scholarly journals Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries

Author(s):  
Dusko Stupar ◽  
Dejan Stevanovic ◽  
Panos Vostanis ◽  
Olayinka Atilola ◽  
Paulo Moreira ◽  
...  

Abstract Background Exposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs). Methods Data were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12–18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms. Results The most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2–8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2–10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria. Conclusions Nearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.

Intervention ◽  
2014 ◽  
Vol 12 (2) ◽  
pp. 250-266 ◽  
Author(s):  
Adrian P. Mundt ◽  
Petra Wünsche ◽  
Andreas Heinz ◽  
Christian Pross

2016 ◽  
Vol 37 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Nicole L. Hofman ◽  
Austin M. Hahn ◽  
Christine K. Tirabassi ◽  
Raluca M. Gaher

Abstract. Exposure to traumatic events and the associated risk of developing Posttraumatic stress disorder (PTSD) symptoms is a significant and overlooked concern in the college population. It is important for current research to identify potential protective factors associated with the development and maintenance of PTSD symptoms unique to this population. Emotional intelligence and perceived social support are two identified protective factors that influence the association between exposure to traumatic events and PTSD symptomology. The current study examined the mediating role of social support in the relationship between emotional intelligence and PTSD symptoms. Participants included 443 trauma-exposed university students who completed online questionnaires. The results of this study indicated that social support mediates the relationship between emotional intelligence and reported PTSD symptoms. Thus, emotional intelligence is significantly associated with PTSD symptoms and social support may play an integral role in the relationship between emotional intelligence and PTSD. The current study is the first to investigate the role of social support in the relationship between emotional intelligence and PTSD symptoms. These findings have important treatment and prevention implications with regard to PTSD.


Journalism ◽  
2017 ◽  
Vol 19 (9-10) ◽  
pp. 1308-1325 ◽  
Author(s):  
Mina Lee ◽  
Eun Hye Ha ◽  
Jung Kun Pae

This study investigated posttraumatic stress disorder (PTSD) symptoms on Korean journalists and the contributing variables. Predicting variables included the exposure to traumatic events, coping strategy, social support, optimism, negative beliefs, and the journalists’ occupational perspectives. A total of 367 Korean journalists participated in the survey. The findings revealed that, first, Korean journalists had suffered severely from PTSD symptoms according to the prevalence rate. Second, the extent of traumatic event exposure, the length of career, the use of dysfunctional coping strategy, a lack of social support, and negative beliefs were identified as significantly related variables. Finally, occupational perspectives showed meaningful associations with development of the symptoms. This study provided an empirical analysis of Korean journalists’ experiences of traumatic events and psychological stress for the first time.


2017 ◽  
Vol 25 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Valerie Bertaina-Anglade ◽  
Susan M O’Connor ◽  
Emile Andriambeloson

Objectives: Posttraumatic stress disorder (PTSD) is a prevalent, chronic, disabling disorder that may develop following exposure to a traumatic event. This review summarizes currently used animal models of PTSD and their potential role in the development of better therapeutics. Heterogeneity is one of the main characteristics of PTSD with the consequence that many pharmacological approaches are used to relieve symptoms of PTSD. To address the translational properties of the animal models, we discuss the types of stressors used, the rodent correlates of human PTSD (DSM-5) symptoms, and the efficacy of approved, recommended and off-label drugs used to treat PTSD in ‘PTSD-animals’. Conclusions: Currently available animal models reproduce most PTSD symptoms and are validated by existing therapeutics. However, novel therapeutics are needed for this disorder as not one drug alleviates all symptoms and many have side effects that lead to non-compliance among PTSD patients. The true translational power of animal models of PTSD will only be demonstrated when new therapeutics acting through novel mechanisms become available for clinical practice.


2021 ◽  
Author(s):  
Chadi Abdallah ◽  
John Roache ◽  
Ralitza Gueorguieva ◽  
Lynnette Averill ◽  
Stacey Young-McCaughon ◽  
...  

