Violent offence is associated with increased risk for post-trauma stress disorder but faster remission in incarcerated females in China.

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.

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Exploring the impact of COVID-19 and restrictions to daily living as a result of social distancing within veterans with pre-existing mental health difficulties

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001622 ◽

2020 ◽

pp. bmjmilitary-2020-001622 ◽

Cited By ~ 1

Author(s):

Dominic Murphy ◽

C Williamson ◽

J Baumann ◽

W Busuttil ◽

N T Fear

Keyword(s):

Mental Health ◽

Social Support ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Increased Risk ◽

Mental Health Difficulties ◽

Post Traumatic ◽

The Impact

IntroductionData are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic.MethodsData were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions—Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity.ResultsIt was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties.ConclusionsOur findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.

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Abstract P127: Posttraumatic Stress Disorder and Risk for Coronary Heart Disease: A Meta-analytic Review

Circulation ◽

10.1161/circ.127.suppl_12.ap127 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Donald Edmondson ◽

Ian M Kronish ◽

Jonathan A Shaffer ◽

Louise Falzon ◽

Matthew M Burg

Keyword(s):

Posttraumatic Stress Disorder ◽

Coronary Heart Disease ◽

Heart Disease ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Meta Analysis ◽

Cochrane Library ◽

Forest Plot ◽

Increased Risk ◽

Analytic Review

Context: Recent evidence suggests that posttraumatic stress disorder (PTSD) may be associated with increased risk for coronary heart disease (CHD). Objective: To determine the association of PTSD to incident CHD using systematic review and meta-analysis. Data Sources: Articles were identified by searching Ovid MEDLINE, PsycINFO, Scopus, Cochrane Library, PILOTS database, and through manual search of reference lists. Study Selection: Prospective cohort studies that assessed PTSD in participants free of CHD and assessed subsequent CHD or cardiac-specific mortality. Data Extraction: We extracted estimates of the association of PTSD to incident CHD, as well as study characteristics. Odds ratios were converted to hazard ratios (HR), and a random-effects model was used to pool results. Data Synthesis: Five studies met our inclusion criteria (N= 401,712); 4 of these included depression as a covariate. The pooled HR for the magnitude of the relationship between PTSD and CHD was 1.53 (95% CI, 1.27-1.84) before adjustment for depression. The pooled HR estimate for the 4 depression-adjusted estimates (N= 362,388) was 1.22 (95% CI, 1.05-1.42). Conclusion: PTSD is independently associated with increased risk for incident CHD, even after adjusting for depression and other covariates. Figure 1. Forest plot of association of PTSD to incident MI or cardiac mortality Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.

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Pain in the aftermath of trauma is a risk factor for post-traumatic stress disorder

Psychological Medicine ◽

10.1017/s0033291707001389 ◽

2007 ◽

Vol 38 (4) ◽

pp. 533-542 ◽

Cited By ~ 118

Author(s):

S. B. Norman ◽

M. B. Stein ◽

J. E. Dimsdale ◽

D. B. Hoyt

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Traumatic Injury ◽

Surgical Trauma ◽

Post Traumatic Stress ◽

Increased Risk ◽

Post Traumatic

BackgroundIdentifying risk factors for the development of post-traumatic stress disorder (PTSD) is important for understanding and ultimately preventing the disorder. This study assessed pain shortly after traumatic injury (i.e. peritraumatic pain) as a risk factor for PTSD.MethodParticipants (n=115) were patients admitted to a Level 1 Surgical Trauma Center. Admission to this service reflected a severe physical injury requiring specialized, emergent trauma care. Participants completed a pain questionnaire within 48 h of traumatic injury and a PTSD diagnostic module 4 and 8 months later.ResultsPeritraumatic pain was associated with an increased risk of PTSD, even after controlling for a number of other significant risk factors other than acute stress disorder symptoms. An increase of 0.5 s.d. from the mean in a 0–10 pain rating scale 24–48 h after injury was associated with an increased odds of PTSD at 4 months by more than fivefold, and at 8 months by almost sevenfold. A single item regarding amount of pain at the time of hospital admission correctly classified 65% of participants.ConclusionsIf these findings are replicated in other samples, high levels of peritraumatic pain could be used to identify individuals at elevated risk for PTSD following traumatic injury.

