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1.
Neurosci Biobehav Rev ; 150: 105211, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37141960

RESUMO

Stress-related disorders (SRD) disproportionately affect women. Cortisol blunting, a failure to demonstrate a typical rise and fall of cortisol in response to stress, is associated with SRDs and has been found to be more pronounced among women. Cortisol blunting relates to both sex as a biological variable (SABV; e.g., estrogens and their fluctuations, impact on neural circuits) and gender as a psychosocial variable (GAPSV; e.g., discrimination, harassment, gender roles). I suggest a theoretical model linking experience, sex- and gender-related factors, and neuroendocrine substrates of SRD to the heightened risk among women. The model thus bridges multiple gaps in the literature to create a synergistic conceptual framework with which to understand the stress of being a woman. Utilizing such a framework in research may allow identifying targeted, sex-and gender-dependent risk factors, informing psychological treatment, medical advice, educational and community programming, and policy.


Assuntos
Hidrocortisona , Estresse Psicológico , Humanos , Feminino , Transtornos Relacionados a Trauma e Fatores de Estresse , Fatores Sexuais , Psicopatologia
3.
Gerontologist ; 62(1): e1-e16, 2022 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-34436570

RESUMO

BACKGROUND AND OBJECTIVES: Adverse childhood and adult experiences can have far-reaching impacts and, when coupled with typical aging-related changes, may impede the achievement of a suitable person-environment fit for aging adults. The objective of our study was to determine whether extant literature connects older adults with trauma history to successfully aging in place. RESEARCH DESIGN AND METHODS: We proposed a conceptual model regarding trauma history, adaptive capacity of aging adults, and trauma-informed supports for aging in place. We conducted a scoping review using 6 databases (keywords: older adult(s), aging in place, housing, trauma), with a full review of 32 articles. RESULTS: Insights included: (a) Aging in place does not have to mean living in the same house over time. (b) The uncertainty of the aging process can be traumatic and can be exacerbated by previous traumatic experiences. (c) Environmental sensitivities can result from previous traumatic experiences and cause further trauma. (d) Housing precarity is a traumatic experience. (e) Permanent supportive housing is an important resource for people in crisis. (f) Community supports are critical to aging in place. DISCUSSION AND IMPLICATIONS: Our review revealed insights about aging in place and trauma, but did not connect the vulnerabilities specific to aging adults with personal trauma histories to aging in place. Research is needed that confirms the relationship between history of traumatic experiences and difficulties with aging in place as well as trauma-informed approaches that can mitigate housing-related stressors and foster community-living environments that provide equitable access to aging in place.


Assuntos
Habitação , Vida Independente , Transtornos Relacionados a Trauma e Fatores de Estresse , Experiências Adversas da Infância , Idoso , Envelhecimento , Apoio Comunitário , Humanos
4.
Nurs Res ; 71(1): 66-74, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34644271

RESUMO

BACKGROUND: Potentially traumatic experiences throughout the life course are associated with poor cardiovascular health among women. However, research on the associations of trauma with cardiovascular health among Latino populations is limited. Understanding the impact of trauma on cardiovascular health within marginalized populations may provide guidance on developing interventions with a particular focus on preventative care. OBJECTIVE: The purpose of this descriptive cross-sectional study was to examine the associations of lifetime trauma with cardiovascular health among middle-aged and older Latina women. METHODS: Participants were recruited from an existing study in New York City. All participants completed a structured questionnaire to assess lifetime trauma, demographic characteristics (such as age and education), financial resource strain, and emotional support. The Trauma History Questionnaire was used to assess lifetime exposure to potentially traumatic experiences (range 0-24). Cardiovascular health was measured with a validated measure of cardiovascular health from the American Heart Association (Life's Simple 7). We used self-reported and objective data to calculate cardiovascular health scores (range 0-14). Multiple linear regression was used to examine the associations of lifetime trauma with cardiovascular health, adjusted for age, education, financial resource strain, and emotional support. RESULTS: The sample included 50 Latina women with a mean age of 63.1 years, 88% were Dominican, and only 6% had completed a college degree. Women reported an average of 4.8 traumatic experiences. Mean cardiovascular health score was 6.5 (SD = 1.6, range 3-10). Linear regression models found that, after adjusting for age, education, financial resource strain, and emotional support, a higher count of lifetime trauma was associated with worse cardiovascular health. However, this association did not reach statistical significance. DISCUSSION: Women with a higher count of lifetime trauma had worse cardiovascular health scores; this association was not statistically significant. Future studies should investigate associations of lifetime trauma and cardiovascular health in larger and more diverse samples of Latinas. Nurses and other clinicians should incorporate trauma-informed approaches to cardiovascular disease risk reduction to improve the cardiovascular health of Latina women who are survivors of trauma.


