based on DSM-IV criteria (73.6%), the frequency did not significantly increase with the addition of negative beliefs (74.8%), distorted thoughts (76.1%), and reckless or self-destructive behavior (74.2%), and increased significantly with a small effect with the addition of persistent negative emotional state (79.5%). The trend was similar for the youth sample across all new symptoms. A four-cluster structure diagnosed fewer individuals compared to a three-cluster structure across different sets of symptoms. The overall impact, however, was for DSM-5 to diagnose fewer adults but the same number of youths. Significant associations were found for age and sex with some new items. Findings add new concerns to the growing literature on problematic impacts of DSM-5 revisions to PTSD. [ABSTRACT FROM AUTHOR]

The number of studies on post-traumatic stress disorder after hospitalization in a pediatric intensive care unit raised since 2004. The objective of this systematic review was to summarize and critically examine the literature about risk factors for these children to develop post-traumatic stress disorder following admission to an intensive care unit. The data sources were PubMed, Cochrane, Web of Science, PsycInfo, SUDOC, Scopus, and ScienceDirect. Studies were selected if they were in English or French and published between 01/01/2004 and 31/01/2022. Studies were excluded if patients were less than 1 month old and if no post-traumatic stress disorder was found. The internal validity and risk of bias were assessed using the National Institutes of Health Study Quality Assessment Tools for observational studies and the Ottawa Scale was used for the interventional study. The search yielded 523 results and 22 articles met inclusion criteria. Three common risk factors were identified from the data: parental post-traumatic stress disorder (especially in mothers), severity of illness and delusional memories. Internalizing behavior in children, acute parent and child stress, emergency admission and sepsis are also potential risk factors that require further investigation. The prevalence of this pathology is substantial (between 14 and 36%) and increasing awareness among pediatricians and psychologists seems necessary. Prevention programs are being studied to reduce the incidence of post-traumatic stress disorder in this population. Child and adolescent psychiatry liaison should collaborate with pediatric teams to support this objective. [ABSTRACT FROM AUTHOR]

Findings of high rates of complex trauma among justice-involved young people have engendered interest in developing trauma-informed youth justice systems. Although there have been several reviews of trauma-informed practice in youth justice settings, uncertainty remains about whether this approach can produce the outcomes expected of youth justice services. In this study we summarize findings from recent systematic reviews and meta-analyses to provide an overview of evidence relevant to implementing trauma-informed youth justice. We conducted an umbrella review of systematic reviews published between 2017 and 2023 that included group-based primary studies of trauma-informed interventions for justice-involved young people. Reviews were located via searches of PsycINFO, PubMedCentral, Embase, Criminal Justice Abstracts with Full Text, and ProQuest. Data extracted from each review included the number and type of primary studies reviewed, and outcomes related to trauma symptomatology, mental health and wellbeing, and justice system involvement. Nine systematic reviews met our inclusion criteria. Improvements in trauma symptoms, mental health and wellbeing, and justice system involvement were documented in each review. The strongest evidence related to the impact of trauma-focused interventions on posttraumatic stress disorder symptoms, but less evidence was available to demonstrate outcomes of organizational level and systemic components of trauma-informed practice. Each review highlighted the need to strengthen the methodological quality of primary studies. Trauma-informed practice should be seriously considered as part of any effort to implement evidence-based youth justice. This should extend beyond treatment of trauma symptomatology to incorporate a broader approach to trauma-informed practice that is organizationally embedded. [ABSTRACT FROM AUTHOR]

This study is an attempt to explore war-related trauma, its stressful effects, and the coping strategies of Saudi schoolchildren. The authors hypothesized that children exposed to war-related trauma will show higher levels of PTSD, and that those with higher levels of PTSD symptoms use more maladaptive coping strategies. The study describes the correlation between traumatic events and posttraumatic stress disorder (PTSD) as well as coping strategies. Five hundred twenty-seven intermediate and high school students, 12 to 18 years old, living in the conflict zone in southern Saudi Arabia completed three standardized self-reported scales: the War Zone Traumatic Events Checklist, the Child PTSD Symptom Scale, and the Children's Coping Strategies Checklist. Each participating student was randomly chosen. Analysis was based on two groups: the high-PTSD symptoms group (182 children) and the low-PTSD symptoms group (345 children). The study was conducted between September 2020 and April 2022 while the war was ongoing as part of an ongoing larger study. Children exposed to war-related traumatic events exhibited greater prevalence rates for PTSD. The children reported high levels of PTSD symptoms and applied a variety of coping strategies to manage related stress. Participants rarely reported that psychological or educational interventions had been used to manage the war-related traumatic experiences and PTSD or to improve related coping styles. The results are discussed in the context of mental health services needed for children in the conflict zone. To bridge the gap between health care services and the needs of children with PTSD, and for better understanding and interventions, health professionals are invited to develop a biopsychosocial model that identifies the risks of PTSD related to exposure to war-related traumatic events in school-aged children and, hence, provide a multidisciplinary intervention program that educates, encourages, and supports teachers and parents in following medical recommendations and goals. [ABSTRACT FROM AUTHOR]