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Symptoms of dementia or post-traumatic stress disorder? Under-recognised behaviours in veterans with dementia

British Journal of Neuroscience Nursing ◽

10.12968/bjnn.2021.17.4.140 ◽

2021 ◽

Vol 17 (4) ◽

pp. 140-146 ◽

Cited By ~ 1

Author(s):

Deborah Hutchinson ◽

Martin Isaacs ◽

Lucy Chamberlain ◽

Karen Harrison Dening

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Screening Tool ◽

Stress Disorder ◽

Psychological Symptoms ◽

Poor Mental Health ◽

Post Traumatic Stress ◽

People With Dementia ◽

Increased Risk ◽

Post Traumatic

Background: The veteran community are at increased risk of poor mental health and developing dementia as a result of their miliary service, with the potential to lead to delayed onset post-traumatic stress disorder (DOPTSD). The manifestation of DOPTSD may be misinterpreted as behavioural and psychological symptoms of dementia (BPSD), which create difficulties in caring for the person experiencing these distressing symptoms. Aims: This paper details the development of a screening tool for people with dementia, which aims to reframe and contextualise some of the behaviours under the lens of historic traumatic events. Methods: The utility of the screening tool is demonstrated through the presentation and an analysis of an anonymised case study to support nurse practice development. Conclusions: A trauma history tool offers a more comprehensive and interpretive view of the possible historic, trauma-related causes of current behaviours and can aid informal carers' understanding of the stress and distress reactions of their family members.

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Early onset neurocirculatory response to static handgrip is associated with greater blood pressure variability in women with posttraumatic stress disorder

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00490.2019 ◽

2020 ◽

Vol 318 (1) ◽

pp. H49-H58 ◽

Cited By ~ 1

Author(s):

Jeung-Ki Yoo ◽

Mark B. Badrov ◽

Rosemary S. Parker ◽

Elizabeth H. Anderson ◽

Jessica L. Wiblin ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Posttraumatic Stress Disorder ◽

Muscle Contraction ◽

Posttraumatic Stress ◽

Early Onset ◽

Stress Disorder ◽

Muscle Sympathetic Nerve Activity ◽

Pressor Responses ◽

Increased Risk

Posttraumatic stress disorder (PTSD) is a psychiatric illness that is more prevalent in women, and accumulating evidence suggests a link between PTSD and future development of cardiovascular disease. The underlying mechanisms are unclear, but augmented sympathetic reactivity to daily stressors may be involved. We measured muscle sympathetic nerve activity (MSNA), blood pressure (BP), and heart rate responses in 14 women with PTSD and 14 healthy women (controls) during static handgrip (SHG) exercise to fatigue at 40% of maximal voluntary contraction (MVC). Two minutes of postexercise circulatory arrest (PECA) was followed immediately after SHG to fatigue. MVC and the time to fatigue during SHG did not differ between groups (both P > 0.05). At the first 30 s of SHG, women with PTSD showed augmented sympathetic neural [mean ± SD, ∆MSNA burst frequency (BF): 5 ± 4 vs. 2 ± 3 bursts/30 s, P = 0.02 and ∆MSNA total activity (TA): 82 ± 58 vs. 25 ± 38 arbitrary units/30 s, P = 0.004] and pressor (∆systolic BP: 10 ± 5 vs. 4 ± 3 mmHg, P = 0.003) responses compared with controls. However, MSNA and BP responses at fatigue and during PECA were not different between groups. More interestingly, the augmented initial neural and pressor responses to SHG were associated with greater awake systolic BP variability during ambulation in women with PTSD (MSNA BF: r = 0.55, MSNA TA: r = 0.62, and SBP: r = 0.69, all P < 0.05). These results suggest that early onset exercise pressor response in women with PTSD may be attributed to enhanced mechano- rather than metaboreflexes, which might contribute to the mechanisms underlying the link between PTSD and cardiovascular risk. NEW & NOTEWORTHY The novel findings of the current study are that women with posttraumatic stress disorder (PTSD) exhibited augmented sympathetic neural and pressor responses at the first 30 s of submaximal isometric muscle contraction. More interestingly, exaggerated neurocirculatory responses at the onset of muscle contraction were associated with greater ambulatory awake systolic blood pressure fluctuations in women with PTSD. Our findings expand the knowledge on the physiological mechanisms that perhaps contribute to increased risk of cardiovascular disease in such a population.

