A nationwide US study of post-traumatic stress after hospitalization for physical injury

2007 ◽  
Vol 37 (10) ◽  
pp. 1469-1480 ◽  
Author(s):  
DOUGLAS F. ZATZICK ◽  
FREDERICK P. RIVARA ◽  
AVERY B. NATHENS ◽  
GREGORY J. JURKOVICH ◽  
JIN WANG ◽  
...  
Keyword(s):  
Acute Care ◽  
Traumatic Stress ◽  
Private Insurance ◽  
Trauma Survivors ◽  
Care Hospital ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Increased Risk ◽  
The Usa ◽  
Post Traumatic

ABSTRACTBackgroundInjured survivors of individual and mass trauma are at risk for developing post-traumatic stress disorder (PTSD). Few investigations have assessed PTSD after injury in large samples across diverse acute care hospital settings.MethodA total of 2931 injured trauma survivors aged 18–84 who were representative of 9983 in-patients were recruited from 69 hospitals across the USA. In-patient medical records were abstracted, and hospitalized patients were interviewed at 3 and 12 months after injury. Symptoms consistent with a DSM-IV diagnosis of PTSD were assessed with the PTSD Checklist (PCL) 12 months after injury.ResultsApproximately 23% of injury survivors had symptoms consistent with a diagnosis of PTSD 12 months after their hospitalization. Greater levels of early post-injury emotional distress and physical pain were associated with an increased risk of symptoms consistent with a PTSD diagnosis. Pre-injury, intensive care unit (ICU) admission [relative risk (RR) 1·17, 95% confidence interval (CI) 1·02–1·34], pre-injury depression (RR 1·33, 95% CI 1·15–1·54), benzodiazepine prescription (RR 1·46, 95% CI 1·17–1·84) and intentional injury (RR 1·32, 95% CI 1·04–1·67) were independently associated with an increased risk of symptoms consistent with a PTSD diagnosis. White injury survivors without insurance demonstrated approximately twice the rate of symptoms consistent with a diagnosis of PTSD when compared to white individuals with private insurance. By contrast, for Hispanic injury survivors PTSD rates were approximately equal between uninsured and privately insured individuals.ConclusionsNationwide in the USA, more than 20% of injured trauma survivors have symptoms consistent with a diagnosis of PTSD 12 months after acute care in-patient hospitalization. Coordinated investigative and policy efforts could target mandates for high-quality PTSD screening and intervention in acute care medical settings.

scholarly journals Paternal and maternal long-term psychological outcomes after uterine artery embolization for severe post-partum hemorrhage

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maude Bernasconi ◽  
Béatrice Eggel-Hort ◽  
Antje Horsch ◽  
Yvan Vial ◽  
Alban Denys ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Uterine Artery Embolization ◽  
Stress Disorder ◽  
Post Partum ◽  
Post Traumatic Stress ◽  
Artery Embolization ◽  
Increased Risk ◽  
Post Traumatic

AbstractThis study intend to compare the long-term psychological impact (depression, post-traumatic stress disorder) on both partners between patients that underwent uterine artery embolization (UAE) for post-partum hemorrhage (PPH) and uneventful deliveries. Women who experienced severe PPH treated by UAE in our institution between 2003 and 2013 were identified in our obstetrical database. These cases were matched to controls with uneventful deliveries. Matching criteria were maternal age, parity, ethnicity, year of delivery, birthweight, gestational age and mode of delivery. Patients and their partners completed validated questionnaires measuring post-traumatic stress (TSQ), as well as depression symptoms (MINI). A total of 63 cases of PPH and 189 matched controls (1:3) participated in a study exploring gynecological and obstetrical outcomes. With a mean of 8 years post-index delivery, patients after PPH showed increased risk of depression (p = 0.015) and post-traumatic stress disorder (22.2% versus 4.8%, p < 0.005) compared to controls. PPH remains strongly associated with post-traumatic stress disorder, even after adjustment for depression (adjusted odds ratio 5.1; 95% confidence intervals 1.5–17.5). Similarly, partners of patients with PPH showed a propensity to depression (p = 0.029) and post-traumatic stress disorder (11.5% versus 1.5%, p = 0.019). In conclusion, both women and their partners are at increased risk of long-term psychological adverse outcomes after PPH. Couples may benefit from psychological support.

