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204. Improving mental health and psychosocial wellbeing in humanitarian settings: reflections on research funded through R2HC

Author

Tol, Wietse A., Ager, Alastair, Bizouerne, Cecile, Bryant, Richard, El Chammay, Rabih, Colebunders, Robert, García-Moreno, Claudia, Hamdani, Syed Usman, James, Leah E., Jansen, Stefan C.J., Leku, Marx R., Likindikoki, Samuel, Panter-Brick, Catherine, Pluess, Michael, Robinson, Courtland, Ruttenberg, Leontien, Savage, Kevin, Welton-Mitchell, Courtney, Hall, Brian J., Harper Shehadeh, Melissa, Harmer, Anne, and van Ommeren, Mark

Published
2020
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207. Biopsia prostática transperineal bajo anestesia local: una cohorte prospectiva en un centro y operador único.

Author

López, J. Francisco, Bryant, Richard J., and Lamb, Alastair D.

Subjects
MAGNETIC resonance imaging, WATCHFUL waiting, VISUAL analog scale, EARLY detection of cancer, RETENTION of urine, PROSTATE cancer
Abstract

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia 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.)

Published
2024
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209. What Works for Whom?

Author

Cloitre, Marylène, Bryant, Richard A., Schnyder, Ulrich, Schnyder, Ulrich, editor, and Cloitre, Marylène, editor

Published
2015
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215. Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial

Author

Mediavilla, Roberto, primary, Felez-Nobrega, Mireia, additional, McGreevy, Kerry R, additional, Monistrol-Mula, Anna, additional, Bravo-Ortiz, María-Fe, additional, Bayón, Carmen, additional, Giné-Vázquez, Iago, additional, Villaescusa, Rut, additional, Muñoz-Sanjosé, Ainoa, additional, Aguilar-Ortiz, Salvatore, additional, Figueiredo, Natasha, additional, Nicaise, Pablo, additional, Park, A-La, additional, Petri-Romão, Papoula, additional, Purgato, Marianna, additional, Witteveen, Anke B, additional, Underhill, James, additional, Barbui, Corrado, additional, Bryant, Richard, additional, Kalisch, Raffael, additional, Lorant, Vincent, additional, McDaid, David, additional, Melchior, Maria, additional, Sijbrandij, Marit, additional, Haro, Josep Maria, additional, and Ayuso-Mateos, Jose Luis, additional

Published
2023
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220. Childhood Trauma Exposure and PTSD Diagnosis Interact With Polygenic Determinants of Hippocampal and Amygdala Volume

Author

Logue, Mark, primary, Zheng, Yuanchao, additional, Garrett, Melanie, additional, Maihofer, Adam, additional, Clarke, Emily, additional, Haswell, Courtney, additional, Sun, Delin, additional, Peverill, Matthew, additional, McLaughlin, Katie, additional, Sambrook, Kelly, additional, Davenport, Nicholas, additional, Disner, Seth, additional, Korgaonkar, Mayuresh, additional, Bryant, Richard, additional, Varkevisser, Tim, additional, Geuze, Elbert, additional, Beckham, Jean, additional, Kimbrel, Nathan, additional, Coleman, Jonathan, additional, Sullivan, Danielle, additional, Wolf, Erika, additional, Hayes, Jasmeet, additional, Verfaellie, Mieke, additional, Salat, David, additional, Spielberg, Jeffrey M., additional, McGlinchey, Regina, additional, Milberg, William, additional, Medland, Sarah E., additional, Nievergelt, Caroline, additional, Jahanshad, Neda, additional, Thompson, Paul M., additional, Kremen, William S., additional, and Morey, Rajendra, additional

Published
2023
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222. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer

Author

Hamdy, Freddie C., primary, Donovan, Jenny L., additional, Lane, J. Athene, additional, Metcalfe, Chris, additional, Davis, Michael, additional, Turner, Emma L., additional, Martin, Richard M., additional, Young, Grace J., additional, Walsh, Eleanor I., additional, Bryant, Richard J., additional, Bollina, Prasad, additional, Doble, Andrew, additional, Doherty, Alan, additional, Gillatt, David, additional, Gnanapragasam, Vincent, additional, Hughes, Owen, additional, Kockelbergh, Roger, additional, Kynaston, Howard, additional, Paul, Alan, additional, Paez, Edgar, additional, Powell, Philip, additional, Rosario, Derek J., additional, Rowe, Edward, additional, Mason, Malcolm, additional, Catto, James W.F., additional, Peters, Tim J., additional, Oxley, Jon, additional, Williams, Naomi J., additional, Staffurth, John, additional, and Neal, David E., additional

Published
2023
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226. MP55-09 NATURAL HISTORY OF ATYPICAL SMALL ACINAR PROLIFERATION (ASAP): A 10-YEAR CONTEMPORARY SERIES

Author

Anbarasan, Thineskrishna, primary, Raslan, Mutie, additional, Ghosh, Kanchan, additional, Macklin, Philip, additional, Mercader, Claudia, additional, Leslie, Tom, additional, Hamdy, Freddie, additional, Colling, Richard, additional, Verrill, Clare, additional, Bryant, Richard, additional, Lopez, Francisco, additional, and Lamb, Alastair, additional

Published
2023
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227. Are we equally at risk of changing smoking behavior during a public health crisis? Impact of educational level on smoking from the TEMPO cohort

Author

Andersen, A, Hecker, I, Wallez, S, Witteveen, A, Lora, A, Mittendorfer-Rutz, E, Corrao, G, Walter, H, Haro, J, Sijbrandij, M, Compagnoni, M, Felez-Nobrega, M, Kalisch, R, Bryant, R, Melchior, M, Mary-Krause, M, Andersen, Astrid Juhl, Hecker, Irwin, Wallez, Solène, Witteveen, Anke, Lora, Antonio, Mittendorfer-Rutz, Ellenor, Corrao, Giovanni, Walter, Henrik, Haro, Josep Maria, Sijbrandij, Marit, Compagnoni, Matteo Monzio, Felez-Nobrega, Mireia, Kalisch, Raffael, Bryant, Richard, Melchior, Maria, Mary-Krause, Murielle, Andersen, A, Hecker, I, Wallez, S, Witteveen, A, Lora, A, Mittendorfer-Rutz, E, Corrao, G, Walter, H, Haro, J, Sijbrandij, M, Compagnoni, M, Felez-Nobrega, M, Kalisch, R, Bryant, R, Melchior, M, Mary-Krause, M, Andersen, Astrid Juhl, Hecker, Irwin, Wallez, Solène, Witteveen, Anke, Lora, Antonio, Mittendorfer-Rutz, Ellenor, Corrao, Giovanni, Walter, Henrik, Haro, Josep Maria, Sijbrandij, Marit, Compagnoni, Matteo Monzio, Felez-Nobrega, Mireia, Kalisch, Raffael, Bryant, Richard, Melchior, Maria, and Mary-Krause, Murielle

Abstract

Background: The COVID-19 pandemic as a public health crisis has led to a significant increase in mental health difficulties. Smoking is strongly associated with mental health conditions, which is why the pandemic might have influenced the otherwise decline in smoking rates. Persons belonging to socioeconomically disadvantaged groups may be particularly affected, both because the pandemic has exacerbated existing social inequalities and because this group was more likely to smoke before the pandemic. We examined smoking prevalence in a French cohort study, focusing on differences between educational attainment. In addition, we examined the association between interpersonal changes in tobacco consumption and educational level from 2018 to 2021. Methods: Using four assessments of smoking status available from 2009 to 2021, we estimated smoking prevalence over time, stratified by highest educational level in the TEMPO cohort and the difference was tested using chi2 test. We studied the association between interpersonal change in smoking status between 2018 and 2021 and educational attainment among 148 smokers, using multinomial logistic regression. Results: Smoking prevalence was higher among those with low education. The difference between the two groups increased from 2020 to 2021 (4.8–9.4%, p < 0.001). Smokers with high educational level were more likely to decrease their tobacco consumption from 2018 to 2021 compared to low educated smokers (aOR = 2.72 [1.26;5.89]). Conclusion: Current findings showed a widening of the social inequality gap in relation to smoking rates, underscoring the increased vulnerability of persons with low educational level to smoking and the likely inadequate focus on social inequalities in relation to tobacco control policies during the pandemic.

