Lifetime Trauma and Cardiovascular Health in Latinas.

BACKGROUND: Potentially traumatic experiences throughout the life course are associated with poor cardiovascular health among women. However, research on the associations of trauma with cardiovascular health among Latino populations is limited. Understanding the impact of trauma on cardiovascular health within marginalized populations may provide guidance on developing interventions with a particular focus on preventative care. OBJECTIVE: The purpose of this descriptive cross-sectional study was to examine the associations of lifetime trauma with cardiovascular health among middle-aged and older Latina women. METHODS: Participants were recruited from an existing study in New York City. All participants completed a structured questionnaire to assess lifetime trauma, demographic characteristics (such as age and education), financial resource strain, and emotional support. The Trauma History Questionnaire was used to assess lifetime exposure to potentially traumatic experiences (range 0-24). Cardiovascular health was measured with a validated measure of cardiovascular health from the American Heart Association (Life's Simple 7). We used self-reported and objective data to calculate cardiovascular health scores (range 0-14). Multiple linear regression was used to examine the associations of lifetime trauma with cardiovascular health, adjusted for age, education, financial resource strain, and emotional support. RESULTS: The sample included 50 Latina women with a mean age of 63.1 years, 88% were Dominican, and only 6% had completed a college degree. Women reported an average of 4.8 traumatic experiences. Mean cardiovascular health score was 6.5 (SD = 1.6, range 3-10). Linear regression models found that, after adjusting for age, education, financial resource strain, and emotional support, a higher count of lifetime trauma was associated with worse cardiovascular health. However, this association did not reach statistical significance. DISCUSSION: Women with a higher count of lifetime trauma had worse cardiovascular health scores; this association was not statistically significant. Future studies should investigate associations of lifetime trauma and cardiovascular health in larger and more diverse samples of Latinas. Nurses and other clinicians should incorporate trauma-informed approaches to cardiovascular disease risk reduction to improve the cardiovascular health of Latina women who are survivors of trauma.

Trauma informed interventions: A systematic review.

BACKGROUND: Health inequities remain a public health concern. Chronic adversity such as discrimination or racism as trauma may perpetuate health inequities in marginalized populations. There is a growing body of the literature on trauma informed and culturally competent care as essential elements of promoting health equity, yet no prior review has systematically addressed trauma informed interventions. The purpose of this study was to appraise the types, setting, scope, and delivery of trauma informed interventions and associated outcomes. METHODS: We performed database searches- PubMed, Embase, CINAHL, SCOPUS and PsycINFO-to identify quantitative studies published in English before June 2019. Thirty-two unique studies with one companion article met the eligibility criteria. RESULTS: More than half of the 32 studies were randomized controlled trials (n = 19). Thirteen studies were conducted in the United States. Child abuse, domestic violence, or sexual assault were the most common types of trauma addressed (n = 16). While the interventions were largely focused on reducing symptoms of post-traumatic stress disorder (PTSD) (n = 23), depression (n = 16), or anxiety (n = 10), trauma informed interventions were mostly delivered in an outpatient setting (n = 20) by medical professionals (n = 21). Two most frequently used interventions were eye movement desensitization and reprocessing (n = 6) and cognitive behavioral therapy (n = 5). Intervention fidelity was addressed in 16 studies. Trauma informed interventions significantly reduced PTSD symptoms in 11 of 23 studies. Fifteen studies found improvements in three main psychological outcomes including PTSD symptoms (11 of 23), depression (9 of 16), and anxiety (5 of 10). Cognitive behavioral therapy consistently improved a wide range of outcomes including depression, anxiety, emotional dysregulation, interpersonal problems, and risky behaviors (n = 5). CONCLUSIONS: There is inconsistent evidence to support trauma informed interventions as an effective approach for psychological outcomes. Future trauma informed intervention should be expanded in scope to address a wide range of trauma types such as racism and discrimination. Additionally, a wider range of trauma outcomes should be studied.

Analyzing Indian general public's perspective on anxiety, stress and trauma during Covid-19 - A machine learning study of 840,000 tweets.