The restorative effect of physical activity in alpine environments on mental and physical health is well recognized. However, a risk of accidents and post-accident mental health problems is inherent to every sport. We aimed to characterize mental health in individuals following mountain sport accidents requiring professional medical management. Adult victims of mountain sport accidents treated at the hospital of the Medical University of Innsbruck (Austria) between 2018 and 2020 completed a cross-sectional survey at least 6 months following the admission (median 44 months, n = 307). Symptoms of post-traumatic stress disorder (PTSD, PCL-5), anxiety, depression, and somatization (PHQ), resilience (RS-13), sense of coherence (SOC-9L), post-traumatic growth (PTGI), and quality of life (EUROHIS-QOL), as well as sociodemographic and clinical information, were obtained from an online survey and extracted from electronic health records. Mental health outcome patterns were investigated by semi-supervised medoid clustering and modeled by machine learning. Symptoms of PTSD were observed in 19% of participants. Three comparably sized subsets of participants were identified: a (1) neutral, (2) post-traumatic growth, and (3) post-traumatic stress cluster. The post-traumatic stress cluster was characterized by high prevalence of symptoms of mental disorders, low resilience, low sense of coherence, and low quality of life as well as by younger age, the highest frequency of pre-existing mental disorders, and persisting physical health consequences of the accident. Individuals in this cluster self-reported a need for psychological or psychiatric support following the accident and more cautious behavior during mountain sports since the accident. Reliability of machine learning-based prediction of the cluster assignment based on 40 variables available during acute medical treatment of accident victims was limited. A subset of individuals show symptoms of mental health disorders including symptoms of PTSD when assessed at least 6 months after mountain sport accident. Since early identification of these vulnerable patients remains challenging, psychoeducational measures for all patients and low-threshold access to mental health support are key for a successful interdisciplinary management of victims of mountain sport accidents. [ABSTRACT FROM AUTHOR]

Law enforcement personnel work in environments in which exposure to stressors can lead to increased risk for mental health conditions such as depression. Symptoms of these conditions often include sleep disturbance. However, officers are also more likely to experience sleep disturbance because of occupational demands such as shift work, which further increases the risk for depression. There is a lack of research focused on the relationships between sleep quality, mental health, and the role that adaptive coping styles may have in mitigating adverse outcomes in these domains among law enforcement personnel. Therefore, we examined the extent to which insomnia was associated with depression among law enforcement personnel and the degree to which resilience moderates this association after accounting for posttraumatic stress disorder (PTSD, also prevalent in this population and also associated with insomnia) symptom severity as well as age, gender, and racial and ethnic identity. Participants were 246 law enforcement personnel (Mage = 44.20, SD = 11.75; 76% identified as male) from a large urban agency. Results indicated that insomnia significantly relates to depression beyond levels of PTSD symptomatology. In addition, we found that resilience significantly moderates, or attenuates, the association between insomnia and depressive symptom severity. Our findings highlight the potential value of mental health and wellness programs emphasizing the development of resilience among law enforcement personnel. [ABSTRACT FROM AUTHOR]

This study aimed to reveal the level of effect of psychotherapeutic interventions on post-traumatic stress disorder symptoms, depression, and self-esteem in women who had been exposed to violence. For this systematic review and meta-analysis study, PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases were searched without any year limitation in August-December 2022, and 28 studies were included. The data were synthesized using meta-analysis and narrative methods. This systematic review and meta-analysis found that psychotherapeutic interventions for women exposed to violence were effective on post-traumatic stress disorder symptoms in individuals (SMD: -0,590, %95 CI: -0,893- 0.196; Z= -2,937, p = 0.003, I2= %93,59). Psychotherapeutic interventions had a significant effect on women's depression levels in favor of the intervention group, and there was high heterogeneity between the studies (SMD: -0,475, %95 CI: -0,838- 0.113; Z= -2,569, p = 0.010, I2= %90,68). Subgroup analyses showed that cognitive behavioral therapy was effective in the treatment of intimate partner violence. It was also found that psychotherapeutic interventions did not affect women's self-esteem levels. Psychotherapeutic therapies for women who have experienced violence have a favorable impact on them and improve their mental health. [ABSTRACT FROM AUTHOR]

The pandemic is a major public health crisis, which may bring post-traumatic stress disorder (PTSD) as well as post-traumatic growth (PTG) to healthcare professionals. The current study aimed to assess coexistence patterns of PTSD and PTG among healthcare workers during the first outbreak of Corona Virus Disease 2019 (COVID-19). It also explored whether social support and self-disclosure could predict group membership. The questionnaire survey was conducted among Chinese front-line healthcare workers three months after the first outbreak of COVID-19, and 500 valid responses were obtained. Latent class analysis (LCA) was used to analyze the data, and logistic regression was used to examine the predicting effect of social support and self-disclosure. Four latent classes were identified: low PTSD/high PTG (Class 1, 53.2%), moderate PTSD/high PTG (Class 2, 28.0%), moderate PTSD/moderate PTG (Class 3, 6.4%), and high PTSD/high PTG (Class 4, 12.4%). None of the demographic information predicted the membership. Members with "low PTSD/high PTG" were associated with high social support and high self-disclosure of distress. Meanwhile, social support and self-disclosure differentiated those with the same moderate level of PTSD but showed higher or lower PTG. The results of this study confirmed that PTSD and PTG coexist among frontline healthcare workers, and PTG is prominent among them. Social support and self-disclosure are protective factors for low-stress and high-growth combinations. [ABSTRACT FROM AUTHOR]