Background: This study tested the efficacy of repeated intravenous ketamine doses to reduce antidepressant-resistant symptoms of posttraumatic stress disorder (PTSD). Methods: Veterans and service members with PTSD (n=158) who failed previous antidepressant treatment were randomized to 8 infusions administered twice weekly of intravenous placebo (n=54), low dose (0.2mg/kg; n=53) or standard dose (0.5mg/kg; n=51) ketamine. Participants were assessed at baseline, during treatment, and for 4 weeks after their last infusion. Primary analyses used mixed effects models. The primary outcome measure was the self-report PTSD Checklist for DSM-5 (PCL-5), and secondary outcome measures were the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Montgomery Asberg Depression Rating Scale (MADRS). Results: There were no significant group-by-time interactions for PTSD symptoms measured by the PCL-5 or CAPS-5. The standard dose ketamine significantly reduced symptoms after the first infusion, while the low dose showed significant symptom reduction after the last infusion and at the 4-week follow-up. The standard ketamine dose also significantly ameliorated depression measured by the MADRS. Ketamine produced dose-related dissociative and psychotomimetic effects, which returned to baseline within 2 hours and were less pronounced with repeated administration. There was no evidence of differential treatment discontinuation by ketamine dose, consistent with good tolerability. Conclusions: This clinical trial failed to find a significant dose-related effect of ketamine on PTSD symptoms. Secondary analyses suggested that the low dose reduced PTSD symptoms and the standard dose exerted rapid antidepressant effects. Further studies are needed to determine the role of ketamine in PTSD treatment. ClinicalTrials.gov identifier: NCT02655692


2017 ◽  
Vol 47 (13) ◽  
pp. 2260-2274 ◽  
Author(s):  
K. C. Koenen ◽  
A. Ratanatharathorn ◽  
L. Ng ◽  
K. A. McLaughlin ◽  
E. J. Bromet ◽  
...  

BackgroundTraumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking.MethodsData were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics.ResultsThe cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed.ConclusionsPTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.


2016 ◽  
Vol 33 (S1) ◽  
pp. S514-S514 ◽  
Author(s):  
C. Soberón ◽  
M. Crespo ◽  
M. Gómez-Gutiérrez ◽  
V. Fernández-Lansac

IntroductionDespite the four factor model of PTSD proposed in the DSM-5 (APA, 2013) has received a better empirical support than three factor model of DSM-IV (APA, 1994), some alternative models proposed can provide a better representation of PTSD's latent structure.ObjectiveThe current study tested the fit of seven models, including the 3-factor DSM-IV model (APA, 1994), the 4-factor DSM-5 model (APA, 2000), the 4-factor dysphoria model (Simms, Watson & Doebbeling, 2002), the 5-factor dysphoric arousal model (Elhai et al., 2012), the 6-factor anhedonia model (Liu et al., 2014), the 6-factor externalizing behaviors model (Tsai et al., 2014) and the 7-factor hybrid model (Armour et al., 2015) that combines key features of the anhedonia and externalizing behaviors models.AimIt expected that the 7-factor hybrid model (Armour et al., 2015) would be the best fitting model.MethodsPTSD symptoms were assessed using the Global Assessment of Posttraumatic Stress Disorder (EGEP-5; Crespo, Gómez & Soberón, 2016) in a sample of 165 victims of different traumatic events. Confirmatory Factor Analysis (CFAs) were conducted on each of the seven models using Maximum Likelihood (ML) estimation method.ResultsAll the models tested (except for DSM-IV model) yielded an adequate fit to the data. However, 7-factor hybrid model (Armour et al., 2015) provided a better fit than other competing models.ConclusionsThe current findings suggest that the dimensional structure of DSM-5 PTSD symptoms may be best represented by the 7 factors proposed in the hybrid model instead of 4 factors of DSM-5.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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