BACKGROUND AND AIMS: Ever since COVID-19 was declared a pandemic by WHO in late March 2020, more and more people began to share their opinions online about the anxiety, stress, and trauma they suffered because of the pandemic. However, very few studies were conducted to analyze the general public's perception of what causes stress, anxiety, and trauma during COVID-19. This study focuses particularly on understanding Indian citizens. METHODS: By using Machine learning techniques, particularly Natural language processing, this study focuses on understanding the attitude of Indian citizens while discussing the anxiety, stress, and trauma created because of COVID-19 and the major reasons that cause it. We used Tweets as data for this study. We have used 840,000 tweets for this study. RESULTS: Our sentiment analysis study revealed the interesting fact that, even while discussing about the stress, anxiety, and trauma caused by COVID-19, most of the tweets were in neutral sentiments. Death and Lockdown caused by the COVID-19 were the two most important aspects that cause stress, anxiety, and Trauma among Indian citizens. CONCLUSION: It is important for policymakers and health professionals to understand common citizen's perspectives of what causes them stress, anxiety, and trauma to formulate policies and treat the patients. Our study shows that Indian citizens use social media to share their opinions about COVID-19 and as a coping mechanism in unprecedented time.

Childhood trauma and post-trauma environment affect fear memory and alcohol use differently in male and female mice.

BACKGROUND: Childhood trauma is associated with the development of adult mental health and substance use disorders, with females generally being more at risk. Alcohol is commonly used for coping with trauma, and alcohol use disorder (AUD) affects ∼14.4 million adult Americans annually. Research investigating sex differences in the environmental modification of anxiety and alcohol use following childhood trauma will extend our understanding of the etiology of AUD. Here, we sought to model the interacting effects of a single-episode late childhood trauma with post-trauma environment on adult alcohol use using male and female mice. METHODS: C57Bl6/J mice (d22) exposed to predator odor (TMT) or water were reared in standard environments (SE) or environmental enrichment (EE). Mice were assessed for adolescent anxiety and conditioned fear, and for adult alcohol use in a limited access, response non-contingent, alcohol exposure paradigm. RESULTS: A single exposure to predator odor was an effective stressor, inducing long-term sex-dependent changes in conditioned fear and alcohol behaviors that interacted with post-trauma environment. Adolescent EE females showed more conditioned freezing to the trauma-associated context. Adult EE mice consumed less total alcohol than SE mice. However, alcohol use across time differed for males and females. Exposure to a childhood stressor increased alcohol use significantly in females, but not males. EE males, but not EE females, drank less than SE counterparts. CONCLUSIONS: Findings from this model recapitulate greater vulnerability to childhood trauma in females and support sex differences in post-trauma development of conditioned fear and alcohol use that are modified by environment.

Gait Disorder among Elderly People, Psychomotor Disadaptation Syndrome: Post-Fall Syndrome, Risk Factors and Follow-Up - A Cohort Study of 70 Patients.

INTRODUCTION: Falls among older people are a major health issue and the first cause of accidental death after 75 years of age. Post-fall syndrome (PFS) is commonly known and yet poorly studied. OBJECTIVE: Identify risk factors for PFS and do a follow-up 1 year later. METHODS: We included all patients over 70 years of age hospitalized after suffering a fall in a case-control study, and then followed them in a cohort study. PFS was retained in case of functional mobility decline (transferring, walking) occurring following a fall in the absence of an acute neurological, orthopedic or rheumatic pathology directly responsible for the decline. The data initially collected were: clinical (anamnestic, emergency and departmental/ward evolution, medical history, lifestyle, treatments, clinical examination items); and imaging if the patient had been subjected to brain imaging in the last 3 years prior to inclusion. Regarding the follow-up at 1 year, we collected from the general physician the occurrence and the characteristics of new falls, functional mobility assessment, hospitalization and death. RESULTS: Inclusion took place from March 29, 2016 to June 7, 2016 and follow-up until June 30, 2017. We included 70 patients. A total of 29 patients exhibited a PFS (41.4 %). Risk factors for PFS included age, walking disorder prior to the fall, the use of a walking aid prior to the fall, no unaccompanied outdoor walk in the week before the fall, visual impairment making close reading impossible, stiffness in ankle dorsiflexion, grip strength and the fear of falling. Among patients with PFS, 52.9% could still perform a transfer at 1 year and 64.7% could still walk against 80.7% and 85.2%, respectively, for patients without PFS. CONCLUSION: The study showed the existence of body functions/structure impairments and activity limitations prior to the fall among patients exhibiting a PFS. This suggests the existence of a pre-fall syndrome, i.e., a psychomotor disadaptation syndrome existing prior to the fall. Among the 8 risk factors, fear of falling, vision impairment and muscle strength could be targeted for improvement. The diagnosis of PFS could be a marker of loss of functional mobility at 1 year.

