scholarly journals Kintsugi mind: clinicians can emerge from the pandemic whole

2022 ◽  
Vol 9 (1) ◽  
pp. 18-19
Author(s):  
Patricia Lynn Dobkin
Keyword(s):  
Health Care ◽  
Interpersonal Relationships ◽  
Health Care Professionals ◽  
World View ◽  
Meta Analysis ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
The Public ◽  
Post Traumatic Growth ◽  
Post Traumatic

The Japanese practice an ancient art called Kintsugi. A craftsperson repairs broken pottery with gold or silver rendering it more beautiful than in its original state. Can clinicians engage in “Kintsugi Mind” and thereby emerge from this pandemic integrated and whole? Yuan et al. (2021) conducted a meta-analysis including 88 studies of post-traumatic stress disorder (PTSD) following earlier pandemics and COVID-19. Health care professionals had the highest prevalence (26.9%) compared to infected cases and the public. Another type of trauma is called secondary or vicarious; it occurs when a person bears witness to suffering and death but remains powerless to change it; countless clinicians have experienced this over the past year. It manifests as emotional depletion, anxiety, insomnia, and impaired interpersonal relationships. How can clinicians heal from their exposure to the pandemic? Post-traumatic growth (PTG) is defined as positive psychological changes following trauma. PTG manifests in five areas: appreciation of life, relating to others, personal strength, recognizing new possibilities, and spiritual change. A transformation in the person’s world view and their place in it ensues. For health care professionals who are experiencing emotional distress, insomnia, or manifest PTSD symptoms they may heal by engaging in the six “Rs.” These are: relating, resourcing, repatterning, reprocessing, reflecting, and rituals. Both PTG and these six practices may contribute to Kintsugi Mind. While this appears to place the onus on individuals, it is crucial that leaders in the health care system implement programs enabling HCPs to be restored, rather than broken by this crisis.  

scholarly journals Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis

2015 ◽  
Vol 206 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Mathew Hoskins ◽  
Jennifer Pearce ◽  
Andrew Bethell ◽  
Liliya Dankova ◽  
Corrado Barbui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Positive Impact ◽  
Meta Analysis ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

BackgroundPharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.AimsTo determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.MethodA systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.ResultsSelective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.23, 95% CI −0.33 to −0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.ConclusionsSome drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.

scholarly journals Electroencephalography-based neurofeedback as treatment for post-traumatic stress disorder: A systematic review and meta-analysis

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Steinn Steingrimsson ◽  
Gorana Bilonic ◽  
Ann-Catrin Ekelund ◽  
Tomas Larson ◽  
Ida Stadig ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Suicidal Thoughts ◽  
Assessment Development ◽  
Post Traumatic

Abstract Background. Post-traumatic stress disorder (PTSD) is debilitating for patients and society. There are a number of treatment methods albeit not all patients respond to these and an interesting method using electroencephalography-based neurofeedback (EEG-NF) has become more prominent in recent years. This systematic review aimed to assess whether EEG-NF, compared with sham NF, other treatment, or no treatment, is effective for PTSD. Primary outcomes were self-harm, PTSD symptoms, level of functioning and health-related quality of life. Methods. Systematic literature searches for randomized controlled trials (RCTs) were conducted in six databases. Random effects meta-analysis was performed. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. Results. Four RCTs were included (123 participants). Suicidal thoughts were significantly reduced after EEG-NF compared with a waiting list in a small study. PTSD symptoms were assessed in all studies with different instruments. Results were consistently in favor of EEG-NF with large effect sizes (standardized mean difference −2.30 (95% confidence interval: −4.37 to −0.24). One study reported significantly improved level of executive functioning and one study a reduction in use of psychotropic medication. Complications were scarcely reported. Certainty of evidence was assessed as very low for the four assessed outcomes. Conclusions. Based on four RCTs, with several study limitations and imprecision, it is uncertain whether EEG-NF reduces suicidal thoughts, PTSD symptoms, medication use, or improves function. Although all studies showed promising results, further studies are needed to increase the certainty of evidence.

scholarly journals The physician’s Achilles heel—surviving an adverse event

2019 ◽  
Vol 26 (6) ◽  
Author(s):  
I. Stukalin ◽  
B. C. Lethebe ◽  
W. Temple
Keyword(s):  
Health Care ◽  
Adverse Event ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Institutional Support ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
Self Blame ◽  
Brief Cope ◽  
Post Traumatic

