scholarly journals Post-traumatic stress impact on health outcomes in Gulf War Illness

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Mary Jeffrey ◽  
Fanny Collado ◽  
Jeffrey Kibler ◽  
Christian DeLucia ◽  
Steven Messer ◽  
...  

Abstract Background Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder affecting an estimated 25–32% of the returning military veterans of the 1990–1991 Persian Gulf War. GWI presents with a wide range of symptoms including fatigue, muscle pain, cognitive problems, insomnia, rashes and gastrointestinal issues and continues to be a poorly understood illness. This heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. Defining subgroups of the illness may help alleviate these complications. Our aim is to determine if GWI can be divided into distinct subgroups based on PTSD symptom presentation. Methods Veterans diagnosed with GWI (n = 47) and healthy sedentary veteran controls (n = 52) were recruited through the Miami Affairs (VA) Medical Health Center. Symptoms were assessed via the RAND short form health survey (36), the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson Trauma Scale value and performing heteroscedastic t-tests across all measures. Results Overall analyses returned two symptom-based subgroups differing significantly across all health and trauma symptoms. These subgroups supported PTSD symptomatology as a means to subgroup veterans. Hierarchical models showed that GWI and levels of PTSD symptoms both impact measures of physical, social, and emotional consequences of poor health (ΔR2 = 0.055–0.316). However, GWI appeared to contribute more to fatigue measures. Cut-point analysis retained worse health outcomes across all measures for GWI with PTSD symptoms compared to those without PTSD symptoms, and healthy controls. Significant differences were observed in mental and emotional measures. Conclusions Therefore, this research supports the idea that comorbid GWI and PTSD symptoms lead to worse health outcomes, while demonstrating how GWI and PTSD symptoms may uniquely contribute to clinical presentation.

2021 ◽  
Author(s):  
Nandan Shastry ◽  
Esha Sultana ◽  
Mary Jeffrey ◽  
Fanny Collado ◽  
Jeffrey Kibler ◽  
...  

Abstract Background: Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder characterized by fatigue, muscle pain, cognitive problems, insomnia, rashes, and gastrointestinal issues affecting an estimated 30% of the ~750,000 returning military Veterans of the 1990–1991 Persian Gulf War. Female Veterans deployed to combat in this war report medical symptoms, like cognition and respiratory troubles, at twice the rate compared to non-deployed female Veterans of the same era. The heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. This is exacerbated by the presence of co-morbidities. Defining subgroups of the illness may help alleviate these complications. One clear grouping is along the lines of gender. Our aim is to determine if women with GWI can be further subdivided into distinct subgroups based on post-traumatic stress disorder (PTSD) symptom presentation.Methods: Veterans diagnosed with GWI (n = 35) and healthy sedentary controls (n = 35) were recruited through the Miami Veterans Affairs Medical Health Center. Symptoms were assessed via the RAND short form health survey, the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson trauma scale value and performing heteroscedastic t-tests across all measures.Results: Based on the distinct differences found in PTSD symptomology regarding all health and trauma symptoms, two subgroups were derived within female GWI Veterans. Hierarchical regression models displayed the comorbid effects of GWI and PTSD, as both conditions had measurable impacts on physical and social outcomes of poor health (ΔR2 = 0.08- 0.672), with notable differences in mental and emotional measures. Overall, in women with GWI individuals with PTSD, a cut point analysis indicated poorer health outcomes within all measures in comparison to those of women without PTSD symptoms and healthy controls.Conclusions: Our current findings support the understanding that comorbid symptoms of GWI and PTSD subsequently result in poorer experienced health outcomes, along with establishing the possibility of varying clinical presentations.


2018 ◽  
Vol 16 (1) ◽  
pp. 17 ◽  
Author(s):  
Rebecca M. Schwartz, PhD ◽  
Rehana Rasul, MA ◽  
Samantha M. Kerath, MS ◽  
Alexis R. Watson, BS ◽  
Wil Lieberman-Cribbin, MPH ◽  
...  

