Adaptation and validation study of the Indonesian version of the Global Psychotrauma Screen in an undergraduate student population.

BACKGROUND: The high incidence of potentially traumatic events (PTEs) in Indonesia warrants early identification of those with probable trauma-related disorders in order to tailor prevention and intervention for trauma-related symptoms. OBJECTIVES: This study aims to adapt and validate a novel brief transdiagnostic screener, the Global Psychotrauma Screen (GPS), in Indonesian undergraduate students. METHODS: An online survey was administered among Indonesian undergraduate students (N = 322). Exploratory factor analysis, reliability analyses, clinical validity analyses, and correlational analyses were performed to evaluate the construct validity, reliability, clinical validity, and convergent-divergent validity of the Indonesian GPS. Hierarchical multiple regression was conducted to assess the relationship between risk factors and trauma-related symptoms. The relationship between four categories of trauma-related symptom severity and social/work functioning was measured using Analysis of Covariance. RESULTS: Exploratory factor analysis yielded a single-factor solution. The Indonesian GPS demonstrated good internal consistency, test-retest correlation, and absolute agreement, indicating good reliability. The Indonesian GPS also had an acceptable area under the curve, sensitivity, and specificity for a probable diagnosis of Post-Traumatic Stress Disorder (PTSD), Complex-PTSD (CPTSD), depression, and generalized anxiety disorder (GAD). We also established evidence for the convergent and divergent validity of GPS. The GPS risk factors (low psychological resilience, other stressful events, history of mental illness, and low social support) contributed to predicting trauma-related symptoms after controlling for gender, age, employment status, and faculty background. Additionally, in comparison to participants from the mild and low categories of GPS symptoms scores, participants from the severe and moderate category reported impaired lowered social/work functioning. CONCLUSION: The current findings indicate that the Indonesian GPS is a valid and reliable transdiagnostic trauma screener for Indonesian undergraduate students. This first comprehensive validation of the GPS in Indonesia calls for more research in Lower-middle Income Countries (LMICs) as a way towards prevention and early intervention for trauma-related symptoms.

Validation of the Indonesian resilience evaluation scale in an undergraduate student population.

BACKGROUND: Psychological resilience is an important factor in coping with Potentially Traumatic Events (PTEs) and might mitigate the development of trauma-related disorders. Due to the high risk of natural disasters, criminal activity, and transportation accidents among the Indonesian population, it is critical to assess psychological resilience as a protective factor. This study aimed to validate the Resilience Evaluation Scale (RES) in Indonesian undergraduate students. METHODS: We recruited 327 students (78% female, the mean age is 19.61 (SD = 1.24)) between March and June 2020 using convenience sampling, 256 (78.28%) of whom completed the RES twice with an interval of 2 weeks for test-retest reliability purposes. Parallel Analysis and Exploratory Factor Analysis were performed to examine the construct validity of the RES. The internal consistency and the test-retest reliability were assessed using Cronbach Alpha, Pearson Correlations, and Interclass Correlation Coefficients (ICC). Convergent and divergent validity were examined using Pearson Correlations. RESULTS: EFA analysis yielded a two-factor structure for the final eight-item Indonesian version of RES, which reflected two underlying constructs of resilience: self-confidence and self-efficacy. The Indonesian version of RES demonstrated good internal consistency (α = 0.74-0.82) and test-retest reliability (r = 0.68-0.78; ICC = 0.67-0.78). The result showed that the RES total and subscale scores positively correlated with all criterion variables (resilience, self-efficacy, self-esteem, level of global functioning, and adaptive coping strategy; r = 0.27-0.73). RES total and subscale scores negatively correlated with opposite constructs (PTSD, depression, social/work impairment, and maladaptive coping strategy; r = - 0.27- -0.46). CONCLUSIONS: The current study showed that the Indonesian RES is a valid and reliable measurement of psychological resilience in Indonesian undergraduate students. The final 8-item Indonesian RES, a freely available resilience instrument, is recommended for future studies and public mental health initiatives in the Indonesian population.

