The impact of social unrest and pandemic on mental health of young people in Hong Kong: The transdiagnostic role of event-based rumination

2021 ◽  
pp. 000486742110257
Author(s):  
Stephanie MY Wong ◽  
Christy LM Hui ◽  
Yi Nam Suen ◽  
Corine SM Wong ◽  
Sherry KW Chan ◽  
...  
Keyword(s):  
Young People ◽  
Confidence Interval ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Odds Ratio ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Event Based

Objective: Co-occurring population-level events, such as social unrest and coronavirus disease 2019, are observed in many societies today. Few studies have explored their combined mental health effects on young people. While self-focused rumination has been suggested to be a key mechanism underlying depression, the role of event-based rumination in mediating the impact of population stressors has yet to be elucidated. Methods: Data were collected from 6988 young people in a large-scale community online survey in Hong Kong. The survey assessed symptoms of post-traumatic stress disorder and depression, direct exposure to social unrest-related traumatic events, coronavirus disease 2019 pandemic-related events, personal stressful life events, event-based rumination and other individual risk factors. Results: High levels of comorbid post-traumatic stress disorder and depressive symptoms were observed. Logistic regression analysis revealed that probable post-traumatic stress disorder was associated with traumatic events (odds ratio = 1.73, 95% confidence interval = [1.64, 1.82]), pandemic-related events (odds ratio = 1.08, confidence interval = [1.01, 1.16]), stressful life events (odds ratio = 1.20, confidence interval = [1.21, 1.37]), high event-based rumination (odds ratio = 3.00, confidence interval = [2.58, 3.48]), lower resilience (odds ratio = 1.18, confidence interval = [1.15, 1.21]), higher smartphone reliance (odds ratio = 1.09, confidence interval = [1.05, 1.13]) and financial concerns (odds ratio = 1.25, confidence interval = [1.18, 1.33]). The odds for probable post-traumatic stress disorder was also significantly higher when two or more traumatic events were experienced (odds ratio = 4.03, confidence interval = [3.52, 4.62]). Factors associated with moderate-to-severe level depressive symptoms were similar. Event-based rumination significantly mediated between different types of external events (traumatic events, pandemic-related events, stressful life events) and both post-traumatic stress disorder and depressive symptoms. Conclusion: These findings suggest that diverse types of stressful events during population-level crises could add to personal stressors to affect mental health outcomes in young people. Among other protective and risk factors, event-based rumination presented as a prominent transdiagnostic mediator for different symptom dimensions which may be a potentially important target for early risk detection and intervention.

scholarly journals Trauma and post-traumatic stress disorder in patients treated for opioid use disorder: findings from a 12-month cohort study

BJPsych Open ◽  
2021 ◽  
Vol 7 (4) ◽  
Author(s):  
Tea Rosic ◽  
Vivian Y. O. Au ◽  
Andrew Worster ◽  
David C. Marsh ◽  
Lehana Thabane ◽  
...  
Keyword(s):  
Substance Use ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Odds Ratio ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Opioid Use Disorder ◽  
Post Traumatic Stress ◽  
Opioid Use ◽  
Post Traumatic

Background Exposure to traumatic events is both a risk factor for substance use and an adverse outcome of substance use disorders. Identifying and managing post-traumatic stress disorder (PTSD) in patients with addiction requires attention. Aims To examine the lifetime prevalence of traumatic events and past-month prevalence of PSTD in patients treated for opioid use disorder, and explore the association between trauma, PTSD and treatment outcomes. Method Participants (n = 674) receiving methadone treatment in 20 community clinics across Ontario, Canada, were administered the Mini-International Neuropsychiatric Interview to identify self-reported traumatic events and PTSD. Drug use was measured for 12 months by urine drug screens. Results Eleven per cent of participants met past-month criteria for PTSD (n = 72), and 48% reported history of traumatic events with no current PTSD (n = 323). Participants with PTSD were more likely to be female (odds ratio 2.13, 95% CI 1.20–3.76) and less likely to be employed (odds ratio 0.31, 95% CI 0.16–0.61) or married (odds ratio 0.51, 95% CI 0.26–0.90) than those with no trauma history. Antidepressants (39 v. 24%) and benzodiazepines (36 v. 18%) were differentially prescribed to patients with and without PTSD. Length of time in treatment and opioid use were not associated with trauma; however, suicidal ideation was more common in PTSD (odds ratio 2.29, 95% CI 1.04–5.01). Conclusions Trauma and PTSD are prevalent among patients with opioid use disorder, and consideration of trauma symptoms and associated characteristics is warranted. Patients with and without comorbid PTSD differ clinically and psychosocially, highlighting the relevance of integrating addiction and mental health services for this population.

scholarly journals Experiences with traumatic events, consequences and care among people with visual impairment and post-traumatic stress disorder: a qualitative study from The Netherlands

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041469
Author(s):  
Alida J van der Ham ◽  
Hilde P A van der Aa ◽  
Peter Verstraten ◽  
Ger H M B van Rens ◽  
Ruth M A van Nispen
Keyword(s):  
Qualitative Study ◽  
Visual Impairment ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Self Esteem ◽  
Stress Reactions ◽  
Post Traumatic Stress ◽  
Post Traumatic

