Stress and Coping of Critical Care Nurses After Unsuccessful Cardiopulmonary Resuscitation

2017 ◽  
Vol 26 (2) ◽  
pp. 128-135 ◽  
Author(s):  
Dawn E. McMeekin ◽  
Ronald L. Hickman ◽  
Sara L. Douglas ◽  
Carol G. Kelley
Keyword(s):  
Critical Care ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Institutional Support ◽  
Critical Care Nurses ◽  
Ptsd Symptoms ◽  
Coping Behaviors ◽  
Event Scale ◽  
Ptsd Symptom Severity ◽  
The Impact

Background Participation by a critical care nurse in an unsuccessful resuscitation can create a unique heightened level of psychological stress referred to as postcode stress, activation of coping behaviors, and symptoms of posttraumatic stress disorder (PTSD). Objectives To explore the relationships among postcode stress, coping behaviors, and PTSD symptom severity in critical care nurses after experiencing unsuccessful cardiopulmonary resuscitations and to see whether institutional support attenuates these repeated psychological traumas. Methods A national sample of 490 critical care nurses was recruited from the American Association of Critical-Care Nurses’ eNewsline and social media. Participants completed the Post-Code Stress Scale, the Brief COPE (abbreviated), and the Impact of Event Scale–Revised, which were administered through an online survey. Results Postcode stress and PTSD symptom severity were weakly associated (r = 0.20, P = .01). No significant associations between coping behaviors and postcode stress were found. Four coping behaviors (denial, self-distraction, self-blame, and behavioral disengagement) were significant predictors of PTSD symptom severity. Severity of postcode stress and PTSD symptoms varied with the availability of institutional support. Conclusions Critical care nurses show moderate levels of postcode stress and PTSD symptoms when asked to recall an unsuccessful resuscitation and the coping behaviors used. Identifying the critical care nurses most at risk for PTSD will inform the development of interventional research to promote critical care nurses’ psychological well-being and reduce their attrition from the profession.

Physical Exercise as Treatment for PTSD: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Frida Björkman ◽  
Örjan Ekblom
Keyword(s):  
Subgroup Analysis ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Study Quality ◽  
Ptsd Symptoms ◽  
Military Trauma ◽  
Exercise Type ◽  
Ptsd Symptom Severity

ABSTRACT Introduction Post-traumatic stress disorder (PTSD) is a cluster of physical and psychiatric symptoms following military or civilian trauma. The effect of exercise on PTSD symptoms has previously been investigated in several studies. However, it has not been fully determined what type of exercise most impacts PTSD symptoms. The aim of the present study was to systematically review the effects of different types of exercise on PTSD symptom severity and symptoms of coexisting conditions in adults. Materials and Methods Electronic searches were conducted in the databases PubMed, APA PsycInfo, and SportDiscus, from database inception up until February 1, 2021. Inclusion criteria were randomized controlled trials published in English, participants having a PTSD diagnosis or clinically relevant symptoms, and participants randomly allocated to either a non-exercising control group or an exercise group. Data concerning the number of participants, age, exercise type and duration, PTSD symptom severity (primary outcome), and symptoms of coexisting conditions (secondary outcomes) were extracted. The subgroup analysis included high or low training dose, military trauma versus non-military trauma, the type of intervention (yoga versus other exercise), active or passive control condition, group training versus individual exercise, and study quality. The study quality and risk of bias were assessed using grading of recommendation assessment, development and evaluation (GRADE) guidelines. A meta-analysis was performed with a mixed-effects model and restricted maximum likelihood as model estimator, and effect size was calculated as the standardized difference in mean and 95% CI. Results Eleven studies were included in the present review. Results showed a main random effect of exercise intervention (0.46; 95% CI: 0.18 to 0.74) and a borderline significant interaction between more voluminous (>20 hours in total) and less voluminous (≤20 hours in total) exercise interventions (P = .07). No significant findings from the subgroup analysis were reported. The secondary outcome analysis showed a small but significant effect of exercise on depressive symptoms (0.20, 95% CI: 0.01 to 0.38), and a larger effect on sleep (0.51, 95% CI: 0.29 to 0.73). For substance use (alcohol and drugs combined) and quality of life, we found significant effects of 0.52 (95% CI: 0.06 to 0.98) and 0.51 (95% CI: 0.34 to 0.69), respectively. No significant effect was found for anxiety (0.18, 95% CI: −0.15 to 0.51), and no sign of publication bias was found. Conclusions Exercise can be an effective addition to PTSD treatment, and greater amounts of exercise may provide more benefits. However, as there were no differences found between exercise type, possibly due to the inclusion of a low number of studies using different methodologies, further research should aim to investigate the optimal type, dose, and duration of activity that are most beneficial to persons with PTSD.