Published
2023

228. Psychological flexibility in South Sudanese female refugees in Uganda as a mechanism for change within a guided self-help intervention

Author

Lakin, Daniel P., Cooper, Samuel E., Andersen, Lena, Brown, Felicity L., Augustinavicius, Jura L.S., Carswell, Kenneth, Leku, Marx, Adaku, Alex, Au, Teresa, Bryant, Richard, Garcia-Moreno, Claudia, White, Ross G., Tol, Wietse A., Lakin, Daniel P., Cooper, Samuel E., Andersen, Lena, Brown, Felicity L., Augustinavicius, Jura L.S., Carswell, Kenneth, Leku, Marx, Adaku, Alex, Au, Teresa, Bryant, Richard, Garcia-Moreno, Claudia, White, Ross G., and Tol, Wietse A.

Abstract

Objective: To examine the role of psychological flexibility as a potential mediator in the relationship between involvement in a guided self-help intervention, Self-Help Plus, and psychological distress in a sample of South Sudanese refugee women living in northern Uganda. Method: We conducted secondary analysis of data from a cluster randomized controlled trial conducted in 2018. We used multilevel mediation modeling to explore the relationship of psychological flexibility, as measured by the Acceptance and Action Questionnaire (AAQ-II), as a mediating factor in the relationship between Self-Help Plus involvement and general psychological distress as measured by the Kessler Psychological Distress Scale–6 (K6). Results: We found strong multilevel mediation of decreased K6 scores in the treatment group by AAQ-II scores (multilevel b = −3.28). A more pronounced mediation effect was discovered immediately post intervention (b = −1.09) compared to 3-month follow-up (b = −0.84). This is in line with the current literature that demonstrates the role of psychological flexibility as a primary mechanism of change in ACT-based interventions. Conclusions: Psychological flexibility is a contributing component in the theory of change for this ACT-based intervention. Identifying the core components of interventions allows for more effective adaptation and implementation of relevant services, especially in low-resource contexts., OBJECTIVE: To examine the role of psychological flexibility as a potential mediator in the relationship between involvement in a guided self-help intervention, Self-Help Plus, and psychological distress in a sample of South Sudanese refugee women living in northern Uganda. METHOD: We conducted secondary analysis of data from a cluster randomized controlled trial conducted in 2018. We used multilevel mediation modeling to explore the relationship of psychological flexibility, as measured by the Acceptance and Action Questionnaire (AAQ-II), as a mediating factor in the relationship between Self-Help Plus involvement and general psychological distress as measured by the Kessler Psychological Distress Scale-6 (K6). RESULTS: We found strong multilevel mediation of decreased K6 scores in the treatment group by AAQ-II scores (multilevel b = -3.28). A more pronounced mediation effect was discovered immediately post intervention (b = -1.09) compared to 3-month follow-up (b = -0.84). This is in line with the current literature that demonstrates the role of psychological flexibility as a primary mechanism of change in ACT-based interventions. CONCLUSIONS: Psychological flexibility is a contributing component in the theory of change for this ACT-based intervention. Identifying the core components of interventions allows for more effective adaptation and implementation of relevant services, especially in low-resource contexts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Published
2023

229. Neuroimaging-based classification of PTSD using data-driven computational approaches: A multisite big data study from the ENIGMA-PGC PTSD consortium

