Neuroimaging evidence of disturbed self-appraisal in posttraumatic stress disorder: A systematic review.

BACKGROUND: The experience of self-hood in posttraumatic stress disorder (PTSD) is altered cognitively and somatically. Dysfunctional negative cognitions about the self are a central mechanism of PTSD symptomatology and treatment. However, while higher-order brain models of disturbances in self-appraisal (i.e., cognitive processes relating to evaluating the self) have been examined in other psychiatric disorders, it is unclear how normative brain function during self-appraisal is impaired in PTSD. METHODS: This paper presents a PRISMA systematic review of functional neuroimaging studies (n = 5), to establish a neurobiological account of how self-appraisal processes are disturbed in PTSD. The review was prospectively registered with PROSPERO (CRD42023450509). RESULTS: Self-appraisal in PTSD is linked to disrupted activity in core self-processing regions of the Default Mode Network (DMN); and regions involved in cognitive control and emotion regulation, salience and valuation. LIMITATIONS: Because self-appraisal in PTSD is relatively under-studied, only a small number of studies could be included for review. Cross-study heterogeneity in analytic approaches and trauma-exposure history prohibited a quantitative meta-analysis. CONCLUSIONS: This paper proposes a mechanistic account of how neural dysfunctions may manifest clinically in PTSD and inform targeted selection of appropriate treatment options. We present a research agenda for future work to advance the field.

Underlying mechanisms of change in the effects of cognitive behavior therapy on posttraumatic stress disorders among Chinese children: Results from a randomized controlled trial.

BACKGROUND: Evidence for the effectiveness of group-based trauma-focused cognitive behavior therapy (TF-CBT) has existed, but little is known about how group-based TF-CBT works in the treatment of children with PTSD. The purpose of the present study is to explore the mediators for the reduction of PTSD severity in group-based TF-CBT. METHOD: We analyzed data from a randomized controlled trial conducted in China. In this trial, 234 children with PTSD were randomly assigned to the TF-CBT group or the treatment as usual (TAU) group. The primary outcome (reduction in severity of PTSD symptoms) and possible mediators (trauma memory quality, emotion regulation strategies, and resilience) were assessed at baseline and posttreatment. The mediation analysis was performed to investigate the indirect effects of possible mediators on treatment outcomes. RESULTS: The mediation model revealed that changes in trauma memory quality, maladaptive emotion regulation strategies, and resilience mediated the relationship between the group (TF-CBT vs. TAU) and PTSD at post-treatment. Adaptive emotion regulation strategies were not a key mechanism underlying PTSD reduction in group-based TF-CBT. CONCLUSION: Group-based TF-CBT might affect PTSD by reducing risk factors, like trauma memory quality and maladaptive emotion strategies. Group-based TF-CBT also might affect PTSD by increasing protective factors, like resilience. Thus, monitoring these mediators throughout treatment might be an important factor in optimizing treatment outcomes.

Neural processing of audiovisual and painful analogue trauma and its relationship with subsequent audiovisual and pain intrusions.

Background: Posttraumatic stress disorder and medically unexplained pain frequently co-occur. While pain is common during traumatic events, the processing of pain during trauma and its relation to audiovisual and pain intrusions is poorly understood.Objective: Here we investigate neural activations during painful analogue trauma, focusing on areas that have been related to threat and pain processing, and how they predict intrusion formation. We also examine the moderating role of cumulative lifetime adversity.Methods: Sixty-five healthy women were assessed using functional magnetic resonance imaging. An analogue trauma was induced by an adaptation of the trauma-film paradigm extended by painful electrical stimulation in a 2 (film: aversive, neutral) x 2 (pain: pain, no-pain) design, followed by 7-day audiovisual and pain intrusion assessment using event-based ecological momentary assessment. Intrusions were fitted with Bayesian multilevel regression and a hurdle lognormal distribution.Results: Conjunction analysis confirmed a wide network including anterior insula (AI) and dorsal anterior cingulate cortex (dACC) being active both, during aversive films and pain. Pain resulted in activation in areas amongst posterior insula and deactivation in a network around ventromedial prefrontal cortex (VMPFC). Higher AI and dACC activity during aversive>neutral film predicted greater audiovisual intrusion probability over time and predicted greater audiovisual intrusion frequency particularly for participants with high lifetime adversity. Lower AI, dACC, hippocampus, and VMPFC activity during pain>no-pain predicted greater pain intrusion probability particularly for participants with high lifetime adversity. Weak regulatory VMPFC activation was associated with both increased audiovisual and pain intrusion frequency.Conclusions: Enhanced AI and dACC processing during aversive films, poor pain vs. no-pain discrimination in AI and dACC, as well as weak regulatory VMPFC processing may be driving factors for intrusion formation, particularly in combination with high lifetime adversity. Results shed light on a potential path for the etiology of PTSD and medically unexplained pain.