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Depression and Psychosocial Stress Are Associated With Subclinical Carotid Atherosclerosis Among Women Living With HIV

Journal of the American Heart Association ◽

10.1161/jaha.120.016425 ◽

2020 ◽

Vol 9 (13) ◽

Author(s):

Matthew E. Levy ◽

Kathryn Anastos ◽

Steven R. Levine ◽

Michael Plankey ◽

Amanda D. Castel ◽

...

Keyword(s):

Risk Factors ◽

Posttraumatic Stress Disorder ◽

Depressive Symptoms ◽

Posttraumatic Stress ◽

Psychosocial Stress ◽

Latent Class ◽

Stress Disorder ◽

Plaque Formation ◽

Psychosocial Risk ◽

Increased Risk

Background To identify reasons for increased atherosclerotic risk among women living with HIV ( WLWH ), we evaluated the associations between psychosocial risk factors (depressive symptoms, perceived stress, and posttraumatic stress disorder symptoms) and subclinical atherosclerosis among WLWH and HIV ‐negative women. Methods and Results Carotid artery focal plaque (localized intima‐media thickness >1.5 mm) was measured using B‐mode ultrasound imaging in 2004–2005 and 2010–2012 in the Women's Interagency HIV Study. We created psychosocial risk groups using latent class analysis and defined prevalent plaque at the final measurement. We also examined repeated semiannual depression measures with respect to focal plaque formation throughout follow‐up. The associations between latent class and prevalent plaque, and between depressive symptom persistence and plaque formation, were assessed separately by HIV status using multivariable logistic regression. Among 700 women (median age 47 years), 2 latent classes were identified: high (n=163) and low (n=537) psychosocial risk, with corresponding prevalence of depression (65%/13%), high stress (96%/12%), and probable posttraumatic stress disorder (46%/2%). Among WLWH , plaque prevalence was 23% and 11% in high versus low psychosocial risk classes (adjusted odds ratio [aOR], 2.12; 95% CI, 1.11–4.05) compared with 9% and 9% among HIV ‐negative women (aOR, 1.07; 95% CI, 0.24–4.84), respectively. New plaque formation occurred among 17% and 9% of WLWH who reported high depressive symptoms at ≥45% versus <45% of visits (aOR, 1.96; 95% CI, 1.06–3.64), compared with 9% and 7% among HIV ‐negative women (aOR, 0.82; 95% CI, 0.16–4.16), respectively. Conclusions Psychosocial factors were independent atherosclerotic risk factors among WLWH . Research is needed to determine whether interventions for depression and psychosocial stress can mitigate the increased risk of atherosclerosis for WLWH .

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Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD

Psychological Medicine ◽

10.1017/s0033291719004008 ◽

2020 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Sarah R. Lowe ◽

Andrew Ratanatharathorn ◽

Betty S. Lai ◽

Willem van der Mei ◽

Anna C. Barbano ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Multinomial Logistic Regression ◽

