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1.
BMC Psychol ; 9(1): 96, 2021 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-34112232

RESUMEN

BACKGROUND: Refugees and asylum seekers are frequently exposed to violence, human rights violations and unstable living conditions before, during, and after their displacement. Elevated prevalence rates of psychiatric disorders in forcibly displaced persons are well documented. However, less is known about other problems related to common refugee experiences, such as embitterment, moral injury, and diminished self-efficacy, and how they are related to trauma exposure and post-migration living difficulties. METHODS: A cross-sectional sample of 71 refugees and asylum seekers in treatment were examined regarding exposure to potentially traumatic events, post-migration living difficulties, moral injury appraisals, self-efficacy, and embitterment. RESULTS: Elevated levels of embitterment were reported by 68% of participants. The regression analysis revealed that greater moral injury appraisals and low levels of self-efficacy were significantly associated with higher levels of embitterment. CONCLUSION: The results provide first insights into embitterment and associated factors in refugee populations. Furthermore, they highlight the significance of moral transgressions and low levels of self-efficacy emerging from displacement and traumatic experiences for the development of mental health problems in a clinical sample of refugees. The findings have implications for future research, policy development and clinical practice.


Asunto(s)
Refugiados , Trastornos por Estrés Postraumático , Estudios Transversales , Humanos , Principios Morales , Prevalencia
2.
Artículo en Inglés | MEDLINE | ID: mdl-34067315

RESUMEN

The purpose of this study was to examine the severity of post-traumatic stress disorder (PTSD) symptoms related to the COVID-19 pandemic in people with no diagnosis of mental illness, as well as in people who were diagnosed with depression or anxiety. Moreover, this study aimed to investigate the interplay between PTSD symptoms and self-assessed mental health associated with well-being. The 210 participants were divided into 3 groups: mentally healthy, participants with diagnosed depression, and participants with anxiety disorders. To evaluate the subjective well-being of the participants, the Polish adaptation of the Mental Health Continuum-Short Form (MHC-SF) was applied. The Impact Event Scale-Revised (IES-R) was used to measure the severity of PTSD symptoms. At least a moderate worsening of PTSD symptoms was observed in participants of all groups. The results were as follows: healthy participants M = 37.35 (SD = 18.46); participants with depression M = 36.05 (SD = 18.02); participants with anxiety M = 44.52 (SD = 18.08). The participants diagnosed with depression showed the lowest level of mental well-being M = 41.58 (SD = 15.02). Conclusion: People diagnosed with depression had both the lowest level of well-being and the lowest severity of symptoms specific to PTSD. In all three groups, lower emotional well-being was linked to greater PTSD symptoms.


Asunto(s)
COVID-19 , Trastornos por Estrés Postraumático , Ansiedad/epidemiología , Trastornos de Ansiedad/epidemiología , Depresión/epidemiología , Humanos , Salud Mental , Pandemias , Polonia/epidemiología , SARS-CoV-2 , Trastornos por Estrés Postraumático/epidemiología
3.
Artículo en Inglés | MEDLINE | ID: mdl-34070468

RESUMEN

The COVID-19 outbreak has taken a heavy toll on the mental well-being of healthcare workers. This study aims to describe a psychological screening program developed at a large University Hospital in Milan, Italy, and assess the psychological outcomes of employees and associated factors. A survey was electronically conducted among hospital employees between July and October 2020. Sociodemographic data, information about COVID-19 experience and three scales assessing anxiety (STAI-Y1), depression (HAM-D) and post-traumatic stress disorder (PCL-5) were collected. A total of 308 employees (80% women; mean age 45.1 years) responded: 16% physicians, 68% other healthcare professionals, and 16% administrative staff. Employees reported moderate/severe symptoms of anxiety (23%), depression (53%), and post-traumatic stress disorder (40%). At multivariate logistic regression analysis, having suffered a loss for COVID-19 in the personal context was independently associated with higher risk of moderate/severe anxiety (OR = 2.40; 95% CI 1.16-4.98), being female was associated with higher risk of moderate/severe depression (OR = 2.82; 95% CI 1.43-5.59), and having had a family member affected by COVID-19 was associated with higher risk of moderate/severe post-traumatic stress disorder (OR = 2.75; 95% CI 1.01-7.48). COVID-19 personal experience may have a profound impact on hospital workers' mental health and should be considered in supportive interventions.