Author

MGGZ, Brain, Zhu, Xi, Kim, Yoojean, Ravid, Orren, He, Xiaofu, Suarez-Jimenez, Benjamin, Zilcha-Mano, Sigal, Lazarov, Amit, Lee, Seonjoo, Abdallah, Chadi G., Angstadt, Michael, Averill, Christopher L., Baird, C. Lexi, Baugh, Lee A., Blackford, Jennifer U., Bomyea, Jessica, Bruce, Steven E., Bryant, Richard A., Cao, Zhihong, Choi, Kyle, Cisler, Josh, Cotton, Andrew S., Daniels, Judith K., Davenport, Nicholas D., Davidson, Richard J., DeBellis, Michael D., Dennis, Emily L., Densmore, Maria, deRoon-Cassini, Terri, Disner, Seth G., Hage, Wissam El, Etkin, Amit, Fani, Negar, Fercho, Kelene A., Fitzgerald, Jacklynn, Forster, Gina L., Frijling, Jessie L., Geuze, Elbert, Gonenc, Atilla, Gordon, Evan M., Gruber, Staci, Grupe, Daniel W., Guenette, Jeffrey P., Haswell, Courtney C., Herringa, Ryan J., Herzog, Julia, Hofmann, David Bernd, Hosseini, Bobak, Hudson, Anna R., Huggins, Ashley A., Ipser, Jonathan C., Jahanshad, Neda, Jia-Richards, Meilin, Jovanovic, Tanja, Kaufman, Milissa L., Kennis, Mitzy, King, Anthony, Kinzel, Philipp, Koch, Saskia B.J., Koerte, Inga K., Koopowitz, Sheri M., Korgaonkar, Mayuresh S., Krystal, John H., Lanius, Ruth, Larson, Christine L., Lebois, Lauren A.M., Li, Gen, Liberzon, Israel, Lu, Guang Ming, Luo, Yifeng, Magnotta, Vincent A., Manthey, Antje, Maron-Katz, Adi, May, Geoffery, McLaughlin, Katie, Mueller, Sven C., Nawijn, Laura, Nelson, Steven M., Neufeld, Richard W.J., Nitschke, Jack B., O'Leary, Erin M., Olatunji, Bunmi O., Olff, Miranda, Peverill, Matthew, Phan, K. Luan, Qi, Rongfeng, Quidé, Yann, Rektor, Ivan, Ressler, Kerry, Riha, Pavel, Ross, Marisa, Rosso, Isabelle M., Salminen, Lauren E., Sambrook, Kelly, Schmahl, Christian, Shenton, Martha E., Sheridan, Margaret, Shih, Chiahao, Sicorello, Maurizio, Sierk, Anika, Simmons, Alan N., Simons, Raluca M., Simons, Jeffrey S., Sponheim, Scott R., Stein, Murray B., Stein, Dan J., Stevens, Jennifer S., Straube, Thomas, Sun, Delin, Théberge, Jean, Thompson, Paul M., Thomopoulos, Sophia I., van der Wee, Nic J.A., van der Werff, Steven J.A., van Erp, Theo G.M., van Rooij, Sanne J.H., van Zuiden, Mirjam, Varkevisser, Tim, Veltman, Dick J., Vermeiren, Robert R.J.M., Walter, Henrik, Wang, Li, Wang, Xin, Weis, Carissa, Winternitz, Sherry, Xie, Hong, Zhu, Ye, Wall, Melanie, Neria, Yuval, Morey, Rajendra A., MGGZ, Brain, Zhu, Xi, Kim, Yoojean, Ravid, Orren, He, Xiaofu, Suarez-Jimenez, Benjamin, Zilcha-Mano, Sigal, Lazarov, Amit, Lee, Seonjoo, Abdallah, Chadi G., Angstadt, Michael, Averill, Christopher L., Baird, C. Lexi, Baugh, Lee A., Blackford, Jennifer U., Bomyea, Jessica, Bruce, Steven E., Bryant, Richard A., Cao, Zhihong, Choi, Kyle, Cisler, Josh, Cotton, Andrew S., Daniels, Judith K., Davenport, Nicholas D., Davidson, Richard J., DeBellis, Michael D., Dennis, Emily L., Densmore, Maria, deRoon-Cassini, Terri, Disner, Seth G., Hage, Wissam El, Etkin, Amit, Fani, Negar, Fercho, Kelene A., Fitzgerald, Jacklynn, Forster, Gina L., Frijling, Jessie L., Geuze, Elbert, Gonenc, Atilla, Gordon, Evan M., Gruber, Staci, Grupe, Daniel W., Guenette, Jeffrey P., Haswell, Courtney C., Herringa, Ryan J., Herzog, Julia, Hofmann, David Bernd, Hosseini, Bobak, Hudson, Anna R., Huggins, Ashley A., Ipser, Jonathan C., Jahanshad, Neda, Jia-Richards, Meilin, Jovanovic, Tanja, Kaufman, Milissa L., Kennis, Mitzy, King, Anthony, Kinzel, Philipp, Koch, Saskia B.J., Koerte, Inga K., Koopowitz, Sheri M., Korgaonkar, Mayuresh S., Krystal, John H., Lanius, Ruth, Larson, Christine L., Lebois, Lauren A.M., Li, Gen, Liberzon, Israel, Lu, Guang Ming, Luo, Yifeng, Magnotta, Vincent A., Manthey, Antje, Maron-Katz, Adi, May, Geoffery, McLaughlin, Katie, Mueller, Sven C., Nawijn, Laura, Nelson, Steven M., Neufeld, Richard W.J., Nitschke, Jack B., O'Leary, Erin M., Olatunji, Bunmi O., Olff, Miranda, Peverill, Matthew, Phan, K. Luan, Qi, Rongfeng, Quidé, Yann, Rektor, Ivan, Ressler, Kerry, Riha, Pavel, Ross, Marisa, Rosso, Isabelle M., Salminen, Lauren E., Sambrook, Kelly, Schmahl, Christian, Shenton, Martha E., Sheridan, Margaret, Shih, Chiahao, Sicorello, Maurizio, Sierk, Anika, Simmons, Alan N., Simons, Raluca M., Simons, Jeffrey S., Sponheim, Scott R., Stein, Murray B., Stein, Dan J., Stevens, Jennifer S., Straube, Thomas, Sun, Delin, Théberge, Jean, Thompson, Paul M., Thomopoulos, Sophia I., van der Wee, Nic J.A., van der Werff, Steven J.A., van Erp, Theo G.M., van Rooij, Sanne J.H., van Zuiden, Mirjam, Varkevisser, Tim, Veltman, Dick J., Vermeiren, Robert R.J.M., Walter, Henrik, Wang, Li, Wang, Xin, Weis, Carissa, Winternitz, Sherry, Xie, Hong, Zhu, Ye, Wall, Melanie, Neria, Yuval, and Morey, Rajendra A.

Published
2023

230. Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus

Author

de Graaff, Anne M; https://orcid.org/0000-0001-6686-4432, Cuijpers, Pim; https://orcid.org/0000-0001-5497-2743, Twisk, Jos W R, Kieft, Barbara, Hunaidy, Sam, Elsawy, Mariam, Gorgis, Noer, Bouman, Theo K; https://orcid.org/0000-0002-9066-5553, Lommen, Miriam J J; https://orcid.org/0000-0001-8845-4338, Acarturk, Ceren; https://orcid.org/0000-0001-7093-1554, Bryant, Richard; https://orcid.org/0000-0002-9607-819X, Burchert, Sebastian; https://orcid.org/0000-0003-3126-5485, Dawson, Katie S, Fuhr, Daniela C; https://orcid.org/0000-0001-9020-4629, Hansen, Pernille; https://orcid.org/0000-0002-4782-458X, Jordans, Mark; https://orcid.org/0000-0001-5925-8039, Knaevelsrud, Christine; https://orcid.org/0000-0003-1342-7006, McDaid, David; https://orcid.org/0000-0003-0744-2664, Morina, Naser; https://orcid.org/0000-0002-6470-4408, Moergeli, Hanspeter; https://orcid.org/0000-0002-2101-8627, Park, A-La; https://orcid.org/0000-0002-4704-4874, Roberts, Bayard; https://orcid.org/0000-0003-4482-5859, Ventevogel, Peter; https://orcid.org/0000-0002-3567-8861, Wiedemann, Nana; https://orcid.org/0000-0003-3081-610X, Woodward, Aniek; https://orcid.org/0000-0002-1560-4208, Sijbrandij, Marit; https://orcid.org/0000-0001-5430-9810, STRENGTHS Consortium, de Graaff, Anne M; https://orcid.org/0000-0001-6686-4432, Cuijpers, Pim; https://orcid.org/0000-0001-5497-2743, Twisk, Jos W R, Kieft, Barbara, Hunaidy, Sam, Elsawy, Mariam, Gorgis, Noer, Bouman, Theo K; https://orcid.org/0000-0002-9066-5553, Lommen, Miriam J J; https://orcid.org/0000-0001-8845-4338, Acarturk, Ceren; https://orcid.org/0000-0001-7093-1554, Bryant, Richard; https://orcid.org/0000-0002-9607-819X, Burchert, Sebastian; https://orcid.org/0000-0003-3126-5485, Dawson, Katie S, Fuhr, Daniela C; https://orcid.org/0000-0001-9020-4629, Hansen, Pernille; https://orcid.org/0000-0002-4782-458X, Jordans, Mark; https://orcid.org/0000-0001-5925-8039, Knaevelsrud, Christine; https://orcid.org/0000-0003-1342-7006, McDaid, David; https://orcid.org/0000-0003-0744-2664, Morina, Naser; https://orcid.org/0000-0002-6470-4408, Moergeli, Hanspeter; https://orcid.org/0000-0002-2101-8627, Park, A-La; https://orcid.org/0000-0002-4704-4874, Roberts, Bayard; https://orcid.org/0000-0003-4482-5859, Ventevogel, Peter; https://orcid.org/0000-0002-3567-8861, Wiedemann, Nana; https://orcid.org/0000-0003-3081-610X, Woodward, Aniek; https://orcid.org/0000-0002-1560-4208, Sijbrandij, Marit; https://orcid.org/0000-0001-5430-9810, and STRENGTHS Consortium

Abstract

Background: The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited. Objective: To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands. Methods: We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019-December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat. Findings: Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference -0.25; 95% CI -0.385 to -0.122; p=0.0001, Cohen's d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen's d=0.42), anxiety (p=0.001, Cohen's d=0.27), PTSD symptoms (p=0.0005, Cohen's d=0.39) and self-identified problems (p=0.03, Cohen's d=0.26), but not on impairment (p=0.084, Cohen's d=0.21). Conclusions: PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees wit

