Correlates of prolonged grief, posttraumatic stress and depression symptoms in Brazilian COVID-19 bereaved adults.

The Coronavirus pandemic has hit Brazil exceptionally hard, with more than 700.000 confirmed deaths due to COVID-19, corresponding to an estimated 6.3 million bereaved people. Yet, the mental health consequences among COVID-19 bereaved Brazilians, and the associated loss-related variables have been largely unexplored. Therefore, we aimed to clarify the associations of loss-related characteristics and circumstances with prolonged grief, posttraumatic stress, and depression symptoms experienced by COVID-19-bereaved Brazilian adults. A sample of 371 Brazilian COVID-19 bereaved adults (90% women) completed an online survey. The loss of a partner or first-degree relative, a positive assessment of the healthcare received by the deceased, and the perceived helpfulness of hospital visits in the grief process significantly correlated with prolonged grief and posttraumatic stress symptoms. The findings suggest that farewell ceremonies and positive hospital care experiences may mitigate distress among COVID-19-bereaved Brazilian adults.

Assessment of the relationship between stress and performance in candidates for the Brazilian Bar Association examination.

OBJECTIVE: This study investigated stress and performance levels in candidates for the Brazilian Bar Association examination (Exame da Ordem dos Advogados do Brasil) in Rio Grande do Sul, Southern Brazil. METHODS: The following instruments were used: A sociodemographic data sheet, Lipp's Stress Symptom Inventory for Adults, the Ways of Coping Scale, the Adult Self-Report Scale, and the Self-Report Questionnaire. The final sample comprised 117 candidates, aged from 18 to 59 years (mean = 29.7, standard deviation = 7.8), 76 women (65%) and 41 men (35%). RESULTS: In the first phase of the examination, 67 candidates were approved (57.3%), but there was no significant difference in terms of stress: stress symptoms were present in 76.1% of the successful candidates and 62% of the unsuccessful candidates; (χ2 (1) = 2.09; p = 0.148). In terms of stress phases, 70.6% of the successful candidates (n = 36) were in the resistance phase and 78.4% of these had psychological symptoms. The mean age of successful candidates (28.2 years) was lower than that of unsuccessful candidates (31.7 years); (t (115) = -2.48; p = 0.015). Attention deficit/hyperactivity disorder symptoms were detected in 18 successful candidates (26.9%) and 6 unsuccessful candidates (12.2%); (χ2 (1) = 2.85; p = 0.091). CONCLUSIONS: Candidates who were successful in the first phase of the Brazilian Bar Association examination tended to be younger and scored higher for attention deficit/hyperactivity disorder symptoms, but their stress levels did not differ from those of unsuccessful candidates.

Assessment of the relationship between stress and performance in candidates for the Brazilian Bar Association examination

Abstract Objective: This study investigated stress and performance levels in candidates for the Brazilian Bar Association examination (Exame da Ordem dos Advogados do Brasil) in Rio Grande do Sul, Southern Brazil. Methods: The following instruments were used: A sociodemographic data sheet, Lipp's Stress Symptom Inventory for Adults, the Ways of Coping Scale, the Adult Self-Report Scale, and the Self-Report Questionnaire. The final sample comprised 117 candidates, aged from 18 to 59 years (mean = 29.7, standard deviation = 7.8), 76 women (65%) and 41 men (35%). Results: In the first phase of the examination, 67 candidates were approved (57.3%), but there was no significant difference in terms of stress: stress symptoms were present in 76.1% of the successful candidates and 62% of the unsuccessful candidates; (χ2 (1) = 2.09; p = 0.148). In terms of stress phases, 70.6% of the successful candidates (n = 36) were in the resistance phase and 78.4% of these had psychological symptoms. The mean age of successful candidates (28.2 years) was lower than that of unsuccessful candidates (31.7 years); (t (115) = −2.48; p = 0.015). Attention deficit/hyperactivity disorder symptoms were detected in 18 successful candidates (26.9%) and 6 unsuccessful candidates (12.2%); (χ2 (1) = 2.85; p = 0.091). Conclusions: Candidates who were successful in the first phase of the Brazilian Bar Association examination tended to be younger and scored higher for attention deficit/hyperactivity disorder symptoms, but their stress levels did not differ from those of unsuccessful candidates.

Dysfunctional posttraumatic cognitions, posttraumatic stress and depression in children and adolescents exposed to trauma: a network analysis.