Assuntos
Doenças Cardiovasculares/etnologia , Hispânico ou Latino/estatística & dados numéricos , Transtornos Relacionados a Trauma e Fatores de Estresse/etnologia , Idoso , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Feminino , Hispânico ou Latino/psicologia , Humanos , Acontecimentos que Mudam a Vida , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Cidade de Nova Iorque/etnologia , Transtornos Relacionados a Trauma e Fatores de Estresse/epidemiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia
7.
PLoS One ; 16(6): e0252747, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34157025

RESUMO

BACKGROUND: Health inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as essential elements of promoting health equity, yet no prior review has systematically addressed trauma informed interventions. The purpose of this study was to appraise the types, setting, scope, and delivery of trauma informed interventions and associated outcomes. METHODS: We performed database searches- PubMed, Embase, CINAHL, SCOPUS and PsycINFO-to identify quantitative studies published in English before June 2019. Thirty-two unique studies with one companion article met the eligibility criteria. RESULTS: More than half of the 32 studies were randomized controlled trials (n = 19). Thirteen studies were conducted in the United States. Child abuse, domestic violence, or sexual assault were the most common types of trauma addressed (n = 16). While the interventions were largely focused on reducing symptoms of post-traumatic stress disorder (PTSD) (n = 23), depression (n = 16), or anxiety (n = 10), trauma informed interventions were mostly delivered in an outpatient setting (n = 20) by medical professionals (n = 21). Two most frequently used interventions were eye movement desensitization and reprocessing (n = 6) and cognitive behavioral therapy (n = 5). Intervention fidelity was addressed in 16 studies. Trauma informed interventions significantly reduced PTSD symptoms in 11 of 23 studies. Fifteen studies found improvements in three main psychological outcomes including PTSD symptoms (11 of 23), depression (9 of 16), and anxiety (5 of 10). Cognitive behavioral therapy consistently improved a wide range of outcomes including depression, anxiety, emotional dysregulation, interpersonal problems, and risky behaviors (n = 5). CONCLUSIONS: There is inconsistent evidence to support trauma informed interventions as an effective approach for psychological outcomes. Future trauma informed intervention should be expanded in scope to address a wide range of trauma types such as racism and discrimination. Additionally, a wider range of trauma outcomes should be studied.


Assuntos
Transtornos Relacionados a Trauma e Fatores de Estresse/epidemiologia , Equidade em Saúde/estatística & dados numéricos , Humanos , Psicoterapia/métodos , Psicoterapia/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos Relacionados a Trauma e Fatores de Estresse/terapia
8.
PLoS Med ; 18(6): e1003664, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34111122

RESUMO

BACKGROUND: Anxiety, obsessive-compulsive, and stress-related disorders frequently co-occur, and patients often present symptoms of several domains. Treatment involves the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), but data on comparative efficacy and acceptability are lacking. We aimed to compare the efficacy of SSRIs, SNRIs, and placebo in multiple symptom domains in patients with these diagnoses over the lifespan through a 3-level network meta-analysis. METHODS AND FINDINGS: We searched for published and unpublished randomized controlled trials that aimed to assess the efficacy of SSRIs or SNRIs in participants (adults and children) with diagnosis of any anxiety, obsessive-compulsive, or stress-related disorder in MEDLINE, PsycINFO, Embase, and Cochrane Library from inception to 23 April 2015, with an update on 11 November 2020. We supplemented electronic database searches with manual searches for published and unpublished randomized controlled trials registered in publicly accessible clinical trial registries and pharmaceutical companies' databases. No restriction was made regarding comorbidities with any other mental disorder, participants' age and sex, blinding of participants and researchers, date of publication, or study language. The primary outcome was the aggregate measure of internalizing symptoms of these disorders. Secondary outcomes included specific symptom domains and treatment discontinuation rate. We estimated standardized mean differences (SMDs) with 3-level network meta-analysis with random slopes by study for medication and assessment instrument. Risk of bias appraisal was performed using the Cochrane Collaboration's risk of bias tool. This study was registered in PROSPERO (CRD42017069090). We analyzed 469 outcome measures from 135 studies (n = 30,245). All medications were more effective than placebo for the aggregate measure of internalizing symptoms (SMD -0.56, 95% CI -0.62 to -0.51, p < 0.001), for all symptom domains, and in patients from all diagnostic categories. We also found significant results when restricting to the most used assessment instrument for each diagnosis; nevertheless, this restriction led to exclusion of 72.71% of outcome measures. Pairwise comparisons revealed only small differences between medications in efficacy and acceptability. Limitations include the moderate heterogeneity found in most outcomes and the moderate risk of bias identified in most of the trials. CONCLUSIONS: In this study, we observed that all SSRIs and SNRIs were effective for multiple symptom domains, and in patients from all included diagnostic categories. We found minimal differences between medications concerning efficacy and acceptability. This three-level network meta-analysis contributes to an ongoing discussion about the true benefit of antidepressants with robust evidence, considering the significantly larger quantity of data and higher statistical power when compared to previous studies. The 3-level approach allowed us to properly assess the efficacy of these medications on internalizing psychopathology, avoiding potential biases related to the exclusion of information due to distinct assessment instruments, and to explore the multilevel structure of transdiagnostic efficacy.