The impact of changes in distress tolerance on PTSD symptom severity post-treatment among veterans in residential trauma treatment

2017 ◽  
Vol 47 ◽  
pp. 99-105 ◽  
Author(s):  
Anne N. Banducci ◽  
Kevin M. Connolly ◽  
Anka A. Vujanovic ◽  
Jennifer Alvarez ◽  
Marcel O. Bonn-Miller
Keyword(s):  
Symptom Severity ◽  
Distress Tolerance ◽  
Ptsd Symptom ◽  
Post Treatment ◽  
Trauma Treatment ◽  
Ptsd Symptom Severity ◽  
The Impact

scholarly journals Differential effect of Hurricane Sandy exposure on PTSD symptom severity: comparison of community members and responders

2019 ◽  
Vol 76 (12) ◽  
pp. 881-887 ◽  
Author(s):  
Adam Gonzalez ◽  
Rehana Rasul ◽  
Lucero Molina ◽  
Samantha Schneider ◽  
Kristin Bevilacqua ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Differential Effect ◽  
Ptsd Symptom ◽  
Traumatic Event ◽  
World Trade Center ◽  
Hurricane Sandy ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Community Members ◽  
Ptsd Symptom Severity

ObjectivesTo evaluate whether the association between Hurricane Sandy exposures and post-traumatic stress disorder (PTSD) symptom severity was greater for exposed community members compared with responders.MethodsData were analysed from three existing studies with similar methodologies (N=1648): two community studies, Leaders in Gathering Hope Together (n=531) and Project Restoration (n=763); and the Sandy/World Trade Center Responders Study (n=354). Sandy-related PTSD symptoms were measured using the PTSD checklist-specific traumatic event and dichotomised as elevated (>30) versus low/no (<30) PTSD symptoms. Sandy exposures were measured with a summed checklist. Multivariable logistic regression was performed to evaluate the differential effect of exposures on PTSD by responder status, adjusting for demographics and time elapsed since Sandy.ResultsResponders were somewhat older (50.5 years (SD=8.3) vs 45.8 years (SD=20.0)), more likely to identify as white (92.4% vs 48.1%) and were male (90.7% vs 38.4%). Responders were less likely to have elevated PTSD symptoms than community members (8.6% vs 31.1%; adjusted OR=0.28, 95% CI 0.17 to 0.46). While exposure was significantly related to elevated PTSD status, the effects were similar for responders and community members.ConclusionsResponders appear to be more resilient to PTSD symptoms post-Sandy than community members. Understanding the mechanisms that foster such resilience can inform interventions aimed at populations that are more vulnerable to experiencing PTSD after natural disasters.

scholarly journals Associations between posttraumatic stress disorder and substance use: a longitudinal investigation of individuals recently exposed to trauma

2021 ◽  
Author(s):  
Sonya G. Wanklyn
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Alcohol Use ◽  
Posttraumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Traumatic Event ◽  
Ptsd Symptoms ◽  
Ptsd Symptom Severity