Mental disorders in the context of trauma and violence in a population study. / Trastornos mentales desde la perspectiva del trauma y la violencia en un estudio poblacional.

INTRODUCTION: Traumatic events and violence are widespread public health problems. They do not have limits related to age, sex or socioeconomic level. The prevalence of mental disorders and sociodemographic characteristics were compared in the context of traumatic events and types of violence in the general population. MATERIALS AND METHODS: Observational prevalence study with a secondary information source, in the general population aged 13 to 65 years, selected at random. The interview was conducted using the Compositum International Diagnosis Interview which generates psychiatric diagnoses according to the DSM-IV. The variables included were traumatic events grouped into five categories: related to armed conflict, sexual violence, interfamily violence, other types of violence, traumas and some mental disorders. The prevalence of mental disorders was compared in the five categories of traumatic events. Statistical significance was defined as a p value of <0.05. RESULTS: Sexual and interfamily violence were more prevalent in women (p <0.05). In those under age 13, major depression related to armed conflict had a prevalence of 48.3%, with a significant difference from the other trauma groups (p=0.015). All prevalences for childhood-onset disorders showed significantly different prevalences compared with the group for violence related to armed conflict (p <0.05) and suicidal ideation was higher in the sexual violence group (p=0.006). DISCUSSION: High prevalences of mental disorders were found in people who had been exposed to traumatic events and violence. In those who experienced traumatic events related to armed conflict and sexual violence, higher prevalences of certain mental disorders were detected.

Black Summer in the Shoalhaven, NSW: what was it like and what could we do better? A resident's perspective.

In this perspective paper, I describe the terror of being trapped in an isolated village on the New South Wales (NSW) South Coast as a catastrophic bushfire approached. In the aftermath of the 2019-20 'black summer', I reflect on factors that could have helped reduce the trauma and stress experienced by residents, both during and in the wake of the bushfire event. Education, community planning and preparedness for a situation where modern communication methods fail are key factors to consider.

Impact of Season of Birth on Psychiatric Disorder Susceptibility and Drug Abuse Incidence in a Population from the Köppen Tropical Savanna Region of Brazil.

BACKGROUND: Despite much evidence that season of birth (SOB) my influence the vulnerability to psychiatric disorders, divergence has been reported, in particular between populations born in the northern and southern hemispheres. We analyzed the potential modified risk by SOB to psychiatric disorder or drug addiction comorbidity in a population born in the Triângulo Mineiro region, a southern hemisphere Köppen tropical savanna region in Brazil. METHOD: We accessed the records of 98,457 of patients and healthy controls of the National Datacenter of Medical Promptuary to evaluate the influence of SOB as a modifying factor on the occurrence of mental disorders and drug abuse conditions among individuals born from the year 2000 to 2016. RESULTS: The data revealed significant modification of the relative incidence of major depressive disorder (MDD) (F11, 72 = 2.898; p = 0.003; eta-squared, ES = 0.313; ⍺ = 0.97), anxiety-related disorder (ARD) (F11, 81 =2.389; p = 0.013; ES = 0.241; ⍺ = 0.932), and schizophrenia (SZ) (F11, 83 = 2.764; p = 0.005; ES = 0.303; α = 0.963), while there was no increase in the number of healthy controls born in any month of the year (F11, 71 = 1.469; p = 0.163). Post hoc analyses indicated a significant higher vulnerability to MDD or ARD if the patient was born in August, or October to December, respectively. A relative increase in the incidence of SZ was also observed in patients born from August to October, compared to patients born from November to January. CONCLUSIONS: SOB may influence the risk for psychiatric disorders in the TMR population. Regional particularities associated with the climatic regime may account for the apparent divergence between studies.

Screening and Stepped Care Targeting Psychological Distress in Patients With Metastatic Colorectal Cancer: The TES Cluster Randomized Trial.