Leadership is an important competency across different fields and is a key to socio-economic development. Although leadership involves various social-emotional competencies that can be profoundly affected by childhood trauma, it remains unknown about the potential relationship between childhood trauma and leadership. This study examined whether childhood trauma and complex post-traumatic stress disorder (PTSD) symptoms would be negatively associated with leadership competence. A convenience sample of N = 411 Hong Kong adults (Age: M = 38.6, SD = 12.9) completed self-report measures of the studied variables in an online survey. Hierarchical multiple regression showed that childhood betrayal trauma (β = − 0.140, p =.008) but not non-betrayal trauma (β = 0.035, p =.491) was significantly, negatively associated with perceived leadership competence, even after controlling for covariates. When symptoms of complex PTSD were added into the model, disturbances in self-organization (DSO) symptoms were also a significant factor associated with perceived leadership competence (β = − 0.454, p <.001). This study is the first to show that childhood betrayal trauma and its major mental health consequences (i.e., complex PTSD symptoms) are negatively associated with perceived leadership competence. The findings expand our limited understanding of the socio-economic correlates of childhood trauma and point to the social and economic importance of child protection. If we make efforts to prevent childhood trauma, we may possibly protect our future leaders. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disrupted people's lives and caused significant economic damage around the world, but its impact on people's mental health has not been paid due attention by the research community. According to anecdotal data, the pandemic has raised serious concerns related to mental health among the masses. However, no systematic investigations have been conducted previously on mental health monitoring and, in particular, detection of post-traumatic stress disorder (PTSD). The goal of this study is to use classical machine learning approaches to classify tweets into COVID-PTSD positive or negative categories. To this end, we employed various Machine Learning (ML) classifiers, to segregate the psychotic difficulties with the user's PTSD in the context of COVID-19, including Random Forest Support Vector Machine, Naïve Bayes, and K-Nearest Neighbor. ML models are trained and tested using various combinations of feature selection strategies to get the best possible combination. Based on our experimentation on real-world dataset, we demonstrate our model's effectiveness to perform classification with an accuracy of 83.29% using Support Vector Machine as classifier and unigram as a feature pattern. [ABSTRACT FROM AUTHOR]

Background: The prevalence of co-occurring chronic pain and posttraumatic stress disorder (PTSD) has yet to be established in a nationally representative sample of US veterans, and little is known about the individual contributing roles of these disorders to the psychiatric and functional burden of this comorbidity. Objective: To determine the prevalence of chronic pain, PTSD, and co-occurring chronic pain and PTSD, and psychiatric comorbidities and psychosocial functioning in these groups. Design: Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of US veterans. Participants: Veterans (n=4069) were classified into four groups: control (i.e., no PTSD or chronic pain), chronic pain only, PTSD only, and co-occurring chronic pain and PTSD. Main Measures: A probable PTSD diagnosis was established using the PTSD Checklist for DSM-5, and a chronic pain diagnosis using a self-report item that queried health care professional diagnoses. Psychiatric and functional status were assessed using the Patient Health Questionnaire-4, Alcohol Use Disorders Identification Test, Screen of Drug Use, Suicide Behaviors Questionnaire-Revised, Short Form Health Survey-8, Brief Inventory of Psychosocial Functioning, and Medical Outcomes Study Cognitive Functioning Scale. Key Results: A total of 3.8% of veterans reported both probable PTSD and a diagnosis of chronic pain. Relative to veterans with chronic pain alone, those with co-occurring chronic pain and probable PTSD were more likely to screen positive for psychiatric disorders (odds ratios [ORs]=2.59–9.88) and scored lower on measures of psychosocial functioning (Cohen's ds=0.38–1.43). Relative to veterans with probable PTSD only, those with co-occurring chronic pain and probable PTSD were more likely to have attempted suicide (OR=4.79; 95%CI, 1.81–12.69). Conclusions: Results underscore the importance of whole health care that considers a broad range of health and functional domains in the assessment and treatment of co-occurring chronic pain and PTSD in veterans. [ABSTRACT FROM AUTHOR]

Background: The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) is a screening instrument designed to identify patients with probable PTSD and is mandated to be used in VA primary care settings. However, validation of the diagnostic accuracy of the instrument is lacking in various demographic and diagnostic groups. Objective: To evaluate the diagnostic accuracy of the PC-PTSD-5 in demographically and diagnostically stratified groups of VA primary care patients. Design, Setting, and Participants: Based on a sample of 519 VA primary care patients (40.61% response rate), the PC-PTSD-5 was evaluated against a criterion measure, examining its sensitivity, specificity, and other diagnostic properties. Evaluations were conducted in demographically stratified patient groups, including gender, age, race/ethnicity, marital status, and education, as well as diagnostically stratified groups, in patients with and without a depression, alcohol use, and drug use disorder. Main Measures: The MINI-International Neuropsychiatric Interview was the criterion measure against which the PC-PTSD-5 was evaluated. Key Results: Among the 10 demographically stratified groups of patients, the PC-PTSD-5 demonstrated a sensitivity between 81.25% (95% C.I.: 54.35 – 05.95) and 100% (95% C.I.: 63.06 – 1000) and its specificity ranged from 80.54% (95% C.I.: 74.70 – 85.55) to 88.31% (95% C.I.: 83.45 – 92.15). Among the 6 diagnostically stratified groups of patients (with and without depression, alcohol use, and drug use disorders), the PC-PTSD-5 exhibited a sensitivity between 88.89% (95% C.I.: 65.29 – 98.62) and 95.92% (95% C.I.: 86.02 – 99.50), and its specificity varied from 60.00% (95% C.I.: 40.60 – 77.34) to 88.14% (95% C.I.: 84.50 – 91.19). Conclusions: The PC-PTSD-5, suitable for a diverse range of VA primary care patients, shows satisfactory sensitivity and specificity across various demographic and diagnostic groups. Healthcare providers should be cautious of false positives in patients with depression or substance use disorders, given the potential symptom overlap with PTSD. [ABSTRACT FROM AUTHOR]