ObjectiveHaving a visual impairment is known to be associated with an increased vulnerability to (potentially) traumatic events. Little is known about how people with visual impairment experience and process such events. This qualitative study aimed to provide more insight into experiences with traumatic events, consequences of traumatic events and post-traumatic stress disorder (PTSD)-related care among people with visual impairment and PTSD.MethodsEighteen persons with visual impairment and (a history of) PTSD were interviewed. Among them were 14 women and 4 men aged between 23 and 66 years. Recruitment of participants was done through health professionals from two low-vision service centres and a patient association for people with eye diseases and visual impairment in The Netherlands. Interviews focused on experiences with (1) traumatic events, (2) consequences of traumatic events and (3) PTSD-related care. Thematic content analysis of interview data was performed using ATLAS.ti. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used to check for completeness and transparency of the study. Data were collected between 2018 and 2020.ResultsThe most commonly reported traumatic events were sexual and physical abuse. Many participants experienced that their impairment had negatively affected their acceptance by others, independence and self-esteem, increasing their vulnerability for traumatic events. Additionally, having a visual impairment negatively impacted participants’ ability to respond to situations and aggravated post-traumatic stress reactions. Existing treatments seem suitable for people with visual impairment when accommodated to the impairment.ConclusionsHaving a visual impairment may affect traumatic events and post-traumatic stress reactions, particularly by contributing to low self-esteem, problems in social interactions and a lack of visual information. Insights from this study provide starting points for adapting pretraumatic and post-traumatic care to the needs of people with visual impairment.

scholarly journals Prolonged exposure as early intervention in an emergency department context: lessons learned from a terminated RCT.

2019 ◽  
Author(s):  
Maria Bragesjö ◽  
Filip Arnberg ◽  
Erik Andersson
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Lessons Learned ◽  
Post Traumatic Stress ◽  
Target Sample Size ◽  
Post Traumatic ◽  
Event Based ◽  
High Degree

Abstract Objective The main purpose of the trial was to test if a brief trauma focused cognitive-behavior therapy (prolonged exposure; PE) provided within 72h after a trauma could be effective in decreasing the incidence of post-traumatic stress disorder (PTSD), replicating and extending findings from an earlier trial. After a pilot study (N=10), which indicated feasible and deliverable study procedures and interventions, we subsequently launched an RCT with a target sample size of 352 participants randomized to either three sessions PE or non-directive support. Due to an unforeseen major reorganization at the hospital, the RCT was discontinued after 32 included participants. Results In this paper, we highlight obstacles and lessons learned from our feasibility work, relevant for preventive psychological interventions for PTSD in emergency settings. One important finding was the high degree of attrition: only 78% and 34% respectively came back for the two months and six-months assessments. There were also difficulties in reaching eligible patients immediately after the event. Based on our experiences, we envisage that alternative models of implementation might overcome these obstacles, for example, with remote delivery of both assessments and treatment, combined with multiple recruitment procedures. Lessons learned from this terminated RCT are discussed in depth.

Prevention of Post-Traumatic Stress Disorder

2018 ◽  
Author(s):  
Arieh Y. Shalev ◽  
Anna C. Barbano ◽  
Wei Qi ◽  
Charles R. Marmar
Keyword(s):  
Mental Disorders ◽  
Early Development ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Trauma Exposure ◽  
Post Traumatic Stress ◽  
Post Traumatic

Post-traumatic stress disorder (PTSD) follows an exposure to traumatic events and as such its onset and early development are better charted then those of most other mental disorders. It is not surprising, therefore, that major efforts have been dedicated to preventing its occurrence before, during and after trauma exposure. This chapter discusses the rationale, desirability, feasibility and outcome of interventions designed to prevent PTSD. Several efficient interventions have been documented. Barriers to their early implementations, however, greatly reduce their effectiveness and require urgent attention.

scholarly journals The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales

2019 ◽  
Vol 6 (3) ◽  
pp. 247-256 ◽  
Author(s):  
Stephanie J Lewis ◽  
Louise Arseneault ◽  
Avshalom Caspi ◽  
Helen L Fisher ◽  
Timothy Matthews ◽  
...  
Keyword(s):  
Young People ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
England And Wales ◽  
Post Traumatic ◽  
Representative Cohort

scholarly journals Post-traumatic stress disorder, resilience and vulnerability

2007 ◽  
Vol 13 (5) ◽  
pp. 369-375 ◽  
Author(s):  
Ayesha S. Ahmed
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Events ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
War Experiences

Post-traumatic stress disorder (PTSD), recognised as a diagnostic entity in 1980, was originally associated with combat or war experiences. It has since been recognised that it is prevalent in any population exposed to traumatic events. Although much has been written about the management of PTSD, the concepts of resilience and vulnerability have not received the same attention. This article reviews the conceptualisation, epidemiology and comorbidities of PTSD and highlights the factors underlying vulnerability and conveying resilience.

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