AI and dACC play a common role for both trauma- and pain-processing.In combination with high lifetime adversity, higher AI and dACC aversive film processing was associated with higher audiovisual intrusion frequency, whereas weaker AI and dACC pain discrimination enhanced the chance for pain intrusions.Weak regulatory VMPFC activity in aversive situations increased both audiovisual and pain intrusion formation.

A guided single session intervention to reduce intrusive memories of work-related trauma: a randomised controlled trial with healthcare workers in the COVID-19 pandemic.

BACKGROUND: Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic. METHODS: Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71). The number of intrusive memories was assessed at baseline and 5 weeks after the guided session (primary endpoint). RESULTS: The intervention significantly reduced intrusive memory frequency compared with control [intervention Mdn = 1.0 (IQR = 0-3), control Mdn = 5.0 (IQR = 1-17); p < 0.0001, IRR = 0.30; 95% CI = 0.17-0.53] and led to fewer post-traumatic stress-related symptoms at 1, 3 and 6 month follow-ups (secondary endpoints). Participants and statisticians were blinded to allocation. Adverse events data were acquired throughout the trial, demonstrating safety. There was high adherence and low attrition. CONCLUSIONS: This brief, single-symptom, repeatable digital intervention for subclinical-to-clinical samples after trauma allows scalability, taking a preventing-to-treating approach after trauma. TRIAL REGISTRATION: 2020-07-06, ClinicalTrials.gov identifier: NCT04460014.

The Relationship between REM Sleep Prior to Analogue Trauma and Intrusive Memories.

Intrusive memories are a common experience following trauma exposure but can develop into a symptom of posttraumatic stress disorder (PTSD). Recent research has observed a relationship between sleep disturbance and intrusive memory frequency following analogue trauma exposure and disruptions in REM sleep are found to contribute to emotional dysregulation and an amplified reaction to negative emotional stimuli. The current study examined the association between REM sleep prior to analogue trauma and intrusive memories. To manipulate REM sleep, 27 healthy adults (MAge= 25.4, SD = 2.89) were randomised to either to a circadian misalignment (CM) condition or normal control (NC) condition for four nights. In CM, participants slept normally for two nights followed by a 4-hour phase advance on night three and an additional 4-hour phase advance on night four. In NC, participants had 8-hour sleep opportunities each night. On day 5, participants watched a trauma film and kept an intrusive memory diary for the next three days. Greater REM sleep percentage (p = .004) and REM efficiency (p = .02) across 4 nights prior to analogue trauma, independent of group, was significantly associated with fewer intrusive memories in the 3 days after viewing the film. Findings suggest REM sleep may serve to protect individuals against experiencing intrusive memories. This is consistent with evidence suggesting REM sleep influences emotional memory regulation. Occupations (e.g., emergency services/military personnel) who experience circadian disruptions likely to decrease REM sleep (e.g., from shift work) may be at heightened risk of experiencing intrusive memories after trauma exposure, and thus at increased risk of developing PTSD.

Probiotic treatment improves post-traumatic stress disorder outcomes in mice.

Post-traumatic stress disorder (PTSD) is a mental disorder resulting from traumatic events which are characterized primarily by anxiety and depressive disorder. In this study, we determine the role of gut bacteria in PTSD. PTSD-like symptoms were produced by single prolonged stress (SPS). SPS animals showed increased levels of anxiety as measured by the elevated plus maze test, while depressive behaviour was confirmed using sucrose preference, force swim, and tail suspension tests. Gut dysbiosis was confirmed in PTSD animals by next-generation sequencing of 16 s RNA of faecal samples, while these animals also showed increased intestinal permeability and altered intestinal ultrastructure. Probiotic treatment increases beneficial microbiota, improves intestinal health and reduces PTSD-associated anxiety and depression. We also found a decrease in cortical BDNF levels in PTSD animals, which was reversed after probiotic administration. Here, we establish the link between gut dysbiosis and PTSD and show that probiotic treatment may improve the outcome of PTSD like symptoms in mice.