Published
2023

231. Posttraumatic Stress Disorder in Refugees

Author

Bryant, Richard A; https://orcid.org/0000-0002-9607-819X, Nickerson, Angela; https://orcid.org/0000-0001-9171-4209, Morina, Naser; https://orcid.org/0000-0002-6470-4408, Liddell, Belinda; https://orcid.org/0000-0002-8036-5864, Bryant, Richard A; https://orcid.org/0000-0002-9607-819X, Nickerson, Angela; https://orcid.org/0000-0001-9171-4209, Morina, Naser; https://orcid.org/0000-0002-6470-4408, and Liddell, Belinda; https://orcid.org/0000-0002-8036-5864

Abstract

The number of refugees and internally displaced people in 2022 is the largest since World War II, and meta-analyses demonstrate that these people experience elevated rates of mental health problems. This review focuses on the role of posttraumatic stress disorder (PTSD) in refugee mental health and includes current knowledge of the prevalence of PTSD, risk factors, and apparent differences that exist between PTSD in refugee populations and PTSD in other populations. An emerging literature on understanding mechanisms of PTSD encompasses neural, cognitive, and social processes, which indicate that these factors may not function exactly as they have functioned previously in other PTSD populations. This review recognizes the numerous debates in the literature on PTSD in refugees, including those on such issues as the conceptualization of mental health and the applicability of the PTSD diagnosis across cultures, as well as the challenge of treating PTSD in low- and middle-income countries that lack mental health resources to offer standard PTSD treatments.

Published
2023

232. Understanding the protective effect of social support on depression symptomatology from a longitudinal network perspective

Author

Li, Gen; https://orcid.org/0000-0002-9625-208X, Li, Yifan, Lam, Agnes Iok Fong, Tang, Weiming, Seedat, Soraya, Barbui, Corrado, Papola, Davide; https://orcid.org/0000-0001-6482-8593, Panter-Brick, Catherine, van der Waerden, Judith, Bryant, Richard; https://orcid.org/0000-0002-9607-819X, Mittendorfer-Rutz, Ellenor, Gémes, Katalin, Purba, Fredrick D, Setyowibowo, Hari, Pinucci, Irene, Palantza, Christina, Acarturk, Ceren, Kurt, Gülşah, Tarsitani, Lorenzo, Morina, Naser; https://orcid.org/0000-0002-6470-4408, Burchert, Sebastian, Patanè, Martina, Quero, Soledad, Campos, Daniel, Huizink, Anja C, Fuhr, Daniela C, Spiller, Tobias, Sijbrandij, Marit, Hall, Brian J, Li, Gen; https://orcid.org/0000-0002-9625-208X, Li, Yifan, Lam, Agnes Iok Fong, Tang, Weiming, Seedat, Soraya, Barbui, Corrado, Papola, Davide; https://orcid.org/0000-0001-6482-8593, Panter-Brick, Catherine, van der Waerden, Judith, Bryant, Richard; https://orcid.org/0000-0002-9607-819X, Mittendorfer-Rutz, Ellenor, Gémes, Katalin, Purba, Fredrick D, Setyowibowo, Hari, Pinucci, Irene, Palantza, Christina, Acarturk, Ceren, Kurt, Gülşah, Tarsitani, Lorenzo, Morina, Naser; https://orcid.org/0000-0002-6470-4408, Burchert, Sebastian, Patanè, Martina, Quero, Soledad, Campos, Daniel, Huizink, Anja C, Fuhr, Daniela C, Spiller, Tobias, Sijbrandij, Marit, and Hall, Brian J

Abstract

Background: Higher social support protects people from developing mental disorders. Limited evidence is available on the mechanism through which social support plays this protective role. Objective: To investigate the stress-buffering process of social support on depressive symptoms using a novel longitudinal dynamic symptom network approach. Methods: A total of 4242 adult participants who completed the first two waves (from May to October 2020) of the International Covid Mental Health Survey were included in the study. Cross-lagged panel network modelling was used to estimate a longitudinal network of self-reported social support, loneliness and depressive symptoms. Standardised regression coefficients from regularised cross-lagged regressions were estimated as edge weights of the network. Findings: The results support a unidirectional protective effect of social support on key depressive symptoms, partly mediated through loneliness: A higher number of close confidants and accessible practical help was associated with decreased anhedonia (weight=-0.033) and negative self-appraisal symptoms (weight=-0.038). Support from others was also negatively associated with loneliness, which in turn associated with decreased depressed mood (weight=0.086) and negative self-appraisal (weight=0.077). We identified a greater number of direct relationships from social support to depressive symptoms among men compared with women. Also, the edge weights from social support to depression were generally stronger in the men's network. Conclusions: Reductions in negative self-appraisal might function as a bridge between social support and other depressive symptoms, and, thus, it may have amplified the protective effect of social support. Men appear to benefit more from social support than women. Clinical implications: Building community-based support networks to deliver practical support, and loneliness reduction components are critical for depression prevention interventions after stress

Published
2023

233. The effect of a low-level psychological intervention (PM+) on post-migration living difficulties – Results from two studies in Switzerland and in the Netherlands

Author

Spaaij, Julia; https://orcid.org/0000-0002-6979-3489, de Graaff, Anne M; https://orcid.org/0000-0001-6686-4432, Akhtar, Aemal; https://orcid.org/0000-0002-8510-3636, Kiselev, Nikolai; https://orcid.org/0000-0003-0617-0353, McDaid, David; https://orcid.org/0000-0003-0744-2664, Moergeli, Hanspeter; https://orcid.org/0000-0002-2101-8627, Pfaltz, Monique C; https://orcid.org/0000-0002-4030-4514, Schick, Matthis; https://orcid.org/0000-0002-8212-6277, Schnyder, Ulrich; https://orcid.org/0000-0003-3556-7990, Bryant, Richard A; https://orcid.org/0000-0002-9607-819X, Cuijpers, Pim; https://orcid.org/0000-0001-5497-2743, Sijbrandij, Marit; https://orcid.org/0000-0001-5430-9810, Morina, Naser; https://orcid.org/0000-0002-6470-4408, Spaaij, Julia; https://orcid.org/0000-0002-6979-3489, de Graaff, Anne M; https://orcid.org/0000-0001-6686-4432, Akhtar, Aemal; https://orcid.org/0000-0002-8510-3636, Kiselev, Nikolai; https://orcid.org/0000-0003-0617-0353, McDaid, David; https://orcid.org/0000-0003-0744-2664, Moergeli, Hanspeter; https://orcid.org/0000-0002-2101-8627, Pfaltz, Monique C; https://orcid.org/0000-0002-4030-4514, Schick, Matthis; https://orcid.org/0000-0002-8212-6277, Schnyder, Ulrich; https://orcid.org/0000-0003-3556-7990, Bryant, Richard A; https://orcid.org/0000-0002-9607-819X, Cuijpers, Pim; https://orcid.org/0000-0001-5497-2743, Sijbrandij, Marit; https://orcid.org/0000-0001-5430-9810, and Morina, Naser; https://orcid.org/0000-0002-6470-4408

Published
2023

234. GWAS Meta-Analysis of Suicide Attempt:Identification of 12 Genome-Wide Significant Loci and Implication of Genetic Risks for Specific Health Factors

