Clinical Utility of Semistructured Interview and Scales to Assess Withdrawal Syndromes With Dose Reduction or Discontinuation of Selective Serotonin Reuptake Inhibitors or Serotonin Norepinephrine Reuptake Inhibitors.

BACKGROUND: Withdrawal syndromes can occur after dose reduction or discontinuation of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Few measurement instruments are available to assess them: Diagnostic Clinical Interview for Drug Withdrawal 1-New Symptoms of SSRI and SNRI (DID-W1) and Discontinuation Emergent Signs and Symptoms (DESS) checklist. We assessed their interrater reliability, verified the percent agreement between the two, and tested DESS sensitivity and specificity on the basis of the diagnoses formulated via the DID-W1. METHODS: One-hundred thirty-four subjects who referred for withdrawal at 3 outpatient facilities were enrolled and assessed via the DESS and the DID-W1. Percent agreement and Cohen κ were calculated to measure DID-W1 and DESS interrater reliability, as well as the agreement between DID-W1 and DESS items. Sensitivity and specificity of DESS were derived from the identification of true-positive, false-negative, true-negative, and false-positive on the DID-W1. RESULTS: Both tools showed excellent interrater reliability (DID-W1 Cohen κ = 0.958; DESS Cohen κ = 0.81-1). The degree of agreement between DID-W1 and DESS items was poor or fair (Cohen κ < 0.40) for some items and moderate (Cohen κ = 0.41-0.60) for others. Sensitivity and specificity of DESS were 0.937 (true-positive = 60, false-negative = 4) and 0.285 (true-negative = 20, false-positive = 50), respectively. CONCLUSIONS: DID-W1 was a reliable method to identify and diagnose withdrawal syndromes. The DESS checklist showed to be a useful tool for detecting withdrawal SSRI/SNRI symptoms when the aim is to achieve high sensitivity to identify true positives.

Social Functioning in Individuals Affected by Childhood Maltreatment: Establishing a Research Agenda to Inform Interventions.

Childhood maltreatment (CM) is linked to impairments in various domains of social functioning. Here, we argue that it is critical to identify factors that underlie impaired social functioning as well as processes that mediate the beneficial health effects of positive relationships in individuals exposed to CM. Key research recommendations are presented, focusing on: (1) identifying attachment-related alterations in specific inter- and intrapersonal processes (e.g., regulation of closeness and distance) that underlie problems in broader domains of social functioning (e.g., lack of perceived social support) in individuals affected by CM; (2) identifying internal (e.g., current emotional state) and external situational factors (e.g., cultural factors, presence of close others) that modulate alterations in specific social processes; and (3) identifying mechanisms that explain the positive health effects of intact social functioning. Methodological recommendations include: (1) assessing social processes through interactive and (close to) real-life assessments inside and outside the laboratory; (2) adopting an interdisciplinary, lifespan perspective to assess social processes, using multi-method assessments; (3) establishing global research collaborations to account for cultural influences on social processes and enable replications across laboratories and countries. The proposed line of research will contribute to globally develop and refine interventions that prevent CM and further positive relationships, which - likely through buffering the effects of chronic stress and corresponding allostatic load - foster resilience and improve mental and physical health, thereby reducing personal suffering and the societal and economic costs of CM and its consequences. Interventions targeting euthymia and psychological well-being are promising therapeutic concepts in this context.

Dosage, effectiveness, and safety of sertraline treatment for posttraumatic stress disorder in a Japanese clinical setting: a retrospective study.