Transdiagnostic depression severity and its relationship to global and prefrontal-amygdala structural properties in people with major depression and post-traumatic stress disorder.

While some studies have used a transdiagnostic approach to relate depression to metabolic or functional brain alterations, the structural substrate of depression across clinical diagnostic categories is underexplored. In a cross-sectional study of 52 patients with major depressive disorder and 51 with post-traumatic stress disorder, drug-naïve, and spanning mild to severe depression severity, we examined transdiagnostic depressive correlates with regional gray matter volume and the topological properties of gray matter-based networks. Locally, transdiagnostic depression severity correlated positively with gray matter volume in the right middle frontal gyrus and negatively with nodal topological properties of gray matter-based networks in the right amygdala. Globally, transdiagnostic depression severity correlated positively with normalized characteristic path length, a measure implying brain integration ability. Compared with 62 healthy control participants, both major depressive disorder and post-traumatic stress disorder patients showed altered nodal properties in regions of the fronto-limbic-striatal circuit, and global topological organization in major depressive disorder in particular was characterized by decreased integration and segregation. These findings provide evidence for a gray matter-based structural substrate underpinning depression, with the prefrontal-amygdala circuit a potential predictive marker for depressive symptoms across clinical diagnostic categories.

Posttraumatic stress disorder (PTSD) prevalence: an umbrella review.

Posttraumatic stress disorder (PTSD) is one of the most serious and incapacitating mental diseases that can result from trauma exposure. The exact prevalence of this disorder is not known as the literature provides very different results, ranging from 2.5% to 74%. The aim of this umbrella review is to provide an estimation of PTSD prevalence and to clarify whether the prevalence depends on the assessment methods applied (structured interview v. self-report questionnaire) and on the nature of the traumatic event (interpersonal v. not-interpersonal). A systematic search of major databases and additional sources (Google Scholar, EBSCO, Web of Science, PubMed, Galileo Discovery) was conducted. Fifty-nine reviews met the criteria of this umbrella review. Overall PTSD prevalence was 23.95% (95% confidence interval 95% CI 20.74-27.15), with no publication bias or significant small-study effects, but a high level of heterogeneity between meta-analyses. Sensitivities analyses revealed that these results do not change after removing meta-analysis also including data from underage participants (23.03%, 95% CI 18.58-27.48), nor after excluding meta-analysis of low quality (24.26%, 95% CI 20.46-28.06). Regarding the impact of diagnostic instruments on PTSD prevalence, the results revealed a lack of significant differences in PTSD prevalence when structured v. self-report instruments were applied (p = 0.0835). Finally, PTSD prevalence did not differ following event of intentional (25.42%, 95% CI 19.76-31.09) or not intentional (22.48%, 95% CI 17.22-27.73) nature (p = 0.4598). The present umbrella review establishes a robust foundation for future research and provides valuable insights on PTSD prevalence.

Posttraumatic growth modulates the response to negative emotions related to COVID-19: An event-related potentials study.

There is increasing interest in identifying how posttraumatic growth (PTG) impacts emotional processing following traumatic events (e.g., the COVID-19 pandemic). Previous research suggests that high PTG levels may lead to enduring changes in positive emotional processing. Despite this fact, little is known regarding brain activation and responses to stressful emotional stimuli. The present study utilised event-related potentials (ERPs) to investigate whether individual differences in emotional responses toward neutral and negative emotional stimuli related to COVID-19 are related to self-reported PTG levels. A total of 77 participants were analysed: 21 in the high PTG group and 56 in the control group. The amplitude of the N2 was smaller in the high PTG group compared to the control group under both negative and neutral conditions. When viewing the negative emotion pictures (vs. neutral pictures), the N2 amplitude significantly decreased for the high PTG group in the right occipital and frontal-parietal areas, whereas no significant change was observed among the control group. In the time window Late Positive Potential (LPP) 600-1000 ms, emotional stimuli and the group interaction were significant. Viewing negative pictures (vs. neutral pictures) decreased the LPP 600-1000 ms amplitudes for the control group, mainly originating from the brain's frontal regions. However, there were no such significant differences for the PTG group. Due to the limited sample size and cultural differences, the applicability of these results to other regions or countries needs to be verified. The presented findings suggest that the impact of PTG during emotional response is reflected in both bottom-up (evidenced by the early ERP components) and top-down (evidenced by the later ERP components) processes. Individuals with high PTG may use a meditation-related emotional regulation strategy of acceptance at the basic stage and non-judgement at a later stage.

