Medicine JournalFeeds

Adolescents’ reactions after a wildfire disaster in Greece.

J Trauma Stress. 2012 Feb 1;

Authors: Papadatou D, Giannopoulou I, Bitsakou P, Bellali T, Talias MA, Tselepi K

Abstract

This cross-sectional study examined the factors associated with higher levels of posttraumatic stress disorder (PTSD) and depression symptoms in 1,468 adolescents, 6 months after a wildfire. The rate of probable PTSD was 29.4% and 20% for probable depression. Findings on predisaster, disaster-related, and postdisaster factors revealed that disaster-related factors-specifically objective and perceived threat to self and others-were associated with symptoms of PTSD but not depression. Predisaster life events, postdisaster losses, and escape-oriented coping strategies were associated with higher levels of both PTSD and depression symptoms, while control-oriented coping and perceived social support were differentially associated with symptoms of and depression. Findings have implications for the assessment and treatment of traumatized and depressed adolescents after a disaster.

PMID: 22298431 [PubMed - as supplied by publisher]

PRISM (Pictorial Representation of Illness and Self Measure): A new method for the assessment of suffering after trauma.

J Trauma Stress. 2012 Jan 25;

Authors: Wittmann L, Schnyder U, Büchi S

Abstract

This pilot study tested the validity of a 1-item visual assessment method originally developed to evaluate suffering in chronic illness that has been adapted for use with patients who have been exposed to traumatic events. The Pictorial Representation of Illness and Self Measure (PRISM) was administered 5 times during the course of a posttraumatic stress disorder (PTSD) treatment outcome study (N = 29). The PRISM scores declined significantly under trauma-focused psychotherapy and differentiated between participants with and without PTSD diagnoses. Test-retest reliability over a 6-month period was high (r = .85). PRISM showed significant correlations with measures of PTSD, depression, and psychopathology symptom load (r = -.38 to r = -.81; convergent validity). At the same time, PRISM was not significantly related to trauma history (discriminant validity). Illustrations of symptom time courses indicated that PRISM was more closely related to trauma-specific psychopathology than to nontrauma-specific psychopathology (discriminant validity) and sensitive to change. In summary, PRISM appears to be a valid tool for the assessment of trauma-related suffering and adds to multimethod approaches in trauma research.

PMID: 22278709 [PubMed - as supplied by publisher]

Recollection of negative information in posttraumatic stress disorder.

J Trauma Stress. 2012 Jan 25;

Authors: Tapia G, Clarys D, Bugaiska A, El-Hage W

Abstract

The purpose of the present study was to investigate the effects of posttraumatic stress disorder (PTSD) associated with the effects of emotional valence on recall processes in recognition memory. Patients suffering from PTSD (n = 15) were compared with 15 nontraumatized patients with anxious and depressive symptoms and with 15 nontraumatized controls on the remember/know paradigm using negative, positive, and neutral words. The PTSD group remembered more negative words than the nontraumatized controls, F(1, 42) = 7.20, p = .01, but there was no difference between those with PTSD and those with anxiety or depression, F(1, 42) = 2.93, p = .09, or between the latter and controls, F(1, 42) < 1. This study did not allow us to determine whether this recollection bias for negative information was specific to the PTSD status or was triggered by the greater level of anxiety displayed in this group.

PMID: 22278745 [PubMed - as supplied by publisher]

Military to civilian questionnaire: A measure of postdeployment community reintegration difficulty among veterans using Department of Veterans Affairs medical care.