BACKGROUND: Many of the posttraumatic stress disorder (PTSD) treatment guidelines recognize the use of selective serotonin reuptake inhibitors as first-line pharmacological treatment. In Japan, there were no published studies investigating the effectiveness and safety of sertraline for PTSD in a clinical setting. METHODS: We conducted a retrospective medical chart review of the dosage, effectiveness, and safety of sertraline for the PTSD treatment in Japan. Data were collected from medical charts of patients of PTSD, caused by various types of trauma, who were treated with sertraline between July 2006 and October 2012 during their regular clinical practice. To evaluate the effectiveness, the investigators retrospectively assessed the severity and improvement of the symptoms using the Clinical Global Impressions - Severity and the Clinical Global Impressions - Improvement. RESULTS: The study population was 122 Japanese patients aged ≥18 years with a diagnosis of PTSD who were treated with sertraline (median duration, 10.6 months). Doses ranged from 12.5 to 150 mg/day, mostly 25 and 50 mg/day. The median duration of observation was 10.8 months. Out of those, 50% of patients were regarded as responders by using the Clinical Global Impressions - Improvement at the end of sertraline treatment or the last observation. Two-thirds (65.6%) of patients improved in the severity of PTSD, as assessed by Clinical Global Impressions - Severity, whereas 32.8% showed no change, and 1.6% worsened. Subgroups analyses and logistic regression analyses suggested that the type of traumatic events was the factor with the highest influence on the response rate. The adverse events in this chart review were consistent with the known safety profile of sertraline. There were no reports of serious or severe adverse events considered to be related to sertraline. CONCLUSIONS: Our study suggested the effectiveness of sertraline for the treatment of PTSD in a Japanese clinical setting, and the obtained safety profile was consistent with the generally known safety profile of sertraline. TRIAL REGISTRATION: ClinicalTrials.gov (Identification No. NCT01607593 ). Registered May 21, 2012.

Diagnostic interview study of the prevalence of depression among public employees engaged in long-term relief work in Fukushima.

AIM: The Great East Japan Earthquake and in particular, the Fukushima Daiichi Nuclear Power Plant accident, have had a serious psychological impact on not only residents, but also relief workers in Fukushima. Although public employees work in highly stressful situations and play a very important role in long-term relief, their psychiatric features have yet to be clarified. The two aims of this study were to identify the current prevalence rate of depression and post-traumatic stress disorder among public employees working in the disaster area using diagnostic interviews, and to speculate on the psychosocial factors affecting their mental condition. METHODS: We conducted diagnostic interviews and self-administered questionnaires with 168 public employees working in two coastal towns in Fukushima. RESULTS: Results showed that the current prevalence of depression among public employees is as high as 17.9%, in contrast to the relatively low prevalence of post-traumatic stress disorder (4.8%). Based on the results of self-administered questionnaires and interview contents, frequent exposure to strong complaints or anger from residents and role conflicts were considered the cause of the high prevalence of depression. CONCLUSION: The present study reveals the serious mental status of public employees working in Fukushima and sheds light on the urgent need to establish an efficient care network to provide adequate psychiatric intervention.

Three-year trend survey of psychological distress, post-traumatic stress, and problem drinking among residents in the evacuation zone after the Fukushima Daiichi Nuclear Power Plant accident [The Fukushima Health Management Survey].

AIM: Prolonged periods of instability in terms of living environment can lead to a serious increase in mental health issues among disaster-affected individuals. The aim of this study was to assess long-term trends in mental health among adult residents in a nuclear-disaster-affected area. METHODS: Mail-based, self-administered questionnaire surveys were conducted three times (T1-T3), targeting all residents registered with the municipalities in the evacuation zone in Fukushima prefecture at the time of the disaster. Age-adjusted prevalences of the following were analyzed by sex: risk of psychological distress by the Kessler 6-item Scale, post-traumatic stress by the Post-traumatic Stress Disorder Checklist, and problem drinking by CAGE. RESULTS: The numbers of respondents and response rates were: 73 568, 40.7% (T1); 55 076, 29.9% (T2); and 46 386, 25.0% (T3). Compared with normal Japanese levels in non-disaster settings (4.7%), the prevalence of general psychological distress by Kessler 6-item Scale ≥ 13 was still high 3 years after the event in both men (11.4%) and women (15.8%). Although the age-adjusted prevalence of psychological distress and post-traumatic stress (Post-traumatic Stress Disorder Checklist ≥ 44) had decreased over time (from 19.0% [T1] to 17.8% [T3] for men, and from 25.3% [T1] to 23.3% [T3] for women), the age-adjusted prevalence of problem drinking (CAGE ≥ 2) remained steady in both men (20.7% [T2] and 20.4% [T3]; P = 0.18) and women (10.5% [T2] and 10.5% [T3]; P = 0.91). CONCLUSION: Our results suggest that long-term interventions focused on post-traumatic stress as well as other mental health problems are strongly needed for disaster-affected individuals.

An Exploratory Study of the Associations Between Sensory Processing Patterns and Emotional/Behavioral Problems in Children with Autism Spectrum Disorder.