Asunto(s)
COVID-19 , Trastornos por Estrés Postraumático , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Brotes de Enfermedades , Femenino , Personal de Salud , Hospitales , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , SARS-CoV-2 , Trastornos por Estrés Postraumático/epidemiología , Estrés Psicológico
4.
Artículo en Inglés | MEDLINE | ID: mdl-34073524

RESUMEN

Understanding the presence of post-traumatic stress disorder (PTSD) symptoms in quarantined/isolated individuals is essential for decreasing morbidity and mortality caused by the COVID-19 pandemic. However, there is a paucity of evidence quantifying PTSD status globally during confinement in quarantine/isolation facilities during COVID-19. Therefore, we aimed to assess the PTSD status and factors contributing to PTSD development in quarantined/isolated people during pandemic. Using the Impact of Event Scale-Revised (IES-R) scale, our multicentre, multinational, and cross-sectional online survey assessed the psychological impacts on the quarantine/isolation experience of participants suspected or confirmed to have COVID-19, their PTSD status, and various correlates with developing PTSD. We had 944 (35.33%) valid responses (51.1% from females), mostly from Asian countries (635, 71.4%), and 33.9% were healthcare workers. The number of quarantine days in the PTSD symptoms group (using the IES-R cutoff of 24 for symptomatic or full PTSD) was significantly shorter compared to the non-PTSD group (14 (range 14-40) vs. 14 (14-23.75), p = 0.031). Lower rates of PTSD symptoms were observed in participants practicing Buddhist religion than in participants having no religion (OR: 0.30; 95% CI: 0.13-0.68; p = 0.005); individuals with vocational training had a higher risk of developing PTSD symptoms (OR: 2.28 (1.04-5.15); p = 0.043) compared to university graduates. Individuals forced to be quarantined/isolated had higher odds of developing PTSD symptoms than those voluntarily quarantined/isolated (OR: 2.92 (1.84-4.74); p < 0.001). We identified several PTSD correlations among individuals quarantined/isolated during the COVID-19 pandemic, including religious practice, reason for quarantine/isolation, education level, and being a case of the infection. These findings can inform worldwide policies to minimize the adverse effects of such social control measures.


Asunto(s)
COVID-19 , Trastornos por Estrés Postraumático , Ansiedad , Asia , Estudios Transversales , Femenino , Humanos , Pandemias , Cuarentena , SARS-CoV-2 , Trastornos por Estrés Postraumático/epidemiología , Estrés Psicológico
5.
Zhen Ci Yan Jiu ; 46(5): 439-44, 2021 May 25.
Artículo en Chino | MEDLINE | ID: mdl-34085470

RESUMEN

Post-traumatic stress disorder (PTSD) is a kind of chronic mental disorder after severe traumatic events. In this paper, the author reviewed the development of clinical and mechanism research of acupuncture and moxibustion for treating PTSD in the past 5 years. Clinical studies have shown that acupuncture could alleviate the symptoms of PTSD, and is an effective therapy for PTSD. The underlying mechanisms may include regulating neural circuit, neurotransmitters and receptors expression, signal pathway, apoptosis, immune cytokines and endocannabinoid system, et al. It could provide scientific basis of acupuncture and moxibustion for treating PTSD, and provide references for further study.


Asunto(s)
Terapia por Acupuntura , Acupuntura , Moxibustión , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/terapia
6.
Int J Mol Sci ; 22(10)2021 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-34068160

RESUMEN

Post-traumatic stress disorder (PTSD) is a neuropsychiatric disorder occurring in susceptible individuals following a traumatic event. Understanding the mechanisms subserving trauma susceptibility/resilience is essential to develop new effective treatments. Increasing evidence suggests that non-coding RNAs, such as microRNAs (miRNAs), may play a prominent role in mediating trauma susceptibility/resilience. In this study, we evaluated the transcriptional expression of two key PTSD-related genes (FKBP5 and BDNF) and the relative targeting miRNAs (miR-15a-5p, miR-497a-5p, miR-511-5p, let-7d-5p) in brain areas of PTSD-related susceptible and resilient mice identified through our recently developed mouse model of PTSD (arousal-based individual screening (AIS) model). We observed lower transcript levels of miR-15a-5p, miR-497a-5p, and miR-511a-5p in the hippocampus and hypothalamus of susceptible mice compared to resilient mice, suggesting that the expression of these miRNAs could discriminate the two different phenotypes of stress-exposed mice. These miRNA variations could contribute, individually or synergically, to the inversely correlated transcript levels of FKBP5 and BDNF. Conversely, in the medial prefrontal cortex, downregulation of miR-15a-5p, miR-511-5p, and let-7d-5p was observed both in susceptible and resilient mice, and not accompanied by changes in their mRNA targets. Furthermore, miRNA expression in the different brain areas correlated to stress-induced behavioral scores (arousal score, avoidance-like score, social memory score and PTSD-like score), suggesting a linear connection between miRNA-based epigenetic modulation and stress-induced phenotypes. Pathway analysis of a miRNA network showed a statistically significant enrichment of molecular processes related to PTSD and stress. In conclusion, our results indicate that PTSD susceptibility/resilience might be shaped by brain-area-dependent modulation of miRNAs targeting FKBP5, BDNF, and other stress-related genes.


