Social provision partially mediates the complex associations among posttraumatic stress, obsessive-compulsive and depressive symptoms in traumatized patients.

AIM: To identify the associations among posttraumatic stress, depressive and obsessive-compulsive symptoms (OCS) in outpatients with psychological trauma and to examine the mediating effect of social provision. BACKGROUND: Psychologically traumatized patients simultaneously experience depressive and OCS. Social provision may mediate multiple symptoms differently compared with social support. DESIGN: Cross-sectional and correlational study. METHODS: Data were collected between August 2016-May 2017. Psychiatric outpatients (N = 151) completed a structured questionnaire consisting of the Korean versions of the Social Provision Scale, Beck Depression Inventory-II, Maudsley Obsessional-Compulsive Inventory and Impact of Event Scale-Revised. Structural equation modelling was used to examine the recursive association among the three symptoms and the mediation of social provision. RESULTS: There was a recursive association between posttraumatic stress symptoms (PTSS) and depressive symptoms, which were simultaneously associated with OCS with a one-way direction. OCS and social provision partially mediated these identified associations among three symptoms. CONCLUSIONS: Our findings provide insight into the complex associations of multiple symptoms experienced by traumatized outpatients and the partial mediation of social provision. Psychiatric and mental health professionals may enhance social functioning and interpersonal interactions based on social provision components used for helping traumatized patients with obsessive-compulsive and depressive symptoms. IMPACT: There was a recursive association between PTSS and depressive symptoms that were simultaneously associated with OCS with a one-way direction. Social provision functions as a partial mediator when working with OCS. Mental health nurses can develop social provision interventions for depressive symptoms for traumatized outpatients with OCS.

Resilience Mediates Impact of Some Childhood Maltreatment on Post-Traumatic Stress Symptoms in Conscripted Marines in the Republic of Korea.

Although it is known that post-traumatic stress symptoms (PTSS) can result from military service, the variance in PTSS unexplained by military service warrants further investigation, and no researchers have investigated South Korean Marines' vulnerability during their 2-year conscripted service as the first line of national defense against threats from North Korea. This study was designed to examine whether resilience mediated the relationship between childhood maltreatment and PTSS in 169 Korean conscripts into the Marine Corps. In a cross-sectional study design, the Childhood Trauma Questionnaire-Short Form was used to measure childhood maltreatment, including abuse and neglect. The Impact of Event Scale-Revised and the Connor-Davidson Resilience Scale were used to measure PTSS and resilience. Structural equation modeling was used for data analysis. Half the conscripts reported at least one type of childhood maltreatment, and 22.3% had high PTSS, even in a short period of service. Childhood abuse was significantly associated with PTSS during military service, a relationship that was not mediated by resilience. However, resilience mediated the relationship between childhood neglect and PTSS during military service. Assessment of childhood maltreatment and resilience prior to military service is crucial for identifying conscripts at increased risk for PTSS during even brief military service. In addition to direct interventions for abuse effects among all Marines, interventions enhancing resilience may benefit conscripts who experienced childhood neglect. © 2016 Wiley Periodicals, Inc.

Associations between childhood psychological trauma, posttraumatic stress symptoms, and mental health in female college students: Mediation of coping styles.

PURPOSE: To investigate the associations between childhood psychological trauma, posttraumatic stress symptoms (PTSS), and mental health in adulthood and to identify the mediation of active and passive coping on these associations in Korean female undergraduates. CONCLUSIONS: Childhood psychological trauma had a direct association with current mental health in adulthood (ß = 0.15, p < 0.001), which was mediated by PTSS (ß = 0.34, p < 0.001). Each coping style partially mediated the relationship between (a) childhood psychological trauma and mental health and (b) PTSS and mental health. PRACTICE IMPLICATIONS: It is necessary to develop nursing interventions to enhance coping strategies in female undergraduates to ensure better mental health and well-being.

Childhood trauma as a predictor of eating psychopathology and its mediating variables in patients with eating disorders.