AIM: In autism spectrum disorder (ASD), abnormal sensory processing patterns are observed in various sensory modalities, including visual, auditory, touch, olfactory, taste, vestibular, and proprioceptive senses. Few studies have examined the relationship between sensory processing patterns and emotions, or their effects on daily life. We investigated the relationship between sensory processing patterns and emotional/behavioral problems in children with ASD. PARTICIPANTS AND METHODS: A retrospective chart review was conducted. Forty-three children with ASD (33 boys, 10 girls, median age 9 years) in the outpatient clinic of a psychiatric hospital participated; their parent (s) were invited to complete the Sensory Profile 2 (SP2) and the Child Behavior Checklist (CBCL) questionnaires. The participants' teachers were invited to complete the Teacher's Report Form (TRF). RESULTS: In the correlation analyses, each of the four quadrants of the SP2 (low registration, sensory seeking, hypersensitivity, and sensory avoiding) had significant positive correlations with different types of emotional and behavioral problems measured by the CBCL. Focusing on emotion, 'anxious/depressed' was correlated with low registration (r = 0.41) and sensory avoiding (r = 0.60), while 'withdrawal/depressed' was correlated with sensory avoiding (r = 0.46). Only one significant correlation was revealed between the SP2 and the TRF. CONCLUSION: Our results suggest a link between sensory processing patterns and emotional/behavioral problems. In school settings, the relationship between sensory processing patterns and emotional/behavioral problems may be easily overlooked.

Perceived Acceptability of Child Maltreatment as a Moderator of the Association Between Experiences of Child Maltreatment and Post-Traumatic Symptoms: A Cross-Cultural Study.

Despite the well-documented link between child maltreatment (CM) and mental health, evidence suggests substantial variability in the post-traumatic sequelae of CM across cultures. The perceived acceptability of CM in one's community might moderate the association between CM and mental health, but little research has been conducted on it so far. This study examined how the perceived acceptability of CM may influence the relationship between CM experiences and post-traumatic symptoms in individuals from four different continents and if the pattern of associations is the same across countries. We recruited a sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122). We administered online questionnaires and performed multiple group moderation analyses for total CM, neglect, physical abuse, emotional maltreatment, sexual abuse, and exposure to domestic violence (DV). A significant positive main effect of CM on post-traumatic symptoms was found in the overall sample and in Cameroon; in Germany, only neglect and emotional maltreatment were positively associated to post-traumatic symptoms. Moderation effects were identified; the perceived acceptability of neglect in Cameroon and Germany and of exposure to DV in Cameroon had a dampening effect on the relationship between CM experiences and post-traumatic symptoms. Our findings confirm that CM experiences entail long-term post-traumatic sequelae that can vary across cultures and CM subtypes and further our understanding of this issue by showing that the perceived acceptability of CM may be an understudied moderator.

Visual Assessment of Therapeutic Relationships in Psychiatric Patients: A Pilot Study Using the Pictorial Representation of Illness and Self Measure.

BACKGROUND: Although the therapeutic relationship (or 'alliance') is well known to be a key component of psychiatric treatment, there has been no simple way to objectively measure the patient-therapist relationship. Here, we measured the psychological distance between patients and their therapists by using the Pictorial Representation of Illness and Self Measure (PRISM). PATIENTS AND METHODS: We analyzed the patient-therapist relationship of 112 patients from two hospitals in Japan (54 males, 57 females, 1 unknown; age 46.20 ± 15.03 years [mean ± SD]) who completed the PRISM and self report questionnaires (LSNS-6, K6, and BASIS-32) about their social network, psychological distress, and outcomes of mental health treatment. RESULTS: PRISM measurements were available for all patients who consented to participate. In the comparison by disease category, schizophrenia recorded the closest distance to the psychiatrist in charge, followed by bipolar disorder, depression, and neurotic disorder. Regarding the distance to the psychiatrist in charge, PRISM showed a weak negative correlation (r = -0.23, p < 0.05) with age, indicating that with increasing age, the therapeutic rela tionship was more important to the patients. CONCLUSION: Our findings indicate the possibility of implementing PRISM to assess the impact of the therapeutic relationship in patients with a wide range of psychiatric disorders, and they suggest that PRISM holds great potential for clinical application.

Childhood maltreatment is linked to larger preferred interpersonal distances towards friends and strangers across the globe.