A Unidirectional Surface-Anchored N-Heterocyclic Carbene Rotor.

A molecular rotor based on N-heterocyclic carbenes (NHCs) has been rationally designed following theoretical predictions, experimentally realized, and characterized. Utilizing the structural tunability of NHCs, a computational screening protocol was first applied to identify NHCs with asymmetric rotational potentials on a surface as a prerequisite for unidirectional molecular rotors. Suitable candidates were then synthesized and studied using scanning tunneling microscopy/spectroscopy (STM/STS), analytical theoretical models, and molecular dynamics simulations. For our best NHC rotor featuring a mesityl N substituent on one side and a chiral naphthylethyl substituent on the other, unidirectional rotation is driven by inelastic tunneling of electrons from the NHC to the STM tip. While electrons preferentially tunnel through the mesityl N substituent, the chiral naphthylethyl substituent controls the directionality. Such NHC-based surface rotors open up new possibilities for the design and construction of functionalized molecular systems with high catalytic applicability and superior stability compared with other classes of molecular rotors.

Cooperation of N-Heterocyclic Carbenes on a Gold Surface.

Atomically precise tailoring of interface structures is crucial for developing functional materials. We demonstrate an N-heterocyclic carbene (NHC) based molecular tool, which modifies the structure of a gold surface with atomic accuracy by the formation of gold nanorods. After adsorption on the gold surface, individual surface atoms are pulled out by the NHCs, generating single-atom surface defects and mobile NHC-Au species. Atomistic calculations reveal that these molecular "ballbots" can act as assembling tools to dislocate individual surface atoms. The predicted functionality of these carbene-based complexes is confirmed by scanning tunneling microscopy measurements. Cooperative operation of these NHC-Au species induces a step-wise formation of gold nanorods. Consequently, the surface is re-structured by a zipper-type mechanism. Our work presents a foundation to utilize molecular-based nanotools to design surface structures.

An Electron-Rich Cyclic (Alkyl)(Amino)Carbene on Au(111), Ag(111), and Cu(111) Surfaces.

The structural properties and binding motif of a strongly σ-electron-donating N-heterocyclic carbene have been investigated on different transition-metal surfaces. The examined cyclic (alkyl)(amino)carbene (CAAC) was found to be mobile on surfaces, and molecular islands with short-range order could be found at high coverage. A combination of scanning tunneling microscopy (STM), X-ray photoelectron spectroscopy (XPS), and density functional theory (DFT) calculations highlights how CAACs bind to the surface, which is of tremendous importance to gain an understanding of heterogeneous catalysts bearing CAACs as ligands.

Modification of the Potential Landscape of Molecular Rotors on Au(111) by the Presence of an STM Tip.

Molecular rotors on solid surfaces are fundamental components of molecular machines. No matter whether the rotation is activated by heat, electric field or light, it is determined by the intrinsic rotational potential landscape. Therefore, tuning the potential landscape is of great importance for future applications of controlled molecular rotors. Here, using scanning tunneling microscopy (STM), we demonstrate that both tip-molecule distance and sample bias can modify the rotational potential of molecular rotors. We achieve the potential energy difference variations of ∼0.3 meV/pm and ∼18 meV/V between two configurations of a molecular rotor, a tetra- tert-butyl nickel phthalocyanine molecule on Au(111) substrate. Further analysis indicates that the mechanism of modifying the rotational potential is a combination of the van der Waals interaction and the interaction between the molecular dipole and an electric field. This work provides insight into the methods used to modify the effective rotational potential energy of molecular rotors.

Elucidating the Binding Modes of N-Heterocyclic Carbenes on a Gold Surface.

Tuning the binding mode of N-heterocyclic carbenes on metal surfaces is crucial for the development of new functional materials. To understand the impact of alkyl side groups on the formation of NHC species at the Au(111) surface, we combined scanning tunneling microscopy, X-ray photoelectron spectroscopy, and density functional theory calculations. We reveal two significantly different binding modes depending on the alkyl chain length. In the case of a short alkyl substituent, an up-standing configuration with one Au adatom is preferred, whereas the longer alkyl groups result exclusively in NHC-Au-NHC complexes lying flat on the surface. Our study highlights how well-defined structural modifications of NHCs allow for controlling the local binding motif on surfaces, which is important to design designated catalytic sites at interfaces.