The debate over whether intellectual giftedness acts as a protective or a risk factor for various socioemotional difficulties has persisted in gifted studies for almost a century, with two contrasting views of giftedness still coexisting in the literature. Our goal was to investigate if early adversity could contribute to reconcile these views, specifically by investigating if Early Adverse Experiences (ACEs) could account for some of the vulnerabilities (e.g., anxiety, daydreaming, heightened emotional reactivity) sometimes associated with intellectual giftedness (Intellectual Quotient, IQ ≥ 130). For that purpose, 245 intellectually gifted adults (Mage = 41.71, MIQ = 137.87) and 205 control adults (Mage = 33.36, MIQ = 116.11) were surveyed. Main results revealed comparable high rates of ACEs among both groups. Severe ACE exposure correlated with heightened anxiety (r = 0.23, p < 0.001) and absorption in thoughts (r = 0.26, p < 0.001). Heightened emotional reactivity was associated with the duration of exposure (r = 0.11, p < 0.05). Parental verbal abuse correlated with reduced scores in positive relationships with others (r = 0.12, p < 0.05) and purpose in life (r = 0.13, p < 0.05). Conversely, IQ was not associated with these difficulties, except for a small protective effect against absorption (r = − 0.10, p < 0.05). These findings suggest that ACEs contribute to distinguishing gifted adults who experience socioemotional issues. However, subthreshold Post-Traumatic Stress Disorder (PTSD) symptoms and the limited protective effect of IQ on this condition may have led to underestimating the clinical assessment of their early environment, and to conflate early adversity effects with intelligence-related traits. Despite limitations and some nuances in our results, this study was the first to assess maltreatment and neglect in gifted adults. By contributing to fill the gap between two historical views of giftedness, it may inform improved clinical practices with intellectually gifted adults while better understanding them. [ABSTRACT FROM AUTHOR]

Disturbance of self-organization (DSO) is defined by affective dysregulation, negative self-concept, and disturbances in relationships. Along with post-traumatic stress disorder (PTSD), DSO is a part of complex post-traumatic stress disorder (CPTSD), which often results from childhood trauma and has life-long consequences. We investigated the association between CPTSD, PTSD, DSO, childhood adversity, and irritable bowel syndrome (IBS). Individuals with IBS exhibited markedly higher prevalences of DSO, CPTSD, and PTSD symptoms and higher trauma scores compared with healthy individuals. The odds of having IBS were 3.718 and 1.924 times greater for those with DSO symptoms (p <.001) and CPTSD symptoms (p =.005), respectively. IBS severity was highest in the DSO group, followed by the CPTSD, PTSD, and non-DSO/CPTSD/PTSD groups. DSO symptoms mediate the impact of childhood adversity on IBS symptoms, explaining half of this effect, whereas PTSD symptoms do not. These findings suggest a significant role of DSO in the development of IBS. [ABSTRACT FROM AUTHOR]

With about 1200 individuals murdered, the massacre of October 7th was one of the deadliest terrorist attacks in modern history. The mental health consequences of terrorist attacks have been documented. However, little is known of the impact of the potentially morally injurious experience (PMIE) of betrayal––in which individuals feel betrayed by leaders they once trusted––on levels of psychological burden in the aftermath of such an attack. In this national prospective cohort study, we examined to what extent the PMIE of betrayal exacerbates the risk for posttraumatic stress disorder (PTSD) and depression in the wake of the October 7th terrorist attack. A representative sample of 710 Israeli adults (362 female, 51.1%), Jews (557, 79.9%) and Arabs (153, 20.1%), aged 18–85 (M = 41.01, SD = 13.72) completed validated self-report questionnaires assessing PTSD, depression, and PMIE-betrayal at two timepoints: T1, in August 2023 (6–7 weeks before the attack) and T2, in November 2023 (5–6 weeks after the attack). In two hierarchical logistic regressions, we found that experience of PMIE-betrayal predicted diagnoses of both PTSD (OR 1.92, 95% CI 1.26–2.92) and depression (OR 2.03, 95% CI 1.37–3.01) at T2, beyond probable PTSD/depression at T1 and demographic and trauma-related variables. Moreover, in two repeated-measure analyses predicting PTSD/depression symptoms, we found significant interactions between PTSD/depression trajectories and PMIE-betrayal, meaning that the increase of PTSD/depression symptoms was significantly higher among participants experiencing betrayal in the context of the attack. Our study highlights the impact of PMIE of betrayal on the dramatic increase in psychopathology following the October 7th terror attack on Israel's population. Clinicians treating individuals coping with PTSD and depression should attend to their patients' possible exposure to betrayal following the attack. Moreover, national leaders and policymakers should take significant steps to repair the public's betrayal experience. [ABSTRACT FROM AUTHOR]

Sexual victimization is associated with worse mental health outcomes among LGBQ + adolescents and adults; however, limited work has focused on these relations among emerging adults in college and has not tested mechanisms that might explain these associations. Thus, the current study tested the associations between sexual victimization and mental health outcomes (i.e., anxiety symptoms, depressive symptoms, and posttraumatic stress disorder symptoms) and examined social support and trauma-related drinking as mediators of these associations among diverse LGBQ + college student emerging adults. Additionally, we tested whether findings varied among Students of Color and White Students. Participants included 179 LGBQ + college students (M = 19.48, SD = 0.74) who completed measures of sexual victimization, social support, trauma-related drinking, and mental health. Trauma-related drinking was a significant mediator, such that sexual victimization was associated with greater trauma-related drinking and, in turn, greater anxiety symptoms, depressive symptoms, and posttraumatic stress disorder symptoms. Although social support was not a significant mediator, social support was associated with less anxiety symptoms and less depressive symptoms. Findings did not vary by ethnicity/race. Findings have research and intervention implications by highlighting the ways in which sexual victimization, social support, and trauma-related drinking affect LGBQ + college students' mental health. [ABSTRACT FROM AUTHOR]