Childhood maltreatment (CM) is thought to be associated with altered responses to social stimuli and interpersonal signals. However, limited evidence exists that CM is linked to larger comfortable interpersonal distance (CID) - the physical distance humans prefer towards others during social interactions. However, no previous study has investigated this association in a comprehensive sample, yielding sufficient statistical power. Moreover, preliminary findings are limited to the European region. Finally, it is unclear how CM affects CID towards different interaction partners, and whether CID is linked to social functioning and attachment. To address these outstanding issues, adults (N = 2986) from diverse cultures and socio-economic strata completed a reaction time task measuring CID towards an approaching stranger and friend. Higher CM was linked to a larger CID towards both friends and strangers. Moreover, insecure attachment and less social support were associated with larger CID. These findings demonstrate for the first time that CM affects CID across countries and cultures, highlighting the robustness of this association.

How are experiences and acceptability of child maltreatment related to resilience and posttraumatic growth: a cross cultural study.

Background: Post-traumatic growth (PTG) and resilience, regarded as positive psychological change following a traumatic experience, are under-researched across cultures in people exposed to child maltreatment (CM).Objective: We investigated how experiences and the perceived acceptability of CM are related to resilience and PTG in countries with different cultures, living standards, and gross national income.Method: A total of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) completed an online survey with self-reported questionnaires, including the Brief Resilience Scale and the Post Traumatic Growth Inventory-Short Form.Results: Across countries, self-reported male gender and age were positively associated with resilience, while experiences of physical abuse and emotional maltreatment were negatively associated with resilience. Experiences of emotional maltreatment were positively associated with PTG. Higher levels of PTG and resilience were found amongst Cameroonian participants as compared to other countries.Conclusion: Our results suggest that positive changes following CM can vary significantly across cultures and that experiences of specific CM subtypes, but not the perceived acceptability of CM, may be important for a deeper understanding of how individuals overcome trauma and develop salutogenic outcomes. Our findings may inform CM intervention programmes for an enhanced cultural sensitivity.

Across the four countries (Canada, Cameroon, Germany, Japan), more experiences of physical abuse and emotional maltreatment were associated with lower resilience; more experiences of emotional maltreatment were associated with greater post-traumatic growth.Higher levels of post-traumatic growth and resilience were found in Cameroon as compared to other countries.Positive changes following child maltreatment vary across cultures and experiences of specific child maltreatment subtypes, but the perceived acceptability of child maltreatment did not exert an influence on salutogenic post-traumatic outcomes.

Associations between experiences of childhood maltreatment and perceived acceptability of child maltreatment: A cross-cultural and exploratory study.

BACKGROUND: Acceptable parental behaviors and practices toward a child vary across countries and may impact the risk of exposure to maltreatment. Conversely, prior experiences of maltreatment as a child may influence the acceptability of child maltreatment (CM) behaviors. OBJECTIVE: This exploratory study examined the association between CM experiences and perceived acceptability of CM using data from four countries representing different cultures, living standards, and gross national income. PARTICIPANTS AND SETTING: We recruited a convenience sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) through online postings on social media. METHODS: We administered questionnaires and conducted a three-stage hierarchical multiple regression with perceived acceptability of CM subscales as the dependent variable. RESULTS: In all countries, higher scores of childhood neglect were associated with greater perceived acceptability of neglect in one's community (p < .001). Equally, our results showed that higher scores of childhood neglect or sexual abuse were associated with greater perceived acceptability of sexual abuse (p < .044). However, we did not find a significant relationship between other forms of CM (i.e., physical abuse, emotional maltreatment, exposure to domestic violence), and their perceived acceptability. CONCLUSIONS: Our findings suggest that experiences of some CM types, namely neglect and sexual abuse, may be associated with the perception that these are more acceptable within one's community. Perceived acceptability of CM might be a driver that can either prevent or perpetuate CM. Therefore, intervention and prevention programs could incorporate a deeper cross-cultural understanding and assessment of these social norms in order to foster meaningful behavioral changes.

Development of a Subclinical Dissociation Scale by Comparing Healthy Controls with Patients.