Assuntos
Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Inibidores da Recaptação de Serotonina e Norepinefrina/uso terapêutico , Transtornos Relacionados a Trauma e Fatores de Estresse/tratamento farmacológico , Adulto , Idoso , Ansiolíticos/efeitos adversos , Ansiedade/diagnóstico , Ansiedade/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metanálise em Rede , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversos , Inibidores da Recaptação de Serotonina e Norepinefrina/efeitos adversos , Transtornos Relacionados a Trauma e Fatores de Estresse/diagnóstico , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia , Resultado do Tratamento
9.
PLoS One ; 16(5): e0251984, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34010358

RESUMO

The COVID-19 pandemic has had a significant influence on the lives of people around the world and could be a risk factor for mental health diseases. This study aimed to explore the psychological impact of the COVID-19 pandemic by identifying patterns related to post-traumatic symptoms by considering personality and defensive styles. Specifically, it was hypothesized that neuroticism was negatively associated with impact of event, as opposed to extraversion, agreeableness, conscientiousness, and openness traits. The mediation role of mature, neurotic, and immature defenses in these relationships was also investigated. This study involved 557 Italian individuals (71.3% women, 28.7% men; Mage = 34.65, SD = 12.05), who completed an online survey including the Impact of Event Scale-Revised, Forty Item Defense Style Questionnaire (DSQ-40) and Ten Item Personality Inventory. Results showed a nonsignificant effect for extraversion and openness on impact of event. The negative influence of neuroticism was instead confirmed in a partial parallel mediation involving significant effects from immature and neurotic defenses in the indirect path. Finally, agreeableness and conscientiousness delineated two protective pathways regarding impact of event, determining two total parallel mediation models in which both these personality traits were negatively associated with immature defensive styles, and conscientiousness was also positively related to mature defenses. These findings provide an exploration post-traumatic symptom patterns during the COVID-19 pandemic, involving the big five personality traits and defense mechanisms. These results may be useful for developing interventions, treatments, and prevention activities.


Assuntos
COVID-19/psicologia , Transtornos Mentais/etiologia , Personalidade/fisiologia , Adulto , COVID-19/epidemiologia , Mecanismos de Defesa , Extroversão Psicológica , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Neuroticismo , Pandemias , Inventário de Personalidade , SARS-CoV-2/isolamento & purificação , Inquéritos e Questionários , Transtornos Relacionados a Trauma e Fatores de Estresse/etiologia
11.
Diabetes Metab Syndr ; 15(3): 667-671, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33813239

RESUMO

BACKGROUND AND AIMS: Ever since COVID-19 was declared a pandemic by WHO in late March 2020, more and more people began to share their opinions online about the anxiety, stress, and trauma they suffered because of the pandemic. However, very few studies were conducted to analyze the general public's perception of what causes stress, anxiety, and trauma during COVID-19. This study focuses particularly on understanding Indian citizens. METHODS: By using Machine learning techniques, particularly Natural language processing, this study focuses on understanding the attitude of Indian citizens while discussing the anxiety, stress, and trauma created because of COVID-19 and the major reasons that cause it. We used Tweets as data for this study. We have used 840,000 tweets for this study. RESULTS: Our sentiment analysis study revealed the interesting fact that, even while discussing about the stress, anxiety, and trauma caused by COVID-19, most of the tweets were in neutral sentiments. Death and Lockdown caused by the COVID-19 were the two most important aspects that cause stress, anxiety, and Trauma among Indian citizens. CONCLUSION: It is important for policymakers and health professionals to understand common citizen's perspectives of what causes them stress, anxiety, and trauma to formulate policies and treat the patients. Our study shows that Indian citizens use social media to share their opinions about COVID-19 and as a coping mechanism in unprecedented time.


