Translation, validation and exploration of the factor structure in the French version of the Posttraumatic Cognitions Inventory (PTCI).

OBJECTIVES: In order to validate a French version of the PTCI, this study investigates two objectives using two French speaking samples: (1) test 10 factor structures identified in prior studies, and (2) assess the other psychometric properties of the best fitting factor structure. METHOD: The PTCI was translated in French using a reverse translation method and administered to 202 university students and 114 aid workers. Suitability indexes of the appropriate factor structures previously identified in prior studies were examined. Internal consistency, correlations between subscales and convergent, divergent and discriminant validities in the most appropriate structure were evaluated. RESULTS: Results support that only Wells et al.'s short 9-item version of the PTCI and three factors shows excellent suitability indexes. This version also outlines an excellent internal consistency and solid convergent, divergent, and discriminant validities. CONCLUSIONS: This study confirms the empirical validity, fidelity, and utility of Wells et al.'s short version of the PTCI. This is the first PTCI French validation, which is a major advantage when it comes to assess posttraumatic cognitions in French trauma victims.

Identifying Trajectories and Predictors of Response to Psychotherapy for Post-Traumatic Stress Disorder in Adults: A Systematic Review of Literature.

OBJECTIVE: There exists considerable individual variability in the development and progression of pathological stress reactions after experiencing trauma, as well as in individuals' response to psychological interventions. Yet until recently, such individual differences had not been considered when evaluating the efficacy of therapeutic interventions for post-traumatic stress disorder (PTSD). This systematic review aims to examine the emerging literature on this subject and, specifically, to identify trajectories and predictors of psychotherapeutic response in adults with PTSD. METHOD: Four databases were searched using specific keywords without date or language restrictions. For each study, independent reviewers systematically evaluated whether it met eligibility criteria and assessed risk of bias. For included studies, reviewers completed data extraction using standard formats. Those examining how subgroups of adults respond to therapy for clinical PTSD using trajectory modeling were deemed eligible. Demographic, PTSD, clinical, and trauma-related factors associated to particular trajectories were also examined. RESULTS: Of the 1,727 papers identified, 11 were included in this analysis. Of these studies, six focused on military-related traumas and five on civilian ones. Although studies found between two and five trajectories, most supported a three-trajectory model of response categorized as responders, nonresponders, and subclinical participants. Over 22 predictors of treatment trajectories were examined. Comorbid depression, anxiety, and alcohol abuse were the strongest predictors of poor therapeutic response. Age, combat exposure, social support, and hyperarousal were moderate predictors. CONCLUSION: This review provides valuable insight into the treatment of PTSD, as it supports the heterogeneous trajectories of psychotherapeutic responses and provides avenues for the development of interventions that consider individual-level factors in treatment response.

Morally injurious events among aid workers: examining the indirect effect of negative cognitions and self-care in associations with mental health indicators.

Introduction: Potentially morally injurious events (PMIE) are events that violate one's deeply held moral values or beliefs, and that have the potential to create significant inner conflict and psychological distress. PMIE have been recognized as an important psychological risk factor in many high-risk occupational groups. However, no study to date has investigated how PMIE relate to the mental health of aid workers. Furthermore, little is known about the mechanisms by which PMIE might be associated with mental health indicators. Methods: Participants were 243 aid workers (72% female; M age = 39.31) who had completed at least one aid assignment (M = 8.17). They completed an online questionnaire about their PMIE, trauma history, and mental health. A structural equation model was constructed to examine the roles of negative cognitions and subsequent self-care behaviors in the relationship between PMIE and PTSD symptoms, depression symptoms, and posttraumatic growth, above and beyond the contribution of potentially traumatic events. Results: Within the model, the indirect effect through negative cognitions fully accounted for the associations between PMIE and symptoms of PTSD and depression. For the association between PMIE and posttraumatic growth, two indirect effects emerged: the first through negative cognitions and subsequent self-care and, the second, through self-care alone. Discussion: This study highlighted PMIE as a novel psychological risk factor for aid workers and pointed to two possible mechanisms by which these events may lead to PTSD, depression, and posttraumatic growth. This study adds to the current understanding of how high-risk occupational groups adapt psychologically to PMIE.