Female Gender ◽

Interpersonal Trauma ◽

Demographic Characteristics ◽

Ptsd Symptoms ◽

Symptom Trajectories ◽

Increased Risk

Abstract Background Research exploring the longitudinal course of posttraumatic stress disorder (PTSD) symptoms has documented four modal trajectories (low, remitting, high, and delayed), with proportions varying across studies. Heterogeneity could be due to differences in trauma types and patient demographic characteristics. Methods This analysis pooled data from six longitudinal studies of adult survivors of civilian-related injuries admitted to general hospital emergency departments (EDs) in six countries (pooled N = 3083). Each study included at least three assessments of the clinician-administered PTSD scale in the first post-trauma year. Latent class growth analysis determined the proportion of participants exhibiting various PTSD symptom trajectories within and across the datasets. Multinomial logistic regression analyses examined demographic characteristics, type of event leading to the injury, and trauma history as predictors of trajectories differentiated by their initial severity and course. Results Five trajectories were found across the datasets: Low (64.5%), Remitting (16.9%), Moderate (6.7%), High (6.5%), and Delayed (5.5%). Female gender, non-white race, prior interpersonal trauma, and assaultive injuries were associated with increased risk for initial PTSD reactions. Female gender and assaultive injuries were associated with risk for membership in the Delayed (v. Low) trajectory, and lower education, prior interpersonal trauma, and assaultive injuries with risk for membership in the High (v. Remitting) trajectory. Conclusions The results suggest that over 30% of civilian-related injury survivors admitted to EDs experience moderate-to-high levels of PTSD symptoms within the first post-trauma year, with those reporting assaultive violence at increased risk of both immediate and longer-term symptoms.

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The Relationship Between Experiences With the Criminal Justice System and Mental Health Outcomes Among Survivors of Homicide

Violence and Victims ◽

10.1891/0886-6708.v33.i2.124 ◽

2018 ◽

Vol 33 (2) ◽

pp. 310-329 ◽

Cited By ~ 3

Author(s):

Evgenia Milman ◽

Joah L. Williams ◽

Kaitlin Bountress ◽

Alyssa A. Rheingold

Keyword(s):

Mental Health ◽

Criminal Justice ◽

Criminal Justice System ◽

Justice System ◽

Stress Disorder ◽

Police Department ◽

Survey Study ◽

Homicide Survivors ◽

Increased Risk ◽

The Relationship

Homicide survivors are at increased risk for mental health disorders, including depression, posttraumatic stress disorder (PTSD), and complicated grief (CG). Accordingly, this survey study examined how satisfaction with the criminal justice system (CJS) was associated with depression, PTSD, and CG among 47 homicide survivors. It also examined how satisfaction with specific aspects of the CJS related to satisfaction with the overall CJS. Satisfaction with the overall CJS was uniquely associated with depression (odds ratio [OR] = 2.32; 95% confidence interval [CI] [1.16, 4.66]) while satisfaction with the police department was uniquely associated with CG (OR = 2.14; 95% CI [1.02, 4.47]). Satisfaction with having input into the CJS process and satisfaction with efforts devoted by the CJS to apprehend the perpetrator were uniquely related to satisfaction with the overall CJS (β = .49, p = .003 and β = .40, p = .007, respectively).

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The Cycle of Trauma: Relationship Aggression in Male Vietnam Veterans With Symptoms of Posttraumatic Stress Disorder

Violence and Victims ◽

10.1891/0886-6708.11.3.213 ◽

1996 ◽

Vol 11 (3) ◽

pp. 213-225 ◽

Cited By ~ 121

Author(s):

Christina A. Byrne ◽

David S. Riggs

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Vietnam Veterans ◽

Stress Disorder ◽

Psychological Aggression ◽

Future Research ◽

Ptsd Symptoms ◽

Female Partners ◽

Relationship Aggression ◽

Increased Risk

This study examined the association between symptoms of Posttraumatic Stress Disorder (PTSD) in male Vietnam veterans and their use of aggressive behavior in relationships with intimate female partners. Fifty couples participated in the study. Veterans reported on their PTSD symptoms, and veterans and partners completed measures assessing the veterans’ use of physical, verbal,’ and psychological aggression during the preceding year as well as measures of their own perceptions of problems in the relationship. Results indicated that PTSD symptomatology places veterans at increased risk for perpetrating relationship aggression against their partners. The association between veterans’ PTSD symptoms and their use of aggression in relationships was mediated by relationship problems. Clinical implications of these findings and suggestions for future research are discussed.

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