Emotional Sequelae of Elective Abortion: The Role of Guilt and Shame

2017 ◽  
Vol 71 (2) ◽  
pp. 98-105 ◽  
Author(s):  
Donna Krupkin Whitney
Keyword(s):  
Healthcare Providers ◽  
Post Traumatic Stress ◽  
Elective Abortion ◽  
Effective Care ◽  
Interpersonal Difficulties ◽  
Post Traumatic ◽  
Post Abortion ◽  
Relationship Disturbances

Although estimates vary, many women experience long-term emotional, spiritual, psychological and interpersonal difficulties following abortion, including complicated grief, depression, post-traumatic stress disorder (PTSD) and relationship disturbances. Developmental, drive, object-relations and narcissism models for perinatal loss also illuminate the dynamics of post-abortion syndromes. Guilt and shame play important roles in generating and concealing post-abortion sequelae. Pastoral care and healthcare providers can increase their awareness of post-abortion sequelae and provide effective care for women experiencing these syndromes.

scholarly journals Glucocorticoids and the brain after critical illness

Endocrinology ◽  
2021 ◽  
Author(s):  
Alice R Hill ◽  
Joanna L Spencer-Segal
Keyword(s):  
Critical Illness ◽  
Structural Integrity ◽  
Treatment Strategies ◽  
Current Evidence ◽  
Post Traumatic Stress ◽  
Free Cortisol ◽  
Acute Elevation ◽  
Post Traumatic

Abstract Treatment for critical illness typically focuses on a patient’s short-term physical recovery; however, recent work has broadened our understanding of the long-term implications of illness and treatment strategies. In particular, survivors of critical illness have significantly elevated risk of developing lasting cognitive impairment and psychiatric disorders. In this review, we examine the role of endogenous and exogenous glucocorticoids in neuropsychiatric outcomes following critical illness. Illness is marked by acute elevation of free cortisol and adrenocorticotropic hormone (ACTH) suppression, which typically normalize after recovery; however, prolonged dysregulation can sometimes occur. High glucocorticoid levels can cause lasting alterations to the plasticity and structural integrity of the hippocampus and prefrontal cortex, and this mechanism may plausibly contribute to impaired memory and cognition in critical illness survivors, though specific evidence is lacking. Glucocorticoids may also exacerbate inflammation-associated neural damage. Conversely, current evidence indicates that glucocorticoids during illness may protect against the development of post-traumatic stress disorder (PTSD). We propose future directions for research in this field, including determining the role of persistent glucocorticoid elevations after illness in neuropsychiatric outcomes, the role of systemic vs. neuroinflammation, and probing unexplored lines of investigation on the role of mineralocorticoid receptors and the gut-brain axis. Progress toward personalized medicine in this area has the potential to produce tangible improvements to the lives patients after a critical illness, including Coronavirus Disease 2019 (COVID-19).

Childhood emotional abuse and posttraumatic stress symptoms in women: the mediating role of mindfulness

2017 ◽  
Vol 10 ◽  
pp. 105-116
Author(s):  
Stéphanie Laforte ◽  
Caroline Dugal ◽  
Claude Bélanger ◽  
Natacha Godbout
Keyword(s):  
Traumatic Stress ◽  
Emotional Abuse ◽  
Post Traumatic Stress ◽  
Mediating Role ◽  
Stress Symptoms ◽  
Post Traumatic ◽  
Childhood Emotional Abuse ◽  
The Relationship

More than one-third of adults report having experienced emotional abuse in childhood, which is one of the most common interpersonal traumas. Although survivors of interpersonal trauma are at risk of developing post-traumatic stress symptoms, few studies have specifically examined the links between childhood emotional abuse and symptoms of post-traumatic stress in adulthood. Recent studies highlight the role of mindfulness as a key variable in understanding how interpersonal traumas can be associated with long-term post-traumatic stress symptoms (Godbout, Dion, & Bigras, 2016). The purpose of this study is to examine the mediating role of mindfulness in the relationship between emotional abuse in childhood and post- traumatic stress symptoms. The sample consisted of 354 women from the community who responded to self -reported online questionnaires. The results of multiple regression analyses show that the relationship between emotional abuse in childhood and symptoms of post-traumatic stress is explained by a decrease in mindfulness capacities. Overall, the results highlight the role of mindfulness as a mechanism partially explaining the impacts of interpersonal traumas in childhood.

