scholarly journals Survivor guilt: a cognitive approach

2021 ◽  
Vol 14 ◽  
Author(s):  
Hannah Murray ◽  
Yasmin Pethania ◽  
Evelina Medin
Keyword(s):  
Traumatic Stress ◽  
Treatment Strategies ◽  
Research Literature ◽  
List Type ◽  
Survivor Guilt ◽  
Post Traumatic Stress ◽  
Cognitive Approach ◽  
Treatment Interventions ◽  
Psychological Models ◽  
Post Traumatic

Abstract Survivor guilt is a common experience following traumatic events in which others have died. However, little research has addressed the phenomenology of survivor guilt, nor has the issue been conceptualised using contemporary psychological models which would help guide clinicians in effective treatment approaches for this distressing problem. This paper summarises the current survivor guilt research literature and psychological models from related areas, such as post-traumatic stress disorder, moral injury and traumatic bereavement. Based on this literature, a preliminary cognitive approach to survivor guilt is proposed. A cognitive conceptualisation is described, and used as a basis to suggest potential treatment interventions for survivor guilt. Both the model and treatment strategies require further detailed study and empirical validation, but provide testable hypotheses to stimulate further research in this area. Key learning aims (1) To appreciate an overview of the current available literature on the phenomenology and prevalence of survivor guilt. (2) To understand a preliminary cognitive conceptualisation of survivor guilt. (3) To understand and be able to implement treatment recommendations for addressing survivor guilt.

scholarly journals Physiological parameters of mental health predict the emergence of post-traumatic stress symptoms in physicians treating COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
T. Dolev ◽  
S. Zubedat ◽  
Z. Brand ◽  
B. Bloch ◽  
E. Mader ◽  
...  
Keyword(s):  
Mental Health ◽  
Sleep Quality ◽  
Traumatic Stress ◽  
A Priori ◽  
Treatment Strategies ◽  
Physiological Measures ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Post Traumatic

AbstractLack of established knowledge and treatment strategies, and change in work environment, may altogether critically affect the mental health and functioning of physicians treating COVID-19 patients. Thus, we examined whether treating COVID-19 patients affect the physicians’ mental health differently compared with physicians treating non-COVID-19 patients. In this cohort study, an association was blindly computed between physiologically measured anxiety and attention vigilance (collected from 1 May 2014 to 31 May 31 2016) and self-reports of anxiety, mental health aspects, and sleep quality (collected from 20 April to 30 June 2020, and analyzed from 1 July to 1 September 2020), of 91 physicians treating COVID-19 or non-COVID-19 patients. As a priori hypothesized, physicians treating COVID-19 patients showed a relative elevation in both physiological measures of anxiety (95% CI: 2317.69–2453.44 versus 1982.32–2068.46; P < 0.001) and attention vigilance (95% CI: 29.85–34.97 versus 22.84–26.61; P < 0.001), compared with their colleagues treating non-COVID-19 patients. At least 3 months into the pandemic, physicians treating COVID-19 patients reported high anxiety and low quality of sleep. Machine learning showed clustering to the COVID-19 and non-COVID-19 subgroups with a high correlation mainly between physiological and self-reported anxiety, and between physiologically measured anxiety and sleep duration. To conclude, the pattern of attention vigilance, heightened anxiety, and reduced sleep quality findings point the need for mental intervention aimed at those physicians susceptible to develop post-traumatic stress symptoms, owing to the consequences of fighting at the forefront of the COVID-19 pandemic.

scholarly journals Cognitive therapy for post-traumatic stress disorder following critical illness and intensive care unit admission

2020 ◽  
Vol 13 ◽  
Author(s):  
Hannah Murray ◽  
Nick Grey ◽  
Jennifer Wild ◽  
Emma Warnock-Parkes ◽  
Alice Kerr ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cognitive Therapy ◽  
Intensive Care Units ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
List Type ◽  
Post Traumatic Stress ◽  
Case Examples ◽  
Post Traumatic

Abstract Around a quarter of patients treated in intensive care units (ICUs) will develop symptoms of post-traumatic stress disorder (PTSD). Given the dramatic increase in ICU admissions during the COVID-19 pandemic, clinicians are likely to see a rise in post-ICU PTSD cases in the coming months. Post-ICU PTSD can present various challenges to clinicians, and no clinical guidelines have been published for delivering trauma-focused cognitive behavioural therapy with this population. In this article, we describe how to use cognitive therapy for PTSD (CT-PTSD), a first line treatment for PTSD recommended by the National Institute for Health and Care Excellence. Using clinical case examples, we outline the key techniques involved in CT-PTSD, and describe their application to treating patients with PTSD following ICU. Key learning aims (1) To recognise PTSD following admissions to intensive care units (ICUs). (2) To understand how the ICU experience can lead to PTSD development. (3) To understand how Ehlers and Clark’s (2000) cognitive model of PTSD can be applied to post-ICU PTSD. (4) To be able to apply cognitive therapy for PTSD to patients with post-ICU PTSD.

scholarly journals The psychosocial impact of the COVID-19 pandemic on 4,378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic

2021 ◽  
Author(s):  
Danielle Lamb ◽  
Sam Gnanapragasam ◽  
Neil Greenberg ◽  
Rupa Bhundia ◽  
Ewan Carr ◽  
...  
Keyword(s):  
Mental Health ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Healthcare Workers ◽  
Alcohol Misuse ◽  
Common Mental Disorders ◽  
Moral Injury ◽  
List Type ◽  
Post Traumatic Stress ◽  
Post Traumatic