We developed a Subclinical Dissociation Scale by comparing healthy controls with patients with post-traumatic stress disorder (PTSD) or dissociative disorder. The Dissociative Experiences Scale, Subclinical Dissociation Scale, and General Health Questionnaire were completed by 441 healthy Japanese adolescents (mean age, 19.9 years) and 23 psychiatric inpatients (mean age, 28.8 years) diagnosed with PTSD or dissociative disorder. The initial Subclinical Dissociation Scale included 52 items grouped into five factors: F1, absentmindedness (14 items); F2, immersion or preoccupation (15 items); F3, temporary amnesia (10 items); F4, feelings of unreality (eight items); and F5, feelings of alienation (five items). Factor and correlation analyses revealed the validity and reliability of the Subclinical Dissociation Scale. The final version of the scale that comprised three factors (F1, F2, and F4) and 37 items underwent logistic regression and receiver operating characteristic (ROC) curve analyses to compare healthy controls with patients with PTSD or dissociative disorder. The ROC curve analysis using the Youden Index indicated a cut-off score of 18 for the borderline or abnormal range, which was calculated using the following formula: "(F1) + (F4) - (F2)." This study provides evidence of the partial test-retest reliability and con current validity of the Subclinical Dissociation Scale.

Mental Health Consequences of the Three Mile Island, Chernobyl, and Fukushima Nuclear Disasters: A Scoping Review.

Many individuals who were affected by the Great East Japan earthquake and tsunami and the subsequent Fukushima Daiichi Nuclear Power Plant accident continue to face a challenging recovery. We reviewed the long-term mental health consequences of three major nuclear power plant accidents: the Three Mile Island (TMI, 1979), Chernobyl (1986), and Fukushima (2011) nuclear disasters. We examined the relevant prospective cohort studies and before-and-after studies that covered more than two timepoints, searching four databases (PubMed, Ichushi, PsyArticles, and PTSDPub). We identified a total of 35 studies: TMI, n = 11; Chernobyl, n = 6; and Fukushima, n = 18. The smaller numbers of early-phase studies (within 6 months) of the Chernobyl and Fukushima disasters may also indicate the chaotic situation at those timepoints, as large-scale interviews were conducted in the early phase after the TMI disaster. Although the patterns of effects on mental health outcomes were diverse, more than half of the participants in the studies we evaluated were categorized into low or under-threshold symptom groups in all three disasters. Across the three disasters, the radiation exposure level estimated by the proximity and stigma were the common risk factors for mental health outcomes. Our findings will contribute to a comprehensive understanding of the impact of the worst nuclear accidents in history on the affected individuals' mental health, and our results illustrate the longitudinal consequences of such disasters.

Global Psychotrauma Screen (GPS): psychometric properties in two Internet-based studies.

Background: Potentially traumatic stressors can lead to various transdiagnostic outcomes beyond PTSD alone but no brief screening tools exist for measuring posttraumatic responses in a transdiagnostic manner. Objective: Assess the psychometric characteristics of a new 22-item transdiagnostic screening measure, the Global Psychotrauma Screen (GPS). Method: An internet survey was administered with English speaking participants recruited passively via the website of the Global Collaboration on Traumatic Stress (GC-TS) (nGC-TS  = 1,268) and actively via Amazon's MTurk (nMTurk  = 1,378). Exploratory factor analysis, correlational analysis, sensitivity and specificity analysis, and comparisons in response between the two samples and between male and female respondents were conducted. Results: Exploratory factor analysis revealed a single factor underlying symptom endorsements in both samples, suggesting that such problems may form a unitary transdiagnostic, posttraumatic outcome. Convergent validity of the GPS symptom and risk factors was established with measures of PTSD and dissociative symptoms in the MTurk sample. Gender differences were seen primarily at the item level with women more often endorsing several symptoms and specific risk factors in the MTurk sample, and the GC-TS recruited sample endorsed more symptoms and risk factors than the MTurk sample, suggesting that the GPS may be sensitive to group differences. A GPS symptom cut-off score of 8 identified optimized sensitivity and specificity relative to probable PTSD based on PCL-5 scores. Conclusions: The current results provide preliminary support for the validity of the GPS as a screener for the concurrent measurement of several transdiagnostic outcomes of potentially traumatic stressors and the apparent unifactorial structure of such symptoms is suggestive of a single or unitary posttraumatic outcome. Future research is needed to evaluate whether similarly strong psychometric properties can be yielded in response to completion of the GPS in other languages.