Asunto(s)
Factor Neurotrófico Derivado del Encéfalo/metabolismo , MicroARNs/genética , Resiliencia Psicológica , Trastornos por Estrés Postraumático/patología , Proteínas de Unión a Tacrolimus/metabolismo , Animales , Factor Neurotrófico Derivado del Encéfalo/genética , Regulación de la Expresión Génica , Masculino , Ratones , Ratones Endogámicos C57BL , Trastornos por Estrés Postraumático/genética , Trastornos por Estrés Postraumático/metabolismo , Proteínas de Unión a Tacrolimus/genética
7.
J Pak Med Assoc ; 71(5): 1341-1344, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34091611

RESUMEN

OBJECTIVE: To find out the moderating effect of emotion reactivity and several demographic variables following symptoms of post-traumatic stress disorder among individuals having undergone an amputation. METHODS: The cross-sectional study was conducted from March to July 2015 at the Government College University, Lahore, Pakistan, and comprised individuals, enrolled from difference orthopaedic and rehabilitation centres, aged 18-60 years having undergone amputation of upper or lower limb either because of diseases, like diabetes, gangrene, cancer ulcer, or because of traumatic injuries, like road accident, electrical shock. Assessment of the study variables was done using the Emotion Reactivity Scale and the Post-traumatic Stress Disorder Checklist-5. Data was analysed using SPSS 21. RESULTS: Of the 160 subjects, 117(72%) were males and 43(28%) were females. The overall mean age was 38.45±13.17 years. Upper limb amputation cases were 17(10.6%), lower limb 138(86.2%) and both upper and lower limb amputation 5(3.2%). Amputation due to any disease was the case with 76(47.5%) subjects, while traumatic injury was the cause in 84(52.5%). There was a significant positive association of emotional reactivity with symptoms severity of post-traumatic stress disorder (p<0.05). CONCLUSIONS: Post-amputation effects were found to have a significant impact on individual emotions, and traumatic flashbacks had a leading role in the development of post-traumatic stress disorder symptoms severity.


Asunto(s)
Amputados , Trastornos por Estrés Postraumático , Adulto , Estudios Transversales , Emociones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pakistán/epidemiología , Trastornos por Estrés Postraumático/epidemiología
8.
BMC Health Serv Res ; 21(1): 494, 2021 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-34030684

RESUMEN

BACKGROUND: Chronic pain presents a significant burden for both federal health care systems designed to serve combat Veterans in the United States (i.e., the Military Health System [MHS] and Veterans Health Administration [VHA]), yet there have been few studies of Veterans with chronic pain that have integrated data from both systems of care. This study examined 1) health care utilization in VHA as an enrollee (i.e., linkage to VHA) after military separation among soldiers with postdeployment chronic pain identified in the MHS, and predictors of linkage, and 2) persistence of chronic pain among those utilizing the VHA. METHODS: Observational, longitudinal study of soldiers returning from a deployment in support of the Afghanistan/Iraq conflicts in fiscal years 2008-2014. The analytic sample included 138,206 active duty soldiers for whom linkage to VHA was determined through FY2019. A Cox proportional hazards model was estimated to examine the effects of demographic characteristics, military history, and MHS clinical characteristics on time to linkage to VHA after separation from the military. Among the subpopulation of soldiers who linked to VHA, we described whether they met criteria for chronic pain in the VHA and pain management treatments received during the first year in VHA. RESULTS: The majority (79%) of soldiers within the chronic pain cohort linked to VHA after military separation. Significant predictors of VHA linkage included: VHA utilization as a non-enrollee prior to military separation, separating for disability, mental health comorbidities, and being non-Hispanic Black or Hispanic. Soldiers that separated because of misconduct were less likely to link than other soldiers. Soldiers who received nonpharmacological treatments, opioids/tramadol, or mental health treatment in the MHS linked earlier to VHA than soldiers who did not receive these treatments. Among those who enrolled in VHA, during the first year after linking to the VHA, 49.7% of soldiers met criteria for persistent chronic pain in VHA. CONCLUSIONS: The vast majority of soldiers identified with chronic pain in the MHS utilized care within VHA after military separation. Careful coordination of pain management approaches across the MHS and VHA is required to optimize care for soldiers with chronic pain.