J Trauma Stress. 2011 Dec 7;

Authors: Sayer NA, Frazier P, Orazem RJ, Murdoch M, Gravely A, Carlson KF, Hintz S, Noorbaloochi S

Abstract

The primary objective of this study was to describe the development, reliability, and construct validity of scores on the Military to Civilian Questionnaire (M2C-Q), a 16-item self-report measure of postdeployment community reintegration difficulty. We surveyed a national, stratified sample of 1,226 Iraq and Afghanistan veterans who used U.S. Department of Veterans Affairs (VA) medical care; 745 completed the M2C-Q and validated mental health screening measures. All analyses were based on weighted estimates. The internal consistency of the M2C-Q was .95 in this sample. Factor analyses indicated a single total score was the best-fitting model. Total scores were associated with measures theoretically related to reintegration difficulties including perception of overall difficulty readjusting back into civilian life (R(2) = .49), probable PTSD (d = 1.07), probable problem drug or alcohol use (d = 0.34), and overall mental health (r = -.83). Subgroup analyses revealed a similar pattern of findings in those who screened negative for PTSD. Nonwhite and unemployed veterans reported greater community reintegration difficulty (d = 0.20 and 0.45, respectively). Findings offer preliminary support for the reliability and construct validity of M2C-Q scores.

PMID: 22162082 [PubMed - as supplied by publisher]

Israeli adolescents with ongoing exposure to terrorism: Suicidal ideation, posttraumatic stress disorder, and functional impairment.

J Trauma Stress. 2011 Dec 12;

Authors: Chemtob CM, Pat-Horenczyk R, Madan A, Pitman SR, Wang Y, Doppelt O, Burns KD, Abramovitz R, Brom D

Abstract

In this study, we examined the relationships among terrorism exposure, functional impairment, suicidal ideation, and probable partial or full posttraumatic stress disorder (PTSD) from exposure to terrorism in adolescents continuously exposed to this threat in Israel. A convenience sample of 2,094 students, aged 12 to 18, was drawn from 10 Israeli secondary schools. In terms of demographic factors, older age was associated with increased risk for suicidal ideation, OR = 1.33, 95% CI [1.09, 1.62], p < .01, but was protective against probable partial or full PTSD, OR = 0.72, 95% CI [0.54, 0.95], p < .05; female gender was associated with greater likelihood of probable partial or full PTSD, OR = 1.57, 95% CI [1.02, 2.40], p < .05. Exposure to trauma due to terrorism was associated with increased risk for each of the measured outcomes including probable partial or full PTSD, functional impairment, and suicidal ideation. When age, gender, level of exposure to terrorism, probable partial or full PTSD, and functional impairment were examined together, only terrorism exposure and functional impairment were associated with suicidal ideation. This study underscores the importance and feasibility of examining exposure to terrorism and functional impairment as risk factors for suicidal ideation.

PMID: 22162099 [PubMed - as supplied by publisher]

The psychological impact of deployment on OEF/OIF healthcare providers.

J Trauma Stress. 2011 Dec 2;

Authors: Hickling EJ, Gibbons S, Barnett SD, Watts D

Abstract

The psychological impact of military experience on healthcare providers has received little attention to date. The 2005 Department of Defense Survey of Health Related Behaviors Among Active Duty Personnel was used as a secondary data source, and deployed healthcare officers and healthcare specialists were identified and compared to deployed non-healthcare officers and enlisted personnel: 6,116 respondents were surveyed. Findings revealed clinically significant psychological distress among deployed military healthcare provider respondents including posttraumatic stress symptoms, depression, anxiety, and adverse psychosocial impact, more prominent in the deployed healthcare specialist group. Based upon findings, possible factors for resilience and increased risk, as well as potential intervention needs in this healthcare provider group of service members are offered. Implications for future prospective studies are suggested.

PMID: 22139677 [PubMed - as supplied by publisher]

Exposure to violence and PTSD symptoms among Somali women.

J Trauma Stress. 2011 Dec 5;

Authors: de Jong K, van der Kam S, Swarthout T, Ford N, Mills C, Yun O, Kleber RJ

Abstract

Posttraumatic stress disorder (PTSD) symptoms, exposure to traumatic stressors, and health care utilization were examined in 84 women attending a primary health care clinic in Mogadishu, Somalia. The Somalia-Posttraumatic Diagnostic Scale was used in this active warzone to measure symptoms. Nearly all women reported high levels of confrontations with violence; half described being exposed to a potentially traumatizing event. Nearly one third had significant PTSD symptoms. Compared to those who did not, women who reported exposure to a traumatic stressor reported more confrontations with violence (7.1 vs. 3.3; p < . 001), health complaints (3.8 vs. 2.9; p = .03), and nearly 3 times as much (p = .03) health service utilization. A potentially traumatizing event was found to be a simplified proxy for assessing mental health distress in women attending a primary health care facility in highly insecure, unpredictable, resource-limited settings.