Two sides of the same coin? What neural processing of emotion and rewards can tell us about complex post-traumatic stress disorder and borderline personality disorder.

BACKGROUND: Borderline personality disorder (BPD) and complex posttraumatic stress disorder (cPTSD) share clinical similarities, complicating diagnosis and treatment. Research on the neurobiology of BPD and monotraumatic PTSD has shown that a prefrontal-limbic imbalance in emotional and reward processing is a hallmark of both disorders, but studies examining this network in cPTSD are lacking. Therefore, this study aimed to directly compare neural processing of emotion and reward during decision making in cPTSD and BPD. METHODS: Using functional magnetic resonance imaging, we measured neural activity in female patients (27 patients with cPTSD, 21 patients with BPD and 37 healthy controls) during a Desire-Reason Dilemma task featuring distracting fearful facial expressions. RESULTS: We found no differences in neural activation when comparing cPTSD and BPD. However, when grouping patients based on symptom severity instead on diagnosis, we found that increased symptoms of cPTSD were associated with increased activation of dorsolateral prefrontal cortex during reward rejection, whereas increased symptoms of BPD were associated with decreased activation in prefrontal and limbic regions during reward rejection with distracting negative emotional stimuli. CONCLUSION: This is the first study to investigate and compare emotional processing and reward-based decision making in cPTSD and BPD. Although we found no neural differences between disorders, we identified symptom-related neural patterns. Specifically, we found that elevated cPTSD symptoms were related to greater sensitivity to reward stimuli, whereas heightened BPD symptoms were related to increased susceptibility to emotional stimuli during goal-directed decision making. These findings enhance our understanding of neural pathomechanisms in trauma-related disorders.

Long-lasting effects of post-traumatic stress disorder in Yazidi women living in Northern Iraqi camps.

The severity of post-traumatic stress disorder and its long-lasting effects among the Yazidi population has not yet been investigated. Objectives: This study evaluated the impact of PTSD severity and chronicity on physiological and anthropometric parameters in women survivors of the genocide-related events after the so-called Islamic State of Iraq and Syria (ISIS) attack in 2014. Methods: The diagnosis PTSD was assessed using PTSD Checklist for DSM-5 (PCL-5). Participants were divided into: External control (healthy individuals living outside the camps), Internal control (healthy individuals living in the camps), and PTSD group (individuals diagnosed with PTSD). The PTSD group was subdivided according to chronicity <2 years, 2-5 years, and >5 years and subdivided according to PTSD severity into "Moderate", "Severe" and "Extreme". Systolic blood pressure (SBP), diastolic blood pressure (DBP), blood oxygen saturation (SPO2) and heart rate (HR) were evaluated. Weight, height and waist circumference were measured. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated. Results: The PTSD group showed significant increases in SBP, DBP, heart rate, BMI, WC, weight, and WHtR compared to the control groups. SPO2 values decreased in the PTSD group. As the disease progressed, there were further increases in SBP, DBP, heart rate, BMI, WC, WHtR, and weight. Similar increases were observed with the severity of the disease. Conclusion: Our data indicates that a long-term impact on physiological and anthropometric parameters is present in women diagnosed with PTSD which might be aggravated by the severity and chronicity of the disease.

Effect of Motor Interference Therapy on Distress Related to Traumatic Memories: A Randomized, Double-Blind, Controlled Feasibility Trial.

INTRODUCTION: Traumatic memories (TM) are a core feature of stress-related disorders, including posttraumatic stress disorder (PTSD). Treatment is often difficult, and specific pharmacological interventions are lacking. We present a novel non-pharmacological intervention called motor interference therapy (MIT) as a promising alternative for these symptoms. AIMS: To determine the feasibility of MIT, a brief, audio-delivered, and non-pharmacological intervention that uses cognitive and motor tasks to treat TM. METHODS: We designed a randomized, double-blind trial. Twenty-eight participants from an outpatient clinic with at least one TM were included to receive either MIT or progressive muscle relaxation (PMR). Spanish versions of the PTSD symptom severity scale (EGS), visual analog scale for TM (TM-VAS), and quality of life (EQ-VAS) were applied prior to intervention, 1 week, and 1 month following intervention. RESULTS: Mean scores on all measures improved from baseline to posttest for both groups. MIT participants showed significantly more positive scores at 1 week and 1 month (TM-VAS baseline: 9.8 ± 0.4; immediate: 6.0 ± 2.0; 1 week: 3.8 ± 3.1 [d = 1.57]; 1 month 2.9 ± 2.8 [d = 1.93]) than PMR participants on measures of distress due to TM, trauma re-experiencing, anxiety, and a composite measure of PTSD. CONCLUSION: MIT is a simple, effective, and easy-to-use tool for treating TM and other stress-related symptoms. It requires relatively few resources and could be adapted to many contexts. The results provide proof-of-principle support for conducting future research with larger cohorts and controls to improve clinical effectiveness and research on brief interventions. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03627078.