Asunto(s)
Dolor Crónico , Servicios de Salud Militares , Personal Militar , Trastornos por Estrés Postraumático , Veteranos , Afganistán , Dolor Crónico/tratamiento farmacológico , Dolor Crónico/epidemiología , Humanos , Irak , Guerra de Irak 2003-2011 , Estudios Longitudinales , Estados Unidos/epidemiología , United States Department of Veterans Affairs , Salud de los Veteranos
9.
Crim Behav Ment Health ; 31(3): 183-197, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33969558

RESUMEN

BACKGROUND: Despite the prevalence of depression among women in the justice system, and its potentially significant consequences, there is a dearth of studies investigating psychological treatments for depression in this context, especially outside prison. AIMS: Our aim was to gather preliminary data on whether individual interpersonal psychotherapy (IPT) is an acceptable and effective treatment for depression in women at an early stage in the justice system. METHOD: In this pilot study, IPT was offered to 24 depressed women following their first or second contact with the justice system. The women were assessed using a range of scales to quantify depression, anxiety, post-traumatic stress disorder (PTSD) and social support. Multilevel models were used to explore interactions between change in depression and other features given the multiplicity and complexity of problems. Details on engagement and attrition were also collected. RESULTS: Therapy attrition was low, despite challenging life-circumstances and depression scores followed a linear trajectory with scores significantly decreasing over the time (ß = -0.59, SE = 0.07, p < 0.001). Participants with more adverse life events, attachment related anxiety and lower social support had poorer outcomes. CONCLUSIONS AND IMPLICATIONS: Results are encouraging. More than half of the hard-to-reach women who were eligible did engage, and retention rates suggest the therapy was acceptable to them. Depression scores improved, and potential factors affecting treatment outcome were identified. A randomised controlled trial is now warranted, ensuring adequate supplementary support for women with dependants living on their own and without employment.


Asunto(s)
Psicoterapia Interpersonal , Trastornos por Estrés Postraumático , Trastornos de Ansiedad , Femenino , Humanos , Proyectos Piloto , Psicoterapia , Resultado del Tratamiento
10.
BMC Psychol ; 9(1): 73, 2021 May 05.
Artículo en Inglés | MEDLINE | ID: mdl-33952352

RESUMEN

BACKGROUND: Experiences of potentially morally injurious events (PMIEs) have been found to negatively impact the mental health of US personnel/veterans, yet little is known about the effect of PMIEs on the mental health of the UK Armed Forces (AF). This cross-sectional study aimed to examine the association between PMIEs and the mental health outcomes of UK AF veterans. METHOD: Assessments of PMIE exposure and self-report measures of common mental disorders were administered using an online questionnaire to 204 UK veterans. Subjects were classified as having experienced a morally injurious event (n = 66), a non-morally injurious traumatic event (n = 57), a 'mixed' event (n = 31), or no event (n = 50). RESULTS: Potentially morally injurious experiences were associated with adverse mental health outcomes, including likely anxiety disorders and suicidal ideation, compared to those who reported no event exposure. The likelihood of meeting criteria for probable PTSD was greatest in those who had experienced a non-morally injurious trauma. No statistically significant association between alcohol misuse and experiencing a PMIE or traumatic event was observed. CONCLUSIONS: The results provide preliminary evidence that potentially morally injurious experiences are associated with adverse mental health outcomes in UK AF veterans. Further work is needed to better understand the interplay between morally injurious events and threat-based trauma in order to design effective pathways for prevention and intervention for people exposed to highly challenging events.


Asunto(s)
Trastornos por Estrés Postraumático , Veteranos , Estudios Transversales , Humanos , Principios Morales , Trastornos por Estrés Postraumático/epidemiología , Reino Unido/epidemiología
11.
BMC Public Health ; 21(1): 896, 2021 05 12.
Artículo en Inglés | MEDLINE | ID: mdl-33975567

RESUMEN

BACKGROUND: Previous studies have already proven high rates of common mental disorders in Syrian refugees. Nevertheless, little is known about the patterns of somatic distress among this refugee population. For this reason, we aimed to examine the prevalence, co-occurrence, and risk factors of somatic distress among Syrian refugees in Germany. METHODS: This study analyzes the second measurement point (N = 116) of a prospective register-based survey among 200 adult Syrian refugees with residence permission in Germany. The survey consisted of information on sociodemographic and migration-specific characteristics, health care utilization, traumatic life events, acculturative stress (Barcelona Immigration Stress Scale (BISS); subscales: perceived discrimination, intercultural contact stress, homesickness, and general psychosocial stress), and self-reported outcomes of somatic distress (Patient Health Questionnaire (PHQ-15)), depression (PHQ-9), generalized anxiety disorder (GAD-7), and post-traumatic symptoms (Essen Trauma Inventory (ETI)). RESULTS: Almost half of the respondents (49.1%) were identified as being at risk of somatic distress (PHQ-15 score ≥ 6), and even 24.1% being bothered by moderate-to-severe levels of somatic distress (PHQ-15 score ≥ 10). The most robust associations with somatic distress were found for female gender, the amount of health care utilization, multiple trauma exposures, general psychosocial stress, and self-reported depression and anxiety symptoms. High comorbidities with somatic distress were shown for all of the common mental disorders studied. CONCLUSIONS: The presented study reveals a significant risk of somatic distress among this displaced population and highlights implications for policy and health care providers.