Cardiac sarcoidosis: challenges in clinical practice.

PURPOSE OF REVIEW: To address the current recommendations for screening, diagnosis, and treatment of cardiac sarcoidosis and the difficulties to put these recommendations into clinical practice. RECENT FINDINGS: The incidence of cardiac sarcoidosis appears to be higher than earlier reported, probably because of improved imaging techniques. Late gadolinium enhancement with cardiac MRI (LGE-CMR) and fluorodeoxyglucose positron emission tomography obtained a central role in the diagnostic algorithm and monitoring of disease activity. New techniques are being investigated: T1 and T2 mapping for early detection in CMR, a sarcoid-specific tracer in PET, integrated positron emission tomography/MRI scanners, and assessment of scar with LGE in cardiac computed tomography. Isolated cardiac sarcoidosis is an increasingly recognized phenotype, but still an enormous challenge in clinical practice. The prognostic value of (and extent of) LGE-CMR should be taken into account for risk assessment and internal cardiac defbrillator therapy, even in patients with preserved left ventricular function. Unfortunately, randomized controlled trials to guide immunosuppressive therapy are still lacking. A multidisciplinary approach to diagnose and treat cardiac sarcoidosis patients in specialized centers is strongly recommendable. SUMMARY: Cardiac sarcoidosis is increasingly recognized because of improved imaging techniques; however, treatment of cardiac sarcoidosis is still mainly based on expert opinion.

Gender and Age Differences in Trauma and PTSD Among Dutch Treatment-Seeking Police Officers.

Little is known about how age and gender are associated with posttraumatic stress disorder (PTSD) symptoms and traumatic experiences in treatment-seeking police offers. In this study, we examined 967 diagnostic files of police officers seeking treatment for PTSD. Six hundred twelve (63%) of the referred police officers were diagnosed with PTSD (n = 560) or partial PTSD (n = 52). Police officers reported on average 19.5 different types of traumatic events (range 1-43). Those who experienced a greater variety of traumatic events suffered from more PTSD symptoms. Also, women reported more often direct life-threatening or private events as their index trauma than men and suffered from more PTSD symptoms than their male colleagues. Results indicate that police officers experience a considerable number of different traumatic events, which is significantly associated with PTSD symptoms. The results highlight the importance of early detection of PTSD symptoms in the police force.

Traumatic Stress, Depression, and Recovery: Child and Parent Responses After Emergency Medical Care for Unintentional Injury.

OBJECTIVE: To assess psychological symptoms in injured children (aged 8-17 years) and their parents after emergency department (ED) care to examine the relationship between posttraumatic stress and depression symptoms, co-occurrence of symptoms within families, and the relationship of these symptoms to parent-reported overall recovery. METHODS: Children and parents (n = 263 child-parent dyads) were enrolled during ED treatment for unintentional injury. Approximately 5 months later, children and parents (n = 178 dyads) completed standardized measures of posttraumatic stress and depression symptoms and parents reported on child overall recovery. RESULTS: Follow-up assessments found significant posttraumatic stress symptoms in 15% of children and 5% of parents, significant depression symptoms in 13% of children and 16% of parents, and problematic overall recovery in 17% of children. For both children and parents, posttraumatic stress and depression symptom severity were strongly associated. Child and parent symptoms were only modestly associated with each other, and there were few families in which both child and parent had significant posttraumatic stress or depression. Parent symptoms, but not child symptoms, were inversely associated with children's overall recovery. CONCLUSIONS: For about 1 in 6 children and parents, unintentional injury treated in the ED can be associated with negative psychological sequelae and suboptimal recovery. Within families, child and parent responses may differ; their relative association with overall recovery deserves additional research. To promote emotional recovery, ED clinicians should be aware of the potential psychological impact of unintentional injury, provide timely evidence-based anticipatory guidance, and communicate these concerns to primary care clinicians.