Assuntos
COVID-19/epidemiologia , COVID-19/psicologia , Percepção , Ansiedade/epidemiologia , Ansiedade/psicologia , Atitude Frente a Morte , Atitude Frente a Saúde , COVID-19/mortalidade , Controle de Doenças Transmissíveis , Análise de Dados , Humanos , Índia/epidemiologia , Aprendizado de Máquina , Saúde Mental/estatística & dados numéricos , Pandemias , Distanciamento Físico , Opinião Pública , Quarentena/psicologia , Quarentena/estatística & dados numéricos , SARS-CoV-2 , Mídias Sociais/estatística & dados numéricos , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Transtornos Relacionados a Trauma e Fatores de Estresse/epidemiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia
12.
J Korean Med Sci ; 36(15): e96, 2021 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-33876585

RESUMO

BACKGROUND: Suicide is one of the leading causes of death in the military as in the general population. To mitigate such a serious public health problem, identifying the risk or protective factors of suicide behaviors is crucial. METHODS: We analyzed the representative data of the 2014 Korean Armed Forces to explore the relationship between past year adverse events (PAE), accumulated lifetime trauma (ALT), mental illness vulnerability, perceived social support, and suicidal ideation in the previous year. RESULTS: Among the 6,377 subjects, 3.7% of males and 6.2% of females reported suicidal ideation in the previous year. Multivariate analytic models identified significant associations of PAE and ALT with suicidal ideation with a dose-response pattern. The mental illness vulnerability showed the most significant association with suicidal ideation even after controlling PAE or ALT. We found that perceived social support may be potentially linked with a reduced risk of suicidal ideation. CONCLUSION: This Korean military representative data demonstrates mental illness vulnerability; PAE; and lifetime trauma as significant risk factors of suicidal ideation, while perceived social support was found as a potential protective factor. Given the importance of the prevention of suicide in the military, those risk and protective factors may be used to screen soldiers at risk of suicide and provide further support on mental health services as needed.


Assuntos
Transtornos Mentais/patologia , Militares/estatística & dados numéricos , Apoio Social , Ideação Suicida , Adolescente , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Angústia Psicológica , República da Coreia , Fatores de Risco , Transtornos Relacionados a Trauma e Fatores de Estresse/patologia , Adulto Jovem , Prevenção ao Suicídio
13.
Drug Alcohol Depend ; 219: 108471, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33385691

RESUMO

BACKGROUND: Childhood trauma is associated with the development of adult mental health and substance use disorders, with females generally being more at risk. Alcohol is commonly used for coping with trauma, and alcohol use disorder (AUD) affects ∼14.4 million adult Americans annually. Research investigating sex differences in the environmental modification of anxiety and alcohol use following childhood trauma will extend our understanding of the etiology of AUD. Here, we sought to model the interacting effects of a single-episode late childhood trauma with post-trauma environment on adult alcohol use using male and female mice. METHODS: C57Bl6/J mice (d22) exposed to predator odor (TMT) or water were reared in standard environments (SE) or environmental enrichment (EE). Mice were assessed for adolescent anxiety and conditioned fear, and for adult alcohol use in a limited access, response non-contingent, alcohol exposure paradigm. RESULTS: A single exposure to predator odor was an effective stressor, inducing long-term sex-dependent changes in conditioned fear and alcohol behaviors that interacted with post-trauma environment. Adolescent EE females showed more conditioned freezing to the trauma-associated context. Adult EE mice consumed less total alcohol than SE mice. However, alcohol use across time differed for males and females. Exposure to a childhood stressor increased alcohol use significantly in females, but not males. EE males, but not EE females, drank less than SE counterparts. CONCLUSIONS: Findings from this model recapitulate greater vulnerability to childhood trauma in females and support sex differences in post-trauma development of conditioned fear and alcohol use that are modified by environment.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Animais , Criança , Condicionamento Clássico/fisiologia , Meio Ambiente , Etanol , Medo/psicologia , Feminino , Humanos , Masculino , Memória , Camundongos , Camundongos Endogâmicos C57BL , Caracteres Sexuais
14.
J Gerontol B Psychol Sci Soc Sci ; 76(2): 262-272, 2021 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-31155651