Asunto(s)
Refugiados , Trastornos por Estrés Postraumático , Adulto , Estudios Transversales , Depresión/epidemiología , Femenino , Alemania/epidemiología , Humanos , Siria
12.
Sci Rep ; 11(1): 10173, 2021 05 13.
Artículo en Inglés | MEDLINE | ID: mdl-33986414

RESUMEN

To provide a contemporary global prevalence of mental health issues among the general population amid the coronavirus disease-2019 (COVID-19) pandemic. We searched electronic databases, preprint databases, grey literature, and unpublished studies from January 1, 2020, to June 16, 2020 (updated on July 11, 2020), with no language restrictions. Observational studies using validated measurement tools and reporting data on mental health issues among the general population were screened to identify all relevant studies. We have included information from 32 different countries and 398,771 participants. The pooled prevalence of mental health issues amid the COVID-19 pandemic varied widely across countries and regions and was higher than previous reports before the COVID-19 outbreak began. The global prevalence estimate was 28.0% for depression; 26.9% for anxiety; 24.1% for post-traumatic stress symptoms; 36.5% for stress; 50.0% for psychological distress; and 27.6% for sleep problems. Data are limited for other aspects of mental health issues. Our findings highlight the disparities between countries in terms of the poverty impacts of COVID-19, preparedness of countries to respond, and economic vulnerabilities that impact the prevalence of mental health problems. Research on the social and economic burden is needed to better manage mental health problems during and after epidemics or pandemics. Systematic review registration: PROSPERO CRD 42020177120.


Asunto(s)
COVID-19/epidemiología , Salud Mental , Ansiedad/epidemiología , Depresión/epidemiología , Humanos , Prevalencia , SARS-CoV-2/aislamiento & purificación , Trastornos del Sueño-Vigilia/epidemiología , Trastornos por Estrés Postraumático/epidemiología , Estrés Psicológico/epidemiología
13.
Infect Dis Poverty ; 10(1): 69, 2021 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-34001277

RESUMEN

BACKGROUND: COVID-19 can lead to increased psychological symptoms such as post-traumatic stress disorder (PTSD), depression, and anxiety among patients with COVID-19. Based on the previous mindfulness-based interventions proved to be effective, this protocol reports a design of a randomized controlled trial aiming to explore the efficacy and possible mechanism of a mindful living with challenge (MLWC) intervention developed for COVID-19 survivors in alleviating their psychological problems caused by both the disease and the pandemic. METHODS: In April 2021, more than 1600 eligible participants from Hubei Province of China will be assigned 1:1 to an online MLWC intervention group or a waitlist control group. All participants will be asked to complete online questionnaires at baseline, post-program, and 3-month follow-up. The differences of mental health status (e.g. PTSD) and physical symptoms including fatigue and sleeplessness between the COVID-19 survivors who receiving the online MLWC intervention and the control group will be assessed. In addition, the possible mediators and moderators of the link between the MLWC intervention and target outcomes will be evaluated by related verified scales, such as the Five Facets Mindfulness Questionnaire. Data will be analyzed based on an intention-to-treat approach, and SPSS software will be used to perform statistical analysis. DISCUSSION: The efficacy and potential mechanism of MLWC intervention in improving the quality of life and psychological status of COVID-19 survivors in China are expected to be reported. Findings from this study will shed light on a novel and feasible model in improving the psychological well-being of people during such public health emergencies. Trial registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000037524; Registered on August 29, 2020, http://www.chictr.org.cn/showproj.aspx?proj=60034 .