The relationship between behavioural problems in preschool children and parental distress after a paediatric burn event.

This study examines mother- and father-rated emotional and behaviour problems in and worries about 0- to 5-year-old children at 3 and 12 months after a burn event and the relation with parental distress. Mothers (n = 150) and fathers (n = 125) representing 155 children participated in this study. Child emotional and behaviour problems and parental worries about the child were assessed with the Child Behavior Checklist at both time points. Parents' level of acute subjective distress was assessed within the first month after the burn event with the Impact of Event Scale. Mothers and fathers held comparable views of their child's emotional and behaviour problems, which were generally within the normal limits. Parents' own acute stress reactions were significantly related to parent-rated child behaviour problems at 3 and 12 months postburn. A substantial part of mothers' and fathers' worries about the child concerned physical and emotional aspects of the burn trauma, and potential future social problems. Parents with high acute stress scores more often reported burn-related concerns about their child at 3 and 12 months postburn. Health-care professionals should be informed that parents' distress in the subacute phase of their child's burn event may be related to subsequent worries about their child and to (parent-observed) child emotional and behaviour problems. The authors recommend a family perspective, with particular attention for the interplay between parents' distress and parent-reported child behaviour problems and worries, in each phase of paediatric burn care.

Prognostic value of total tumor volume in patients with colorectal liver metastases: A secondary analysis of the randomized CAIRO5 trial with external cohort validation.

BACKGROUND: This study aimed to assess the prognostic value of total tumor volume (TTV) for early recurrence (within 6 months) and overall survival (OS) in patients with colorectal liver metastases (CRLM), treated with induction systemic therapy followed by complete local treatment. METHODS: Patients with initially unresectable CRLM from the multicenter randomized phase 3 CAIRO5 trial (NCT02162563) who received induction systemic therapy followed by local treatment were included. Baseline TTV and change in TTV as response to systemic therapy were calculated using the CT scan before and the first after systemic treatment, and were assessed for their added prognostic value. The findings were validated in an external cohort of patients treated at a tertiary center. RESULTS: In total, 215 CAIRO5 patients were included. Baseline TTV and absolute change in TTV were significantly associated with early recurrence (P = 0.005 and P = 0.040, respectively) and OS in multivariable analyses (P = 0.024 and P = 0.006, respectively), whereas RECIST1.1 was not prognostic for early recurrence (P = 0.88) and OS (P = 0.35). In the validation cohort (n = 85), baseline TTV and absolute change in TTV remained prognostic for early recurrence (P = 0.041 and P = 0.021, respectively) and OS in multivariable analyses (P < 0.0001 and P = 0.012, respectively), and showed added prognostic value over conventional clinicopathological variables (increase C-statistic, 0.06; 95 % CI, 0.02 to 0.14; P = 0.008). CONCLUSION: Total tumor volume is strongly prognostic for early recurrence and OS in patients who underwent complete local treatment of initially unresectable CRLM, both in the CAIRO5 trial and the validation cohort. In contrast, RECIST1.1 did not show prognostic value for neither early recurrence nor OS.

Acute stress reactions in couples after a burn event to their young child.

OBJECTIVE: This multicenter study examines acute stress reactions in couples following a burn event to their preschool child. METHODS: Participants were 182 mothers and 154 fathers, including 143 couples, of 193 children (0-4 years) with acute burns. Parents' self-reported acute stress reactions and emotions regarding the burn event were measured within the first month postburn. RESULTS: More mothers than fathers reported clinically significant acute stress reactions. Multilevel analysis revealed that individual parent reactions were associated with parent gender and negative emotions about the burn event. Interestingly, avoidance symptoms overlapped to an important extent within couples, whereas intrusion symptoms were mainly intra-individual. Burn characteristics, such as burn size, contributed to acute stress within couples. CONCLUSIONS: Mothers and fathers are seriously affected by their child's burn trauma and share a part of their acute stress reactions. These results emphasize the importance of a family-based approach to support adjustment after pediatric medical trauma.

