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The German PCL-5: evaluating structural validity in a large-scale sample of the general German population. 德国 PCL-5:在大规模德国普通人群样本中评估结构有效性。
IF 5 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-21 DOI: 10.1080/20008066.2024.2317055
Amelie Pettrich, Michael Friedrich, Yuriy Nesterko, Heide Glaesmer

Background: In attempts to elucidate PTSD, recent factor analytic studies resulted in complex models with a proliferating number of factors that lack psychometrical and clinical utility. Recently, suggestions have been made to optimize factor analytic practices to meet a refined set of statistical and psychometric criteria.Objective: This study aims to assess the factorial structure of the German version of the PCL-5, implementing recent methodological advancements to address the risk of overfitting models. In doing so we diverge from traditional factor analytical research on PTSD.Method: On a large-scale sample of the German general population (n = 1625), exploratory factor analyses were run to investigate the dimensionality found within the data. Subsequently, we validated and compared all model suggestions from our preliminary analyses plus all standard and common alternative PTSD factor models (including the ICD-11 model) from previous literature with confirmatory factor analyses. We not only consider model fit indices based on WLSMV estimation but also deploy criteria such as favouring less complex models with a parsimonious number of factors, sufficient items per factor, low inter-factor correlations and number of model misspecifications.Results: All tested models showed adequate to excellent fit in respect to traditional model fit indices; however, models with two or more factors increasingly failed to meet other statistical and psychometric criteria.Conclusion: Based on the results we favour a two-factor bifactor model with a strong general PTSD factor and two less dominant specific factors - one factor with trauma-related symptoms (re-experiencing and avoidance) and one factor with global psychological symptoms (describing the trauma's higher-order impact on mood, cognition, behaviour and arousal).From the perspective of clinical utility, we recommend the cut-off scoring method for the German version of the PCL-5. Basic psychometric properties and scale characteristics are provided.

背景:在试图阐明创伤后应激障碍的过程中,最近的因素分析研究产生了复杂的模型,其中的因素数量激增,但却缺乏心理计量学和临床实用性。最近,有人建议对因子分析方法进行优化,以符合一套完善的统计和心理测量标准:本研究旨在评估德文版 PCL-5 的因子结构,采用最新的先进方法来解决模型过拟合的风险。在此过程中,我们与创伤后应激障碍的传统因子分析研究有所不同:方法:在大规模的德国普通人群样本(n = 1625)中,我们进行了探索性因子分析,以研究数据中发现的维度。随后,我们对初步分析中提出的所有模型建议,以及以往文献中所有标准和常见的创伤后应激障碍替代因素模型(包括 ICD-11 模型)进行了确认性因素分析验证和比较。我们不仅考虑了基于 WLSMV 估计的模型拟合指数,而且还采用了一些标准,如倾向于选择复杂性较低的模型,这些模型应具有合理的因素数量、每个因素有足够的项目、因素间相关性较低以及模型失当的数量等:根据传统的模型拟合指数,所有测试模型都显示出足够或出色的拟合度;然而,包含两个或更多因素的模型越来越不符合其他统计和心理测量标准:根据测试结果,我们倾向于采用双因素模型,即一个强有力的创伤后应激障碍一般因素和两个主导性较弱的特定因素--一个是创伤相关症状因素(再经历和回避),另一个是整体心理症状因素(描述创伤对情绪、认知、行为和唤醒的高阶影响)。我们还提供了基本的心理测量特性和量表特征。
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引用次数: 0
Posttraumatic stress disorder in people with dementia: study protocol. 痴呆症患者的创伤后应激障碍:研究方案。
IF 5 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-03-15 DOI: 10.1080/20008066.2024.2320040
J E Ruisch, D C D Havermans, E M J Gielkens, M Olff, M A M J Daamen, S P J van Alphen, M van Kordenoordt, J M G A Schols, K R J Schruers, S Sobczak

Background: Posttraumatic stress disorder (PTSD) is considered an independent risk factor for dementia. Despite the (clinical) evidence that PTSD is associated with neuropsychiatric symptoms in people with dementia, studies on its prevalence and clinical manifestation are limited, and their quality is affected by the lack of a structured method to diagnose PTSD in this population. The primary aim of the current study is to validate the 'TRAuma and DEmentia' interview as a diagnostic tool for PTSD in people with dementia and to test feasibility of EMDR treatment for people with PTSD and dementia.Methods: This prospective multi-centre study is divided into two parts. In study A, 90 participants with dementia will be included to test the criterion validity, inter-rater reliability and feasibility of the 'TRAuma and DEmentia' interview. In study B, 29 participants with dementia and PTSD will receive eye movement desensitisation and reprocessing therapy by a trained psychologist, and 29 participants with dementia and PTSD will be placed on the waiting list control group.Conclusion: This study aims to improve the diagnostic process of PTSD and to assess the effects of eye movement desensitisation and reprocessing treatment in people with dementia living in Dutch care facilities.Trial registration: NL70479.068.20 / METC 20-063 / OSF registration: https://doi.org/10.17605/OSF.IO/AKW4F.