Asunto(s)
Ansiedad , COVID-19/psicología , Depresión , Intervención basada en la Internet , Atención Plena , Trastornos por Estrés Postraumático , Ansiedad/etiología , Ansiedad/terapia , China/epidemiología , Depresión/etiología , Depresión/terapia , Humanos , Salud Mental , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/terapia , Encuestas y Cuestionarios
14.
Front Public Health ; 9: 655357, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34017813

RESUMEN

Background: The 2016 wildfires in Fort McMurray (Alberta, Canada) led to a massive displacement of 88,000 people and destroyed 2,400 homes. Although no direct human fatality resulted, many individuals feared for their lives or those of their loved ones. Objectives: (1) To estimate the prevalence of post-traumatic stress, major depressive, insomnia, generalized anxiety, and substance use disorders in the adult population of Fort McMurray 1 year after the evacuation; (2) To identify pre-, peri-, and post-disaster correlates of mental health disorders. Methods: A phone survey using random digit sampling was used to survey evacuees. A total of 1,510 evacuees (response rate = 40.2%, 55.5% women, mean age = 44.11, SD = 12.69) were interviewed between May 9th and July 28th, 2017. Five validated scales were administered: the PTSD Symptoms Checklist (PCL-5), the Insomnia Severity Index (ISI), the depression and anxiety subscales of the Patient Health Questionnaire (PHQ-9, GAD-7), and the CAGE Substance Abuse Screening Tool. Results: One year after the wildfires, 38% had a probable diagnosis of either post-traumatic stress, major depressive, insomnia, generalized anxiety, or substance use disorder, or a combination of these. Insomnia disorder was the most common, with an estimated prevalence of 28.5%. Post-traumatic stress, major depressive and generalized anxiety disorders were almost equally prevalent, with ~15% each. The estimated prevalence of substance use disorder was 7.9%. For all five mental health disorders, having a mental health condition prior to the fires was a significant risk factor, as well as having experienced financial stress or strain due to the economic decline already present in Fort McMurray. Five post-disaster consequences were significant predictors of four of the five disorders: decrease in work, decrease in social life, poorer current health status, increase in drug and alcohol use, and higher level of stress experienced since the fires. Conclusion: One year after the fires, more than one third of the evacuees had clinically significant psychological symptoms, including those of insomnia, post-traumatic stress, depression, anxiety, and substance use. This study helped identify individuals more at risk for mental health issues after a natural disaster and could guide post-disaster psychosocial support strategies.


Asunto(s)
Trastorno Depresivo Mayor , Trastornos por Estrés Postraumático , Incendios Forestales , Adulto , Alberta , Trastornos de Ansiedad/diagnóstico , Trastorno Depresivo Mayor/diagnóstico , Femenino , Humanos , Masculino , Trastornos por Estrés Postraumático/diagnóstico
15.
Exp Clin Psychopharmacol ; 29(2): 166-177, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34043400

RESUMEN

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly comorbid with complex and often unclear associations. Working memory deficits may represent a shared mechanism implicated in emotion regulation and control over impulsive alcohol use. Here we test whether PTSD symptoms and working memory correlated with performance on a behavioral economic assessment of alcohol demand. 113 veterans (mean age 51 years; 89% male) completed an Alcohol Purchase Task (APT) and were assessed for PTSD, alcohol use, and working memory. We examined the interaction of PTSD symptoms and working memory on four indices of alcohol demand measured from the APT; specifically, we used separate models to test whether associations between working memory and intensity (consumption at $0), Omax (maximum expenditure), Pmax (price at maximum expenditure), and elasticity (price sensitivity), differed as a function of PTSD symptoms. In a model controlling for hazardous drinking, average drinking levels, age, sex, marital status, occupation, and education, we observed a significant interaction between PTSD symptoms and working memory on elasticity, whereby greater working memory capacity was associated with greater elasticity for veterans with lower PTSD symptoms. Follow-up analyses regarding specific PTSD symptom domains indicated that this effect was strongest for avoidance symptoms. Taken together, working memory abilities correlated with subjective valuations of alcohol in a laboratory setting for veterans with less severe PTSD symptoms. This work highlights the conditions under which working memory may be a potential target for interventions geared toward reducing alcohol use in veterans with co-occurring PTSD and AUD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Alcoholismo/psicología , Memoria a Corto Plazo , Trastornos por Estrés Postraumático/psicología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Veteranos/psicología
16.
BMC Psychiatry ; 21(1): 228, 2021 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-33941110