Background Of hospitalized patients in Canada, 7.5% experience an adverse event (ae). Physicians whose patients experience aes often become second victims of the incident. The present study is the first to evaluate how physicians in Canada cope with aes occurring in their patients.Methods Survey participants included oncologists, surgeons, and trainees at the Foothills Medical Centre, Calgary, AB. The surveys were administered through REDCap (Research Electronic Data Capture, version 9.0: REDCap Consortium, Vanderbilt University, Nashville, TN, U.S.A.). The Brief cope (Coping Orientation to Problems Experienced) Inventory, the ies-r (Impact of Event Scale–Revised), the Causal Dimension Scale, and the Institutional Punitive Response scale were used to evaluate coping strategies, prevalence of post-traumatic stress, and institutional culture with respect to aes.Results Of 51 responses used for the analysis, 30 (58.8%) came from surgeons and 21 (41.2%) came from medical specialists. On the ies-r, 54.9% of respondents scored 24 or higher, which has been correlated with clinically concerning post-traumatic stress. Individuals with a score of 24 or higher were more likely to report self-blame (p = 0.00026) and venting (p = 0.042). Physicians who perceive institutional support to be poor reported significant post-traumatic stress (p = 0.023). On multivariable logistic regression modelling, self-blame was associated with an ies-r score of 24 or higher (p = 0.0031). No significant differences in ies-r scores of 24 or higher were observed between surgeons and non-surgeons (p = 0.15). The implications of aes for physicians, patients, and the health care system are enormous. More than 50% of our respondents showed emotional pathology related to an ae. Higher levels of self-blame, venting, and perception of inadequate institutional support were factors predicting increased post-traumatic stress after a patient ae.Conclusions Our study identifies a desperate need to establish effective institutional supports to help health care professionals recognize and deal with the emotional toll resulting from aes.

scholarly journals Integrating fragmented evidence by network meta-analysis: relative effectiveness of psychological interventions for adults with post-traumatic stress disorder

2014 ◽  
Vol 44 (15) ◽  
pp. 3151-3164 ◽  
Author(s):  
H. Gerger ◽  
T. Munder ◽  
A. Gemperli ◽  
E. Nüesch ◽  
S. Trelle ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Relative Effectiveness ◽  
Psychological Interventions ◽  
Ptsd Symptoms ◽  
Specific Intervention ◽  
Post Traumatic Stress ◽  
Post Traumatic

Background.To summarize the available evidence on the effectiveness of psychological interventions for patients with post-traumatic stress disorder (PTSD).Method.We searched bibliographic databases and reference lists of relevant systematic reviews and meta-analyses for randomized controlled trials that compared specific psychological interventions for adults with PTSD symptoms either head-to-head or against control interventions using non-specific intervention components, or against wait-list control. Two investigators independently extracted the data and assessed trial characteristics.Results.The analyses included 4190 patients in 66 trials. An initial network meta-analysis showed large effect sizes (ESs) for all specific psychological interventions (ESs between −1.10 and −1.37) and moderate effects of psychological interventions that were used to control for non-specific intervention effects (ESs −0.58 and −0.62). ES differences between various types of specific psychological interventions were absent to small (ES differences between 0.00 and 0.27). Considerable between-trial heterogeneity occurred (τ2 = 0.30). Stratified analyses revealed that trials that adhered to DSM-III/IV criteria for PTSD were associated with larger ESs. However, considerable heterogeneity remained. Heterogeneity was reduced in trials with adequate concealment of allocation and in large-sized trials. We found evidence for small-study bias.Conclusions.Our findings show that patients with a formal diagnosis of PTSD and those with subclinical PTSD symptoms benefit from different psychological interventions. We did not identify any intervention that was consistently superior to other specific psychological interventions. However, the robustness of evidence varies considerably between different psychological interventions for PTSD, with most robust evidence for cognitive behavioral and exposure therapies.

scholarly journals Vicarious trauma and secondary traumatic stress in health care professionals

2017 ◽  
Vol 86 (2) ◽  
pp. 42-43 ◽  
Author(s):  
Nicole A Guitar ◽  
Monica L Molinaro
Keyword(s):  
Health Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Secondary Traumatic Stress ◽  
Vicarious Trauma ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Post Traumatic Stress ◽  
Post Traumatic