Author

Docherty, Anna R., Mullins, Niamh, Ashley-Koch, Allison E., Qin, Xuejun, Coleman, Jonathan R.I., Shabalin, Andrey, Kang, Joo Eun, Murnyak, Balasz, Wendt, Frank, Adams, Mark, Campos, Adrian I., DiBlasi, Emily, Fullerton, Janice M., Kranzler, Henry R., Bakian, Amanda V., Monson, Eric T., Rentería, Miguel E., Walss-Bass, Consuelo, Andreassen, Ole A., Behera, Chittaranjan, Bulik, Cynthia M., Edenberg, Howard J., Kessler, Ronald C., John Mann, J., Nurnberger, John I., Pistis, Giorgio, Streit, Fabian, Ursano, Robert J., Polimanti, Renato, Dennis, Michelle, Garrett, Melanie, Hair, Lauren, Harvey, Philip, Hauser, Elizabeth R., Hauser, Michael A., Huffman, Jennifer, Jacobson, Daniel, Madduri, Ravi, McMahon, Benjamin, Oslin, David W., Trafton, Jodie, Awasthi, Swapnil, Berrettini, Wade H., Bohus, Martin, Chang, Xiao, Chen, Hsi Chung, Chen, Wei J., Christensen, Erik D.M.D., Crow, Scott, Duriez, Philibert, Edwards, Alexis C., Fernández-Aranda, Fernando, Galfalvy, Hanga, Gandal, Michael, Gorwood, Philip, Guo, Yiran, Hafferty, Jonathan D., Hakonarson, Hakon, Halmi, Katherine A., Hishimoto, Akitoyo, Jain, Sonia, Jamain, Stéphane, Jiménez-Murcia, Susana, Johnson, Craig, Kaplan, Allan S., Kaye, Walter H., Keel, Pamela K., Kennedy, James L., Kim, Minsoo, Klump, Kelly L., Levey, Daniel F., Li, Dong, Liao, Shih Cheng, Lieb, Klaus, Lilenfeld, Lisa, Marshall, Christian R., Mitchell, James E., Okazaki, Satoshi, Otsuka, Ikuo, Pinto, Dalila, Powers, Abigail, Ramoz, Nicolas, Ripke, Stephan, Roepke, Stefan, Rozanov, Vsevolod, Scherer, Stephen W., Schmahl, Christian, Sokolowski, Marcus, Starnawska, Anna, Strober, Michael, Su, Mei Hsin, Thornton, Laura M., Treasure, Janet, Ware, Erin B., Watson, Hunna J., Witt, Stephanie H., Blake Woodside, D., Yilmaz, Zeynep, Zillich, Lea, Adolfsson, Rolf, Agartz, Ingrid, Alda, Martin, Alfredsson, Lars, Appadurai, Vivek, Artigas, María Soler, Van Der Auwera, Sandra, Helena Azevedo, M., Bass, Nicholas, Bau, Claiton H.D., Baune, Bernhard T., Bellivier, Frank, Berger, Klaus, Biernacka, Joanna M., Bigdeli, Tim B., Binder, Elisabeth B., Boehnke, Michael, Boks, Marco P., Braff, David L., Bryant, Richard, Budde, Monika, Byrne, Enda M., Cahn, Wiepke, Castelao, Enrique, Cervilla, Jorge A., Chaumette, Boris, Corvin, Aiden, Craddock, Nicholas, Djurovic, Srdjan, Foo, Jerome C., Forstner, Andreas J., Frye, Mark, Gatt, Justine M., Giegling, Ina, Grabe, Hans J., Green, Melissa J., Grevet, Eugenio H., Grigoroiu-Serbanescu, Maria, Gutierrez, Blanca, Guzman-Parra, Jose, Hamshere, Marian L., Hartmann, Annette M., Hauser, Joanna, Heilmann-Heimbach, Stefanie, Hoffmann, Per, Ising, Marcus, Jones, Ian, Jones, Lisa A., Jonsson, Lina, Kahn, René S., Kelsoe, John R., Kendler, Kenneth S., Kloiber, Stefan, Koenen, Karestan C., Kogevinas, Manolis, Krebs, Marie Odile, Landén, Mikael, Leboyer, Marion, Lee, Phil H., Levinson, Douglas F., Liao, Calwing, Lissowska, Jolanta, Mayoral, Fermin, McElroy, Susan L., McGrath, Patrick, McGuffin, Peter, McQuillin, Andrew, Mehta, Divya, Melle, Ingrid, Mitchell, Philip B., Molina, Esther, Morken, Gunnar, Nievergelt, Caroline, Nöthen, Markus M., O'Donovan, Michael C., Ophoff, Roel A., Owen, Michael J., Pato, Carlos, Pato, Michele T., Penninx, Brenda W.J.H., Potash, James B., Power, Robert A., Preisig, Martin, Quested, Digby, Ramos-Quiroga, Josep Antoni, Reif, Andreas, Ribasés, Marta, Richarte, Vanesa, Rietschel, Marcella, Rivera, Margarita, Roberts, Andrea, Roberts, Gloria, Rouleau, Guy A., Rovaris, Diego L., Sanders, Alan R., Schofield, Peter R., Schulze, Thomas G., Scott, Laura J., Serretti, Alessandro, Shi, Jianxin, Sirignano, Lea, Sklar, Pamela, Smeland, Olav B., Smoller, Jordan W., Sonuga-Barke, Edmund J.S., Trzaskowski, MacIej, Tsuang, Ming T., Turecki, Gustavo, Vilar-Ribó, Laura, Vincent, John B., Völzke, Henry, Walters, James T.R., Weickert, Cynthia Shannon, Weickert, Thomas W., Weissman, Myrna M., Williams, Leanne M., Wray, Naomi R., Zai, Clement C., Agerbo, Esben, Børglum, Anders D., Breen, Gerome, Demontis, Ditte, Erlangsen, Annette, Gelernter, Joel, Glatt, Stephen J., Hougaard, David M., Hwu, Hai Gwo, Kuo, Po Hsiu, Lewis, Cathryn M., Li, Qingqin S., Liu, Chih Min, Martin, Nicholas G., McIntosh, Andrew M., Medland, Sarah E., Mors, Ole, Nordentoft, Merete, Olsen, Catherine M., Porteous, David, Smith, Daniel J., Stahl, Eli A., Stein, Murray B., Wasserman, Danuta, Werge, Thomas, Whiteman, David C., Willour, Virginia, Coon, Hilary, Beckham, Jean C., Kimbrel, Nathan A., Ruderfer, Douglas