scholarly journals Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties

2020 ◽  
pp. bmjmilitary-2020-001622 ◽  
Author(s):  
Dominic Murphy ◽  
C Williamson ◽  
J Baumann ◽  
W Busuttil ◽  
N T Fear
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
Mental Health Difficulties ◽  
Post Traumatic ◽  
The Impact

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.

scholarly journals An epistasis between dopaminergic and oxytocinergic systems confers risk of post-traumatic stress disorder in a traumatized Chinese cohort

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kunlin Zhang ◽  
Gen Li ◽  
Li Wang ◽  
Chengqi Cao ◽  
Ruojiao Fang ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Trauma Exposure ◽  
Environment Interaction ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Psychiatric Syndrome ◽  
Chinese Cohort ◽  
Post Traumatic

AbstractPost-traumatic stress disorder (PTSD) is a psychiatric syndrome that occurs after trauma exposure. Neurotransmitters such as dopamine and oxytocin have been reported to be involved in neuropathology of PTSD. Previous studies indicated that the dopamine–oxytocin interaction may contribute to behavioral disorders. Thus, exploring the epistasis (gene–gene interaction) between oxytocinergic and dopaminergic systems might be useful to reveal the genetic basis of PTSD. In this study, we analyzed two functional single nucleotide polymorphisms (SNPs), rs2268498 for oxytocinergic gene OXTR and rs1801028 for dopaminergic gene DRD2 based on putative oxytocin receptor–dopamine receptor D2 (OTR–DR2) heterocomplex in a Chinese cohort exposed to the 2008 Wenchuan earthquake (156 PTSD cases and 978 controls). Statistical analyses did not find any single variant or gene–environment interaction (SNP × earthquake-related trauma exposure) associated with provisional PTSD diagnosis or symptoms. An OXTR–DRD2 interaction (rs2268498 × rs1801028) was identified to confer risk of provisional PTSD diagnosis (OR = 9.18, 95% CI = 3.07–27.46 and P = 7.37e-05) and further subset analysis indicated that rs2268498 genotypes controlled the association directions of rs1801028 and rs1801028 genotypes also controlled the association directions of rs2268498. Rs2268498 × rs1801028 is also associated with PTSD symptoms (P = 0.043). Our study uncovered a genetic and putative function-based contribution of dopaminergic–oxytocinergic system interaction to PTSD.

Effort-Reward Imbalance and Post-Traumatic Stress After a Workplace Terror Attack

2016 ◽  
Vol 10 (2) ◽  
pp. 219-224
Author(s):  
Camilla Hem ◽  
Morten Birkeland Nielsen ◽  
Marianne Bang Hansen ◽  
Trond Heir
Keyword(s):  
Traumatic Stress ◽  
Terrorist Attack ◽  
Work Conditions ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Extra Effort ◽  
Increased Risk ◽  
Effort Reward Imbalance ◽  
Post Traumatic ◽  
Reward Imbalance

AbstractObjectiveFollowing adverse work conditions, health consequences can be explained by an imbalance between the effort made and the reward received. We investigated the association between extra effort, perceived reward, and post-traumatic stress disorder (PTSD). The Effort-Reward Imbalance Model was used to examine whether extra effort at work in the aftermath of a workplace-related terrorist attack affected the risk of PTSD and the effects of reward for extra effort from a leader or colleagues.MethodsCross-sectional data were collected 10 months after a terrorist attack in Norway in 2011. Out of 3520 Ministry employees invited, 1927 agreed to participate. Employees reported any extra effort performed as a result of the bomb explosion and any reward received from a leader or colleagues. PTSD was assessed with the PTSD Checklist.ResultsEmployees who reported extra effort displayed increased risk for PTSD (odds ratio [OR]=1.71, 95% confidence interval [CI]: 1.15-2.55, P=0.008). Perceived reward for extra effort from a leader was associated with lower risk for PTSD (OR=0.39, 95% CI: 0.23-0.64, P<0.001) but not perceived reward from colleagues.ConclusionsExtra effort may increase the risk of PTSD, but reward from a leader may mitigate this effect. The Effort-Reward Imbalance Model appears to be an appropriate approach that may contribute to understanding of the etiology of work-related PTSD. (Disaster Med Public Health Preparedness. 2016;10:219–224)

Treating post-traumatic stress disorder in the ‘real world’: evaluation of a specialist trauma service and adaptations to standard treatment approaches