BACKGROUND: This study evaluated the effectiveness of a screening and stepped care program (the TES program) in reducing psychological distress compared with care as usual (CAU) in patients with metastatic colorectal cancer starting with first-line systemic palliative treatment. PATIENTS AND METHODS: In this cluster randomized trial, 16 hospitals were assigned to the TES program or CAU. Patients in the TES arm were screened for psychological distress with the Hospital Anxiety and Depression Scale and the Distress Thermometer/Problem List (at baseline and 10 and 18 weeks). Stepped care was offered to patients with distress or expressed needs, and it consisted of watchful waiting, guided self-help, face-to-face problem-solving therapy, or referral to specialized mental healthcare. The primary outcome was change in psychological distress over time, and secondary outcomes were quality of life, satisfaction with care, and recognition and referral of distressed patients by clinicians. Linear mixed models and effect sizes were used to evaluate differences. RESULTS: A total of 349 patients were randomized; 184 received the TES program and 165 received CAU. In the TES arm, 60.3% of the patients screened positive for psychological distress, 26.1% of which entered the stepped care program (14.7% used only watchful waiting and 11.4% used at least one of the other treatment steps). The observed low use of the TES program led us to pursue a futility analysis, which showed a small conditional power and therefore resulted in halted recruitment for this study. No difference was seen in change in psychological distress over time between the 2 groups (effect size, -0.16; 95% CI, -0.35 to 0.03; P>.05). The TES group reported higher satisfaction with the received treatment and better cognitive quality of life (all P<.05). CONCLUSIONS: As a result of the low use of stepped care, a combined screening and treatment program targeting psychological distress in patients with metastatic colorectal cancer did not improve psychological distress. Our results suggest that enhanced evaluation of psychosocial concerns may improve aspects of patient well-being.

Lifetime Trauma and Cardiometabolic Risk in Sexual Minority Women.

Background: Sexual minority women (SMW; such as lesbian, bisexual, and mostly lesbian) exhibit excess cardiometabolic risk, yet factors that contribute to cardiometabolic risk in this population are poorly understood. Trauma exposure has been posited as a contributor to cardiometabolic risk in SMW. Materials and Methods: An analysis of data from Wave 3 of the Chicago Health and Life Experiences of Women Study was conducted. Multinomial logistic regression was used to examine correlates of trauma. Next, multiple logistic regression was used to examine the associations of different forms of trauma throughout the life course (childhood, adulthood, and lifetime), with psychosocial and behavioral risk factors and self-reported cardiometabolic risk (obesity, hypertension, and diabetes) in SMW adjusted for relevant covariates. Results: A total of 547 participants were included. Older age was associated with higher rates of childhood and adulthood trauma. SMW of color reported higher rates of childhood trauma than white participants. Higher education was associated with lower rates of adulthood trauma. All forms of trauma were associated with probable diagnosis of post-traumatic stress disorder and lower perceived social support. Adult trauma was associated with anxiety, whereas childhood and lifetime trauma were associated with higher odds of depression. No significant associations between forms of trauma and behavioral risk factors were noted, except that childhood trauma was associated with higher odds of past-3-month overeating. Logistic regression models examining the association of trauma and cardiometabolic risk revealed that childhood trauma was an independent risk factor for diabetes. Adulthood and lifetime trauma were significantly associated with obesity and hypertension. Conclusions: Trauma emerged as an independent risk factor for cardiometabolic risk in SMW. These findings suggest that clinicians should screen for trauma as a cardiovascular risk factor in SMW, with special attention to SMW most at risk.

Psychiatric Comorbidity of Sex Offenses in a Military Forensic Sample.

OBJECTIVE: To examine the prevalence of psychiatric disorders among service members charged with sexual offenses. METHODS: The sample comprised service members charged with any type of sexual offense and referred for forensic evaluation (N = 67). Forensic mental health evaluations (competency to stand trial, criminal responsibility, risk assessment) of service members charged with sexual offenses were examined and the assigned clinical diagnoses (according to DSM-IV or -5) were enumerated to provide natural frequencies and percentages. Data were collected from February 2018 to May 2018. RESULTS: Findings suggest that alcohol use disorder is the most prevalent disorder both at the time of offense (28%) and time of the forensic evaluation (38%). The 2 most prominent diagnostic categories were substance use disorders and trauma-and-stress-related disorders. CONCLUSIONS: Identification and treatment of psychiatric disorders among service members charged with sexual offenses may facilitate rehabilitation, reduce recidivism, and offer public health benefits. This topic should be further studied in a larger sample to effectively address this public health problem.