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly cooccur following trauma, and their co-occurrence is associated with substantial costs; however, our understanding of the timing and sequencing of these posttrauma mental health conditions is limited. This study examined the trajectories of PTSD symptom severity and substance use among individuals recently exposed to a traumatic event, with a focus on the potential moderating roles of PTSD and SUD diagnoses at the final assessment. Additionally, in attempt to better understand the functional relationship between PTSD symptoms and substance use posttrauma, this study compared models reflecting the theories of self-medication, susceptibility, and mutual maintenance. Participants included 137 individuals who had experienced a traumatic event within 6 months prior to study enrollment. Participants completed four assessments over an approximate 1-year period that included clinician-administered measures for DSM-5 PTSD symptoms and SUD diagnosis and self-report measures of alcohol and drug use. Change over time in PTSD symptoms and substance use by diagnostic status were investigated using growth curve models. Temporal sequencing between PTSD symptom severity and substance use was investigated with bivariate latent difference score structural equation modeling. In line with the conceptualization of PTSD as a disorder of impeded recovery, having a diagnosis of PTSD at the final assessment moderated the trajectory of PTSD symptom severity such that symptom severity declined only among those without PTSD. In contrast, the influence of SUD appeared to be negligible. Both PTSD and SUD diagnoses were associated with initial drug use frequency. However, the relationship between alcohol use and diagnostic status did not reach statistical significance. Regarding temporal relationships between PTSD symptoms and substance use, significant and negative PTSD to change in substance use cross-lagged paths were found across most of the models, while only one significant substance use to change in PTSD severity crosslagged path emerged in the PTSD intrusion with alcohol use model. These results add to a growing body of research suggesting trauma-focused intervention is viable for individuals with PTSD/SUD. Further, examination of potential mediators and moderators of the relation between PTSD and SUD is recommended as a critical focus for future research.

scholarly journals The invisible scars of emotional abuse: a common and highly harmful form of childhood maltreatment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Camila Monteiro Fabricio Gama ◽  
Liana Catarina Lima Portugal ◽  
Raquel Menezes Gonçalves ◽  
Sérgio de Souza Junior ◽  
Liliane Maria Pereira Vilete ◽  
...  
Keyword(s):  
Childhood Maltreatment ◽  
Symptom Severity ◽  
Emotional Abuse ◽  
Negative Binomial ◽  
Ptsd Symptom ◽  
Traumatic Experiences ◽  
Student Sample ◽  
Increased Risk ◽  
Ptsd Symptom Severity ◽  
The Impact

Abstract Background Childhood maltreatment (CM) is unfortunately widespread globally and has been linked with an increased risk of a variety of psychiatric disorders in adults, including posttraumatic stress disorder (PTSD). These associations are well established in the literature for some maltreatment forms, such as sexual and physical abuse. However, the effects of emotional maltreatment are much less explored, even though this type figures among the most common forms of childhood maltreatment. Thus, the present study aims to investigate the impact of each type of childhood maltreatment, both individually and conjointly, on revictimization and PTSD symptom severity using a nonclinical college student sample. Methods Five hundred and two graduate and undergraduate students participated in the study by completing questionnaires assessing lifetime traumatic experiences in general, maltreatment during childhood and PTSD symptoms. Bivariate and multivariate negative binomial regressions were applied to examine the associations among childhood maltreatment, revictimization, and PTSD symptom severity. Results Our results showed that using bivariate models, all types of CM were significantly associated with revictimization and PTSD symptom severity. Multivariate models showed that emotional abuse was the type of maltreatment associated with the highest incidence rates of revictimization and PTSD symptom severity. Conclusions These data provide additional evidence of the harmful effects of childhood maltreatment and its long-term consequences for individuals’ mental health. Notably, the findings highlight the importance of studying the impacts of emotional abuse, which seems to be a highly prevalent, understudied, and chronic form of maltreatment that is as toxic as other maltreatment forms.

scholarly journals The effect of twice-weekly versus once-weekly sessions of either imagery rescripting or eye movement desensitization and reprocessing for adults with PTSD from childhood trauma (IREM-Freq): a study protocol for an international randomized clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Carlijn J. M. Wibbelink ◽  
Christopher W. Lee ◽  
Nathan Bachrach ◽  
Sarah K. Dominguez ◽  
Thomas Ehring ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Childhood Trauma ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Ptsd Symptoms ◽  
Treatment Type ◽  
Imagery Rescripting ◽  
Ptsd Symptom Severity