Rehabilitation Psychology Insights for Treatment of Critical Illness Survivors

2017 ◽  
Author(s):  
Jennifer E. Jutte ◽  
James C. Jackson ◽  
Ramona O. Hopkins
Keyword(s):  
Critical Illness ◽  
Critically Ill Patient ◽  
Post Traumatic Stress ◽  
Rehabilitation Psychology ◽  
Acute Distress ◽  
Post Traumatic ◽  
Anxiety Depression

This chapter discusses the role of rehabilitation psychologists in the care of the critically ill patient during and after a stay in intensive care unit (ICU). Since post-ICU cognitive impairments and psychiatric difficulties such as anxiety, depression, acute distress disorder, and post-traumatic stress disorder may not be preventable altogether, it is important to attempt to minimize long-term impairment and distress. Because of the thorough training rehabilitation psychologists receive in assessment and intervention practices in patients with a variety of complex medical conditions, rehabilitation psychologists are particularly well-suited to identify and address the complex post-ICU morbidities faced by critical illness survivors across the continuum of care environments. Interventions across settings to minimize delirium, reduce psychological distress, and shore up cognitive deficits could positively influence patients’ recovery trajectories and quality of life.

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 The Role of HPA Axis and Allopregnanolone on the Neurobiology of Major Depressive Disorders and PTSD

2021 ◽  
Vol 22 (11) ◽  
pp. 5495
Author(s):  
Felipe Borges Almeida ◽  
Graziano Pinna ◽  
Helena Maria Tannhauser Barros
Keyword(s):  
Hpa Axis ◽  
Depressive Disorders ◽  
Post Traumatic Stress ◽  
Major Depressive ◽  
Physiological Adaptations ◽  
Suppression Test ◽  
Post Traumatic ◽  
Major Depressive Disorders ◽  
Cortisol Release

Under stressful conditions, the hypothalamic-pituitary-adrenal (HPA) axis acts to promote transitory physiological adaptations that are often resolved after the stressful stimulus is no longer present. In addition to corticosteroids (e.g., cortisol), the neurosteroid allopregnanolone (3α,5α-tetrahydroprogesterone, 3α-hydroxy-5α-pregnan-20-one) participates in negative feedback mechanisms that restore homeostasis. Chronic, repeated exposure to stress impairs the responsivity of the HPA axis and dampens allopregnanolone levels, participating in the etiopathology of psychiatric disorders, such as major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). MDD and PTSD patients present abnormalities in the HPA axis regulation, such as altered cortisol levels or failure to suppress cortisol release in the dexamethasone suppression test. Herein, we review the neurophysiological role of allopregnanolone both as a potent and positive GABAergic neuromodulator but also in its capacity of inhibiting the HPA axis. The allopregnanolone function in the mechanisms that recapitulate stress-induced pathophysiology, including MDD and PTSD, and its potential as both a treatment target and as a biomarker for these disorders is discussed.

scholarly journals Environmental enrichment prevents the late effect of acute stress-induced fear extinction deficit: the role of hippocampal AMPA-GluA1 phosphorylation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Leonardo Santana Novaes ◽  
Letícia Morais Bueno-de-Camargo ◽  
Carolina Demarchi Munhoz
Keyword(s):  
Environmental Enrichment ◽  
Basolateral Amygdala ◽  
Acute Stress ◽  
Fear Memory ◽  
Fear Extinction ◽  
Post Traumatic Stress ◽  
Related Disorder ◽  
Memory Extinction ◽  
Post Traumatic

AbstractThe persistence of anxiety and the deficit of fear memory extinction are both phenomena related to the symptoms of a trauma-related disorder, such as post-traumatic stress disorder (PTSD). Recently we have shown that single acute restraint stress (2 h) in rats induces a late anxiety-related behavior (observed ten days after stress), whereas, in the present work, we found that the same stress impaired fear extinction in animals conditioned ten days after stress. Fourteen days of environmental enrichment (EE) prevented the deleterious effect of stress on fear memory extinction. Additionally, we observed that EE prevented the stress-induced increase in AMPA receptor GluA1 subunit phosphorylation in the hippocampus, but not in the basolateral amygdala complex and the frontal cortex, indicating a potential mechanism by which it exerts its protective effect against the stress-induced behavioral outcome.

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