2008 ◽  
Vol 32 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Damon Lab ◽  
Ines Santos ◽  
Felicity de Zulueta
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Treatment ◽  
Self Report ◽  
Trauma Survivors ◽  
Post Traumatic Stress ◽  
Trauma Service ◽  
Social Difficulties ◽  
Post Traumatic

Aims and MethodTo evaluate the effectiveness of treatment at the Traumatic Stress Service (TSS) by comparing pre- and post-treatment scores on patient self-report measures. Through a questionnaire survey, to explore therapists' views of problems presenting in addition to post-traumatic stress disorder (PTSD) and how, as a result, they adapted their approach to trauma work.ResultsTherapists reported that their patients present with a range of complex problems, and self-report measures show that patients suffer particularly high levels of psychopathology. Therapists identified a number of adaptations to trauma-focused work to deal with these additional problems. Of the 112 patients who completed therapy, 43% filled in pre- and post-treatment questionnaire measures. Analysis showed clinically and statistically significant improvements in levels of PTSD, depression and social functioning.Clinical ImplicationsThe typical presentation of trauma survivors is often not ‘simple’ PTSD, but PTSD resulting from chronic and multiple traumas and complicated by additional psychological and social difficulties. Adaptations to trauma-focused work can successfully treat such ‘complex’ PTSD.

scholarly journals Using a Biopsychosocial Approach to Examine Differences in Post-Traumatic Stress Symptoms Among Arab and Jewish Israeli Mothers Following A Child’s Traumatic Medical Event

2020 ◽  
Author(s):  
Sewar Hussien ◽  
Yaara Sadeh ◽  
Rachel Dekel ◽  
Efrat Shadmi ◽  
Amichai Brezner ◽  
...  
Keyword(s):  
Traumatic Stress ◽  
Negative Impact ◽  
Psychosocial Assessment ◽  
Post Traumatic Stress ◽  
Biopsychosocial Approach ◽  
Targeted Interventions ◽  
Stress Symptoms ◽  
Medical Event ◽  
Increased Risk ◽  
Post Traumatic

Abstract Background: Parents of children following a traumatic medical event (TME) are known to be at high risk for developing severe post-traumatic stress symptoms (PTSS). Findings on the negative impact of TMEs on parents’ PTSS have been described in different cultures and societies worldwide. However, in some cases, a specific ethnic group may also be a minority within a given region or a country, contributing to increased risk for parental PTSS following a child’s TME.Objectives: The current study aimed to examine differences in PTSS between Israeli-Arab and Israeli-Jewish mothers, following a child’s TME. More specifically, we aimed to examine the risk and protective factors affecting mother’s PTSS from a biopsychosocial approach.Methods: Data were collected from medical files of children following TMEs, hospitalized in a pediatric rehabilitation department, during the period 2008–2018. The sample included 47 Israeli-Arab mothers and 47 Israeli-Jewish mothers. Mothers completed the psychosocial assessment tool (PAT), the post-traumatic diagnostic scale (PDS).Results: Arab mothers self-reported significantly higher levels of PTSS than their Jewish counterparts. Further, Arab mothers perceived having more social support than Jewish mothers did. Finally, our prediction model indicated that both Arab ethnicity and pre-trauma family problems predicted higher levels of PTSS among mothers of children following TMEs.Conclusions: Focusing on ethnic and cultural effects following a child’s TME may help improve our understanding of the mental health needs of mothers from different minority ethnic groups and aid in developing appropriate health services and targeted interventions for this population.

Pain in the aftermath of trauma is a risk factor for post-traumatic stress disorder

2007 ◽  
Vol 38 (4) ◽  
pp. 533-542 ◽  
Author(s):  
S. B. Norman ◽  
M. B. Stein ◽  
J. E. Dimsdale ◽  
D. B. Hoyt
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Injury ◽  
Surgical Trauma ◽  
Post Traumatic Stress ◽  
Increased Risk ◽  
Post Traumatic

BackgroundIdentifying risk factors for the development of post-traumatic stress disorder (PTSD) is important for understanding and ultimately preventing the disorder. This study assessed pain shortly after traumatic injury (i.e. peritraumatic pain) as a risk factor for PTSD.MethodParticipants (n=115) were patients admitted to a Level 1 Surgical Trauma Center. Admission to this service reflected a severe physical injury requiring specialized, emergent trauma care. Participants completed a pain questionnaire within 48 h of traumatic injury and a PTSD diagnostic module 4 and 8 months later.ResultsPeritraumatic pain was associated with an increased risk of PTSD, even after controlling for a number of other significant risk factors other than acute stress disorder symptoms. An increase of 0.5 s.d. from the mean in a 0–10 pain rating scale 24–48 h after injury was associated with an increased odds of PTSD at 4 months by more than fivefold, and at 8 months by almost sevenfold. A single item regarding amount of pain at the time of hospital admission correctly classified 65% of participants.ConclusionsIf these findings are replicated in other samples, high levels of peritraumatic pain could be used to identify individuals at elevated risk for PTSD following traumatic injury.

