scholarly journals Co-occurrence of severe PTSD, somatic symptoms and dissociation in a large sample of childhood trauma inpatients: a network analysis

2021 ◽  
Author(s):  
Leonhard Kratzer ◽  
Matthias Knefel ◽  
Alexander Haselgruber ◽  
Peter Heinz ◽  
Rebecca Schennach ◽  
...  
Keyword(s):  
Childhood Abuse ◽  
Somatic Symptoms ◽  
Treatment Target ◽  
Symptom Level ◽  
Poor Treatment ◽  
Treatment Plans ◽  
Mental And Physical Health ◽  
Full Network ◽  
Insight Into ◽  
Combine Evidence

AbstractCo-occurrence of mental disorders including severe PTSD, somatic symptoms, and dissociation in the aftermath of trauma is common and sometimes associated with poor treatment outcomes. However, the interrelationships between these conditions at symptom level are not well understood. In the present study, we aimed to explore direct connections between PTSD, somatic symptoms, and dissociation to gain a deeper insight into the pathological processes underlying their comorbidity that can inform future treatment plans. In a sample of 655 adult inpatients with a diagnosis of severe PTSD following childhood abuse (85.6% female; mean age = 47.57), we assessed symptoms of PTSD, somatization, and dissociation. We analyzed the comorbidity structure using a partial correlation network with regularization. Mostly positive associations between symptoms characterized the network structure. Muscle or joint pain was among the most central symptoms. Physiological reactivation was central in the full network and together with concentrations problems acted as bridge between symptoms of PTSD and somatic symptoms. Headaches connected somatic symptoms with others and derealization connected dissociative symptoms with others in the network. Exposure to traumatic events has a severe and detrimental effect on mental and physical health and these consequences worsen each other trans-diagnostically on a symptom level. Strong connections between physiological reactivation and pain with other symptoms could inform treatment target prioritization. We recommend a dynamic, modular approach to treatment that should combine evidence-based interventions for PTSD and comorbid conditions which is informed by symptom prominence, readiness to address these symptoms and preference.

scholarly journals Exploring the effects of long-term anti-social behaviour victimisation

2020 ◽  
pp. 026975802096197
Author(s):  
Vicky Heap
Keyword(s):  
Qualitative Research ◽  
Social Behaviour ◽  
Empirical Work ◽  
Criminal Behaviour ◽  
Structured Interviews ◽  
Different Types ◽  
The Impact ◽  
Mental And Physical Health ◽  
Insight Into

Despite victimological interest in the impacts of different types of criminal victimisation, there is little empirical work that examines the effects of sub-criminal behaviour on victims. This article begins to redress the balance by reporting the findings from a qualitative research project in England that investigated the effects of long-term anti-social behaviour victimisation. Semi-structured interviews explored victims’ accounts of the long-term anti-social behaviour they experienced and the resultant effects it had on their lives. The research uncovered that victims experience a range of mental and physical health effects as well as behavioural changes and has provided the first in-depth insight into the impact of this type of victimisation. The findings suggest the cumulative harms associated with anti-social behaviour need to be better acknowledged, understood and addressed, with greater support made available to victims.

scholarly journals Anticipatory Minority Stressors among Same-Sex Couples: A Relationship Timeline Approach

2018 ◽  
Author(s):  
Mieke Beth Thomeer ◽  
Allen LeBlanc ◽  
David Frost ◽  
Kayla Bowen
Keyword(s):  
Life Events ◽  
Well Being ◽  
Daily Hassles ◽  
Minority Populations ◽  
Same Sex ◽  
Relationship Duration ◽  
Same Sex Couples ◽  
Race Ethnicity ◽  
Mental And Physical Health ◽  
Insight Into