Background: Military personnel who complete cognitive processing therapy (CPT) can still experience residual symptoms of posttraumatic stress disorder (PTSD). Gaining a deeper understanding of the characteristics that influence response to CPT may increase the likelihood of treatment success. Emotion regulation and trait resilience are associated with PTSD severity and may influence treatment response in active duty service members with PTSD. Methods: This secondary analysis explored the association among reports of baseline emotion regulation (Cognitive Emotion Regulation Questionnaire-Short Form) and trait resilience (Response to Stressful Experiences Scale) with PTSD severity reductions in a sample of active duty service members (N = 268) who participated in a clinical trial that compared group-delivered and individual CPT. Population averaged models were utilized to examine if baseline predictors were related to change in PTSD severity from pre- to posttreatment. Results: Trait resilience predicted PTSD severity changes such that participants who reported less trait resilience at baseline demonstrated greater PTSD severity reductions over a course of CPT. There was also a main effect of adaptive emotion regulation on PTSD severity. Post-hoc correlation analyses revealed that baseline adaptive emotion regulation was positively associated with PTSD severity at pre- and posttreatment. Conclusions: Findings imply that service members with lower trait resilience may particularly benefit from CPT. Whether trait resilience moderates PTSD outcomes specific to CPT will require a trial with an alternative comparison treatment arm. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT02173561 (6/25/2014) [ABSTRACT FROM AUTHOR]

There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p <.008) and a severity of problems when trying to quit (p <.001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology. [ABSTRACT FROM AUTHOR]

The coronavirus disease-2019 (COVID-19) pandemic has impaired the quality of life (QoL) for many due to its extensive impacts. However, few studies have addressed the specific impact of COVID-19 on the mental health of adolescents, particularly post-traumatic stress disorder (PTSD). This study considered the impact of COVID-19-related PTSD on the QoL of adolescents in China, the mediating effects of insomnia, and the moderating effects of resilience. Participants included 50,666 adolescents aged 12–18 years selected using a comprehensive sampling method. We performed data collection from January 8th to January 18th, 2023, using the Children's Revised Impact of Event Scale, Pittsburgh Sleep Quality Index, Ten-item Connor-Davidson Resilience Scale, and Screening for and Promotion of Health-related QoL in Children and Adolescents Questionnaire for data collection. Male adolescents exhibited significantly lower levels of PTSD and insomnia compared to females and scored significantly higher in psychological resilience and overall QoL. Insomnia played a mediating role between PTSD and QoL. Psychological resilience moderated the impact of COVID-19-related stress on adolescents' QoL through its influence on insomnia. PTSD resulting from the COVID-19 pandemic affects the QoL of adolescents through the presence of insomnia. Psychological resilience plays a moderating role in this process. Cultivating psychological resilience in adolescents can effectively enhance their ability to cope with the impacts of sudden public events. [ABSTRACT FROM AUTHOR]

Since the new millennium, biblical scholars have begun to reread certain writings in the Hebrew Bible through the concepts of post-traumatic stress disorder and post-traumatic growth. Some scholars believe such a reading is legitimate, whereas others think it problematic, and still, others hold a midway perspective. This article argues for the midway, the position that accepts the applicability of the Hebrew Bible to today's psychological concepts but calls for caution. Because ancient Israelites reacted to traumatic events and distinguished the human mind from the body like modern people, it is reasonable to approach their thoughts and emotions in the Hebrew Bible through today's psychological concepts. However, the cultural differences between today's society and ancient Israelites in understanding and reacting to traumatic events should be considered. [ABSTRACT FROM AUTHOR]

No research has been conducted on PTSD manifestation in children with severe or moderate intellectual disability (SID; IQ 20 – 49) and no PTSD measurement instrument was available. This pilot explores the psychometric properties of a new diagnostic instrument to investigate trauma and to classify PTSD in children with SID. The Diagnostic Interview Trauma and Stressors-Severe Intellectual Disabilities (DITS-SID), Aberrant Behavior Checklist and Child and Adolescent Trauma Screener 3-6 were administered to parents and residential caregivers of fifteen children with SID. The inter-rater reliability of the DITS-SID is good to excellent. There are indications of a good convergent validity. PTSD prevalence seems high at 27%-33%. Self-injurious behavior was one of the most commonly reported PTSD symptoms. There is evidence that the PTSD manifestation of children with SID does not differ from that of children without SID. PTSD is probably underdiagnosed in this target group. In understanding challenging behavior, it is important to consider an underlying PTSD in order to provide appropriate treatment. The DITS-SID is potentially suitable for diagnosing PTSD. Follow-up research in a larger sample is needed. [ABSTRACT FROM AUTHOR]

Rationale: Intensely stressful experiences can lead to long-lasting changes in appetitive and aversive behaviors. In humans, post-traumatic stress disorder increases the risk of comorbid appetitive disorders including addiction and obesity. We have previously shown that an acute stressful experience in adult male rats suppresses motivation for natural reward. Objectives: We examine the impact of sex and age on the effects of intense stress on action-based (instrumental) and stimulus-based (Pavlovian) motivation for natural reward (food). Methods: Rats received 15 unsignaled footshocks (stress) in a single session followed by appetitive training and testing in a distinct context. In Experiment 1, stress occurred in either adolescence (PN28) or adulthood (PN70) with appetitive training and testing beginning on PN71 for all rats. In Experiment 2, stress and appetitive training/testing occurred in adolescence. Results: Acute stress in adolescent females suppressed instrumental motivation assessed with progressive ratio testing when testing occurred in late adolescence or in adulthood, whereas in males stress in adolescence did not suppress instrumental motivation. Acute stress in adulthood did not alter instrumental motivation. In contrast, Pavlovian motivation assessed with single-outcome Pavlovian-to-instrumental transfer (SO-PIT) was consistently enhanced in females following adolescent or adult stress. In males, however, stress in adolescence had no effect, whereas stress in adulthood attenuated SO-PIT. Conclusions: Acute stress in adolescence or adulthood altered instrumental motivation and stimulus-triggered Pavlovian motivation in a sex and developmentally specific manner. These findings suggest that the persistent effects of acute stress on Pavlovian and instrumental motivational processes differ in females and males, and that males may be less vulnerable to the deleterious effects of intense stress during adolescence on appetitive motivation. Highlights: Acute stress during adolescence or adulthood enhanced Pavlovian motivation in females. Acute stress during adulthood impaired Pavlovian motivation in males, but adolescent stress had no effect. [ABSTRACT FROM AUTHOR]