Assessing psychological resilience: translation and validation of the Chinese version of the resilience evaluation scale (RES).

Background: The Resilience Evaluation Scale (RES) is a novel and freely available measure of psychological resilience (factored into self-confidence and self-efficacy). To date, psychometric properties were evaluated in Dutch and American samples, but not yet in a Chinese sample. Objective: We aimed to validate the RES in a Chinese sample by examining its factor structure, reliability, and construct validity. Methods: The RES was translated into Chinese following a cross-cultural translation and adaptation procedure. Self-report questionnaires including the RES, exposure to potentially traumatic events (PTE's), the PTSD checklist for DSM-5 (PCL-5), and scales for conceptually related constructs of psychological resilience were then administered via an online survey. Results: In total, 484 Chinese adults (females, 66.9%; age: 27.33 ± 6.86 years) participated. Parallel analysis results suggested a one-factor structure for the Chinese RES. The Chinese RES demonstrated good internal consistency (Cronbach's alpha = 0.88). Construct validity was demonstrated through significant associations with hypothesised related constructs and through a relation with lower levels of PTSD among the PTE-exposed subsample (n = 116) via the mediating role of avoidant coping strategies, i.e. behavioural disengagement and self-blame. Conclusion: Our results suggest that the RES is a reliable and valid assessment of psychological resilience to use in Chinese, in addition to its Dutch and English versions. The RES could potentially be adopted to measure psychological resilience in cross-cultural contexts.

Antecedentes: La Escala de Evaluación de la Resiliencia (RES en su sigla en inglés) es una medida nueva y disponible de forma gratuita de la resiliencia psicológica (conformada por los factores de autoconfianza y autoeficacia). A la fecha, las propiedades psicométricas fueron evaluadas en muestras danesas y americanas, pero no en una muestra china todavía.Objetivo: Buscamos validar la RES en una muestra china evaluando su estructura factorial, confiabilidad, y validez de constructo.Métodos: La RES fue traducida al chino siguiendo un procedimiento de traducción y adaptación intercultural. Se administraron en una encuesta en línea los cuestionarios de autoinforme incluyendo la RES, exposición a eventos potencialmente traumáticos (PTE's en su sigla en inglés), y la lista de chequeo del TEPT para el DSM-5 (PCL-5 en su sigla en inglés), y las escalas de constructos conceptualmente relacionados a la resiliencia psicológica.Resultados: En total, participaron 484 adultos chinos (mujeres, 66.9%; edad: 27.33 ± 6.86 años). Los resultados de los análisis paralelos sugirieron una estructura de un factor para la RES china. La RES china demostró una buena consistencia interna (alfa de Cronbach = 0.88). La validez de constructo fue demostrada a través de asociaciones significativas con los constructos hipotéticamente relacionades y a través de una relación con niveles más bajo de TEPT en la sub-muestra expuesta a PTEs (n = 116) por medio del rol mediador de los mecanismos de afrontamiento evitativos, es decir, desconexión conductual y autoculpa.Conclusión: Nuestros resultados sugieren que la RES es una evaluación fiable y valida de resiliencia psicológica para usar en chino, en adición a sus versiones danesa e inglesa. La RES podría potencialmente ser adaptada para medir la resiliencia psicológica en contextos interculturales.

Detecting Interval Distant Metastases With 18F-FDG PET/CT After Neoadjuvant Chemoradiotherapy for Locally Advanced Esophageal Cancer.