Abstract: We build on previous stress theories by drawing attention to the concept of anticipatory couple-level minority stressors (i.e., stressors expected to occur in the future that emanate from the stigmatization of certain relationship forms). A focus on anticipatory couple-level minority stressors brings with it the potential for important insight into vulnerabilities and resiliencies of people in same-sex relationships—the focus of our study. We use relationship timelines to examine stressors among a diverse sample of same-sex couples (N = 120). Respondents in same-sex relationships anticipated stressors that may not be unique to same-sex couples (e.g., purchasing a home together), but labeled many of their anticipatory stressors as reflecting the stigmatization of their same-sex relationship, in and of itself. Respondents rated anticipatory minority stressors as more stressful than other anticipatory stressors. Moreover, stressors varied by gender, age, and relationship duration, although not race/ethnicity or geographic site. This analysis is a preliminary step in examining how unique anticipatory couple-level minority stressors function as determinants of relationship quality, mental and physical health, and health disparities faced by sexual minority populations. Attempts to understand current stress levels should consider anticipatory stressors, alongside past and current life events, chronic strains, daily hassles, and minority stressors, as these processes are impossible to disentangle and may be consequential for current well-being. Cite as: Thomeer, Mieke Beth, Allen J. LeBlanc, David M. Frost, & Kayla Bowen. (2018). Anticipatory Minority Stressors among Same-Sex Couples: A Relationship Timeline Approach. Social Psychology Quarterly 81(2): 126-148

scholarly journals Caregivers’ Mental Health and Somatic Symptoms During COVID-19

2020 ◽  
Author(s):  
Sung S Park
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Negative Binomial ◽  
Somatic Symptoms ◽  
Health Conditions ◽  
Group Differences ◽  
Short Term ◽  
The Impact ◽  
Mental And Physical Health

Abstract Objectives This study examines differences in the mental and physical health of the U.S. population during the early stages of the COVID-19 pandemic among 3 groups: noncaregivers, short-term caregivers (1 year or less), and long-term caregivers (greater than 1 year). Methods Data from the Understanding America Study are used to describe group differences in reports of psychological distress and somatic symptoms. Logistic and negative binomial regression models are used to examine whether these differences persist after adjusting for demographic, socioeconomic, and prepandemic health conditions. To understand within-group differences in caregiving demands, the intensity of care provided by short-term and long-term caregivers, as well as selected patients’ health conditions are summarized. Results Adults’ mental and physical health varied substantially by caregiver status. Caregivers continued to fare worse than noncaregivers in terms of mental health and fatigue, and long-term caregivers were more likely to report headache, body aches, and abdominal discomfort than both short-term caregivers and noncaregivers, net of controls. The nature of caregiving differed between short-term and long-term caregivers, with the latter more likely to provide greater hours of care, and to be looking after patients with permanent medical conditions. Discussion Efforts to understand and mitigate the impact of the pandemic on population health should include caregivers, whose mental and physical health were already vulnerable before COVID-19.

Factors associated with poor satisfaction with treatment and trial discontinuation in chronic schizophrenia

CNS Spectrums ◽  
2018 ◽  
Vol 24 (04) ◽  
pp. 380-389 ◽  
Author(s):  
Joep H. Schoemaker ◽  
Ad J.J.M. Vingerhoets ◽  
Robin A. Emsley
Keyword(s):  
Patient Satisfaction ◽  
Clinical Improvement ◽  
Treatment Effectiveness ◽  
Chronic Schizophrenia ◽  
Poor Patient ◽  
Poor Treatment ◽  
Satisfaction With Treatment ◽  
Using Data ◽  
Trial Discontinuation ◽  
Insight Into