Three-quarters of Canadians are exposed to a traumatic event sufficient to cause psychological trauma in their lifetime. In fact, post-traumatic stress disorder is a global health issue with a prevalence as high as 37%. Health care professionals trained to provide mental health treatment for these individuals are at risk of developing vicarious trauma and secondary traumatic stress, both of which result in adverse symptoms for the health care provider that often mimic post-traumatic stress disorder (PTSD). Vicarious trauma develops over time as the clinician is continually exposed to their clients’ traumatic experiences, while clinicians experiencing secondary traumatic stress begin to experience the symptoms of PTSD due to secondary exposure of the traumatic event. Both vicarious trauma and secondary traumatic stress cause mental, physical, and emotional issues for health care professionals that include burnout and decreased self-worth. Health care systems and administration should aim to develop training and professional education for health care providers. This review will emphasize what factors lead to the development of vicarious trauma and secondary traumatic stress, and what aids or supports can be implemented to treat the symptoms. The implications for policy development and training will be discussed.

scholarly journals Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis

2019 ◽  
Vol 49 (11) ◽  
pp. 1761-1775 ◽  
Author(s):  
Thanos Karatzias ◽  
Philip Murphy ◽  
Marylene Cloitre ◽  
Jonathan Bisson ◽  
Neil Roberts ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Psychological Interventions ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Affect Dysregulation ◽  
Post Traumatic ◽  
Disturbed Relationships

AbstractBackgroundThe 11th revision to the WHO International Classification of Diseases (ICD-11) identified complex post-traumatic stress disorder (CPTSD) as a new condition. There is a pressing need to identify effective CPTSD interventions.MethodsWe conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for post-traumatic stress disorder (PTSD), where participants were likely to have clinically significant baseline levels of one or more CPTSD symptom clusters (affect dysregulation, negative self-concept and/or disturbed relationships). We searched MEDLINE, PsycINFO, EMBASE and PILOTS databases (January 2018), and examined study and outcome quality.ResultsFifty-one RCTs met inclusion criteria. Cognitive behavioural therapy (CBT), exposure alone (EA) and eye movement desensitisation and reprocessing (EMDR) were superior to usual care for PTSD symptoms, with effects ranging from g = −0.90 (CBT; k = 27, 95% CI −1.11 to −0.68; moderate quality) to g = −1.26 (EMDR; k = 4, 95% CI −2.01 to −0.51; low quality). CBT and EA each had moderate–large or large effects on negative self-concept, but only one trial of EMDR provided useable data. CBT, EA and EMDR each had moderate or moderate–large effects on disturbed relationships. Few RCTs reported affect dysregulation data. The benefits of all interventions were smaller when compared with non-specific interventions (e.g. befriending). Multivariate meta-regression suggested childhood-onset trauma was associated with a poorer outcome.ConclusionsThe development of effective interventions for CPTSD can build upon the success of PTSD interventions. Further research should assess the benefits of flexibility in intervention selection, sequencing and delivery, based on clinical need and patient preferences.

Post-traumatic stress symptomatology among health care professionals in Croatia.

1999 ◽  
Vol 69 (4) ◽  
pp. 529-535 ◽  
Author(s):  
Jodi Shields ◽  
Kristi Erdal ◽  
Jarmila Skrinjaric ◽  
Gordan Majic
Keyword(s):  
Health Care ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Post Traumatic Stress ◽  
Post Traumatic

scholarly journals Coronavirus Disease (COVID-19) and the risk of Post-Traumatic Stress Disorder: A mental health concern in Nepal

2020 ◽  
Vol 10 (2) ◽  
pp. 841-844
Author(s):  
Mohammad Asim ◽  
Edwin Van Teijlingen ◽  
Brijesh Sathian
Keyword(s):  
Mental Health ◽  
Interpersonal Relationships ◽  
Healthcare Providers ◽  
Health Concern ◽  
Traumatic Experiences ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Mental Health Concern ◽  
Post Traumatic ◽  
National Mental Health

The sudden outbreak of Coronavirus-19 disease (COVID-19) is transforming the psychology and interpersonal relationships of millions across the globe. In Nepal, there is a need for national mental health surveys post COVID-19. This pandemic can cause traumatic experiences to the patients, caregivers, those quarantined and frontline healthcare providers which may lead to PTSD. Special attention should be focused on high-risk individuals, including policies to implement regular screening of PTSD symptoms. 

Sign in / Sign up

Export Citation Format

Share Document