The relationship between menstrual cycle pattern and post-traumatic stress in women following the 2023 earthquake in Turkey.

AIM: In the aftermath of natural disasters, understanding the intricate links between mental health and physiological responses, such as menstrual cycle patterns, becomes crucial. This study explores the relationship between post-traumatic stress and menstrual irregularities among women of reproductive age residing in regions affected by the 2023 earthquake in Turkey. METHODS: 309 women of reproductive age living in 11 provinces affected by the earthquake centered in Kahramanmaras on February 6, 2023 and declared as disaster areas constituted the study sample. Data were collected online using Google forms nine months after the earthquake. The collected data were obtained using the Participant Information Form, Impact of Events Scale and Post-traumatic Stress Disorder-Short Form. In the data analysis, descriptive statistics such as count, percentage, median, minimum, and maximum were used, along with statistical tests including the Mann-Whitney U test, chi-squared test, multiple logistic regression analysis, and ROC analysis. RESULTS: In the study, an increase in menstrual irregularities among women was observed following the earthquake (%14.3 to %44.8, p < .001). Risk factors for menstrual irregularities included post-traumatic stress symptoms, comorbid chronic diseases, and smoking. The prevalence of PTSD was found to be 22.7% and this was associated with women with menstrual irregularities. Setting the cut-off score of the IES-R scale at 45.50 resulted in higher sensitivity for detecting irregular menstrual cycles. CONCLUSIONS: Women's menstrual cycles are affected after an earthquake. Therefore, post-earthquake mental health recovery programs should specifically address the protection of women's physical and mental health. This comprehensive approach can reduce the effects of earthquake-induced stress and trauma.

Lower Perceived Social Support During Hospitalization by Close Family Members may have Significant Associations with Psychological Distress 1 Month After Cardiac Arrest.

BACKGROUND: The perception of having poor social support is associated with worse symptoms of psychological distress in close family members of critically ill patients, yet this has never been tested after cardiac arrest. METHODS: Close family members of consecutive patients with cardiac arrest hospitalized at an academic tertiary care center participated in a prospective study. The validated Multidimensional Scale of Perceived Social Support (MSPSS) cued to index hospitalization was administered before discharge. Multivariate linear regressions estimated the associations between the total MSPSS score and total scores on the Patient Health Questionnaire-8 (PHQ-8), Generalized Anxiety Disorder 2-item (GAD-2), and the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), assessed 1 month after cardiac arrest. RESULTS: In 102 participants (mean age 52 ± 15 years, 70% female, 21% Black, 33% Hispanic) with complete data, the prevalence of depression, generalized anxiety, and probable posttraumatic stress disorder at a median duration of 28.5 days (interquartile range 10-63 days) from cardiac arrest was 61%, 34%, and 13%, respectively. A lower MSPSS score was significantly associated with higher PHQ-8 scores (ß = - 0.11 [95% confidence interval - 0.04 to - 0.18]; p < 0.01), even after adjusting for family members' age, sex, prior psychiatric condition, and witnessing of cardiopulmonary resuscitation and patient's discharge disposition (ß = - 0.11 [95% confidence interval - 0.02 to - 0.15]; p < 0.01). Similarly, significant inverse associations of total MSPSS scores were seen with 1-month GAD-2 and PCL-5 scores. CONCLUSIONS: Poor social support during hospitalization, as perceived by close family members of cardiac arrest survivors, is associated with worse depressive symptoms at 1 month. Temporal changes in social networks and psychological distress warrant further investigation.

Moving beyond vulnerability and focusing on resilience: An intersectional posttraumatic growth model for LGBTQ+ people of color.