Objective: Residents of Puerto Rico are disproportionately exposed to social and environmental stressors (e.g., Hurricane María and the 2020 sequence of tremors) known to be associated with psychological distress. Shift-and-persist (SP), or the ability to adapt the self to stressors while preserving focus on the future, has been linked with lower psychological distress, but no study has evaluated this in Puerto Rico. This study examined the association between SP and psychological distress (including that from natural disasters) in a sample of young adults in Puerto Rico. Methods: Data from the Puerto Rico-OUTLOOK study (18–29 y) were used. Participants (n = 1497) completed assessments between September 2020 and September 2022. SP was measured with the Chen scale and categorized into quartiles (SPQ1–SPQ4). Psychological distress included symptoms of depression (CESD-10), anxiety (STAI-10), post-traumatic stress disorder (Civilian Abbreviated Scale PTSD checklist), and ataque de nervios (an idiom of distress used by Latinx groups). Outcomes were dichotomized according to clinical cutoffs when available, otherwise used sample-based cutoffs. Two additional items assessed the perceived mental health impact of Hurricane María and the 2020 sequence of tremors (categorized as no/little impact vs. some/a lot). Adjusted prevalence ratios (PR) and their 95% confidence intervals (CI) were estimated. Results: The most commonly reported psychological distress outcome was PTSD (77%). In adjusted models, compared to SP Q1, persons in SP Q2–Q4 were less likely to have elevated symptoms of depression (PR Q2 = 0.79, 95% CI = 0.72–0.85; PR Q3 = 0.65, 95% CI = 0.58–0.73; and PR Q4 = 0.41, 95% CI = 0.35–0.48), PTSD (PR Q2 = 0.92, 95% CI = 0.87–0.98; PR Q3 = 0.86, 95% CI = 0.80–0.93; and PR Q4 = 0.76, 95% CI = 0.70–0.83), anxiety (PR Q2 = 0.39, 95% CI = 0.31–0.48; PR Q3 = 0.27, 95% CI = 0.20–0.37; and PR Q4 = 0.11, 95% CI = 0.07–0.17) and experiences of ataque de nervios (PR Q2 = 0.85, 95% CI = 0.76–0.94; PR Q3 = 0.79, 95% CI = 0.70–0.90; and PR Q4 = 0.68, 95% CI = 0.60–0.78). Compared to persons in SP Q1, persons in SP Q3–Q4 were less likely to report adverse mental health impacts from Hurricane María (PR Q3 = 0.66, 95% CI = 0.55–0.79; and PR Q4 = 0.53, 95% CI = 0.44–0.65) and the 2020 sequence of tremors (PR Q3 = 0.77, 95% CI = 0.61–0.98; and PR Q4 = 0.74, 95% CI = 0.59–0.94). Conclusion: SP was associated with lower psychological distress. Studies are needed to confirm our findings and evaluate potential mechanisms of action. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the longitudinal trajectories of adolescent survivors' nightmares after the Wenchuan earthquake and tested whether specific trajectory memberships of nightmares could predict depression and post-traumatic stress disorder (PTSD) in the 10 years after earthquake. Methods: 610 adolescents exposed to the Wenchuan earthquake were surveyed on nightmares at 18 months (T18m), 24 months (T24m), and 30 months (T30m) after the earthquake. Depression and PTSD were assessed at baseline (T18m) and 10 years (T10y) after the catastrophe. Data were analyzed using linear regression analysis. Results: The prevalence rates of frequent nightmares at three time points were 9.8%, 11.5%, and 9.3%, respectively. Five different trajectories of nightmares were identified: resistance (77.0%), recover (8.4%), delayed-dysfunction (7.9%), chronic-dysfunction (1.1%), and relapsing/remitting (5.6%). Additionally, we found that participants in relapsing/remitting, chronic or delayed dysfunction trajectories compared with those in the resistant group were more likely to experience depression and PTSD in young adulthood after adjusting for a wide range of covariates. Conclusions: Nightmares had heterogeneity after a catastrophic earthquake. Timely assessment and targeted interventions on specific nightmares are necessary for reducing the incidence of psychiatric disorders. [ABSTRACT FROM AUTHOR]