RESUMO

OBJECTIVES: Sleep is necessary for brain function as well as physical and cognitive processes. Sleep disruptions, common with aging, intensify among trauma survivors. Moreover, former prisoners-of-war (ex-POWs) often experience premature aging. This study investigates the longitudinal effects of sleep disruptions for ex-POWs in relation to cognitive performance and telomere length as well as between cognition and telomeres. METHOD: This study included Israeli veterans from the 1973 Yom Kippur War who participated in four assessments (1991, 2003, 2008, 2015): (a) ex-POWs (n = 99), and (b) veterans who not were captured (controls) (n = 101). Among both groups, sleep disruptions were assessed using a self-report item in all four assessments. Cognitive performance was assessed using the Montreal Cognitive Assessment (MOCA) and telomere length was assessed via total white blood cells (leukocytes) from whole blood samples using Southern blot, both were measured only among ex-POWs in 2015. We conducted descriptive statistics, repeated measures, correlations, and path analyses. RESULTS: Sleep disruptions were related to lower cognitive performance but not to shorter telomeres. Moreover, cognitive performance and telomere length were found to be related when sleep disruptions were taken into consideration. CONCLUSION: Interpersonal trauma was shown to be a unique experience resulting in sleep disruptions over time, leading to cognitive impairment. These findings highlight the importance of viewing trauma survivors at high-risk for sleep disruptions. Therefore, it is imperative to inquire about sleep and diagnose cognitive disorders to help identify and treat premature aging.


Assuntos
Senilidade Prematura , Cognição/fisiologia , Prisioneiros de Guerra/psicologia , Transtornos do Sono-Vigília , Transtornos Relacionados a Trauma e Fatores de Estresse , Idoso , Senilidade Prematura/diagnóstico , Senilidade Prematura/etiologia , Senilidade Prematura/metabolismo , Senilidade Prematura/psicologia , Biomarcadores/análise , Feminino , Humanos , Testes de Inteligência , Israel , Estudos Longitudinais , Masculino , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/metabolismo , Transtornos do Sono-Vigília/psicologia , Sobreviventes/psicologia , Encurtamento do Telômero , Transtornos Relacionados a Trauma e Fatores de Estresse/complicações , Transtornos Relacionados a Trauma e Fatores de Estresse/metabolismo , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia , Saúde dos Veteranos
15.
Am J Psychiatry ; 178(2): 165-173, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32972201

RESUMO

OBJECTIVE: Dissociative experiences commonly occur in response to trauma, and while their presence strongly affects treatment approaches in posttraumatic spectrum disorders, their etiology remains poorly understood and their phenomenology incompletely characterized. Methods to reliably assess the severity of dissociation symptoms, without relying solely on self-report, would have tremendous clinical utility. Brain-based measures have the potential to augment symptom reports, although it remains unclear whether brain-based measures of dissociation are sufficiently sensitive and robust to enable individual-level estimation of dissociation severity based on brain function. The authors sought to test the robustness and sensitivity of a brain-based measure of dissociation severity. METHODS: An intrinsic network connectivity analysis was applied to functional MRI scans obtained from 65 women with histories of childhood abuse and current posttraumatic stress disorder (PTSD). The authors tested for continuous measures of trauma-related dissociation using the Multidimensional Inventory of Dissociation. Connectivity estimates were derived with a novel machine learning technique using individually defined homologous functional regions for each participant. RESULTS: The models achieved moderate ability to estimate dissociation, after controlling for childhood trauma and PTSD severity. Connections that contributed the most to the estimation mainly involved the default mode and frontoparietal control networks. By contrast, all models performed at chance levels when using a conventional group-based network parcellation. CONCLUSIONS: Trauma-related dissociative symptoms, distinct from PTSD and childhood trauma, can be estimated on the basis of network connectivity. Furthermore, between-network brain connectivity may provide an unbiased estimate of symptom severity, paving the way for more objective, clinically useful biomarkers of dissociation and advancing our understanding of its neural mechanisms.