In the context of the legacy of deficit-focused research and application of theoretical models in research on minoritized groups that are underrepresented in the literature, we explored the strengths-based literature among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people of color to develop a more inclusive and relevant understanding of how posttraumatic growth (PTG) occurs in this population. Our intersectional PTG model is tailored to the experiences of LGBTQ+ people of color that builds upon previous models of PTG, intersectionality theory, and empirical findings of trauma and PTG among LGBTQ+ people of color. Our intersectional PTG model incorporates the unique intrapersonal, interpersonal, institutional, and cultural factors that are unique to this population and contribute to PTG. We challenge the limited scope of Criterion A traumatic events and emphasize empirical findings that support that LGBTQ+ people of color often experience posttraumatic stress after oppression and discrimination. Our model also recognizes the impact of intersecting risk factors, such as gendered racism, that may occur on various levels. Our model acknowledges that LGBTQ+ people of color have often demonstrated PTG in the face of adversity. Intrapersonal factors such as cognitive flexibility, interpersonal factors such as social support, and institutional and cultural factors such as identity-related activism are identified as key contributors to resilience. We discuss practice implications, highlighting that clinicians should recognize limitations of traditional trauma frameworks and adopt culturally sensitive approaches when working with LGBTQ+ people of color. Overall, our model provides a foundation for strengths-based interventions and research, emphasizing resiliency and potential for PTG in this population.

Post-traumatic osteoarthritic-mediated changes in condylar shape do not covary with changes in the internal microstructure of the bone.

Post-traumatic osteoarthritis (PTOA) in the temporomandibular joint (TMJ) is associated with remodeling of the subchondral bone. This remodeling changes both the external appearance of the condylar bone and the internal bony microstructure. The external geometry can be quantified using shape, a multivariate mathematical measurement that contains all of the structure's geometric information with location, scale, and rotation effects removed. There is an important gap in knowledge related to how TMJ PTOA affects the shape of the mandible and if the external shape covaries with the internal bony microstructure. To evaluate these gaps, TMJ PTOA was induced in male and female skeletally mature mice using a surgical destabilization procedure. After four weeks, tissues were collected and characterized using a high-resolution µCT scanner. Shape was calculated from surface reconstructions of the mandibular condyle, and the internal bony microstructure was characterized by the region of interest including the subchondral trabeculae. The covariance of shape with and without corrections for allometric scaling and internal bony microstructure was calculated using a Procrustes ANOVA. The data illustrate that PTOA significantly alters the shape of the condyle in a sex-independent manner. PTOA does alter some aspects of the internal bony microstructure in a sex-dependent manner. Allometric scaling was a significant factor in the variance of shape. Shape including the effects of allometric scaling significantly covaries with some internal bony microstructure variables in both sexes. Shape scaled to remove the effects of allometric scaling does not covary with internal bony microstructure in either sex. These findings indicate that PTOA progression is associated with changes in the size and shape of the condyle but variance in trabecular bone remodeling is only associated with size related shape change. Thus, the allostatic response of subchondral bone is multimodal, coordinating two independent biological processes controlling size and shape. Since subchondral bone participates in and guides the progression of PTOA, these findings have implications for identifying select and specific mechanisms contributing to the progression and pathophysiology of the PTOA in the TMJ.

Psychological aspects in young people with venous thromboembolic disease, preliminary report.

BACKGROUND: The decline in the mental well-being of young adults following an episode of venous thromboembolism may be related to the uncertainty of long-term health and fear of recurrence. In recent years, post-pulmonary embolism syndrome has gained acceptance, however, less attention has been given to the psychological impact on young patients after venous thromboembolism. This study explores the prevalence, type, and severity of psychological disorders of patients following venous thromboembolism. METHODS: A retrospective observational cohort study was performed of over 18-year-old patients diagnosed with venous thromboembolism followed in the Vascular Medicine Service at Hospital Privado de Córdoba, Argentina from July 2020 to October 2021. Due to the COVID-19 pandemic, virtual interviews were conducted using two pre-established questionnaires administered by the same psychiatrist. The first questionnaire gathered personal data, clinical history, and mental health information, while the second, evaluated mood disorders using the Mini International Neuropsychiatric Interview. Patients with a positive MINI score underwent further assessment using the Hamilton Scale. Patients were considered young if ≤45 years. RESULTS: A total of 50 patients were assessed, 56 % were women, and 54 % were ≤45 years. Major depression was documented in 11 (22 %) patients, eight (72 %) in the younger group, and three (28 %) in the older group. Eight (16 %) patients had an anxiety disorder, four in the younger group, and ten (20 %) patients had post-traumatic stress disorder, seven (70 %) of the younger patients. Generalized anxiety disorder was identified in 20 (40 %) patients with similar proportions in both groups. CONCLUSION: Psychological and emotional symptoms are common following an episode of venous thromboembolism. Post-traumatic stress disorder and depression appear to be numerically more prevalent in the young.