RESUMEN

BACKGROUND: Our goal was to accurately detect young children at risk for long-term psychiatric disturbances after potentially traumatic experiences in the course of relocation. In addition to detailed assessment of parent-rated parent and child symptomatology, we focused on disruptive behaviors in the education environment summarized as survival states, as these frequently lead to clinical referral. METHODS: We screened 52 refugee children aged 3-7 (M = 5.14 years, SD = 1.17) for symptoms of Posttraumatic Stress Disorder (PTSD) with the Child and Adolescent Trauma Screening (CATS) in parent rating. The parents' mental health was assessed using the Refugee Health Screener (RHS-15). Furthermore, the child's educators were asked to evaluate the pathological survival states of the child and we made a general assessment of the children's symptoms with the Strengths and Difficulties Questionnaire (SDQ) rated by parents and educators. Children in the refugee sample completed a working memory learning task (Subtest Atlantis from the Kaufmann Assessment Battery for Children, KABC-II) and delivered saliva samples for testing of the cortisol level. RESULTS: The parental rating of their child's PTSD symptoms was significantly related to their own mental well-being (r = .50, p < .001). Children with survival states in educator ratings exhibited weaker learning performance (F = 3.49, p < .05) and higher evening cortisol levels (U = 113, z = - 1.7, p < .05, one-tailed). CONCLUSIONS: Survival states are promising indicators for children's learning performance and distress level complementary to parent rating of child PTSD, which is highly intercorrelated with the parents' own symptom load. TRIAL REGISTRATION: Trial registration number: DRKS00021150 on DRKS Date of registration: 04.08.2020 retrospectively registered.


Asunto(s)
Refugiados , Trastornos por Estrés Postraumático , Adolescente , Niño , Preescolar , Estudios Transversales , Humanos , Padres , Trastornos por Estrés Postraumático/diagnóstico , Estrés Fisiológico
17.
Zhongguo Zhong Yao Za Zhi ; 46(10): 2380-2391, 2021 May.
Artículo en Chino | MEDLINE | ID: mdl-34047082

RESUMEN

This paper aims to investigate the active components and mechanism of Valerianae Jatamansi Rhizoma et Radix against post-traumatic stress disorder(PTSD) based on network pharmacology and molecular docking. The main components and targets of Valerianae Jatamansi Rhizoma et Radix were obtained by literature mining methods, SwissTargetPrediction, BATMAN and ETCM database. PTSD-related genes were collected from DrugBank, TTD and CTD databases. The protein-protein interaction(PPI) network was constructed based on STRING, and the core targets of Valerianae Jatamansi Rhizoma et Radix in the treatment of PTSD were selected according to the topological parameters. Cytoscape 3.7.2 was used to construct the compound-target network. DAVID database was used for GO enrichment analysis and KEGG enrichment analysis. The relationship network of "compound-target-pathway" was constructed through Cytoscape 3.7.2 to analyze and obtain the key targets and their corresponding components in the network, and their results were verified by molecular docking. The results showed that a total of 47 components(such as valeraldehyde, dihydrovalerin, valerate, chlorovaltrate K, 8-hydroxypinoresinol, 6-hydroxyluteolin, apigenin, farnesin, vanillin, luteolin, kaempferol, glycosmisic acid and pogostemon) of Valerianae Jatamansi Rhizoma et Radix may act on 94 key targets such as CNR1, MAOA, NR3 C1, MAPK14, MAPK8, HTR2 C and DRD2. Totally 29 GO terms were obtained by GO functional enrichment analysis(P<0.05), and 20 signaling pathways were obtained from KEGG pathway enrichment, mainly involving neuroactive ligand-receptor interaction, serotonergic synapse, calcium signaling pathway, cAMP signaling pathway, dopaminergic synapse, retrograde endocannabinoid signaling, neurotrophin signaling pathway, gap junction, cholinergic synapse, estrogen signaling pathway, glutamatergic synapse and long-term potentiation. Molecular docking analysis showed that hydrogen bonding, π-π interaction and hydrophobic effecting may be the main forms of interaction. This study used the network of compound-target-pathway and molecular docking technology to screen the effective components of Valerianae Jatamansi Rhizoma et Radix against PTSD, and explore its anti-PTSD mechanism, so as to provide scientific basis for exploring the anti-PTSD drugs from traditional Chinese medicine and clarifying its mechanism of action.


Asunto(s)
Medicamentos Herbarios Chinos , Trastornos por Estrés Postraumático , Medicina China Tradicional , Simulación del Acoplamiento Molecular , Rizoma , Trastornos por Estrés Postraumático/tratamiento farmacológico
18.
J Nurs Adm ; 51(6): 334-339, 2021 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33989241

RESUMEN

The purpose of this study was to describe the moral distress experiences of nurse managers. Moral distress has been studied among direct patient care providers including nurses and physicians. The moral distress experience among nurse managers is less understood. We conducted a qualitative descriptive study with 19 nurse managers from 5 healthcare institutions in Virginia. Interview data were analyzed using a directed content analysis, as the structural components of the moral distress phenomenon are already known. Participants suffered moral distress when they were unable to achieve or maintain effective unit function and felt caught in the middle between their units' and employees' needs and organizational directives. System-level causes of moral distress are common among nurse managers. Future research should involve measurement of moral distress among nurse managers and exploration of effective interventions.