Prevalence of Trauma in an Australian Inner City Mental Health Service Consumer Population.

This study examined the rates and types of trauma reported by consumers utilising an inner city mental health service in Sydney, Australia. The study also explored whether consumers felt that it had been helpful to be asked about their experience of trauma, whether they thought that these questions should be asked routinely and if they wanted to talk about these experiences. Ninety-one consumers from an inner city mental health service were assessed. Eighty-eight percent of the consumers assessed reported that they had experienced at least one traumatic event, while 79% reported having experienced two or more events. A majority of consumers identified that they thought it was helpful to be asked about trauma and that it should be part of an assessment. However, less than one-third of these consumers surveyed wanted to talk about the trauma at the time of assessment. Concerns that clinicians may have in regards to addressing trauma in mental health assessment are not matched by consumers' expressed beliefs on the issue.

Implementing a Trauma-Informed Public Health System in San Francisco, California.

BACKGROUND: Trauma is a ubiquitous and harmful public health concern. Much like individuals, organizations experience trauma and can embed it within their culture. Left unaddressed, trauma inhibits staff from confronting problems, communicating effectively, and generating solutions, factors that undermine organizational functioning. In response to trauma's far-reaching impact, recent efforts have focused on creating "trauma-informed" systems that emphasize safety and avoid retraumatization. Trauma-informed systems are uniquely connected to relationships, as the impact of trauma both impairs relationships and is heightened in the absence of quality relationships. Developing trauma-informed relationships is therefore critical to creating a healing organizational culture. AIMS: The objective of this article is to describe the process through which the San Francisco Department of Public Health (SFDPH) developed and implemented their Trauma-Informed Systems (TIS) Initiative, an organizational model to address trauma at the systems level. The article highlights the centrality of trauma-informed relationships to the initiative's guiding principles, activities, and implementation process. DISCUSSION: Six core principles underlie the work of the SFDPH's TIS Initiative: (1) Understanding Trauma & Stress, (2) Compassion & Dependability, (3) Safety & Stability, (4) Collaboration & Empowerment, (5) Cultural Humility & Responsiveness, (6) Resilience & Recovery. Initiative components focus on creating and sustaining trauma-informed knowledge (i.e., foundational training, train-the-trainer program) and organizational practices (i.e., aligned efforts, leadership, and champion engagement). CONCLUSION: Trauma-informed systems represent an emergent organization-level intervention designed to address trauma and its sequelae. SFDPH's TIS Initiative is creating a healing organization through its innovative response to the impact of trauma.

Prevalence and pattern of mental illnesses in Uttar Pradesh, India: Findings from the National Mental Health Survey 2015-16.

AIM: To estimate the prevalence and distribution of psychiatric morbidity, and study pattern of help-seeking in a community representative sample from the state of Uttar Pradesh in northern India. METHOD: A multi-stage, stratified, random cluster sampling was used. The survey was conducted on 3508 adults during 2015-16 using M.I.N.I 6.0.0, modified Fagerström Nicotine Dependence Scale for all forms of tobacco, questionnaires for epilepsy and intellectual disability. The WHO Pathway Interview Schedule was used to study pattern of help-seeking behaviour. Focused group discussions (FGDs) and key informant interviews (KIIs) were also carried out. RESULT: Current and lifetime prevalence of 'any mental morbidity' (excluding tobacco use disorders) was 6.08% and 7.97%, respectively. The prevalence of substance use disorders, was 16.36%, of which tobacco use disorders alone contributed 16.06%. Neurotic and depressive disorders were the next most common morbidity. Schizophrenia and other psychotic disorders had a current prevalence of 0.09%. High-risk for suicide was reported to be 0.93%. Treatment gap varied between 75 and 100% for different disorders. FGDs and KIIs reflected a higher burden of substance use, including prescription drug abuse, substantial prevalence of cultural mental morbidity, deep rooted stigma, low help-seeking behaviour, and issues surrounding homeless mentally ill persons in the community. CONCLUSION: The survey revealed high mental morbidity and alarming treatment gap. FGDs and KIIs also highlight the burden of morbidity that probably goes un-noticed, due to socio-cultural systems and stigma. Findings from this survey are intended to be the groundwork for the (re)planning of mental healthcare infrastructure in the state.