AbstractObjectivesThis study reports preliminary findings on the prevalence of, and factors associated with, mental health and wellbeing outcomes of healthcare workers during the early months (April-June) of the COVID-19 pandemic in the UK.MethodsPreliminary cross-sectional data were analysed from a cohort study (n=4,378). Clinical and non-clinical staff of three London-based NHS Trusts (UK), including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire (GHQ-12). Secondary outcomes are probable anxiety (GAD-7), depression (PHQ-9), Post-Traumatic Stress Disorder (PTSD) (PCL-6), suicidal ideation (CIS-R), and alcohol use (AUDIT). Moral injury is measured using the Moray Injury Event Scale (MIES).ResultsAnalyses showed substantial levels of CMDs (58.9%, 95%CI 58.1 to 60.8), and of PTSD (30.2%, 95%CI 28.1 to 32.5) with lower levels of depression (27.3%, 95%CI 25.3 to 29.4), anxiety (23.2%, 95%CI 21.3 to 25.3), and alcohol misuse (10.5%, 95%CI, 9.2 to 11.9). Women, younger staff, and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one’s moral code) was strongly associated with increased levels of CMDs, anxiety, depression, PTSD symptoms, and alcohol misuse.ConclusionsOur findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.HighlightsWhat is already known about this subject?Large-scale population studies report increased prevalence of depression, anxiety, and psychological distress during the COVID-19 pandemic.Evidence from previous epidemics indicates a high and persistent burden of adverse mental health outcomes among healthcare workers.What are the new findings?Substantial levels of probable common mental disorders and post-traumatic stress disorder were found among healthcare workers.Groups at increased risk of adverse mental health outcomes included women, nurses, and younger staff, as well as those who reported higher levels of moral injury.How might this impact on policy or clinical practice in the foreseeable future?The mental health offering to healthcare workers must consider the interplay of demographic, social, and occupational factors.Additional longitudinal research that emphasises methodological rigor, namely with use of standardised diagnostic interviews to establish mental health diagnoses, is necessary to better understand the mental health burden, identify those most at risk, and provide appropriate support without pathologizing ordinary distress responses.

Unaccompanied minors’ experiences of narrative exposure therapy

2021 ◽  
Vol 14 ◽  
Author(s):  
Glorianne Said ◽  
Yaman Alqadri ◽  
Dorothy King
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Exposure Therapy ◽  
Refugee Children ◽  
List Type ◽  
Post Traumatic Stress ◽  
Unaccompanied Minors ◽  
Narrative Exposure Therapy ◽  
Post Traumatic

Abstract Despite the understanding that unaccompanied minors’ (UAM) experience high rates of post-traumatic stress, the provision of evidence-based trauma-focused therapies is low for this population. Narrative exposure therapy (NET) is an effective short-term intervention for treating post-traumatic stress disorder (PTSD) after multiple traumatic experiences, such as those experienced by UAM. Within the existing literature, there is a lack of research investigating unaccompanied minors’ experiences of NET or any trauma-focused therapy. Participants were four UAM experiencing PTSD who formed part of a pilot delivery of NET within a dedicated child and adolescent mental health service for refugee children. Semi-structured interviews were conducted and transcripts were analysed using interpretative phenomenological analysis (IPA). This project identified five themes that encapsulated unaccompanied minors’ experiences of receiving NET, including the process of preparing for this therapy, what it was like to receive it, and the differences they identified at the end of treatment. The significance of this taking place within a safe therapeutic relationship was explored within the context of the attachment losses experienced by UAM, and the impact this has on emotion regulation was considered. The potential of a reduction in PTSD symptoms facilitating a positive spiral in adolescence was reflected on within this paper. Key learning aims (1) To understand the experience of unaccompanied asylum-seeking minors (UAM) receiving narrative exposure therapy (NET) for post-traumatic stress disorder. (2) To understand the key concerns and motivators for UAM when considering engaging in NET. (3) To understand how these experiences relate to theoretical frameworks and the existing literature relating to emotional difficulties in adolescence.

scholarly journals Diagnostic and clinical considerations in prolonged grief disorder

2012 ◽  
Vol 14 (2) ◽  
pp. 167-176 ◽  
Keyword(s):  
Traumatic Stress ◽  
Physiological Stress ◽  
Systematic Investigation ◽  
Research Literature ◽  
Post Traumatic Stress ◽  
Therapeutic Approaches ◽  
Prolonged Grief Disorder ◽  
Prolonged Grief ◽  
Natural Response ◽  
Post Traumatic

This review focuses on the similarities and differences between prolonged grief disorder (PGD) and post-traumatic stress disorder (PTSD). It highlights how a PTSD-related understanding aids the investigation and clinical management of PGD. Grief has long been understood as a natural response to bereavement, as serious psychological and physiological stress has been regarded as a potential outcome of extreme or traumatic stress. PTSD was first included in DSM-III in 1980. In the mid-1980s, the first systematic investigation began into whether there is an extreme or pathological form of mourning. Meanwhile, there is much research literature on complicated, traumatic, or prolonged grief This literature is reviewed in this article, with the following questions: Is it possible to distinguish normal from non-normal grief? Which clinical presentation does PGD have-and how does this compare with PTSD? Finally, diagnostic, preventive, and therapeutic approaches and existing tools are presented.

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