BACKGROUND: The latest version of the International Classification of Diseases (ICD-11) proposes a posttraumatic stress disorder (PTSD) diagnosis reduced to its core symptoms within the symptom clusters re-experiencing, avoidance and hyperarousal. Since children and adolescents often show a variety of internalizing and externalizing symptoms in the aftermath of traumatic events, the question arises whether such a conceptualization of the PTSD diagnosis is supported in children and adolescents. Furthermore, although dysfunctional posttraumatic cognitions (PTCs) appear to play an important role in the development and persistence of PTSD in children and adolescents, their function within diagnostic frameworks requires clarification. METHODS: We compiled a large international data set of 2,313 children and adolescents aged 6 to 18 years exposed to trauma and calculated a network model including dysfunctional PTCs, PTSD core symptoms and depression symptoms. Central items and relations between constructs were investigated. RESULTS: The PTSD re-experiencing symptoms strong or overwhelming emotions and strong physical sensations and the depression symptom difficulty concentrating emerged as most central. Items from the same construct were more strongly connected with each other than with items from the other constructs. Dysfunctional PTCs were not more strongly connected to core PTSD symptoms than to depression symptoms. CONCLUSIONS: Our findings provide support that a PTSD diagnosis reduced to its core symptoms could help to disentangle PTSD, depression and dysfunctional PTCs. Using longitudinal data and complementing between-subject with within-subject analyses might provide further insight into the relationship between dysfunctional PTCs, PTSD and depression.

Prevalence and factors associated with PTSD, anxiety and depression symptoms in Haitian migrants in southern Brazil.

BACKGROUND: Prevalence rates of mental health disorders in migrants are controversial. The socio-historical and economic background of the host country may play an important role in the mental health status of migrants. As studies are mostly conducted in developed countries, researching migration in developing countries may add important information to scientific literature. AIMS: This study aims to investigate the prevalence and factors associated with posttraumatic stress disorder (PTSD), anxiety and depression symptoms in Haitian migrants in southern Brazil. METHODS: The sample comprises 66 participants selected from four different sites in three cities of a Brazilian southern state. Participants fulfilled a sociodemographic questionnaire, as well as instruments investigate traumatic events; post-migration difficulties and symptoms of PTSD, anxiety and depression. Linear regression models were utilized to investigate factors associated with PTSD, anxiety and depression symptoms. RESULTS: PTSD prevalence in the sample was 9.1%. Depression and anxiety symptoms were in the clinical range of 10.6%-13.6% of participants, respectively. A number of traumatic events, acculturation difficulties, discrimination and low social support were associated with the investigated mental health disorders. CONCLUSION: The results point to the importance of public policies in promoting better social and mental health support for migrants. Providing information to the Brazilian population about migration may improve receptiveness in the host society.

Culture-sensitive psychotraumatology.

BACKGROUND: Although there is some evidence of the posttraumatic stress disorder (PTSD) construct's cross cultural validity, trauma-related disorders may vary across cultures, and the same may be true for treatments that address such conditions. Experienced therapists tailor psychotherapy to each patient's particular situation, to the nature of the patient's psychopathology, to the stage of therapy, and so on. In addition, culture-sensitive psychotherapists try to understand how culture enhances the meaning of their patient's life history, the cultural components of their illness and help-seeking behaviors, as well as their expectations with regard to treatment. We cannot take for granted that all treatment-seeking trauma survivors speak our language or share our cultural values. Therefore, we need to increase our cultural competencies. METHODS: The authors of this article are clinicians and/or researchers from across the globe, working with trauma survivors in various settings. Each author focused on one or more specific cultural aspects of working with trauma survivors and highlighted the following aspects. RESULTS: As a result of culture-specific individual and collective meanings linked to trauma and trauma-related disorders survivors may be exposed to (self-)stigma in the aftermath of trauma. Patients who are reluctant to talk about their traumatic experiences may instead be willing to write or use other ways of accessing the painful memories such as drawing. In other cultures, community and family cohesion are crucial elements of recovery. While awareness of culture-specific aspects is important, we also need to beware of premature cultural stereotyping. When disseminating empirically supported psychotherapies for PTSD across cultures, a number of additional challenges need to be taken into account: many low and middle income countries have very limited resources available and suffer from a poor health infrastructure. CONCLUSIONS: In summary, culture-sensitive psychotraumatology means assuming an empathic and non-judgmental attitude, trying to understand each individual's cultural background.

Dual-memory processes in crack cocaine dependents: The effects of childhood neglect on recall.

Exposure to adversities during sensitive periods of neurodevelopment is associated with the subsequent development of substance dependence and exerts harmful, long-lasting effects upon memory functioning. In this study, we investigated the relationship between childhood neglect (CN) and memory using a dual-process model that quantifies recollective and non-recollective retrieval processes in crack cocaine dependents. Eighty-four female crack cocaine-dependent inpatients who did (N = 32) or did not (N = 52) report a history of CN received multiple opportunities to study and recall a short list composed of familiar and concrete words and then received a delayed-recall test. Crack cocaine dependents with a history of CN showed worse performance on free-recall tests than did dependents without a history of CN; this finding was associated with declines in recollective retrieval (direct access) rather than non-recollective retrieval. In addition, we found no evidence of group differences in forgetting rates between immediate- and delayed-recall tests. The results support developmental models of traumatology and suggest that neglect of crack cocaine dependents in early life disrupts the adult memory processes that support the retrieval of detailed representations of events from the past.