Post-traumatic stress disorder among civilians 6 and 18 months after the January 2015 terrorist attacks in the Paris region.

In the literature, the association between medium and long-term PTSD (post-traumatic stress disorder) after terrorist attack has rarely been described. The objective of our study was to identify the factors associated with PTSD in the medium and longer term among people exposed to a terrorist attack in France. We used data from a longitudinal survey of 123 terror-exposed people interviewed 6-10 (medium term) and 18-22 (long term) months after. Mental health was assessed by the Mini Neuropsychiatric Interview. PTSD in the medium term was associated with history of traumatic events, low levels of social support and severe peri-traumatic reactions, which were in turn associated with high levels of terror exposure. PTSD in the medium term was linked in turn to the presence of anxiety and depressive disorders, which was also linked to PTSD in the longer term. The factors leading to PTSD are different in the medium and long term. In order to improve future support for people exposed to distressing events, it is important to follow up people with intense peri-traumatic reactions, high levels of anxiety and depression and to measure reactions.

Longitudinal survey on the Psychological Impact of the COVID-19 Pandemic in Healthcare Workers (PsyCOVer) in France: study protocol.

INTRODUCTION: In the pandemic, healthcare professionals face even higher levels of stress. It is therefore a priority to estimate the impact of the pandemic on mental health and to propose targeted strategies to improve resilience. The aims of the study were to (1) assess the mental health of healthcare professionals working with patients with COVID-19 and identify social determinants that may increase the risk of negative outcomes; and (2) test the effectiveness of an intervention to improve the resilience of healthcare professionals in France. METHODS AND ANALYSIS: To evaluate the first objective, a national longitudinal study will be carried out among healthcare professionals working with patients with COVID-19. Participants will be recruited via an internet link that will be widely disseminated on social media, mailing lists, medical boards and French medical journals. Primary outcomes are mental health distress/symptoms and resilience. Secondary outcomes are burnout, social and occupational supports and substance use. To meet the second objective, an interventional study will be conducted. The main outcome is the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter program. Qualitative analyses will be conducted to understand the strategies used to cope with the pandemic. ETHICS AND DISSEMINATION: The study protocol was approved by the Sorbonne Université Ethical Committee (No 2020-CER-2020-27) and was declared to French Commission on Information Technology and Liberties, CNIL (N°2222413, 20-05-2021). The results of this study will provide a better understanding of mental health and social inequalities in mental health among healthcare professionals working in the pandemic; data about the effectiveness of the PsySTART-Responder and the Anticipate.Plan.Deter interventional program in France.

Impact of Longitudinal Social Support and Loneliness Trajectories on Mental Health during the COVID-19 Pandemic in France.

(1) Background: Little is known about how the COVID-19 pandemic has impacted social support and loneliness over time and how this may predict subsequent mental health problems. This study aims to determine longitudinal trajectories of social support and loneliness in the French general population during the first year of the COVID-19 pandemic and study whether variations in these trajectories are associated with symptoms of depression and anxiety; (2) Methods: Analyses were based on data from 681 French participants in the international COVID-19 Mental Health Study (COMET) study, collected at four periods of time between May 2020 and April 2021. Group-based trajectory modelling (GBTM) was used to determine social support and loneliness trajectories. Associations between the identified trajectories and symptoms of depression and anxiety, measured with the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7), were tested through multivariate linear regression models; (3) Results: Social support trajectories revealed four stable groups: 'poor' (17.0%), 'moderate' (42.4%), 'strong' (35.4%) and 'very strong' (5.1%). Loneliness trajectories also identified four groups: 'low stable' (17.8%), 'low rising' (40.2%), 'moderate stable' (37.6%) and 'high rising' (5.0%). Elevated symptoms of depression were associated with poor social support as well as all identified loneliness trajectories, while high levels of anxiety were associated with moderate stable and high rising loneliness trajectories; (4) Conclusions: High and increasing levels of loneliness are associated with increased symptoms of depression and anxiety during the pandemic. Interventions to address loneliness are essential to prevent common mental health problems during the pandemic and afterwards.

The Mass Casualty Incident in Turin, 2017: A Case Study of Disaster Responders' Mental Health in an Italian Level I Hospital.