IntroductionDespite consistently high discontinuation rates due to withdrawal of consent (WOC) and insufficient therapeutic effect (ITE) in schizophrenia trials, insight into the underlying factors contributing to poor satisfaction with treatment and dropout is limited. A better understanding of these factors could help to improve trial design and completion rates.MethodsUsing data from 1,136 trial participants with schizophrenia or schizoaffective disorder, we explored associations between predictor variables with (1) dropout due to WOC and ITE and (2) satisfaction with treatment among patients and investigators by means of hierarchic multiple regression analyses.ResultsITE was associated with poor clinical improvement, poor investigator satisfaction with treatment, and poor patient insight into their own disease, whereas WOC only showed a meaningful association with poor patient satisfaction with treatment. Investigator satisfaction with treatment appeared most strongly associated with Positive and Negative Syndrome Scale (PANSS) positive factor endpoint scores, whereas patient satisfaction with treatment was best predicted by the endpoint score on the PANSS emotional distress factor. The occurrence of severe side effects showed no meaningful association to satisfaction with treatment among investigators and patients, and neither did a patient’s experienced psychopathology, nor their self-rating of functional impairment.ConclusionsWhereas trial discontinuation due to ITE is associated with poor treatment effectiveness, a patient’s decision to withdraw from an antipsychotic trial remains unpredictable and may occur even when the investigator observes a global clinical improvement and is satisfied with the treatment.

The Transition to Late Antiquity, on the Danube and Beyond

2007 ◽  
Keyword(s):  
Roman Empire ◽  
Late Antiquity ◽  
Far East ◽  
Rural Landscape ◽  
Military Organization ◽  
Western Asia ◽  
Medieval Europe ◽  
Late Roman Period ◽  
Insight Into ◽  
Combine Evidence

This book provides a significant insight into the changes that occurred in the late Roman period and which shaped the emergence of early medieval Europe. The book provides detail regarding the changes in the character of urbanism, military organization and the rural landscape which separate the Roman Empire from Late Antiquity (first to early seventh centuries AD). Some chapters focus on the lower Danube, others provide comparative studies which range from northern Italy and Pannonia to Greece, western Asia Minor and as far east as the Euphrates. These chapters compare the results of different international research teams but also contrast approaches and methodology in order to assess the extent to which these differences might account for apparently contradictory conclusions. The volume also demonstrates the uses and pitfalls encountered in attempts to combine evidence provided by ancient historians and archaeologists — a theme which has wider implications beyond this text.

scholarly journals Evaluation of the association between insight and symptoms in a large sample of patients with schizophrenia

2009 ◽  
Vol 24 (8) ◽  
pp. 507-512 ◽  
Author(s):  
M.A.F. De Hert ◽  
V. Simon ◽  
D. Vidovic ◽  
T. Franic ◽  
M. Wampers ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Educational Level ◽  
Clinical Symptoms ◽  
Social Withdrawal ◽  
Structured Interview ◽  
Demographic Variables ◽  
Evaluation Tool ◽  
Symptom Domains ◽  
Symptom Level ◽  
Insight Into

AbstractBackgroundThe objective of the present study was to examine the association of insight into the illness with demographic variables and symptomatology in a sample of 1213 patients with schizophrenia.MethodData were collected with the Psychosis Evaluation tool for Common use by Caregivers (PECC), a semi-structured interview evaluating five symptom domains of schizophrenia and the insight items ‘awareness of having a mental disorder’ and ‘attributing symptoms to a mental disorder’.ResultsInsight was positively associated with educational level and inversely with overall symptom severity, and the positive, negative, excitatory and cognitive symptom domains. At symptom level, the items ‘delusions’, ‘grandiosity’, ‘poor rapport’, ‘social withdrawal’ and ‘guilt feelings’ showed the strongest associations with both insight items. Overall, correlations between insight and symptomatology were modest, explaining less than 30% of the variance in insight.ConclusionLack of insight in schizophrenia is partially explained by clinical symptoms and demographic measures.

scholarly journals Clinical Holistic Medicine: The Case Story of Anna. II. Patient Diary as a Tool in Treatment

2006 ◽  
Vol 6 ◽  
pp. 2006-2034 ◽  
Author(s):  
Sören Ventegodt ◽  
Birgitte Clausen ◽  
Joav Merrick
Keyword(s):  
Childhood Abuse ◽  
Mental Disease ◽  
Philosophical Perspective ◽  
Existential Therapy ◽  
Existential Crisis ◽  
Patient Diary ◽  
Choice Of Life ◽  
Therapeutic Tools ◽  
Suicidal Crisis ◽  
Insight Into