Purpose: Almost 20% of children and adolescents who attend in mental health centres are witnesses of domestic violence (WDVs). It would therefore be clinically useful to have an appropriate screening instrument for this population, such as the PTSD-CBCL. Our aim here was thus to assess the psychometric properties of relevant tools by determining their internal consistency, sensitivity/specificity, and positive/negative predictive values in our centre's population. Methods: We recruited 194 parents of children aged 4–16 at the Child and Adolescent Mental Health Service of the Hospital Sant Joan de Déu and Els Pins primary school. This sample was divided into: (1) a WDV group (n = 104); (2) an ADHD diagnosis group (n = 28); and (3) a general population (GP) primary school group (n = 62). Results: The PTSD-CBCL total reliability score was high (Cronbach's alpha = 0.87). We found significant mean difference for WDV vs. GP (MD = 8.57; p < 0.001) with significantly higher mean scores in WDV than in GP. We also found significant differences for ADHD vs. GP (MD = 6.91; p < 0.001) with higher mean scores in ADHD than in GP. We observed good discriminatory power indices in the following group comparisons: WDV vs. GP, ADHD vs. GP, WDV vs. ADHD + GP, and GP vs. WDV + ADHD. Nevertheless, the PTSD-CBCL did not discriminate WDV vs. ADHD. Conclusions: Thus, we conclude that the PTSD-CBCL instrument has good discriminatory power in general and clinical populations, and could be implemented in the context of prevention and early intervention after trauma. [ABSTRACT FROM AUTHOR]

Background: Originally designed for use with adolescents in group-based settings, there has been limited evaluation of Trauma and Grief Component Therapy (TGCT) with respect to its use with individual patients across a wide age range of children and adolescents. Objectives: This study describes a pilot open trial of individually administered TGCT, an assessment-driven, modularized treatment for traumatized and/or bereaved children and adolescents. Key outcomes measures include posttraumatic stress, depressive symptoms, and maladaptive grief reactions. Method: The sample consisted of 58 treatment-seeking children and adolescents who experienced trauma and/or bereavement (ages 7–17 years, M = 12.78, SD = 2.93; 68.4% female; 45.6% Hispanic, 14.0% Black, 22.8% White, 14.0% Multiracial). The study used a single-group open trial design. Youth referred to the study due to experiencing a potentially traumatic event or death of a loved one completed self-report measures of posttraumatic stress, depressive symptoms, and maladaptive grief reactions (when applicable). Measures were also completed following Module 1 of the treatment. Results: Bayesian regression models revealed youth who completed TGCT Module 1 reported substantial reductions from baseline, with large effect sizes for posttraumatic stress, depressive symptoms, and maladaptive grief reactions. Rates of reliable improvement ranged from 42 to 65% across treatment outcomes with 69% of youth demonstrating reliable improvement in at least one outcome. Conclusions: The present study provides preliminary evidence supporting TGCT as an individual treatment for traumatized and/or bereaved children and adolescents experiencing posttraumatic stress, depressive symptoms, and/or maladaptive grief reactions. [ABSTRACT FROM AUTHOR]

Copyright of Herz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While life expectancy of people living with HIV is increasing, their burden of non-communicable diseases, including mental health disorders, is growing as well. The aim of this study is to investigate the prevalence and identify the risk factors associated with mental health disorders among this population in Rwanda. This cross-sectional study enrolled people living with HIV from 12 HIV clinics across Rwanda using random sampling. Trained HIV nurses conducted the Mini International Neuropsychiatric Interview to estimate the prevalence of major depressive episode, post-traumatic stress disorder, and generalized anxiety disorder. Sociodemographic, psychosocial, and HIV-related data were also collected. Associated risk factors for being diagnosed with one of the mental health disorders were assessed using modified Poisson regression with robust error variance. Of 428 participants, 70 (16.4%) had at least one mental health disorder with major depressive episode being most prevalent (n = 60, 14.0%). Almost all participants were adherent to antiretroviral therapy (n = 424, 99.1%) and virally suppressed (n = 412, 96.9%). Of those diagnosed with a mental health disorder, only few were aware of (n = 4, 5.7%) or under treatment for this mental health disorder (n = 5, 7.2%). Mental health disorders were associated with experiences of HIV-related stigma and discrimination (aRR = 2.14, 95%CI 1.30–3.53, p = 0.003). The results demonstrate underdiagnosis and undertreatment of mental health disorders among Rwandan People Living with HIV. Using HIV nurses to diagnose mental health disorders could serve as a low-cost strategy for integrating mental health care with existing HIV services and could inspire the implementation in other low-resource settings. [ABSTRACT FROM AUTHOR]