Objective: To assess the effect of displacement due to Hurricane Sandy on mental health outcomes among residents of the greater New York City (NYC) area.Design: Prospective, cross sectional.Setting: NYC area residents, including Queens, Staten Island, and Long Island.Participants: In a 4.25 year period (June 2012 to September 2016), a convenience sample of 1,615 adult residents from the greater NYC area completed validated measures of hurricane exposure (including displacement), perceived stress, depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms as well as indicators of alcohol, illicit substance, and tobacco use.Main Outcome Measures: Perceived stress, depression, anxiety and PTSD symptoms and alcohol, illicit substance, and tobacco use.Results: Multivariable analyses indicated that displaced participants were more likely to have PTSD (adjusted Odds Ratio (AOR): 2.21, 95%CI: 1.73-2.82), depression (AOR: 1.37, 95%CI: 1.05-1.79) and anxiety symptoms (AOR: 1.30, 95%CI: 1.01-1.67) and had a 1.16 unit increase in perceived stress score (SE = 0.38) compared to nondisplaced participants. Staying with friends/family vs. at a shelter was significantly associated with a 48 percent decreased odds of having PTSD symptoms (AOR: 0.52, 95%CI: 0.31-0.88) and of being a current tobacco user (AOR: 0.52, 95%CI: 0.30-0.92).Conclusions: Displacement is associated with negative mental health outcomes, particularly displacement to shelters. Disaster preparedness efforts should involve increasing mental health resources to those who are displaced and providing support services within the shelter setting.


2019 ◽  
Vol 29 (8) ◽  
pp. 892-909
Author(s):  
Michelle-Ann Rhoden ◽  
Mark J. Macgowan ◽  
Hui Huang

Purpose: This review discusses the efficacy of trauma-specific interventions among juvenile offenders. Method: The reviewers conducted a comprehensive search of trauma intervention studies completed in the United States in peer-reviewed journals, highlighting their methodological rigor by using the risk of bias tool for quantitative studies and Wu, Wyant, and Fraser's guidelines for qualitative studies. Results: Sixteen studies met the inclusion criteria; fourteen studies used quantitative and two used qualitative research designs. Nine studies reported medium to large effects on post-traumatic stress disorder (PTSD) symptoms and five assessed externalizing behavioral problems. Eye movement desensitization and reprocessing therapy demonstrated the most rigor and had the largest reductions on PTSD symptoms followed by trauma-focused cognitive behavioral therapy. Art therapy was the most rigorous qualitative study, but the intervention did not focus on reducing trauma symptoms. Discussion: Overall, most interventions were effective in reducing participants’ PTSD symptoms, but little is known about their effects on externalizing behavioral problems.


2020 ◽  
pp. 088626052097817
Author(s):  
Eryn N. DeLaney ◽  
Chelsea Derlan Williams ◽  
Della V. Mosley ◽  
Sage E. Hawn ◽  
Danielle M. Dick

Prior studies have demonstrated that sexual minority college students are two to four times more likely to experience sexual victimization (e.g., sexual assault and/or unwanted or uncomfortable sexual experiences) compared to their heterosexual counterparts. However, research that has focused on the detrimental effects of sexual victimization on health outcomes has paid more attention to heterosexual college samples and community-based adults. Understanding how sexual victimization influences mental health and substance use outcomes among lesbian, gay, bisexual, queer, and asexual (LGBQA) emerging adults in college is warranted given that this developmental period represents a critical risk period for trauma exposure, risk behavior, and psychological distress. Thus, the current study tested how sexual victimization was associated with depressive symptoms, post-traumatic stress disorder (PTSD) symptoms, and alcohol use disorder (AUD) symptoms among 234 diverse college students who self-identified as LGBQA. Additionally, social support was tested as a moderator. Findings indicated that sexual victimization was related to greater depressive symptoms, PTSD symptoms, and AUD symptoms. In addition, perceived social support moderated the relation between sexual victimization and depressive symptoms, however, in a direction contrary to hypotheses. In particular, higher sexual victimization was associated with greater depressive symptoms among LGBQA students with higher levels of social support ( b = .29, p = .00), and was not significant among LGBQA students with lower levels of social support ( b = .13, p = .26). The current study highlights the need to consider the detrimental effects of sexual victimization on health outcomes among LGBQA college students, as well as the mechanisms through which social support may be influencing these relations.


2015 ◽  
Vol 45 (13) ◽  
pp. 2849-2859 ◽  
Author(s):  
S. Alsawy ◽  
L. Wood ◽  
P. J. Taylor ◽  
A. P. Morrison

BackgroundExtensive evidence has shown that experiencing a traumatic event and post-traumatic stress disorder (PTSD) are associated with experiences of psychosis. However, less is known about specific PTSD symptoms and their relationship with psychotic experiences. This study aimed to examine the relationship between symptoms of PTSD with paranoia and auditory hallucinations in a large-scale sample.MethodThe Adult Psychiatric Morbidity Survey (APMS) was utilized to examine the prevalence of lifetime trauma, symptoms of PTSD, and experiences of paranoia and auditory hallucinations (n= 7403).ResultsThere were significant bivariate associations between symptoms of PTSD and psychotic experiences. Multiple logistic regression analyses indicated that reliving and arousal symptoms were significant predictors for paranoia while reliving, but not arousal symptoms, also significantly predicted auditory hallucinations. A dose-response relationship was found, the greater the number of PTSD symptoms, the greater the odds were of experiencing both paranoia and hallucinations.ConclusionsThese findings illustrate that symptoms of PTSD are associated with increased odds of experiencing auditory hallucinations and paranoia. Overlaps appear to be present between the symptoms of PTSD and psychotic experiences. Increasing awareness of this association may advance work in clinical practice.