Longitudinal correlates of learning burnout among Chinese adolescents during the COVID-19 pandemic: A cross-lagged panel network analysis.

BACKGROUND: Learning burnout as a serious psychological distress problem among adolescents during the COVID-19 pandemic was investigated using the cross-lagged panel network models. METHODS: A three-wave study using a sample of 11 to 18-year-olds in China was conducted, with baseline data collected in June 2020 (n = 4156) and follow-ups in December 2020 (n = 3209) and August 2021 (n = 2324). Two temporal cross-lagged panel network models were computed to analyze adolescent learning burnout over time. RESULTS: The predictive pathway of adolescent learning burnout demonstrates significant temporal specificity. In the early outbreak period, Positive thinking, Appreciation of life and Depression are the most influential predictive symptoms. In the normalized epidemic prevention period, Goal planning, Affect control and Positive thinking are the most influential predictive symptoms. However, during this period, the extent to which adolescent learning burnout is predicted by other symptoms in the networks is significantly reduced. LIMITATIONS: The samples used in this study are not expected to be nationally representative, and therefore the generalizability of the results may be limited. CONCLUSIONS: These findings highlight the predictive roles of Positive thinking, Appreciation of life, and Depression in adolescent learning burnout and the importance of timely intervention on these symptoms in the early outbreak period of public health emergency similar to the COVID-19 pandemic. Findings also illustrate the essentiality of eliminate unstable factors in the school environment during the normalized epidemic prevention period.

Pathway linking attachment styles to post-traumatic growth among recovered COVID-19 patients: testing the mediating role of coping styles.

Background: Research on post-disaster mental health shows that people have unique resources to undergo positive changes like posttraumatic growth (PTG) after facing adversities.Objective: This study aimed to investigate the relationship between attachment styles and PTG in COVID-19 survivors, with a focus on exploring the mediating role of coping strategies. Through examining these dynamics, the study seeks to contribute to deeper understanding of the psychological processes underlying growth in individuals recovering from the pandemic.Method: A total of 210 participants were enrolled from the hospitals in Tabriz, Iran, in January 2021, and completed self-report questionnaires. PTG, attachment styles, and coping strategies were assessed using Posttraumatic Growth Inventory (PTGI), Revised Adult Attachment Scale (RAAS), and Coping Inventory for Stressful Situations (CISS). Structural equation modelling (SEM) was used to assess the mediation models.Results: The direct effects of secure (ß = 0.22, p < .001), and ambivalent-anxious attachment (ß = -0.22, p < .001) on PTG were significant. Also, task-oriented coping significantly predicted PTG (ß = .60, p < .001). The direct path from secure (ß = 0.16, p < .05) and ambivalent-anxious attachment (ß = -0.38, p < .001) to task-oriented coping was significant, as was direct impact of secure (ß = -0.18, p < .01) and ambivalent-anxious attachment (ß = 0.37, p < .001) to emotion-oriented coping. The association between secure attachment and PTG is significantly mediated by task-oriented coping (ß = 0.1, (95% CI: 0.01-0.18)). Also, task-oriented coping was a significant negative mediator between ambivalent-anxious attachment and PTG (ß = -0.24, (95% CI: -0.33 - -0.15)).Conclusions: Results support the mediating role of coping strategies in the relationship between attachment styles and PTG. It emphasizes the importance of interventions for improving coping resources in individuals with life-threatening illnesses, focusing on improving problem-focused coping and reducing maladaptive strategies.

Individuals with secure attachment styles demonstrate significant positive posttraumatic growth following COVID-19 recovery.Problem focused coping plays a significant mediating role in the relationship between secure attachment style and posttraumatic growth in people who recovered from COVID-19.The findings suggest the importance of developing interventions to enhance coping resources for traumatized populations to facilitate posttraumatic growth.