Asunto(s)
Acontecimientos que Cambian la Vida , Enfermeras Administradoras/psicología , Trastornos por Estrés Postraumático/complicaciones , Adulto , Anciano , Actitud del Personal de Salud , Femenino , Humanos , Persona de Mediana Edad , Poder Psicológico , Autonomía Profesional , Investigación Cualitativa , Trastornos por Estrés Postraumático/psicología , Estrés Psicológico/complicaciones , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Virginia
19.
J Clin Psychiatry ; 82(3)2021 04 27.
Artículo en Inglés | MEDLINE | ID: mdl-34004095

RESUMEN

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has led to an increased risk of psychiatric symptoms among frontline health care workers (FHCWs). In the current study, a novel "symptomics" approach was employed to examine the association between acute transdiagnostic symptoms of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) and burnout and work and relationship difficulties in FHCWs at an urban tertiary care hospital in New York City. METHODS: Symptoms of COVID-19-related PTSD (4-item PTSD Checklist-5), MDD (Patient Health Questionnaire-8), GAD (Generalized Anxiety Disorder-7), burnout (Single-Item Mini-Z Burnout Assessment), and functional difficulties (Brief Inventory of Psychosocial Functioning) were assessed. Relative importance analyses were conducted to identify PTSD, MDD, and GAD symptoms associated with burnout and functional difficulties. RESULTS: The total number of eligible participants included 6,026 presumed FHCWs, of which 3,360 (55.8%) completed the survey and 2,579 (76.8%) of whom endorsed directly treating patients with COVID-19 and provided sufficient responses to our outcome variables for analysis. Feeling tired/having little energy, being easily annoyed or irritable, and feeling nervous, anxious, or on edge were most strongly associated with burnout; feeling tired/having little energy accounted for the greatest amount of explained variance (> 15%). Negative expectations of oneself or the world, trouble concentrating, and feeling easily annoyed or irritable were most strongly associated with work difficulties; negative expectations of oneself or the world accounted for the greatest amount of explained variance (> 9%). Feeling easily annoyed or irritable, negative expectations about oneself or the world, and feeling bad about oneself were most strongly associated with relationship difficulties; feeling easily annoyed or irritable accounted for the greatest amount of explained variance (> 10%). CONCLUSIONS: Results of this study underscore the importance of a transdiagnostic, symptom-based approach when examining associations between acute psychopathology and burnout and functional difficulties in FHCWs. Further work is needed to determine if early interventions aimed at ameliorating specific psychiatric symptoms may help mitigate risk for peri- and posttraumatic burnout and functional difficulties in this population.


Asunto(s)
Trastornos de Ansiedad/fisiopatología , Agotamiento Profesional/fisiopatología , COVID-19/terapia , Trastorno Depresivo Mayor/fisiopatología , Fatiga/fisiopatología , Genio Irritable/fisiología , Personal de Hospital , Trastornos por Estrés Postraumático/fisiopatología , Adulto , Femenino , Hospitales Urbanos , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York , Centros de Atención Terciaria
20.
Front Public Health ; 9: 490604, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33937159

RESUMEN

Research on the use of mobile technology in health sciences has identified several advantages of so-called mHealth (mobile health) applications. Tablet-supported clinical assessments are becoming more and more prominent in clinical applications, even in low-income countries. The present study used tablet computers for assessments of clinical symptom profiles in a sample of Burundian AMISOM soldiers (i.e., African Union Mission to Somalia; a mission approved by the UN). The study aimed to demonstrate the feasibility of mHealth-supported assessments in field research in Burundi. The study was conducted in a resource-poor setting, in which tablet computers are predestined to gather data in an efficient and reliable manner. The overall goal was to prove the validity of the obtained data as well as the feasibility of the chosen study setting. Four hundred sixty-three soldiers of the AMISOM forces were investigated after return from a 1-year military mission in Somalia. Symptoms of posttraumatic stress disorder (PTSD) and depression were assessed. The used data-driven approach based on a latent profile analysis revealed the following four distinct groups, which are based on the soldiers' PTSD and depression symptom profiles: Class 1: moderate PTSD, Class 2: moderate depression, Class 3: low overall symptoms, and Class 4: high overall symptoms. Overall, the four identified classes of soldiers differed significantly in their PTSD and depression scores. The study clearly demonstrates that tablet-supported assessments can provide a useful application of mobile technology in large-scale studies, especially in resource-poor settings. Based on the data collected for the study at hand, it was possible to differentiate different sub-groups of soldiers with distinct symptom profiles, proving the statistical validity of the gathered data. Finally, advantages and challenges for the application of mobile technology in a resource-poor setting are outlined and discussed.


Asunto(s)
Personal Militar , Trastornos por Estrés Postraumático , Burundi , Humanos , Somalia , Tecnología
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