This study aimed to explore the reciprocal relationships between implementation leadership and practitioner implementation citizenship behavior during the implementation of evidence-based practices (EBPs). Data were collected at two timepoints with a time lag of six months during a national implementation of evidence-based treatment for post-traumatic stress disorder in Norwegian mental health clinics. Data from 72 leaders and 346 practitioners were analyzed with a two-wave cross-lagged panel model, accounting for the nested structure and adjusting for demographic variables. Significant positive autoregressive effects for both implementation leadership and implementation citizenship behavior indicated some stability in ratings across time. Significant cross-lagged effects in both directions indicated that practitioners who experienced greater implementation leadership from their leaders demonstrated greater implementation citizenship behavior six months later, and vice versa. Findings hence supported both the social exchange hypothesis and the followership hypothesis, suggesting reciprocal associations between the constructs. The findings underscore the mutually influential relationship between leaders' behavior and practitioners' engagement in citizenship behavior during EBP implementation. The study emphasizes the importance of interventions focusing on leadership behaviors that encourage practitioner engagement and mutually beneficial behavior patterns, highlighting the reciprocal and vital roles that both leaders and practitioners play in successful EBP implementation. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease known as COVID-19 (2019) pandemic may increase the likelihood of psychological symptoms that can reach the level of psychiatric disorders. Aim: We aimed to study psychiatric morbidity in patients with COVID-19 concerning gender differences and disease severity in the acute phase of infection and after 6 months. Methods: This is a multicenter follow-up study registered in ClinicalTrials.gov (NCT04459403). Patients were recruited consecutively from three quarantine hospitals in Egypt. Data were collected through a questionnaire built using Google Forms including the Arabic versions of General Health Questionnaire (GHQ-12), Beck Depression Inventory (BDI), and Taylor Manifest Anxiety Scale (TMAS). Depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms were assessed after 6 months. Results: The study questionnaire was offered to 400 patients and 199 patients agreed to fill it. BDI and TAMS were higher in mild than moderate and severe COVID-19 (14, 8, 8, P-value = 0.009, 17, 13.5, 14, P-value = 0.04, respectively). Females showed a higher prevalence of depression, anxiety, sleep problems, and insomnia due to anxiety than males. Education level, marital status, previous psychiatric illness, and severity of COVID-19 independently affected depression. Marital status, family history of psychiatric illness, and chronic medical illness independently affected anxiety. On 6-month follow-up, BDI significantly decreased in males but not females. TMAS showed no significant changes, but the severity of anxiety was still higher in females. PTSD was more frequent in females (26 (37.1%) versus 4 (9.5%), respectively, P-value = 0.02). Conclusion: The prevalence and severity of depression and anxiety were higher in females than male participants, suggesting that females are more affected by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Communities affected by Ebola disease (EBOD) may face resulting increases in mental health disorders. We evaluated the prevalence of and factors associated with mental health disorders among persons affected by the 2022 Sudan virus disease (SVD) outbreak in Uganda. Methods: We conducted a cross-sectional study among SVD survivors and family members of survivors and fatal cases from 15–31 January 2023. We included only laboratory-confirmed SVD survivors and family members who lived with or cared for confirmed SVD patients during their illness. The Hospital Anxiety and Depression Scale was used to evaluate anxiety and depression. The post-traumatic stress disorder (PTSD) checklist for the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition was used to evaluate PTSD. Modified Poisson regression was used to determine factors associated with each mental health disorder. Results: We enrolled 54 survivors and 82 family members; median age was 30 years (range, 15–73) and 54% were female. The prevalence of anxiety (55%) and depression (50%) was higher than PTSD (17%). The prevalence of all mental health disorders was similar between survivors and family members. Household size was associated with both anxiety and PTSD. Number of SVD deaths in the household was associated with depression. Conclusion: Approximately two-thirds of SVD survivors and family members of patients in the 2022 outbreak in Uganda had ≥ 1 mental health disorders shortly after the outbreak ended. Strengthening mental health services during and after Ebola virus outbreaks for survivors and family members of patients may enhance the quality of outbreak response. [ABSTRACT FROM AUTHOR]

In the earlier phase of the pandemic, suffering from the COVID-19 was regarded as a trauma because of the unknown nature of the disease, uncertain treatment, and mortality and social stigma, and it could cause PTSD symptoms. Hospitalization in intensive care unit (ICU) could be a trauma as well. 1) Investigating the prevalence of PTSD and its risk factors after at least one year of discharge from the hospital in the COVID-19 survivors. 2) Comparing PTSD in COVID-19 survivors who were hospitalized in the non-ICU wards with those hospitalized in the ICU. In this cross-sectional research, sample included two hundred COVID-19 survivors who were hospitalized due to COVID-19 in the teaching hospitals in Iran. After at least one year of their discharge from the hospital, PTSD was assessed with using Posttraumatic Stress Checklist for DSM-5 (PCL-5). The prevalence of elevated PTSD symptoms in those hospitalized in the ICU and those hospitalized in the non-ICU wards was compared. Seventeen (16.8%) of the patients with a history of hospitalization in general ward and 36 (36.4%) of the patients with a history of hospitalization in ICU reported elevated post-traumatic stress disorder symptoms, and a statistically significant difference was observed in the two groups (P =.002). Hospitalization in ICU compared to other wards increased the chance of experiencing elevated post-traumatic stress disorder symptoms in COVID-19 patients by 2.36 times (CI: 95%, 1.07–5.22). Factors related to a higher prevalence of PTSD included older age, longer hospitalization, having a family member with COVID-19, and a history of death of a family member due to COVID-19. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) can develop after trauma exposure. Some studies report that women develop PTSD at twice the rate of men, despite greater trauma exposure in men. Lipids and their metabolites (lipidome) regulate a myriad of key biological processes and pathways such as membrane integrity, oxidative stress, and neuroinflammation in the brain by maintaining neuronal connectivity and homeostasis. In this study, we analyzed the lipidome of 40 adults with PTSD and 40 trauma-exposed non-PTSD individuals (n = 20/sex/condition; 19–39 years old). Plasma samples were analyzed for lipidomics using Quadrupole Time-of-Flight (QToF) mass spectrometry. Additionally, ~ 90 measures were collected, on sleep, and mental and physical health indices. Poorer sleep quality was associated with greater PTSD severity in both sexes. The lipidomics analysis identified a total of 348 quantifiable known lipid metabolites and 1951 lipid metabolites that are yet unknown; known metabolites were part of 13 lipid subclasses. After adjusting for BMI and sleep quality, in women with PTSD, only one lipid subclass, phosphatidylethanolamine (PE) was altered, whereas, in men with PTSD, 9 out of 13 subclasses were altered compared to non-PTSD women and men, respectively. Severe PTSD was associated with 22% and 5% of altered lipid metabolites in men and women, respectively. Of the changed metabolites, only 0.5% measures (2 PEs and cholesterol) were common between women and men with PTSD. Several sphingomyelins, PEs, ceramides, and triglycerides were increased in men with severe PTSD. The correlations between triglycerides and ceramide metabolites with cholesterol metabolites and systolic blood pressure were dependent upon sex and PTSD status. Alterations in triglycerides and ceramides are linked with cardiac health and metabolic function in humans. Thus, disturbed sleep and higher body mass may have contributed to changes in the lipidome found in PTSD. [ABSTRACT FROM AUTHOR]