PURPOSE: Patients with esophageal cancer can develop distant metastases between the start of neoadjuvant chemoradiotherapy (nCRT) and planned surgery (ie, interval distant metastases). 18F-FDG PET/CT restaging after nCRT detects interval distant metastases in ~8% of patients. This study aimed to identify patients for whom 18F-FDG PET/CT restaging after nCRT could be omitted using an existing prediction model predicting for interval distant metastases or by using clinical stage groups. PATIENTS AND METHODS: Patients with locally advanced esophageal cancer who underwent baseline and restaging 18F-FDG PET/CT, nCRT, and were planned for esophagectomy between 2017 and 2021 were eligible for inclusion in this retrospective study. The primary outcome was the existing model's external performance (ie, discrimination and calibration) for predicting interval distant metastases. The existing model predictors included tumor length, cN status, squamous cell carcinoma histology, and baseline SUVmax. The secondary outcome determined the clinical stage groups (AJCC/UICC eighth edition) for adenocarcinoma and squamous cell carcinoma for which the incidence of interval distant metastases was <10%. RESULTS: In total, 127 patients were included, of whom 17 patients developed interval distant metastases (13%; 95% confidence interval [CI], 8%-21%) and 9 patients were deemed to have false-positive lesions on 18F-FDG PET/CT (7%; 95% CI, 2%-11%). Applying the existing model to this cohort yielded a discriminatory c-statistic of 0.56 (95% CI, 0.40-0.72). The calibration of the existing model was poor (ie, mostly underestimating the actual risk). The incidence of true-positive versus false-positive interval distant metastases for patients with clinical stage II disease was 5% versus 0%; clinical stage III, 14% versus 8%; and clinical stage IVa, 22% versus 9%. CONCLUSIONS: The existing prediction model cannot reliably identify patients at risk for developing interval distant metastases after nCRT for esophageal cancer. Omission of 18F-FDG PET/CT restaging after nCRT could be considered in patients with clinical stage II esophageal cancer.

Innate Immune Training of Human Macrophages by Cathelicidin Analogs.

Trained innate immunity can be induced in human macrophages by microbial ligands, but it is unknown if exposure to endogenous alarmins such as cathelicidins can have similar effects. Previously, we demonstrated sustained protection against infection by the chicken cathelicidin-2 analog DCATH-2. Thus, we assessed the capacity of cathelicidins to induce trained immunity. PMA-differentiated THP-1 (dTHP1) cells were trained with cathelicidin analogs for 24 hours and restimulated after a 3-day rest period. DCATH-2 training of dTHP-1 cells amplified their proinflammatory cytokine response when restimulated with TLR2/4 agonists. Trained cells displayed a biased cellular metabolism towards mTOR-dependent aerobic glycolysis and long-chain fatty acid accumulation and augmented microbicidal activity. DCATH-2-induced trained immunity was inhibited by histone acetylase inhibitors, suggesting epigenetic regulation, and depended on caveolae/lipid raft-mediated uptake, MAPK p38 and purinergic signaling. To our knowledge, this is the first report of trained immunity by host defense peptides.

Brief report: mothers' long-term posttraumatic stress symptoms following a burn event of their child.

OBJECTIVE: This prospective longitudinal study examines the course of posttraumatic stress symptoms (PTSS) in mothers of children with burns between 1 and 11 years after the burn event and the role of burn severity and feelings of guilt on this course. METHOD: Self-reported PTSS of 48 mothers were measured with the Impact of Event Scale. Guilt feelings were assessed during an in-depth interview 2 years after the burn event. Eleven years after the burn event, mothers marked their child's scars at the present time on a drawing. RESULTS: Over a period of 10 years, maternal PTSS decreased. Multiple regression analysis showed that the interaction between guilt and burn severity predicted the course of PTSS. CONCLUSIONS: Although PTSS substantially decreases through the years, a subset of mothers, in particular mothers who feel guilty about the burn event and whose children have more extensive permanent scarring seem at risk for longer term PTSS.

E-health applications in the field of traumatic stress.