[Complex Trauma-related Disorders in Research and Practice]. / Komplexe Traumafolgestörungen bei Kindern und Jugendlichen in Forschung und Praxis.

Complex Trauma-related Disorders in Research and Practice Frequent traumata in childhood and adolescence are long-term or repeated interpersonal traumata caused by perpetrators in the close environment of the minors. For the description of the extensive symptoms after interpersonal Type II traumata, the complex trauma-related disorders Complex Posttraumatic Stress Disorder (CPTSD) or Disorder of Extreme Stress Not Otherwise Specified (DESNOS) and the Developmental Trauma Disorder (DTD) are being discussed for inclusion in the classification systems for mental disorders. Scientific knowledge and practical experiences regarding CPTSD, DESNOS and DTD in children and adolescents up to 18 years were examined by 1) a Systematic Review of 1,070 publications identified by database research and additional search strategies, and 2) a nationwide online survey of 374 psychotherapists and psychiatrists for children and adolescents in Germany. Of 13 included empirical studies (8 CPTSD or DESNOS, 5 DTD), 9 were conducted in the USA, 4 based on file coding and 3 on secondary data analysis and only 7 reported diagnosis rates (range: 0-78 %). Of the interviewed therapists, 100 % considered the CPTSD as being met with at least one patient with interpersonal traumata up to 18 years of age in 2014 and 99 % gave this estimate for the DTD. Two thirds of therapists rated the diagnostic option CPTSD and DTD as "very often" or "often" helpful for their therapeutic work with children and adolescents. While empirical data available is to be considered insufficient and characterized by methodological limitations, the relevance of complex trauma-related disorders is perceived as high by practitioners.

Do adverse life events at first onset of auditory verbal hallucinations influence subsequent voice characteristics? Results from an epidemiological study.

Understanding what happens at first onset of auditory verbal hallucinations (AVHs) is extremely important on a clinical and theoretical level. Previous studies have only focused on age with regard to first onset of AVHs. In the current epidemiological study, we examined a number of aspects relating to first onset of AVHs, such as the role of adverse life events at first onset of AVHs on symptom severity and general mental health. For this purpose, we compared participants who reported adverse life events at first onset of AHVs (adverse-trigger group; N = 76) to those that did not report any specific events at first onset of AVHs (no-adverse-trigger group; N = 59) on a large array of variables. Results showed that AVHs in the adverse-trigger group were experienced as more emotional compared to the no-adverse-trigger group. In addition, the adverse-trigger group more often reported hallucinations in other (non-auditory) sensory modalities (e.g. visual) compared to the no-adverse-trigger group. Furthermore, the adverse-trigger group reported poorer general mental health, reported having contact with mental health professionals more often, and also reported more frequently taking medication for psychological problems in general. The implications of these findings are discussed.

Optimizing clinical thresholds for PTSD: Extending the DSM-5 preschool criteria to school-age children / Optimizando el umbral clínico para el TEPT: extendiendo criterios del DSM-5 de preescolares a niños de edad escolar

Background/Objective: To examine the effect of using the DSM-5 preschool criteria to diagnose posttraumatic stress disorder (PTSD) in school-age children (ages 7-11). Method: Children exposed to Hurricane Ike (N=327) were assessed for symptoms of PTSD and other trauma-related factors eight months post-disaster. Results: About twice as many children were identified as having PTSD using the DSM-5 preschool criteria compared to the DSM-5 adult criteria. The preschool criteria identified all children diagnosed by the adult criteria and many additional children. Although children who met both the adult and the preschool criteria reported the most functional impairment, children identified by the preschool criteria only reported greater impairment than children not diagnosed. The effect of including impairment in the diagnostic criteria was more marked for the preschool criteria than for the adult criteria. Additionally, PTSD defined by the preschool criteria was significantly associated with more PTSD risk factors than PTSD as defined by the adult criteria. Model fit was similar for both sets of criteria. Conclusions: The preschool criteria may be advantageous for screening for PTSD risk in school-age children. Further research is needed to optimize developmentally-appropriate PTSD criteria for school-age children (AU)