OBJECTIVE: To assess the psychological impact of a mass casualty incident (MCI) in a subset of personnel in a level I hospital. METHODS: Emergency department staff responded to an MCI in June 2017 in Turin, Italy by an unexpected sudden surge of casualties following a stampede (mass escape). Participants completed the Psychological Simple Triage and Rapid Treatment Responder Self-Triage System (PsySTART-R), which classified the potential risk of psychological distress in "no risk" versus "at risk" categorization and identified a range of impacts aggregated for the population of medical responders. Participants were administered a questionnaire on the perceived effectiveness of management of the MCI. Two months later, the participants were evaluated using the Hospital Anxiety and Depression Scale (HADS), the Kessler Psychological Distress Scale (K6), and the Posttraumatic Stress Disorder Checklist (PCL-5). RESULTS: The majority of the responders were classified as "no risk" by the PsySTART-R; no significant differences on HADS, K6, and PCL-5 were found in the participants grouped by the PsySTART-R categories. The personnel acquainted to work in emergency contexts (emergency department and intensive care unit) scored significantly lower in the HADS than the personnel usually working in other wards. The number of positive PsySTART-R criteria correlated with the HADS depression score. CONCLUSIONS: Most of the adverse psychological implications of the MCI were well handled and averted by the responders. A possible explanation could be related to factors such as the clinical condition of the victims (most were not severely injured, no fatalities), the small number of casualties (87) brought to the hospital, the event not being considered life-threatening, and its brief duration, among others. Responders had mainly to cope with a sudden surge in casualties and with organizational issues.

Intervenção na condição de vulnerabilidade social: um estudo sobre a produção de sentidos com adolescentes do programa do trabalho educativo / An intervention in the social vulnerability condition: a study on the meaning production with adolescents from the “trabalho educativo” program

Este artigo tem por objetivo problematizar a condição de vulnerabilidade social vista como propulsora de políticas públicas. Entendemos vulnerabilidade social como uma posição de desvantagem frente ao acesso às condições de promoção e garantia dos direitos de cidadania de determinadas populações. Para realizarmos este estudo, trabalhamos com jovens do programa Trabalho Educativo, vinculado ao Serviço de Apoio Sócio-Educativo do município de Porto Alegre. Através de observações participantes realizadas no módulo básico deste programa, desenvolvemos discussões utilizando textos e vídeos que refletem temas do cotidiano. As análises desses registros foram fundamentadas na abordagem da produção de sentidos de determinados discursos, os quais, a partir de marcas identitárias, inscrevem jovens como vulneráveis. Deste modo, questionamos ações de programas sociais que, ao entenderem a priori os jovens como vulneráveis, podem atuar restringindo as possibilidades de promoção de vida, ao invés de oportunizar a produção de novos modos de subjetivação(AU)

This article aims at problematizing the social vulnerability condition seen as a starting point of public policies. We understand social vulnerability as a disadvantage position in relation to the access to conditions of promotion and achievement of citizenship rights of certain populations. In order to carry out this study, we have worked with youths from the Trabalho Educativo Program, linked to Serviço de Apoio Sócio-Educativo in Porto Alegre. Through participative observations in the basic module of this program, we developed discussions using texts and videos that reflect daily themes. The analyses of those records were founded on the approach of meaning production of certain discourses, which from identity marks characterize youths as vulnerable. We question actions of social programs that, in understanding youths as being vulnerable a priori, may restrict possibilities of life promotion rather than giving opportunities to produce new modes of subjectivation (AU)

Intervenção na condição de vulnerabilidade social: um estudo sobre a produção de sentidos com adolescentes do programa do trabalho educativo / An intervention in the social vulnerability condition: a study on the meaning production with adolescents from the “trabalho educativo” program

Este artigo tem por objetivo problematizar a condição de vulnerabilidade social vista como propulsora de políticas públicas. Entendemos vulnerabilidade social como uma posição de desvantagem frente ao acesso às condições de promoção e garantia dos direitos de cidadania de determinadas populações. Para realizarmos este estudo, trabalhamos com jovens do programa Trabalho Educativo, vinculado ao Serviço de Apoio Sócio-Educativo do município de Porto Alegre. Através de observações participantes realizadas no módulo básico deste programa, desenvolvemos discussões utilizando textos e vídeos que refletem temas do cotidiano. As análises desses registros foram fundamentadas na abordagem da produção de sentidos de determinados discursos, os quais, a partir de marcas identitárias, inscrevem jovens como vulneráveis. Deste modo, questionamos ações de programas sociais que, ao entenderem a priori os jovens como vulneráveis, podem atuar restringindo as possibilidades de promoção de vida, ao invés de oportunizar a produção de novos modos de subjetivação...

This article aims at problematizing the social vulnerability condition seen as a starting point of public policies. We understand social vulnerability as a disadvantage position in relation to the access to conditions of promotion and achievement of citizenship rights of certain populations. In order to carry out this study, we have worked with youths from the Trabalho Educativo Program, linked to Serviço de Apoio Sócio-Educativo in Porto Alegre. Through participative observations in the basic module of this program, we developed discussions using texts and videos that reflect daily themes. The analyses of those records were founded on the approach of meaning production of certain discourses, which from identity marks characterize youths as vulnerable. We question actions of social programs that, in understanding youths as being vulnerable a priori, may restrict possibilities of life promotion rather than giving opportunities to produce new modes of subjectivation...