Antecedentes: Los factores de estrés potencialmente traumáticos pueden conducir a varios resultados transdiagnósticos más allá del solo diagnóstico de TEPT, pero no existen herramientas de detección breves para medir las respuestas postraumáticas de una manera transdiagnóstica.Objetivo: Evaluar las características psicométricas de una nueva medida de cribado transdiagnóstico de 22 ítems, El Mapeo Global de Psicotrauma (Global Psychotrauma Screen o GPS en inglés).Método: Se administró una encuesta por Internet con participantes de habla inglesa reclutados pasivamente a través del sitio web de la Global Collaboration on Traumatic Stress (GC-TS) (nGC-TS = 1,268) y activamente a través de MTurk de Amazon (nMTurk = 1,378). Se realizaron análisis factoriales exploratorios, análisis correlacionales, análisis de sensibilidad y especificidad, y comparaciones en respuesta entre las dos muestras y entre encuestados masculinos y femeninos.Resultados: El análisis factorial exploratorio reveló un solo factor subyacente a la aprobación de los síntomas en ambas muestras, lo que sugiere que tales problemas pueden formar un resultado postraumático transdiagnóstico unitario. La validez convergente del síntoma GPS y los factores de riesgo se estableció con medidas de TEPT y síntomas disociativos en la muestra de MTurk. Las diferencias de género se observaron principalmente a nivel de ítem y las mujeres a menudo respaldaron varios síntomas y factores de riesgo específicos en la muestra de MTurk, y la muestra reclutada por GC-TS aprobó más síntomas y factores de riesgo que la muestra de MTurk, lo que sugiere que el GPS puede ser sensible a las diferencias de grupo. Una puntuación de corte de síntomas de GPS de 8 identificó una sensibilidad y especificidad optimizadas en relación con el probable TEPT según las puntuaciones de PCL-5.Conclusiones: Los resultados actuales proporcionan un apoyo preliminar para la validez del GPS como un filtro para la medición concurrente de varios resultados transdiagnósticos de factores estresantes potencialmente traumáticos y la aparente estructura unifactorial de tales síntomas sugiere un resultado postraumático único o unitario. Se necesitan investigaciones futuras para evaluar si se pueden producir propiedades psicométricas igualmente fuertes en respuesta al completar el GPS en otros idiomas.

Trajectories of peer relationship problems and emotional symptoms in children 5 years after a nuclear disaster: Fukushima Health Management Survey.

The Fukushima Daiichi Nuclear Power Station (NPS) accident, which occurred in March 2011, is having long-term effects on children. About 3 years after the accident, we identified three patterns of peer relationship problems and four patterns of emotional symptoms using group-based trajectory modeling. As a result, we reported that different factors might be related to very severe trajectories of peer relationship problems and emotional symptoms. In this study, we used five waves of data from fiscal year (FY) 2011 to FY2015 from the Mental Health and Lifestyle Survey, a detailed survey of the Fukushima Health Management Survey started in FY2011. We analyzed 7013 residents within the government-designated evacuation zone (aged 6-12 years old as of 11 March 2011) with responses to all items of psychological distress in at least one wave from FY2011 and FY2015. We planned this study to describe the trajectories of peer relationship problems and emotional symptoms in children and to examine potential risks and protective factors over the 5 years following the NPS accident. We identified four patterns of peer relationship problems and five patterns of emotional symptoms using latent class growth analysis. For peer relationship problems, male sex, experiencing the NPS explosion and lack of exercise habits were associated with the severe trajectory group. For emotional symptoms, experiencing the NPS explosion, experiencing the tsunami disaster and lack of exercise habits were associated with the severe trajectory group. Exercise habits are very important for the mental health of evacuees after a nuclear disaster.

Prevalence and comorbidity of the ICD-11 and DSM-5 for PTSD caseness with previous diagnostic manuals among the Japanese population.

Background: The diagnostic criteria for posttraumatic stress disorder (PTSD) differ between DSM-5 and ICD-11, which may affect the estimation of prevalence. Objective: To investigate the concordance of ICD-11 and DSM-5, as compared to ICD-10 and DSM-IV, regarding PTSD caseness among Japanese people who had experienced different potentially traumatic events. In addition, we estimated the comorbidity with major depressive disorder and generalized anxiety disorder according to these four diagnostic manuals. Method: A web-based survey (n = 6,180) was conducted from November 2016 to March 2017. Participants completed the PTSD Checklist for DSM-5, and other standardized measures of PTSD, depression, and anxiety. Results: The prevalence of PTSD caseness according to ICD-11 was significantly lower as compared to DSM-IV, DSM-5, and ICD-10. Cohen's kappa between DSM-5 and ICD-11 was 0.79, indicating substantial agreement. Comorbidity with depression was significantly higher in unique DSM-5 cases than in unique ICD-11 cases. Unique DSM-5 PTSD cases were significantly stronger functionally impaired than unique ICD-11 PTSD cases. Conclusions: Although requiring fewer items, the ICD-11 showed substantial agreement with DSM-5 regarding PTSD caseness. The lower comorbidity rates in unique cases may support the concept of the ICD-11 which intends to reduce comorbidity by identifying the core elements of PTSD.