Assuntos
Encéfalo/patologia , Transtornos Dissociativos/patologia , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia , Adulto , Transtornos Dissociativos/etiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Rede Nervosa/patologia , Transtornos Relacionados a Trauma e Fatores de Estresse/patologia
16.
J Behav Health Serv Res ; 48(1): 50-62, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32851563

RESUMO

Child and adolescent exposure to potential trauma experiences is pervasive. Given the prevalence, deleterious mental and physical effects, and economic cost of trauma exposure, child- and family-service systems are adopting trauma-informed approaches, including practices like trauma screening. Although a number of trauma-focused screening and assessment measures exist for youth, the majority are lengthy and inappropriate for universal administration. This study describes the development and preliminary validation of the Traumatic Stress Screen for Children and Adolescents (TSSCA), a six-item screening measure for trauma exposure and traumatic stress symptoms. Using two samples of youth presenting at community practice settings (n1 = 134, n2 = 137), reliability, discriminative validity, and criterion-related validity were calculated for the TSSCA. Results support the TSSCA as an empirically derived, reliable, and valid screening measure for exposure to trauma and symptoms of traumatic stress for youth ages 7 to 18.


Assuntos
Programas de Rastreamento/métodos , Escalas de Graduação Psiquiátrica/normas , Transtornos de Estresse Traumático/diagnóstico , Inquéritos e Questionários/normas , Adolescente , Criança , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Transtornos Relacionados a Trauma e Fatores de Estresse
17.
Gerontology ; 67(1): 17-24, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33254165

RESUMO

INTRODUCTION: Falls among older people are a major health issue and the first cause of accidental death after 75 years of age. Post-fall syndrome (PFS) is commonly known and yet poorly studied. OBJECTIVE: Identify risk factors for PFS and do a follow-up 1 year later. METHODS: We included all patients over 70 years of age hospitalized after suffering a fall in a case-control study, and then followed them in a cohort study. PFS was retained in case of functional mobility decline (transferring, walking) occurring following a fall in the absence of an acute neurological, orthopedic or rheumatic pathology directly responsible for the decline. The data initially collected were: clinical (anamnestic, emergency and departmental/ward evolution, medical history, lifestyle, treatments, clinical examination items); and imaging if the patient had been subjected to brain imaging in the last 3 years prior to inclusion. Regarding the follow-up at 1 year, we collected from the general physician the occurrence and the characteristics of new falls, functional mobility assessment, hospitalization and death. RESULTS: Inclusion took place from March 29, 2016 to June 7, 2016 and follow-up until June 30, 2017. We included 70 patients. A total of 29 patients exhibited a PFS (41.4 %). Risk factors for PFS included age, walking disorder prior to the fall, the use of a walking aid prior to the fall, no unaccompanied outdoor walk in the week before the fall, visual impairment making close reading impossible, stiffness in ankle dorsiflexion, grip strength and the fear of falling. Among patients with PFS, 52.9% could still perform a transfer at 1 year and 64.7% could still walk against 80.7% and 85.2%, respectively, for patients without PFS. CONCLUSION: The study showed the existence of body functions/structure impairments and activity limitations prior to the fall among patients exhibiting a PFS. This suggests the existence of a pre-fall syndrome, i.e., a psychomotor disadaptation syndrome existing prior to the fall. Among the 8 risk factors, fear of falling, vision impairment and muscle strength could be targeted for improvement. The diagnosis of PFS could be a marker of loss of functional mobility at 1 year.


Assuntos
Acidentes por Quedas , Transtornos Neurológicos da Marcha , Força Muscular , Transtornos Psicomotores , Transtornos Relacionados a Trauma e Fatores de Estresse , Transtornos da Visão , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Feminino , Seguimentos , França/epidemiologia , Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/epidemiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Limitação da Mobilidade , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/epidemiologia , Transtornos Psicomotores/fisiopatologia , Desempenho Psicomotor/fisiologia , Medição de Risco/métodos , Fatores de Risco , Transtornos Relacionados a Trauma e Fatores de Estresse/epidemiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/fisiopatologia , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia , Transtornos da Visão/complicações , Transtornos da Visão/prevenção & controle
18.
Rev Colomb Psiquiatr (Engl Ed) ; 49(4): 262-270, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33328019