Abstract Background Trauma-focused treatments for posttraumatic stress disorder (PTSD) are commonly delivered either once or twice a week. Initial evidence suggests that session frequency affects treatment response, but very few trials have investigated the effect of session frequency. The present study’s aim is to compare treatment outcomes of twice-weekly versus once-weekly sessions of two treatments for PTSD related to childhood trauma, imagery rescripting (ImRs) and eye movement desensitization and reprocessing (EMDR). We hypothesize that both treatments will be more effective when delivered twice than once a week. How session frequency impacts treatment response, whether treatment type moderates the frequency effect, and which treatment type and frequency works best for whom will also be investigated. Methods The IREM-Freq trial is an international multicenter randomized clinical trial conducted in mental healthcare centers across Australia, Germany, and the Netherlands. We aim to recruit 220 participants, who will be randomized to one of four conditions: (1) EMDR once a week, (2) EMDR twice a week, (3) ImRs once a week, or (4) ImRs twice a week. Treatment consists of 12 sessions. Data are collected at baseline until one-year follow-up. The primary outcome measure is clinician-rated PTSD symptom severity. Secondary outcome measures include self-reported PTSD symptom severity, complex PTSD symptoms, trauma-related cognitions and emotions, depressive symptoms, dissociation, quality of life, and functioning. Process measures include memory, learning, therapeutic alliance, motivation, reluctance, and avoidance. Additional investigations will focus on predictors of treatment outcome and PTSD severity, change mechanisms of EMDR and ImRs, the role of emotions, cognitions, and memory, the optimization of treatment selection, learned helplessness, perspectives of patients and therapists, the network structure of PTSD symptoms, and sudden treatment gains. Discussion This study will extend our knowledge on trauma-focused treatments for PTSD related to childhood trauma and, more specifically, the importance of session frequency. More insight into the optimal session frequency could lead to improved treatment outcomes and less dropout, and in turn, to a reduction of healthcare costs. Moreover, the additional investigations will broaden our understanding of how the treatments work and variables that affect treatment outcome. Trial registration Netherlands Trial Register NL6965, registered 25/04/2018.

scholarly journals The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0246990
Author(s):  
Marcel O. Bonn-Miller ◽  
Sue Sisley ◽  
Paula Riggs ◽  
Berra Yazar-Klosinski ◽  
Julie B. Wang ◽  
...  
Keyword(s):  
Active Treatment ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Controlled Trial ◽  
Military Veterans ◽  
Ptsd Symptoms ◽  
Significant Difference ◽  
Ptsd Symptom Severity ◽  
Stage 1 ◽  
To Receive

Importance There is a pressing need for development of novel pharmacology for the treatment of Posttraumatic Stress Disorder (PTSD). Given increasing use of medical cannabis among US military veterans to self-treat PTSD, there is strong public interest in whether cannabis may be a safe and effective treatment for PTSD. Objective The aim of the present study was to collect preliminary data on the safety and potential efficacy of three active concentrations of smoked cannabis (i.e., High THC = approximately 12% THC and < 0.05% CBD; High CBD = 11% CBD and 0.50% THC; THC+CBD = approximately 7.9% THC and 8.1% CBD, and placebo = < 0.03% THC and < 0.01% CBD) compared to placebo in the treatment of PTSD among military veterans. Methods The study used a double-blind, cross-over design, where participants were randomly assigned to receive three weeks of either active treatment or placebo in Stage 1 (N = 80), and then were re-randomized after a 2-week washout period to receive one of the other three active treatments in Stage 2 (N = 74). The primary outcome measure was change in PTSD symptom severity from baseline to end of treatment in Stage 1. Results The study did not find a significant difference in change in PTSD symptom severity between the active cannabis concentrations and placebo by the end of Stage 1. All three active concentrations of smoked cannabis were generally well tolerated. Conclusions and relevance The present study is the first randomized placebo-controlled trial of smoked cannabis for PTSD. All treatment groups, including placebo, showed good tolerability and significant improvements in PTSD symptoms during three weeks of treatment, but no active treatment statistically outperformed placebo in this brief, preliminary trial. Additional well-controlled and adequately powered studies with cannabis suitable for FDA drug development are needed to determine whether smoked cannabis improves symptoms of PTSD. Trial registration Identifier: NCT02759185; ClinicalTrials.gov.