M., Docherty, Anna R., Mullins, Niamh, Ashley-Koch, Allison E., Qin, Xuejun, Coleman, Jonathan R.I., Shabalin, Andrey, Kang, Joo Eun, Murnyak, Balasz, Wendt, Frank, Adams, Mark, Campos, Adrian I., DiBlasi, Emily, Fullerton, Janice M., Kranzler, Henry R., Bakian, Amanda V., Monson, Eric T., Rentería, Miguel E., Walss-Bass, Consuelo, Andreassen, Ole A., Behera, Chittaranjan, Bulik, Cynthia M., Edenberg, Howard J., Kessler, Ronald C., John Mann, J., Nurnberger, John I., Pistis, Giorgio, Streit, Fabian, Ursano, Robert J., Polimanti, Renato, Dennis, Michelle, Garrett, Melanie, Hair, Lauren, Harvey, Philip, Hauser, Elizabeth R., Hauser, Michael A., Huffman, Jennifer, Jacobson, Daniel, Madduri, Ravi, McMahon, Benjamin, Oslin, David W., Trafton, Jodie, Awasthi, Swapnil, Berrettini, Wade H., Bohus, Martin, Chang, Xiao, Chen, Hsi Chung, Chen, Wei J., Christensen, Erik D.M.D., Crow, Scott, Duriez, Philibert, Edwards, Alexis C., Fernández-Aranda, Fernando, Galfalvy, Hanga, Gandal, Michael, Gorwood, Philip, Guo, Yiran, Hafferty, Jonathan D., Hakonarson, Hakon, Halmi, Katherine A., Hishimoto, Akitoyo, Jain, Sonia, Jamain, Stéphane, Jiménez-Murcia, Susana, Johnson, Craig, Kaplan, Allan S., Kaye, Walter H., Keel, Pamela K., Kennedy, James L., Kim, Minsoo, Klump, Kelly L., Levey, Daniel F., Li, Dong, Liao, Shih Cheng, Lieb, Klaus, Lilenfeld, Lisa, Marshall, Christian R., Mitchell, James E., Okazaki, Satoshi, Otsuka, Ikuo, Pinto, Dalila, Powers, Abigail, Ramoz, Nicolas, Ripke, Stephan, Roepke, Stefan, Rozanov, Vsevolod, Scherer, Stephen W., Schmahl, Christian, Sokolowski, Marcus, Starnawska, Anna, Strober, Michael, Su, Mei Hsin, Thornton, Laura M., Treasure, Janet, Ware, Erin B., Watson, Hunna J., Witt, Stephanie H., Blake Woodside, D., Yilmaz, Zeynep, Zillich, Lea, Adolfsson, Rolf, Agartz, Ingrid, Alda, Martin, Alfredsson, Lars, Appadurai, Vivek, Artigas, María Soler, Van Der Auwera, Sandra, Helena Azevedo, M., Bass, Nicholas, Bau, Claiton H.D., Baune, Bernhard T., Bellivier, Frank, Berger, Klaus, Biernacka, Joanna M., Bigdeli, Tim B., Binder, Elisabeth B., Boehnke, Michael, Boks, Marco P., Braff, David L., Bryant, Richard, Budde, Monika, Byrne, Enda M., Cahn, Wiepke, Castelao, Enrique, Cervilla, Jorge A., Chaumette, Boris, Corvin, Aiden, Craddock, Nicholas, Djurovic, Srdjan, Foo, Jerome C., Forstner, Andreas J., Frye, Mark, Gatt, Justine M., Giegling, Ina, Grabe, Hans J., Green, Melissa J., Grevet, Eugenio H., Grigoroiu-Serbanescu, Maria, Gutierrez, Blanca, Guzman-Parra, Jose, Hamshere, Marian L., Hartmann, Annette M., Hauser, Joanna, Heilmann-Heimbach, Stefanie, Hoffmann, Per, Ising, Marcus, Jones, Ian, Jones, Lisa A., Jonsson, Lina, Kahn, René S., Kelsoe, John R., Kendler, Kenneth S., Kloiber, Stefan, Koenen, Karestan C., Kogevinas, Manolis, Krebs, Marie Odile, Landén, Mikael, Leboyer, Marion, Lee, Phil H., Levinson, Douglas F., Liao, Calwing, Lissowska, Jolanta, Mayoral, Fermin, McElroy, Susan L., McGrath, Patrick, McGuffin, Peter, McQuillin, Andrew, Mehta, Divya, Melle, Ingrid, Mitchell, Philip B., Molina, Esther, Morken, Gunnar, Nievergelt, Caroline, Nöthen, Markus M., O'Donovan, Michael C., Ophoff, Roel A., Owen, Michael J., Pato, Carlos, Pato, Michele T., Penninx, Brenda W.J.H., Potash, James B., Power, Robert A., Preisig, Martin, Quested, Digby, Ramos-Quiroga, Josep Antoni, Reif, Andreas, Ribasés, Marta, Richarte, Vanesa, Rietschel, Marcella, Rivera, Margarita, Roberts, Andrea, Roberts, Gloria, Rouleau, Guy A., Rovaris, Diego L., Sanders, Alan R., Schofield, Peter R., Schulze, Thomas G., Scott, Laura J., Serretti, Alessandro, Shi, Jianxin, Sirignano, Lea, Sklar, Pamela, Smeland, Olav B., Smoller, Jordan W., Sonuga-Barke, Edmund J.S., Trzaskowski, MacIej, Tsuang, Ming T., Turecki, Gustavo, Vilar-Ribó, Laura, Vincent, John B., Völzke, Henry, Walters, James T.R., Weickert, Cynthia Shannon, Weickert, Thomas W., Weissman, Myrna M., Williams, Leanne M., Wray, Naomi R., Zai, Clement C., Agerbo, Esben, Børglum, Anders D., Breen, Gerome, Demontis, Ditte, Erlangsen, Annette, Gelernter, Joel, Glatt, Stephen J., Hougaard, David M., Hwu, Hai Gwo, Kuo, Po Hsiu, Lewis, Cathryn M., Li, Qingqin S., Liu, Chih Min, Martin, Nicholas G., McIntosh, Andrew M., Medland, Sarah E., Mors, Ole, Nordentoft, Merete, Olsen, Catherine M., Porteous, David, Smith, Daniel J., Stahl, Eli A., Stein, Murray B., Wasserman, Danuta, Werge, Thomas, Whiteman, David C., Willour, Virginia, Coon, Hilary, Beckham, Jean C., Kimbrel, Nathan A., and Ruderfer, Douglas M.