AIM: The aims of this study were to determine whether specific forms of childhood trauma predict eating psychopathologies and to investigate the mediating effects of the psychological symptoms of depression and obsessive-compulsion between childhood trauma and eating psychopathologies in patients with eating disorders. BACKGROUND: The highest probability of poor treatment outcomes in patients with eating disorders has been observed in those who experienced childhood trauma. Therefore, researchers are now examining whether childhood trauma should be considered a risk factor for eating psychopathology, but childhood traumatic experiences as predictors of eating psychopathology and their mediating variables has not been investigated sufficiently with this clinical population. DESIGN: Survey. METHODS: The subjects were 73 Korean patients with eating disorders. The Childhood Trauma Questionnaire, Eating Disorder Inventory-2, Beck Depression Inventory and Maudsley Obsessional-Compulsive Inventory were used to assess self-reported childhood trauma in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect), eating psychopathology, depression and obsessive-compulsion. Stepwise multiple regression analyses were used to explore whether these childhood traumatic experiences predict eating psychopathology and mediation analyses were conducted according to Baron and Kenny's guidelines. RESULTS: Emotional abuse, physical neglect and sexual abuse were found to be significant predictors of eating psychopathology. We also found that depression fully mediated the association between some forms of childhood trauma and eating psychopathology, while obsessive-compulsion did not mediate this association. CONCLUSIONS: Future interventions for patients with eating disorders should focus on assessing the possibility of childhood trauma, especially in those patients with poor treatment outcomes. In addition, whether or not traumatised individuals exhibit depression is a more important predictor of eating psychopathology than the traumatic experience itself. RELEVANCE TO CLINICAL PRACTICE: Early intervention for childhood trauma and depression might contribute to preventing eating disorders in traumatised individuals.

[The study for development of day hospital program of eating disorders].

PURPOSE: The purpose of this study was to develop the day hospital program for Korean eating disorders patients and to examine the effect of the day hospital program on improving frequency of binging and purging, eating disorders symptoms, self-esteem, and depression. METHOD: The subjects were 24 binge eaters visited at eating disorders clinic "M". They participated in a modified day hospital program based on the Toronto Day Hospital Program. All subjects completed the Eating Disorders Inventory(EDI)-2, Rosenberg Self-Esteem Scale, Beck Depression Inventory(BDI) at pre and post intervention, and recorded daily food records. RESULT: In paired t-test analysis, frequency of binging and purging, self-esteem, depression, and 11 sub-scales of EDI-2(drive for thinness, bulimia, body dissatisfaction, ineffectiveness, interoceptive awareness, perfectionism, interpersonal distrust, maturity fear, asceticism, impulse regulation, social insecurity) were significantly improved after treatment. CONCLUSION: The results of this study suggest that the day hospital program for Korean eating disorders patients may be an effective initial approach to overcoming various eating disorders symptoms. Further studies should investigate longer term outcome data using a larger sample.

Day treatment programme for patients with eating disorders: randomized controlled trial.

AIM: This paper reports a randomized controlled trial to compare the effects of day treatment programmes for patients with eating disorders with those of traditional outpatient treatment. BACKGROUND: Eating disorders are common, especially in adolescents, and their worldwide prevalence is increasing. Treatment interventions for patients with eating disorders have traditionally been offered on an outpatient or inpatient basis, but the recent introduction of day hospital programmes offers the possibility of greater cost-effectiveness and relapse-prevention for this population. METHODS: Volunteers from an outpatient clinic for eating disorders were randomly assigned either to a treatment group (n = 21), participating in a modified day treatment programme based on the Toronto Day Hospital Program, or to a control group (n = 22) receiving a traditional outpatient programme of interpersonal psychotherapy, cognitive behaviour therapy and pharmacotherapy. Data were collected from January to December 2002 using the Eating Disorder Examination, Eating Disorder Inventory-2, Beck Depression Inventory, and Rosenberg Self-Esteem Scale. RESULTS: Participants in the day treatment programme showed significantly greater improvements on most psychological symptoms of the Eating Disorder Inventory-2, frequency of binging and purging, body mass index, depression and self-esteem scores than the control group. They also showed significant improvement in perfectionism, but the group difference was not significant. CONCLUSION: Nurses in day treatment programmes can play various and important roles establishing a therapeutic alliance between patient and carer in the initial period of treatment. In addition, the cognitive and behavioural work that is vital to a patient's recovery, that is, dealing with food issues, weight issues and self-esteem, is most effectively provided by a nurse therapist who maintains an empathic involvement with the patient.