scholarly journals Psychiatric morbidity and protracted symptoms in recovered COVID-19 patients

2020 ◽  
Author(s):  
Burç Çağrı Poyraz ◽  
Cana Aksoy Poyraz ◽  
Yeşim Olğun ◽  
Özge Gürel ◽  
Sena Alkan ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Demographic Data ◽  
Acute Infection ◽  
Psychiatric Morbidity ◽  
Depression Scale ◽  
Binary Logistic Regression Analysis ◽  
Cross Sectional ◽  
Ptsd Symptom Severity ◽  
The Impact

AbstractWe investigated the psychiatric symptomatology and the protracted symptoms in recently recovered COVID-19 patients. This cross-sectional study assessed 284 patients recruited from a tertiary hospital. Patients completed a web-based survey on socio-demographic data, past medical/psychiatric history, and additional information relevant to the outbreak conditions. The psychiatric status was assessed using the Impact of Events Scale-Revised (IES-R), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and MINI suicidality scale. Patients completed a checklist for the acute symptom burden and protracted symptoms that were experienced after the acute infection. After a mean of 50 days following the diagnosis of COVID-19, 98 patients (34.5%) reported clinically significant PTSD, anxiety, and/or depression, with PTSD being the most common condition reported (25.4%). One hundred and eighteen patients (44.3%) reported one or more protracted symptom(s), with fatigue, muscle aches, alteration of smell/taste, headache and difficulty in concentration, being the most common symptoms reported. Predictors of PTSD symptom severity were the female gender, past traumatic events, protracted symptoms, perceived stigmatization, and a negative view on the seriousness of the COVID-19 pandemic. Binary logistic regression analysis showed that PTSD symptom severity was the sole independent predictor of the presence of protracted symptoms. Our results suggest that COVID-19 patients may be prone to substantial psychological distress in the first months after the infection. The protracted symptoms were also frequent in this period, and these were related to the posttraumatic psychiatric morbidity. Both the psychiatric morbidity and the protracted symptoms were independent of the initial infection severity. Further research on the neurobiological commonalities between the protracted symptoms and PTSD in COVID-19 patients is warranted.

Age differences in PTSD among Canadian veterans: age and health as predictors of PTSD severity

2014 ◽  
Vol 27 (2) ◽  
pp. 297-304 ◽  
Author(s):  
Candace Konnert ◽  
May Wong
Keyword(s):  
Age Differences ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Age Groups ◽  
Symptom Clusters ◽  
Pain Severity ◽  
Ptsd Symptoms ◽  
Outpatient Services ◽  
Ptsd Symptom Severity ◽  
Ptsd Severity

ABSTRACTBackground:To date, few studies have investigated age differences in posttraumatic stress disorder (PTSD) symptoms and none has examined age differences across symptom clusters: avoidance, re-experiencing, and hyperarousal. The first objective of this study was to investigate age differences in PTSD and its three symptom clusters. The second objective was to examine age and indices of health as predictors of PTSD symptom severity.Methods:Participants were 104 male veterans, aged 22 to 87 years, receiving specialized mental health outpatient services. Assessments included measures of health-related quality of life, pain severity, number of chronic health conditions, and symptoms of PTSD, both in total and on the symptom clusters.Results:There were significant age differences across age groups, with older veterans consistently reporting lower PTSD symptom severity, both in total and on each of the symptom clusters. Hierarchical regression analyses indicated that the inclusion of health indices accounted for significantly more variance in PTSD symptoms over and above that accounted for by age alone. Pain severity was a significant predictor of PTSD total and the three symptom clusters.Conclusions: This is the first study to report lower levels of PTSD severity among older veterans across symptom clusters. These findings are discussed in relation to age differences in the experiencing and processing of emotion, autobiographical memory, and combat experiences. This study also emphasizes the importance of assessing pain in those with symptoms of PTSD, particularly older veterans who are less likely to receive specialized mental healthcare.

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