Antecedentes/Objetivo: Examinar el uso los criterios preescolares del DSM-5 para diagnosticar el trastorno de estrés postraumático (TEPT) en niños de edad escolar (7-11 años). Método: Niños expuestos al huracán Ike (N=327) fueron evaluados respecto a los síntomas de TEPT, ocho meses después del desastre. Resultados: Aproximadamente el doble de niños fueron diagnosticados con TEPT usando los criterios preescolares del DSM-5 comparado a los de adultos. Los criterios preescolares identificaron todos los niños diagnosticados usando los criterios de adultos y muchos más. Aunque los niños que cumplieron ambos criterios reportaron el mayor deterioro funcional, los niños identificados solamente por los criterios preescolares reportaron más deterioro que los niños no diagnosticados. El efecto de incluir el deterioro en los criterios diagnósticos fue más intenso para los criterios preescolares. Además, el TEPT definido por los criterios preescolares fue asociado significativamente con más factores de riesgo que TEPT definido por los criterios de adultos. El ajuste del modelo fue similar en ambos conjuntos de criterios. Conclusión: Los criterios preescolares pueden ser útiles para detectar el riesgo de TEPT en niños de edad escolar. Se necesitan más investigaciones para optimizar los criterios de TEPT de acuerdo al nivel de desarrollo para los niños en edad escolar (AU)

Sexual and Non-Sexual Trauma, Depression and Self-Esteem in a Sample of Polish Women. A Cross-Sectional Study.

The purpose of this research was to explore the issue of the psychological aftermaths of traumatic events in women. According to the existing body of evidence, women suffer more often than men from mental health problems as a result of a traumatic event-one of the explanations for this is that women experience sexual trauma more frequently and this type of trauma causes more severe negative consequences. Therefore, the main aim of this research was to compare the aftermaths of sexual and non-sexual traumatic events in women. Only traumatic events in adulthood were taken into consideration and were divided into two categories: recent events (previous two years) and those of an earlier occurrence. Depression and low level of self-esteem were included in the research model as possible consequences of traumatic events. A total of 273 women from Poland took part in a questionnaire survey. As hypothesized, in the case of recent events, participants who experienced a sexual trauma showed a higher level of depression and lower level of self-esteem compared with those subjects, who experienced a non-sexual trauma or did not experience a traumatic event at all. However, this effect was not observed in the case of events of earlier occurrence. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Relations between traumatic experiences and the level of depression and self-esteem in women were demonstrated. Women who experienced sexual trauma showed higher levels of depression and lower levels of self-esteem than women who experienced other types of trauma. Time of the occurrence of the traumatic events matters: the relations between traumatic events, depression and self-esteem were demonstrated in the case of the events that occurred within the last two years.

La interconsulta hospitalaria en salud mental infanto-juvenil: un modelo internacional / Interdisciplinary consultations in child and adolescent mental health: An international model

En este artículo se plantea realizar un análisis de la causas de rechazo del niño al padre/madre u otro familiar significativo, tomando tales manifestaciones como síntoma de una situación en la que pueden considerarse diferentes factores (internos, externos y relacionales o de vinculación). Con ejemplos de casos reales, se pretende resaltar la importancia de diagnosticar adecuadamente las motivaciones reales de estas manifestaciones, sin caer en la simplicidad de la explicación única, ya sea el maltrato, o bien el puro capricho del niño. Al mismo tiempo se considera determinar la justificación auténtica de dicho rechazo. Finalmente, se hace una llamada a la reflexión en las intervenciones profesionales delante de estas situaciones y a la necesidad de una coordinación eficaz para tratar el fenómeno

In this article arises to perform an analysis of the causes of rejection of the child to the parent or other significant family member, taking such manifestations as a symptom of a situation in which different factors can be considered (internal, external and relational or bonding). Examples of real cases, it is intended to highlight the importance of adequately diagnosing the actual motivations of these manifestations, without falling into the simplicity of the single explanation, be it abuse, either the pure whim of the child. At the same time is considered to determine the real justification for the rejection. Finally, a call to reflection on professional interventions in front of these situations and the need for effective coordination is done to treat the phenomenon