2011 ◽  
Vol 26 (3) ◽  
pp. 166-169 ◽  
Author(s):  
Yechiel Soffer ◽  
Jonathan Jacob Wolf ◽  
Menachem Ben-Ezra

AbstractDuring large-scale, sudden-onset disasters, resscue personnel experience severe stress due to the brief window of opportunity for saving lives. Following the earthquake in Haiti, rescue personnel worked in Port-au-Prince under harsh conditions in order to save lives and extricate bodies. Reactions to this disaster among rescue personnel were examined using self-report questionnaires. Correlations between psychosocial factors and psychological trauma (dissociation and post-traumatic stress disorder (PTSD) symptoms) were examined in a sample of 20 rescue personnel who worked in Haiti. The study indicated that negative affect and crisis of meaning were associated with higher levels of dissociative and PTSD symptoms. The results suggest that rescue personnel who are overwhelmed by the destruction and number of bodies being extricated may exhibit negative affect and loss of meaning along with dissociative and PTSD symptoms.


Author(s):  
Andreas Chatzittofis ◽  
Maria Karanikola ◽  
Kyriaki Michailidou ◽  
Anastasia Constantinidou

The coronavirus disease 2019 (COVID-19) has a great impact on healthcare workers (HCWs) that includes negative mental health outcomes, such as post-traumatic stress, anxiety and depressive symptoms. In this cross-sectional study, we report on mental health outcomes among HCWs in Cyprus. Data were collected between 3 May and 27 May 2020, with the use of an online questionnaire that included demographics (sex, age, occupation, education, work sector, years of work experience), the 9-item Patient Health Questionnaire (PHQ-9) which assesses depressive symptoms, the Impact of Events Scale Revised (IES-R), which measures post-traumatic stress disorder (PTSD) symptoms, and the-10 item Perceived Stress Scale (PSS-10) which quantifies stress responses. Participants (42% physicians, 24% nurses, 18% physiotherapists, 16% classified as “other”) were 58% of female gender and aged 21–76. A total of 79 (18.6%) and 62 HCWs (14.6%) reported clinically significant depressive (PHQ-9 ≥ 10) and post-traumatic stress (IES-R > 33) symptoms respectively. Nurses were more likely than physicians to suffer from depression (adjusted prevalence ratio 1.7 (1.06–2.73); p = 0.035) and PTSD (adjusted prevalence ratio 2.51 (1.49–4.23); p = 0.001). Even in a country with a rather low spread of the COVID-19, such as Cyprus, HCWs reported a substantial mental health burden, with nurses reporting increased depressive and PTSD symptoms compared to other HCWs.


Author(s):  
Kathleen Kerr ◽  
Gayle Morse ◽  
Donald Graves ◽  
Fei Zuo ◽  
Alain Lipowicz ◽  
...  

Approximately 30% of the 700,000 US veterans of the 1990–1991 Persian Gulf War developed multiple persistent symptoms called Gulf War illness. While the etiology is uncertain, several toxic exposures including pesticides and chemical warfare agents have shown associations. There is no effective medical treatment. An intervention to enhance detoxification developed by Hubbard has improved quality of life and/or reduced body burdens in other cohorts. We evaluated its feasibility and efficacy in ill Gulf War (GW) veterans in a randomized, waitlist-controlled, pilot study at a community-based rehabilitation facility in the United States. Eligible participants (n = 32) were randomly assigned to the intervention (n = 22) or a four-week waitlist control (n = 10). The daily 4–6 week intervention consisted of exercise, sauna-induced sweating, crystalline nicotinic acid and other supplements. Primary outcomes included recruitment, retention and safety; and efficacy was measured via Veteran’s Short Form-36 (SF-36) quality of life, McGill pain, multidimensional fatigue inventory questionnaires and neuropsychological batteries. Scoring of outcomes was blinded. All 32 completed the trial and 21 completed 3-month follow-up. Mean SF-36 physical component summary score after the intervention was 6.9 (95% CI; −0.3, 14.2) points higher compared to waitlist control and 11 of 16 quality of life, pain and fatigue measures improved, with no serious adverse events. Most improvements were retained after 3 months. The Hubbard regimen was feasible, safe and might offer relief for symptoms of GW illness.


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