Posttraumatic stress symptom profiles of aid workers: Identifying risk and protective factors.

OBJECTIVE: Researchers have documented elevated rates of posttraumatic stress disorder (PTSD) in aid workers. Yet, few have investigated the heterogeneity of PTSD presentations in this population. This study examined clinically relevant patterns of PTSD symptomatology in aid workers and examined whether factors such as the degree of trauma exposure (e.g., morally injurious events), social support, and sociodemographic and work characteristics predict symptom profiles. METHOD: Participants were 243 aid workers who had completed 8.2 assignments on average. They completed measures of trauma exposure, PTSD symptoms, and various types of social support. Latent profile analysis was used to identify PTSD symptom profiles using PCL-5 subscale scores. Next, profiles were compared on 15 potential risk and protective factors. RESULTS: Five profiles were identified: a no PTSD profile (49.4%), a low subclinical PTSD profile (21.8%), a dysphoric subclinical PTSD profile (5.8%), an intermediate clinical PTSD profile (14.8%), and a severe clinical PTSD profile (8.2%). Profiles differed in terms of witnessed traumatic events, morally injurious exposure, social support adequacy, age, number of assignments, types of assignments, and organizational support. CONCLUSIONS: This study is the first to identify distinct patterns of PTSD symptomatology in aid workers and to investigate novel psychological risk factors such as potentially morally injurious events. Overall, these findings provide further insight into the risk and protective factors for the psychological well-being of aid workers as well as avenues for improving the psychological assessment and support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations between self-care practices and psychological adjustment of mental health professionals: a two-wave cross-lagged analysis.

Cultivation of self-care is believed to foster more well-being and to mitigate the psychological difficulties that mental health professionals experience. However, how the well-being and psychological distress of these professionals impact their personal self-care practice is rarely discussed. In fact, studies have yet to investigate whether the use of self-care improves mental health, or whether being in a better place psychologically makes professionals more prone to using self-care (or both). The present study aims to clarify the longitudinal associations between self-care practices and five indicators of psychological adjustment (well-being, posttraumatic growth, anxiety, depression, and compassion fatigue). A sample of 358 mental health professionals were assessed twice (within a 10-month interval). A cross-lagged model tested all associations between self-care and psychological adjustment indicators. Results showed that self-care at T1 predicted increases in well-being and in post-traumatic growth, and a reduction in anxiety and depression at T2. However, only anxiety at T1 significantly predicted greater self-care at T2. No significant cross-lagged associations were found between self-care and compassion fatigue. Overall, findings suggest that implementing self-care is a good way for mental health workers to "take care of themselves." However, more research is needed to understand what leads these workers to use self-care.

Tracking and treating malnutrition: a retrospective observational study of the nutritional status of vulnerable people accessing a meals-on-wheels (MOW) service.

AIM: The aims of the study were to describe the characteristics of meals-on-wheels (MOW) recipients, including prevalence of malnutrition amongst those who have received input from the Nutrition and Wellbeing Service (NWS) and to explore whether the NWS had an impact on the nutritional status (malnutrition risk) of recipients over time. BACKGROUND: Support services, for example, MOW, play an important role in the prevention and treatment of malnutrition in the community. In the UK, MOW services are under threat. However, little is known about how they support the health and well-being of older people. This study reports on the characteristics of MOW recipients and investigates change in nutritional status over time. METHODS: A retrospective study of MOW recipients of nutritional concern who were offered a check through the NWS was conducted. Demographic, social and health information were gathered at the initial visit. Nutritional status (risk of malnutrition) was obtained using the validated Malnutrition Universal Screening Tool (MUST), at the initial and subsequent visits. Changes over time were investigated for recipients receiving at least two follow-up visits. FINDINGS: An initial visit was made to 399 MOW recipients, and 148 recipients had two or more follow-up visits. At initial screening, 177 (44%) of recipients were at medium or high risk of malnutrition. Frailty was significantly related to malnutrition risk (P = 0.049). At follow-up, there was a reduction in malnutrition risk. CONCLUSIONS: The MOW service was associated with a reduction in malnutrition risk. By offering well-being visits within a MOW service, malnutrition can be identified early. Future studies into how MOW services might delay or prevent the need for support from acute health services and social care are warranted.