E-health offers great potential in the field of traumatic stress to deliver training, assessment, prevention, and treatment of adverse outcomes after trauma worldwide. In order to encourage research on E-health applications in the field of traumatic stress, this current special issue of the European Journal of Psychotraumatology presents a series of papers divided into three emergent topics: I) development of digital interventions, II) the use of digital interventions to foster self-management and deliver therapy, and III) digital methods to improve prediction, assessment, and monitoring of post-trauma outcomes. These studies show acceptance of the tools by various end-user groups and improvements of current research and clinical practices, but also areas for improvement regarding the development process and making even better use of technological capabilities of E-Health. We propose three general themes to accelerate the quality of e-Health interventions and studies in this area in the coming years: optimizing user engagement and adherence, conducting more (innovative) research, and increasing implementation and dissemination activities. This issue appears in the midst of the COVID-19 pandemic. It is exactly at times like these that we need effective online interventions and we see an enormous increase in the use of e-Health. We hope this issue will contribute to help those affected and to serve the community worldwide.

La salud electrónica (E-salud) ofrece un gran potencial en el campo del estrés traumático para brindar capacitación, evaluación, prevención y tratamiento de resultados adversos luego de un trauma en todo el mundo. Con el fin de fomentar la investigación sobre aplicaciones de E-salud en el campo del estrés traumático, este número especial de la Revista Europea de Psicotraumatología presenta una serie de artículos divididos en tres temas emergentes: I) desarrollo de intervenciones digitales, II) el uso de intervenciones digitales para fomentar la autogestión y administrar terapia, y III) métodos digitales para mejorar la predicción, evaluación y monitoreo de resultados posteriores a un trauma. Estos estudios muestran aceptación de las herramientas por parte de varios grupos de usuarios finales y mejoras en la investigación actual y prácticas clínicas, pero también áreas para mejorar el proceso de desarrollo y hacer un mejor uso aún de las posibilidades tecnológicas de E-salud. Proponemos tres temas generales para acelerar la calidad de las intervenciones y estudios de E-salud en esta área en los próximos años: optimizar el compromiso y la adherencia del usuario, conducir más investigaciones (innovadoras) y aumentar las actividades de implementación y diseminación. Esta publicación aparece en medio de la pandemia de COVID-19. Es exactamente en tiempos como este que necesitamos intervenciones efectivas en línea y vemos un enorme aumento en el uso de E-salud. Esperamos que esta publicación contribuya a ayudar a los afectados y servir a la comunidad en todo el mundo.

Anorexia nervosa and the size-weight illusion: No evidence of impaired visual-haptic object integration.

Body image disorders in anorexia nervosa (AN) patients and recovered AN (RAN) patients have been suggested to stem from aberrant integration of sensory information. Previous research by Case et al. (2012) used the size-weight illusion (SWI) to study multisensory integration in AN. Their results showed a diminished SWI in AN patients, which they interpreted as evidence of decreased integration of visual and proprioceptive information. However, their method did not distinguish between visual and haptic size information, which was presented concurrently while making weight judgements. Therefore, the reported effect might be attributed to integrating visual, haptic size cues, or a combination of both processes with proprioceptive input. Here, we use the SWI to investigate the integration of visual and haptic object-related sensory information in a sample of AN patients (n = 30), RAN patients (n = 29) and healthy controls (HC) (n = 29). We aimed to distinguish the contribution of visual and haptic object size by including separate visual and haptic SWI conditions. In addition to explicit measures, we included grip force measurements to assess implicit expectations about object weight. We further analysed the correlation between the SWI and a visual body size estimation (VSE) task. In contrast to Case et al. (2012), we found no evidence of differential SWI experience between groups. All participants reported a stronger visual SWI compared to haptic SWI. Grip force rate (but not peak) showed evidence of motor adaptation for the larger object in the visual condition. Furthermore, there was no correlation between the VSE and SWI, indicating no relation between perceived object weight and body size estimation. These results do not support the hypothesised impairment of visual-haptic object related integration in AN.

Sexual function and pelvic floor activity in women: the role of traumatic events and PTSD symptoms.