Abstract

Objective: Suicidal behavior is heritable and is a major cause of death worldwide. Two large-scale genome-wide asso-ciation studies (GWASs) recently discovered and cross- validated genome-wide significant (GWS) loci for suicide attempt (SA). The present study leveraged the genetic co-horts from both studies to conduct the largest GWAS meta- analysis of SA to date. Multi-ancestry and admixture-specific meta-analyses were conducted within groups of significant African, East Asian, and European ancestry admixtures. Methods: This study comprised 22 cohorts, including 43,871 SA cases and 915,025 ancestry-matched controls. Analytical methods across multi-ancestry and individual ancestry ad-mixtures included inverse variance-weighted fixed-effects meta-analyses, followed by gene, gene-set, tissue-set, and drug-target enrichment, as well as summary-data-based Mendelian randomization with brain expression quantitative trait loci data, phenome-wide genetic correlation, and ge-netic causal proportion analyses. Results: Multi-ancestry and European ancestry admixture GWAS meta-analyses identified 12 risk loci at p values <5×10–8. These loci were mostly intergenic and implicated DRD2, SLC6A9, FURIN, NLGN1, SOX5, PDE4B, and CACNG2. The multi-ancestry SNP-based heritability estimate of SA was 5.7% on the liability scale (SE=0.003, p=5.7×10–80). Significant brain tissue gene expression and drug set en-richment were observed. There was shared genetic variation of SA with attention deficit hyperactivity disorder, smoking, and risk tolerance after conditioning SA on both major de-pressive disorder and posttraumatic stress disorder. Genetic causal proportion analyses implicated shared genetic risk for specific health factors. Conclusions: This multi-ancestry analysis of suicide attempt identified several loci contributing to risk and establishes significant shared genetic covariation with clinical pheno-types. These findings provide insight into genetic fa, Objective: Suicidal behavior is heritable and is a major cause of death worldwide. Two large-scale genome-wide association studies (GWASs) recently discovered and crossvalidated genome-wide significant (GWS) loci for suicide attempt (SA). The present study leveraged the genetic cohorts from both studies to conduct the largest GWAS metaanalysis of SA to date. Multi-ancestry and admixture-specific meta-analyses were conducted within groups of significant African, East Asian, and European ancestry admixtures. Methods: This study comprised 22 cohorts, including 43,871 SA cases and 915,025 ancestry-matched controls. Analytical methods across multi-ancestry and individual ancestry admixtures included inverse variance-weighted fixed-effects meta-analyses, followed by gene, gene-set, tissue-set, and drug-target enrichment, as well as summary-data-based Mendelian randomization with brain expression quantitative trait loci data, phenome-wide genetic correlation, and genetic causal proportion analyses. Results: Multi-ancestry and European ancestry admixture GWAS meta-analyses identified 12 risk loci at p values <5×10-8. These loci were mostly intergenic and implicated DRD2, SLC6A9, FURIN, NLGN1, SOX5, PDE4B, and CACNG2. The multi-ancestry SNP-based heritability estimate of SA was 5.7% on the liability scale (SE=0.003, p=5.7×10-80). Significant brain tissue gene expression and drug set enrichment were observed. There was shared genetic variation of SA with attention deficit hyperactivity disorder, smoking, and risk tolerance after conditioning SA on both major depressive disorder and posttraumatic stress disorder. Genetic causal proportion analyses implicated shared genetic risk for specific health factors. Conclusions: This multi-ancestry analysis of suicide attempt identified several loci contributing to risk and establishes significant shared genetic covariation with clinical phenotypes. These findings provide insight into genetic factors associated with suicide attemp

Published
2023

243. Circadian influence on intrusive re-experiencing in trauma survivors’ daily lives

Author

Rosi-Andersen, Alex, Meister, Laura, Graham, Belinda, Brown, Steven, Bryant, Richard, Ehlers, Anke, Kleim, Birgit, University of Zurich, and Kleim, Birgit

Subjects
Stress Disorders, Post-Traumatic, 2738 Psychiatry and Mental Health, Memory, 10093 Institute of Psychology, Humans, 10050 Institute of Pharmacology and Toxicology, Fear, Survivors, Sleep, 150 Psychology
Abstract

Background: The core clinical feature of posttraumatic stress disorder (PTSD) is recurrent re-experiencing in form of intrusive memories. While a great number of biological processes are regulated by sleep and internal biological clocks, the effect of 24-hour biological cycles, named circadian rhythm, has not been investigated in the context of intrusive memories. Objective: Here we examined effects of time of day on frequency and characteristics of intrusive re-experiencing. Methods: Fifty trauma survivors reported intrusive memories for 7 consecutive days using ecological momentary assessment in their daily life. We investigated (i) time-of-day dependent effects on frequency and distribution of intrusive re-experiencing in the overall sample as well as in PTSD versus non-PTSD and (ii) time-of-day dependent effects on the memory characteristics intrusiveness, vividness, nowness and fear. Results: Intrusive memories showed a curvilinear pattern that peaked at 2pm. Intrusive memories in the PTSD group showed a constant level of intrusive re-experiencing in the afternoon and evening, whereas a descending slope was present in the non-PTSD group. In PTSD, intrusive memories might thus be experienced in a more time-scattered fashion throughout the day, indicating chronodisruption. Intrusion characteristics did not follow this pattern. Conclusion: Although preliminary and based on a small sample size, these findings contribute to a better understanding of the everyday occurrence and characteristics of intrusive memories, and point to the added value of examining time-dependent effects, which can directly inform prevention and intervention science. Influencia circadiana en la re-experimentación intrusiva en la vida diaria de los sobrevivientes de trauma Antecedentes: La característica clínica central del trastorno de estrés postraumático (TEPT) es la re-experimentación recurrente en forma de recuerdos intrusivos. Si bien un gran número de procesos biológicos están regulados por el sueño y los relojes biológicos internos, el efecto de los ciclos biológicos de 24 horas, llamado ritmo circadiano, no ha sido investigado en el contexto de los recuerdos intrusivos. Objetivo: Aquí examinamos los efectos de la hora del día sobre la frecuencia y características de la re-experimentación intrusiva. Métodos: Cincuenta sobrevivientes de trauma reportaron recuerdos intrusivos por 7 días consecutivos usando la evaluación ecológica momentánea en su vida diaria. Investigamos (i) los efectos dependientes de la hora del día sobre la frecuencia y distribución de los recuerdos intrusivos en la muestra general, así como en TEPT versus no TEPT y (ii) los efectos dependien- tes de la hora del día sobre las características de la intrusividad de los recuerdos, vividez, momento presente y miedo. Resultados: Los recuerdos intrusivos mostraron un patrón curvilíneo que alcanzaba su punto máximo a las 2 pm. Los recuerdos intrusivos en el grupo con TEPT mostraron un nivel constante de re-experimentación intrusiva en la tarde y la noche, mientras que en el grupo sin TEPT se observó una pendiente descendiente. En el TEPT, los recuerdos intrusivos pueden experimen- tarse en una manera más dispersa en el tiempo a lo largo del día, lo que indica cronodisrupción. Las características de intrusión no siguieron este patrón. Conclusión: Aunque son preliminares y se basan en un tamaño de muestra pequeño, estos hallazgos contribuyen a una mayor comprensión de la ocurrencia cotidiana y las características de los recuerdos intrusivos y apuntan al valor agregado de examinar sus efectos dependientes del tiempo, que pueden informar directamente a la ciencia de la prevención e intervención. 昼夜节律对创伤幸存者日常生活中闯入性再体验的影响 背景: 创伤后应激障碍(PTSD)的核心临床特征是以闯入性记忆的形式反复再体验。虽然大量 的生物过程受睡眠和内部生物钟的调节,尚未在闯入性记忆的背景下研究 24 小时生物周期 (称为昼夜节律)的影响。 目的: 这里我们考查了一天时间对闯入性再体验频率和特征的影响。 方法 : 50 名创伤幸存者在日常生活中使用生态瞬时评估连续 7 天报告了闯入性记忆。我们 研究了 (i)对整个样本以及 PTSD 与非 PTSD 对比组中闯入性再体验的频率和分布的每日时间 依赖影响,以及 (ii) 对记忆特征闯入性、生动性、当下性和恐惧的每日时间依赖影响。 结果: 闯入性记忆呈现出一种在下午 2 点达到峰值的曲线模式。PTSD组的闯入性记忆在下 午和晚上表现出恒定水平的闯入性再体验,而非PTSD组则呈现下降趋势。因此,在 PTSD 组 中,闯入性记忆可能会在一天中以更分散的方式体验,这表明时间中断。闯入特征没有遵循这 种模式。 结论: 虽然是初步研究并且基于小样本量,这些发现有助于更好了解闯入性记忆的日常发生 和特征,并指出考查其时间依赖效应的附加价值,可以直接为预防和干预提供信息科学。

Published
2023
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244. Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial

Author

Mediavilla, Roberto, Felez-Nobrega, Mireia, Mcgreevy, Kerry R, Monistrol-Mula, Anna, Bravo-Ortiz, María-Fe, Bayón, Carmen, Giné-Vázquez, Iago, Villaescusa, Rut, Muñoz-Sanjosé, Ainoa, Aguilar-Ortiz, Salvatore, Figueiredo, Natasha, Nicaise, Pablo, Park, A-La, Petri-Romão, Papoula, Purgato, Marianna, Witteveen, Anke B, Underhill, James, Barbui, Corrado, Bryant, Richard, Kalisch, Raffael, Lorant, Vincent, Mcdaid, David, Melchior, Maria, Sijbrandij, Marit, Haro, Josep Maria, Ayuso-Mateos, Jose Luis, and UCL - SSS/IRSS - Institut de recherche santé et société

Subjects
anxiety disorders, depression & mood disorders, MHSR, RA0421 Public health. Hygiene. Preventive Medicine, COVID-19, adult psychiatry, depression &amp, mood disorders
Abstract

Background: Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. Objective: To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. Methods: We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/ depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. Findings: Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. Conclusions: Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. Clinical implications Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. Trial registration number NCT04980326.