RESUMO

INTRODUCTION: Traumatic events and violence are widespread public health problems. They do not have limits related to age, sex or socioeconomic level. The prevalence of mental disorders and sociodemographic characteristics were compared in the context of traumatic events and types of violence in the general population. MATERIALS AND METHODS: Observational prevalence study with a secondary information source, in the general population aged 13 to 65 years, selected at random. The interview was conducted using the Compositum International Diagnosis Interview which generates psychiatric diagnoses according to the DSM-IV. The variables included were traumatic events grouped into five categories: related to armed conflict, sexual violence, interfamily violence, other types of violence, traumas and some mental disorders. The prevalence of mental disorders was compared in the five categories of traumatic events. Statistical significance was defined as a p value of <0.05. RESULTS: Sexual and interfamily violence were more prevalent in women (p <0.05). In those under age 13, major depression related to armed conflict had a prevalence of 48.3%, with a significant difference from the other trauma groups (p=0.015). All prevalences for childhood-onset disorders showed significantly different prevalences compared with the group for violence related to armed conflict (p <0.05) and suicidal ideation was higher in the sexual violence group (p=0.006). DISCUSSION: High prevalences of mental disorders were found in people who had been exposed to traumatic events and violence. In those who experienced traumatic events related to armed conflict and sexual violence, higher prevalences of certain mental disorders were detected.


Assuntos
Transtornos Mentais/etiologia , Violência/psicologia , Adolescente , Adulto , Idoso , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica , Fatores de Risco , Ideação Suicida , Transtornos Relacionados a Trauma e Fatores de Estresse/diagnóstico , Transtornos Relacionados a Trauma e Fatores de Estresse/epidemiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/etiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia , Exposição à Guerra/efeitos adversos , Adulto Jovem
19.
Public Health Res Pract ; 30(4)2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33294905

RESUMO

In this perspective paper, I describe the terror of being trapped in an isolated village on the New South Wales (NSW) South Coast as a catastrophic bushfire approached. In the aftermath of the 2019-20 'black summer', I reflect on factors that could have helped reduce the trauma and stress experienced by residents, both during and in the wake of the bushfire event. Education, community planning and preparedness for a situation where modern communication methods fail are key factors to consider.


Assuntos
Desastres , Estações do Ano , Incêndios Florestais , Comunicação , Planejamento em Desastres/métodos , Abrigo de Emergência/métodos , Humanos , New South Wales , Características de Residência , Transtornos Relacionados a Trauma e Fatores de Estresse/epidemiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/prevenção & controle
20.
J Perinat Neonatal Nurs ; 34(4): E23-E31, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33079811

RESUMO

Adverse childhood experiences and trauma significantly impact physical and mental health. Increased maternal perinatal depression/anxiety, preterm labor, and low birth weight, as well as infant morbidity and mortality, are some examples of the impact of trauma on perinatal health. Trauma-informed care begins with knowledge about trauma, the ability to recognize signs of a trauma response, responding to patients effectively, and resisting retraumatization. As holistic providers, perinatal nurses can create safe care environments, establish collaborative patient relationships based on trust, demonstrate compassion, offer patients options when possible to support patient autonomy, and provide resources for trauma survivors. This can prevent or reduce the negative impact of trauma and improve the health and well-being of infants, mothers, and future generations. This clinical article outlines key strategies for implementation of patient-centered trauma-informed perinatal nursing care.


Assuntos
Experiências Adversas da Infância/prevenção & controle , Enfermagem Holística/métodos , Enfermagem Materno-Infantil/métodos , Enfermagem Neonatal/métodos , Complicações na Gravidez , Transtornos Relacionados a Trauma e Fatores de Estresse , Depressão Pós-Parto/complicações , Depressão Pós-Parto/enfermagem , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Efeitos Adversos de Longa Duração/enfermagem , Efeitos Adversos de Longa Duração/prevenção & controle , Saúde Mental , Trabalho de Parto Prematuro/enfermagem , Trabalho de Parto Prematuro/psicologia , Assistência Centrada no Paciente , Gravidez , Complicações na Gravidez/enfermagem , Complicações na Gravidez/psicologia , Transtornos Relacionados a Trauma e Fatores de Estresse/etiologia , Transtornos Relacionados a Trauma e Fatores de Estresse/enfermagem , Transtornos Relacionados a Trauma e Fatores de Estresse/prevenção & controle
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