In spite of extreme childhood sexual and violent abuse, a 22-year-old young woman, Anna, healed during holistic existential therapy. New and highly confrontational therapeutic tools were developed and used to help this patient (like acceptance through touch and acupressure through the vagina). Her vulva and introitus were scarred from repeated brutal rape, as was the interior of her mouth. During therapy, these scars were gently contacted and the negative emotional contents released. The healing was in accordance with the advanced holistic medical toolbox that uses (1) love, (2) trust, (3) holding, and (4) helping the patient to process and integrate old traumas.The case story clearly revealed the philosophical adjustments that Anna made during treatment in response to the severe childhood abuse. These adjustments are demonstrated by her diary, where sentences contain both the feelings and thoughts of the painful present (the gestalt) at the time of the abuse, thus containing the essence of the traumas, making the repression of the painful emotions possible through the change in the patient’s philosophical perspective. Anna's case gives a unique insight into the process of traumatization (pathogenesis) and the process of healing (salutogenesis). At the end of the healing, Anna reconnected her existence to the outer world in a deep existential, suicidal crisis and faced her choice of life or death. She decided to live and, in this process, assumed existential responsibility, which made her able to step out of her mental disease. The advanced holistic toolbox seems to help patients heal even from the worst childhood abuse. In spite of the depth of the existential crisis, holistic existential therapy seems to support existential responsibility well and thus safe for the patients.

Specialist support for survivors of domestic abuse during COVID-19

2020 ◽  
Vol 8 (8) ◽  
pp. 334-337 ◽  
Author(s):  
Bethan Ridsdale ◽  
Aasifa Usmani ◽  
Karis Hanson
Keyword(s):  
Physical Health ◽  
Health Effects ◽  
Domestic Abuse ◽  
Unique Role ◽  
Health Visitors ◽  
Mental And Physical Health ◽  
Insight Into

Health visitors have a crucial and unique role in identifying and supporting those affected by domestic abuse as the current pandemic increases the risk of harm towards survivors. This article reflects on how COVID-19 and lockdown restrictions have exacerbated risks to survivors, barriers to support and the mental and physical health effects. It will provide insight into how frontline domestic abuse workers at Solace Women's Aid have continued to support survivors, from the experience of three Identification and Referral to Improve Safety (IRIS) Advocate Educators, working across two London boroughs.

scholarly journals Risk factors, physical and mental health burden of male and female pathological gamblers in the German general population aged 40–80

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Martin Wejbera ◽  
Klaus Wölfling ◽  
Michael Dreier ◽  
Matthias Michal ◽  
Elmar Brähler ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Physical Health ◽  
Somatic Symptoms ◽  
Stress Factors ◽  
Clinical Samples ◽  
Major Public Health Problem ◽  
Work Related ◽  
Health Burden ◽  
Mental And Physical Health

Abstract Background Gambling Disorder (GD) has been associated with considerable mental and physical health risks in clinical samples. The paper determines risk factors, mental and physical health burden of probable GD for both men and women in the general population. Methods In the Gutenberg Health Study, a population-based sample of N = 11,875 aged 40–80 years was analyzed regarding lifetime probable GD prevalence (measured with the Lie/ Bet Questionnaire) and a wide array of health variables including standardized measures of depression, anxiety, and somatic symptoms. Results Probable GD lifetime prevalence was 2.1%, with higher rates among 1st generation migrants (5.5%; vs. non-migrants 1.6%), men (3.0%; vs. women 1.2%), and the sample’s youngest age decade (40–49 y., 3.1%). Lifetime probable GD was associated with current work-related, family and financial stressors as well as unhealthy behavior (smoking, extended screen time), and lifetime legal offenses. In men, but not in women, increased rates of imprisonment, mental and somatic symptoms were found. Conclusions GD is a major public health problem with serious social, mental and physical health burden. Epidemiological findings underscore the preponderance of GD among 1st generation migrants and men. Findings are consistent with a vicious cycle of family, work related and financial stress factors, and mental and physical burden, particularly in men. Demographic risk factors may help to target specific prevention and treatment efforts.

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