Published
2023

247. Effectiveness of Group Problem Management Plus, a brief psychological intervention for adults affected by humanitarian disasters in Nepal: A cluster randomized controlled trial

Author

Jordans, Mark J. D., Kohrt, Brandon A., Sangraula, Manaswi, Turner, Elizabeth L., Wang, Xueqi, Shrestha, Pragya, Ghimire, Renasha, van't Hof, Edith, Bryant, Richard A., Dawson, Katie S., Marahatta, Kedar, Luitel, Nagendra P., and van Ommeren, Mark

Subjects
Disasters -- Psychological aspects -- Health aspects -- Nepal, Group counseling -- Usage, Depression, Mental -- Risk factors -- Prevention, Stress (Psychology) -- Health aspects -- Management, Company business management, Biological sciences
Abstract

Background Globally, 235 million people are impacted by humanitarian emergencies worldwide, presenting increased risk of experiencing a mental disorder. Our objective was to test the effectiveness of a brief group psychological treatment delivered by trained facilitators without prior professional mental health training in a disaster-prone setting. Methods and findings We conducted a cluster randomized controlled trial (cRCT) from November 25, 2018 through September 30, 2019. Participants in both arms were assessed at baseline, midline (7 weeks post-baseline, which was approximately 1 week after treatment in the experimental arm), and endline (20 weeks post-baseline, which was approximately 3 months posttreatment). The intervention was Group Problem Management Plus (PM+), a psychological treatment of 5 weekly sessions, which was compared with enhanced usual care (EUC) consisting of a family psychoeducation meeting with a referral option to primary care providers trained in mental healthcare. The setting was 72 wards (geographic unit of clustering) in eastern Nepal, with 1 PM+ group per ward in the treatment arm. Wards were eligible if they were in disaster-prone regions and residents spoke Nepali. Wards were assigned to study arms based on covariate constrained randomization. Eligible participants were adult women and men 18 years of age and older who met screening criteria for psychological distress and functional impairment. Outcomes were measured at the participant level, with assessors blinded to group assignment. The primary outcome was psychological distress assessed with the General Health Questionnaire (GHQ-12). Secondary outcomes included depression symptoms, posttraumatic stress disorder (PTSD) symptoms, 'heart-mind' problems, social support, somatic symptoms, and functional impairment. The hypothesized mediator was skill use aligned with the treatment's mechanisms of action. A total of 324 participants were enrolled in the control arm (36 wards) and 319 in the Group PM+ arm (36 wards). The overall sample (N = 611) had a median age of 45 years (range 18-91 years), 82% of participants were female, 50% had recently experienced a natural disaster, and 31% had a chronic physical illness. Endline assessments were completed by 302 participants in the control arm (36 wards) and 303 participants in the Group PM+ arm (36 wards). At the midline assessment (immediately after Group PM+ in the experimental arm), mean GHQ-12 total score was 2.7 units lower in Group PM+ compared to control (95% CI: 1.7, 3.7, p < 0.001), with standardized mean difference (SMD) of -0.4 (95% CI: -0.5, -0.2). At 3 months posttreatment (primary endpoint), mean GHQ-12 total score was 1.4 units lower in Group PM+ compared to control (95% CI: 0.3, 2.5, p = 0.014), with SMD of -0.2 (95% CI: -0.4, 0.0). Among the secondary outcomes, Group PM+ was associated with endline with a larger proportion attaining more than 50% reduction in depression symptoms (29.9% of Group PM+ arm versus 17.3% of control arm, risk ratio = 1.7, 95% CI: 1.2, 2.4, p = 0.002). Fewer participants in the Group PM+ arm continued to have 'heart-mind' problems at endline (58.8%) compared to the control arm (69.4%), risk ratio = 0.8 (95% CI, 0.7, 1.0, p = 0.042). Group PM+ was not associated with lower PTSD symptoms or functional impairment. Use of psychosocial skills at midline was estimated to explain 31% of the PM+ effect on endline GHQ-12 scores. Adverse events in the control arm included 1 suicide death and 1 reportable incidence of domestic violence; in the Group PM+ arm, there was 1 death due to physical illness. Study limitations include lack of power to evaluate gender-specific effects, lack of long-term outcomes (e.g., 12 months posttreatment), and lack of cost-effectiveness information. Conclusions In this study, we found that a 5-session group psychological treatment delivered by nonspecialists modestly reduced psychological distress and depression symptoms in a setting prone to humanitarian emergencies. Benefits were partly explained by the degree of psychosocial skill use in daily life. To improve the treatment benefit, future implementation should focus on approaches to enhance skill use by PM+ participants. Trial registration ClinicalTrials.gov NCT03747055., Author(s): Mark J. D. Jordans 1,2, Brandon A. Kohrt 2,3,*, Manaswi Sangraula 2, Elizabeth L. Turner 4, Xueqi Wang 4, Pragya Shrestha 2, Renasha Ghimire 2, Edith van't Hof 5, [...]

Published
2021
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248. The Longitudinal Association Between Posttraumatic Stress Disorder, Emotion Dysregulation, and Postmigration Stressors Among Refugees

Author

Specker, Philippa, Liddell, Belinda J., O’Donnell, Meaghan, Bryant, Richard A., Mau, Vicki, McMahon, Tadgh, Byrow, Yulisha, and Nickerson, Angela

Abstract

Although emotion dysregulation has been robustly associated with posttraumatic stress disorder (PTSD), there is relatively little understanding of this process in refugees. Specifically, longitudinal methodology has not been used to examine the relationship between emotion dysregulation and PTSD among refugees. In this study, we investigated the temporal relationship between emotion dysregulation, postmigration stressors, and PTSD clusters (reexperiencing, avoidance, negative alterations in mood and cognition [NAMC], and hyperarousal) from the fifth edition of the Diagnostic and Statistical Manual of Mental Disordersamong a community sample of refugees (N= 1,081) over a 2-year period. Random intercept cross-lagged panel analysis found that emotion dysregulation was antecedent to within-persons increases in reexperiencing and NAMC symptoms over time and bidirectionally associated with hyperarousal and postmigration stressors. In addition, postmigration stressors were antecedent to within-persons increases in reexperiencing, avoidance, and NAMC and bidirectionally associated with hyperarousal symptoms. Findings provide novel evidence in support of postmigration stressors and emotion dysregulation as mechanisms maintaining PTSD and highlight the potential utility of tailoring interventions to address these factors.

Published
2024
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