Antecedentes: Los criterios diagnósticos para trastorno de estrés postraumático (TEPT) difieren entre el DSM-5 y la CIE-11, lo cual puede afectar la estimación de prevalencia.Objetivo: Investigar la concordancia de la CIE-11 y DSM-5, comparada con la CIE-10 y DSM-IV, en relación a la casuística de TEPT entre la población japonesa que ha experimentado diferentes eventos potencialmente traumáticos. Además, estimamos la comorbilidad con el trastorno depresivo mayor y el trastorno de ansiedad generalizada según estos cuatro manuales diagnósticos.Método: Se condujo una encuesta basada en la web (n= 6.180) entre Noviembre del 2016 y Marzo del 2017. Los participantes completaron la Lista de verificación de TEPT según el DSM-5, y otras mediciones estandarizadas para TEPT, depresión y ansiedad.Resultados: La prevalencia de casuística de TEPT según la CIE-11 fue significativamente menor comparada con el DSM-IV, DSM-5 y CIE-10. La kappa de Cohen entre el DSM-5 y CIE-11 fue de 0.79, lo que indica un acuerdo sustancial. La comorbilidad con depresión fue significativamente mayor en casos únicos del DSM-5 que en casos únicos de la CIE-11. Los casos únicos de TEPT según el DSM-5 tuvieron una discapacidad funcional significativamente más fuerte que los casos únicos de TEPT según la CIE-11.Conclusiones: Aunque la CIE-11 requiere menos ítems, mostró un acuerdo sustancial con el DSM-5 en relación a la casuística de TEPT. Las tasas más bajas de comorbilidad en los casos únicos pueden respaldar el concepto de la CIE-11 que tiene la intención de reducir la comorbilidad mediante la identificación de los elementos centrales del TEPT.

Workplace Violence and Its Effects on Burnout and Secondary Traumatic Stress among Mental Healthcare Nurses in Japan.

Workplace violence (WPV) in healthcare settings has drawn attention for over 20 years, yet few studies have investigated the association between WPV and psychological consequences. Here, we used a cross-sectional design to investigate (1) the 12-month prevalence of workplace violence (WPV), (2) the characteristics of WPV, and (3) the relationship between WPV and burnout/secondary traumatic stress among 599 mental healthcare nurses (including assistant nurses) from eight hospitals. Over 40% of the respondents had experienced WPV within the past 12 months. A multivariate logistic regression analysis indicated that occupation and burnout were each significantly related to WPV. Secondary traumatic stress was not related to WPV. Our results suggest that WPV may be a long-lasting and/or cumulative stressor rather than a brief, extreme horror experience and may reflect specific characteristics of psychological effects in psychiatric wards. A longitudinal study measuring the severity and frequency of WPV, work- and non-work-related stressors, risk factors, and protective factors is needed, as is the development of a program that helps reduce the psychological burden of mental healthcare nurses due to WPV.

Screening for psychotrauma related symptoms: Japanese translation and pilot testing of the Global Psychotrauma Screen.

Background: The impact of traumatic experiences or adverse life experiences has been shown to potentially affect a wide range of mental health outcomes. However, there was no brief instrument to screen for a range of psychological problems in different domains after a potentially traumatic event, and for risk factors and protective factors. Objective: The aim of this study is to examine the internal consistency and concurrent validity of the Japanese version of the Global Psychotrauma Screen (GPS) in a traumatized sample in Japan. Method: A total sample (n = 58) with varying levels of potential posttrauma symptoms due to domestic violence or other events were recruited into this study. Self-rating measures of posttraumatic stress disorder (PTSD), depression, anxiety, and alcohol problems were conducted to investigate the concurrent validity. Results: The results show that a range of posttrauma symptoms assessed by the GPS were highly endorsed by this traumatized sample in all domains except for self-harm, derealization, and depersonalization. The GPS sum score was highly correlated (r > 0.79) with other measures of PTSD, depression, and anxiety symptoms. Also, the subdomain scores showed acceptable correlations with corresponding domain measures. Participants who had been sexually assaulted or had unwanted sexual experiences, and participants who had been physically assaulted during childhood, had higher scores on the total GPS and on subdomains of PTSD, as well as symptoms associated with Complex PTSD. Conclusions: This study provides an initial indication that the GPS may be a useful screening tool for trauma survivors and elucidates that the consequences of trauma are not limited to PTSD.