Symptoms of dementia or post-traumatic stress disorder? Under-recognised behaviours in veterans with dementia

2021 ◽  
Vol 17 (4) ◽  
pp. 140-146 ◽  
Author(s):  
Deborah Hutchinson ◽  
Martin Isaacs ◽  
Lucy Chamberlain ◽  
Karen Harrison Dening
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Screening Tool ◽  
Stress Disorder ◽  
Psychological Symptoms ◽  
Poor Mental Health ◽  
Post Traumatic Stress ◽  
People With Dementia ◽  
Increased Risk ◽  
Post Traumatic

Background: The veteran community are at increased risk of poor mental health and developing dementia as a result of their miliary service, with the potential to lead to delayed onset post-traumatic stress disorder (DOPTSD). The manifestation of DOPTSD may be misinterpreted as behavioural and psychological symptoms of dementia (BPSD), which create difficulties in caring for the person experiencing these distressing symptoms. Aims: This paper details the development of a screening tool for people with dementia, which aims to reframe and contextualise some of the behaviours under the lens of historic traumatic events. Methods: The utility of the screening tool is demonstrated through the presentation and an analysis of an anonymised case study to support nurse practice development. Conclusions: A trauma history tool offers a more comprehensive and interpretive view of the possible historic, trauma-related causes of current behaviours and can aid informal carers' understanding of the stress and distress reactions of their family members.

scholarly journals An iterative design process to develop a randomized feasibility study and inform recruitment of minority women after stillbirth

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Jennifer Huberty ◽  
Jeni Green ◽  
Katherine J. Gold ◽  
Jenn Leiferman ◽  
Joanne Cacciatore
Keyword(s):  
Feasibility Study ◽  
Traumatic Stress ◽  
Emotional Regulation ◽  
Minority Women ◽  
Post Traumatic Stress ◽  
Yoga Intervention ◽  
Iterative Design ◽  
Self Compassion ◽  
Increased Risk ◽  
Post Traumatic

Abstract Background Yearly, approximately 25,000 US women experience stillbirth and African American women have a 2.2 fold increased risk of stillbirth compared with white women. After stillbirth, women are subject to a sevenfold increased risk of post-traumatic stress compared with women after a live-birth. This paper presents findings from phase one of a National Institutes of Health funded, two-phase feasibility study to examine an online yoga intervention to reduce symptoms of post-traumatic stress in mothers after stillbirth. An iterative design was used to (1) inform the development of the online yoga intervention and (2) inform recruitment strategies to enroll minority women into phase two. Methods Ten mothers (N = 5 stillbirth moms with no yoga experience, N = 5 nonstillbirth moms with yoga experience) participated in a series of online yoga videos (N = 30) and were assessed for self-compassion (SC) and emotional regulation (ER) before and after each video. An independent group of five minority women who had experienced stillbirth were interviewed about cultural barriers to recruitment and perceptions/opinions of yoga. A mean was calculated for SC and ER scores for each video at pre- and post-time points. The percent change of the mean difference between pre-post SC and ER scores were used to select videos for phase two. Videos with a negative change score or that had a 0% change on SC or ER were not used. A combination of deductive and inductive coding was used to organize the interview data, generate categories, and develop themes. Results Five of the 30 tested yoga videos were not used. An additional 12 videos were developed, filmed, and used in the prescription for phase two. Topics from interview findings included perceived benefits/barriers of and interest in yoga, preferred yoga environment, suggested recruitment methods, content of recruitment material, and recommended incentives. Conclusions Online yoga may be beneficial for improving emotional regulation and self-compassion, but further testing is needed. Additionally, minority women express interest in online yoga but suggest that researchers apply culturally specific strategies regarding methods, content of material, and incentives to recruit minority women into a study.

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