PMID: 22144120 [PubMed - as supplied by publisher]

Contextualizing the trauma experience of women immigrants from Central America, South America, and Mexico.

J Trauma Stress. 2011 Dec 5;

Authors: Kaltman S, Hurtado de Mendoza A, Gonzales FA, Serrano A, Guarnaccia PJ

Abstract

Trauma has been understudied among Latina immigrants from Central and South America. This study examined the types and context of trauma exposure experienced by immigrant women from Central America, South America, and Mexico living in the United States. Twenty-eight women seeking care in primary care or social service settings completed life history interviews. The majority of the women reported some type of trauma exposure in their countries of origin, during immigration, and/or in the United States. In the interviews, we identified types of trauma important to the experience of these immigrants that are not queried by trauma assessments typically used in the United States. We also identified factors that are likely to amplify the impact of trauma exposure. The study highlights the importance of utilizing a contextualized approach when assessing trauma exposure among immigrant women.

PMID: 22144133 [PubMed - as supplied by publisher]

Postcombat outcomes among marines with preexisting mental diagnoses.

J Trauma Stress. 2011 Dec 5;

Authors: Crain JA, Larson GE, Highfill-McRoy RM, Schmied EA

Abstract

Preexisting mental disorders are not always considered in mental health studies with military populations, even though prior diagnoses may be a risk factor for additional psychiatric harm stemming from combat exposure, as well as postdeployment behavioral problems. The objectives of this study were to investigate postcombat psychiatric and career outcomes among Marines with preexisting mental disorder diagnoses who deployed to combat in Iraq, Afghanistan, or Kuwait from 2002 to 2008. Marines with a preexisting diagnosis were 3.6 times (p < .001) more likely to have at least 1 postdeployment mental health disorder within 6 months postdeployment compared with Marines with no prior psychiatric diagnoses. Marines with a preexisting diagnosis were also 1.8 (p < .001) times more likely to receive a new-onset psychiatric diagnosis within 6 months postdeployment, indicating that postdeployment mental health concerns in this cohort extend beyond continuation of earlier disorders. Additionally, demotions and separation were significantly associated with having any preexisting mental health diagnoses (yielding odds ratios of 2.34 and 2.00, p < .001, respectively. Based on the current findings, it may be advisable to mandate a full medical and psychiatric record review during deployment health screening as part of new initiatives to address whether combat exposure has worsened preexisting conditions or compounded them with new-onset concerns.

PMID: 22144144 [PubMed - as supplied by publisher]

Pervasive exposure to violence and posttraumatic stress disorder in a predominantly African American Urban Community: The Detroit neighborhood health study.

J Trauma Stress. 2011 Dec 5;

Authors: Goldmann E, Aiello A, Uddin M, Delva J, Koenen K, Gant LM, Galea S

Abstract

Exposure to traumatic events is common, particularly among economically disadvantaged, urban African Americans. There is, however, scant data on the psychological consequences of exposure to traumatic events in this group. We assessed experience with traumatic events and posttraumatic stress disorder (PTSD) among 1,306 randomly selected, African American residents of Detroit. Lifetime prevalence of exposure to at least 1 traumatic event was 87.2% (assault = 51.0%). African Americans from Detroit have a relatively high burden of PTSD; 17.1% of those who experienced a traumatic event met criteria for probable lifetime PTSD. Assaultive violence is pervasive and is more likely to be associated with subsequent PTSD than other types of events. Further efforts to prevent violence and increase access to mental health treatment could reduce the mental health burden in economically disadvantaged urban areas.

PMID: 22144187 [PubMed - as supplied by publisher]