Antecedentes: Se ha demostrado que el impacto de las experiencias traumáticas o de las experiencias vitales adversas tiene el potencial de comprometer la salud mental dentro de un amplio rango de consecuencias. Sin embargo, no existía ningún instrumento breve para tamizar una variedad de problemas psicológicos, en diferentes dominios, después de un evento potencialmente traumático, ni para los factores de riesgo, ni para los factores protectores.Objetivo: El objetivo de este estudio es el de examinar la consistencia interna y la validez concurrente de la versión japonesa del Mapeo Global de Psicotrauma (GPS, por sus siglas en ingles) en una muestra de personas traumatizadas en Japón.Método: Para este estudio, se reclutó una muestra total (n=58) con distintos niveles de síntomas postraumáticos potenciales secundarios a violencia domestica u otros eventos. Para investigar la validez concurrente, se realizaron mediciones auto reportadas para el trastorno de estrés postraumático (TEPT), la depresión, la ansiedad y para problemas asociados al consumo de alcohol.Resultados: Los resultados muestran que un espectro de síntomas postraumáticos, evaluados mediante el GPS, se encontraba altamente vinculado a esta muestra de personas traumatizadas en todos los dominios, a excepción de las autolesiones, la desrealización, y la despersonalización. El puntaje final del GPS se encontraba altamente correlacionado (r > 0,79) con otras mediciones del TEPT, la depresión y los síntomas ansiosos. Además, los puntajes de los subdominios del GPS mostraron una correlación aceptable con las medidas de dominios correspondientes. Los participantes que habían sido agredidos sexualmente o habían tenido experiencias sexuales no deseadas, y los participantes que habían sido agredidos físicamente durante su infancia mostraban puntajes más altos en el GPS total y en los subdominios del TEPT, así como para los síntomas asociados al TEPT complejo.Conclusiones: Este estudio proporciona un primer indicio de que el GPS podría ser una herramienta de tamizaje útil para sobrevivientes al trauma, y esclarece que las consecuencias del trauma no se limitan al TEPT.

Screening for consequences of trauma - an update on the global collaboration on traumatic stress.

This letter provides an update on the activities of "The Global Collaboration on Traumatic Stress" (GC-TS) as first described by Schnyder et al. in 2017. It presents in further detail the projects of the first theme, in particular the development of and initial data on the Global Psychotrauma Screen (GPS), a brief instrument designed to screen for the wide range of potential outcomes of trauma. English language data and ongoing studies in several languages provide a first indication that the GPS is a feasible, reliable and valid tool, a tool that may be very useful in the current pandemic of the coronavirus disease 2019 (COVID-19). Further multi-language and cross-cultural validation is needed. Since the start of the GC-TS, new themes have been introduced to focus on in the coming years: a) Forcibly displaced persons, b) Global prevalence of stress and trauma related disorders, c) Socio-emotional development across cultures, and d) Collaborating to make traumatic stress research data "FAIR". The most recent theme added is that of Global crises, currently focusing on COVID-19-related projects.

Parental Recognition of Bullying and Associated Factors Among Children After the Fukushima Nuclear Disaster: A 3-Year Follow-Up Study From the Fukushima Health Management Survey.

This study examined parental recognition of bullying victimization and associated factors among evacuated children after the 2011 Fukushima Daiichi Nuclear Power Plant accident, using a 3-year follow-up data (wave 1: January 2012; wave 2: January 2013; wave 3: February 2014). The sample included the caregivers of 2,616 children in the first-sixth grades of elementary school, who lived in one of the 13 municipalities that were the target areas of the Mental Health and Lifestyle Survey, conducted as part of the Fukushima Mental Health Management Survey. Across 3 years, around 80% of caregivers responded "not true," 15% responded "somewhat true," and 5% responded "certainly true" in response to a question about bullying victimization of their children. Being male was significantly associated with the parental recognition of bullying victimization at wave 1 and wave 3. At wave 1, experiencing the nuclear plant explosion was significantly associated with parental recognition of bullying victimization. Moreover, age at wave 3 was negatively associated with parental recognition of bullying victimization. Our findings will be helpful for establishing community- and school-based mental health care for children, parents, and teachers.