BACKGROUND: Traumatic sexual experiences can negatively affect sexual functioning and increase pelvic floor activity in women, especially when post-traumatic stress disorder (PTSD) is developed. However, little is known about the effect of other types of interpersonal and non-interpersonal, traumatic experiences on sexual function and pelvic floor overactivity. OBJECTIVE: The aim of this study was to examine the effects of lifetime traumatic experiences and subsequent PTSD symptoms on sexual function and pelvic floor activity and to investigate whether the effects differ for interpersonal and non-interpersonal trauma. METHODS: Women (N=82) with obesity and a history of infertility, participating in a follow-up study of an RCT investigating a lifestyle intervention programme, completed questionnaires on lifetime exposure to traumatic events (LEC-5), PTSD symptoms (PC-PTSD-5), sexual function (MFSQ) and pelvic floor activity (AOPFS-SV). RESULTS: A large majority of women (85%) reported exposure to at least one traumatic event during their lifetime. Sexual function and pelvic floor activity did not differ between women who experienced non-interpersonal or interpersonal (including sexual) trauma and those who did not experience traumatic events during their lifetime. Women who had developed PTSD symptoms, however, did have higher pelvic floor activity, but sexual function was not affected. Women with a positive screen for PTSD had the highest pelvic floor activity score, and individual PTSD symptoms nightmares and hypervigilance were associated with significantly higher pelvic floor activity scores. CONCLUSION: Trauma exposure is associated with pelvic floor overactivity in women with a positive screen for PTSD, such that pelvic floor overactivity is more severe with greater PTSD severity. These findings suggest that the development of PTSD after interpersonal trauma is pivotal in this association. Sexual function was unrelated to trauma exposure and pelvic floor function, perhaps related to the fact that the interpersonal trauma events reported in this study were mainly non-sexual.

Antecedentes: Las experiencias sexuales traumáticas pueden comprometer negativamente el funcionamiento sexual e incrementar la actividad del piso pélvico en mujeres, especialmente cuando se desarrolla un trastorno de estrés postraumático (TEPT). Sin embargo, se sabe poco sobre los efectos de otros tipos de experiencias traumáticas, interpersonales y no interpersonales, en la función sexual y la hiperactividad del piso pélvico.Objetivo: El propósito de este estudio fue evaluar los efectos de las experiencias traumáticas a lo largo de la vida, con síntomas del TEPT subsecuentes, en la función sexual y la actividad del piso pélvico e investigar si los efectos difieren entre trauma interpersonal y no interpersonal.Métodos: Un grupo (N=82) de mujeres con obesidad y antecedente de infertilidad que estaba participando de un estudio clínico longitudinal aleatorizado (RCT) sobre un programa de intervención sobre estilos de vida, respondió un cuestionario sobre exposición a eventos traumáticos a lo largo de la vida (LEC-5, por sus siglas en inglés), síntomas del TEPT (PC-PTSD-5, por sus siglas en inglés), función sexual (MFSQ, por sus siglas en inglés) y actividad del piso pélvico (AOPFS-SV, por sus siglas en inglés).Resultados: Una gran mayoría de las mujeres (85%) reportó exposición a al menos un evento traumático a lo largo de la vida. No hubo diferencia de la función sexual y la actividad del piso pélvico entre las mujeres que experimentaron trauma no interpersonal, entre las mujeres que experimentaron trauma interpersonal (incluyendo el sexual), y entre aquellas que no experimentaron eventos traumáticos a lo largo de su vida. Sin embargo, en las mujeres que desarrollaron síntomas del TEPT se encontró mayor actividad del piso pélvico, pero sin comprometer la función sexual. Las mujeres con un puntaje significativo para el TEPT presentaban los puntajes más altos en actividad del piso pélvico, y síntomas puntuales del TEPT como pesadillas e hipervigilancia se asociaron a puntajes de actividad del piso pélvico más altas.Conclusión: La exposición a trauma se asocia con hiperactividad del piso pélvico en mujeres con puntajes significativos para el TEPT, y tal hiperactividad del piso pélvico es más severa a mayor severidad del TEPT. Estos hallazgos sugieren que el desarrollo del TEPT luego del trauma interpersonal es un aspecto clave en esta asociación. La función sexual no estaba relacionada con la exposición al trauma o a la función del piso pélvico, quizá relacionado al hecho que los eventos reportados como eventos traumáticos interpersonales eran principalmente no sexuales.