背景:创伤后应激障碍(PTSD创伤后应激障碍(PTSD)被认为是痴呆症的一个独立风险因素。尽管有(临床)证据表明创伤后应激障碍与痴呆症患者的神经精神症状有关,但有关其患病率和临床表现的研究却很有限,而且由于缺乏对这一人群进行创伤后应激障碍诊断的结构化方法,研究质量也受到了影响。本研究的主要目的是验证 "创伤与痴呆 "访谈作为痴呆症患者创伤后应激障碍诊断工具的有效性,并测试 EMDR 治疗创伤后应激障碍和痴呆症患者的可行性:这项前瞻性多中心研究分为两个部分。在研究 A 中,将纳入 90 名痴呆症患者,以测试 "创伤后应激障碍与痴呆症 "访谈的标准有效性、评分者之间的可靠性和可行性。在研究B中,29名患有痴呆症和创伤后应激障碍的参与者将接受由训练有素的心理学家提供的眼动脱敏和再处理疗法,29名患有痴呆症和创伤后应激障碍的参与者将被列入候补对照组:本研究旨在改进创伤后应激障碍的诊断过程,并评估眼动脱敏和再处理疗法对居住在荷兰护理机构的痴呆症患者的影响:NL70479.068.20 / METC 20-063 / OSF注册:https://doi.org/10.17605/OSF.IO/AKW4F。
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引用次数: 0
Changes in trauma appraisal during brief internet-based exposure and cognitive restructuring treatment for Arabic-speaking people with PTSD. 在对讲阿拉伯语的创伤后应激障碍患者进行简短的网络暴露和认知重组治疗期间,创伤评价发生了变化。
IF 5 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-03-21 DOI: 10.1080/20008066.2024.2324631
Jana Stein, Rayan El-Haj-Mohamad, Nadine Stammel, Max Vöhringer, Birgit Wagner, Yuriy Nesterko, Maria Böttche, Christine Knaevelsrud

Background: Maladaptive trauma appraisal plays an important role in the development and maintenance of posttraumatic stress disorder (PTSD). While studies have demonstrated the effectiveness of exposure and cognitive treatments for PTSD symptomatology, the effect of such treatments on specific trauma appraisals is still not well understood.Objective: The study investigated the effect of an exposure and a cognitive restructuring internet-based treatment on specific trauma appraisals in Arabic-speaking participants with PTSD.Method: 334 participants received either an exposure (n = 167) or a cognitive restructuring (n = 167) internet-based treatment. PTSD symptom severity (PCL-5) and specific trauma appraisals (TAQ) were assessed at pre- and post-treatment. Changes in specific trauma appraisals within and between the two treatments were analyzed using multi-group change modelling. Associations between changes in PTSD symptom severity and changes in trauma appraisals were evaluated using Pearson product-moment correlation. For both treatments, participants with versus without reliable improvement were compared regarding changes in specific trauma appraisals using Welch tests. Analyses were performed on 100 multiple imputed datasets.Results: Both treatments yielded significant changes in shame, self-blame, fear, anger, and alienation (all ps < .001). Changes in betrayal were only significant in the cognitive restructuring treatment (p < .001). There was no evidence of differences between treatments for any specific trauma appraisal. Changes in PTSD symptom severity were significantly associated with changes in trauma appraisals (all ps < .001). In both treatments, participants who experienced reliable improvement in PTSD symptom severity showed significantly larger pre- to post-treatment changes in specific trauma appraisals compared to those without reliable improvement. Again, differences in betrayal were only significant in the cognitive restructuring treatment.Conclusions: The findings indicate that both treatments are effective in reducing trauma appraisals in Arabic-speaking people with PTSD. Changes in trauma appraisal seem to be associated with changes in PTSD symptomatology.Trial registration: German Clinical Trials Register identifier: DRKS00010245.

背景:适应不良的创伤评价在创伤后应激障碍(PTSD)的发展和维持中起着重要作用。虽然已有研究证明暴露疗法和认知疗法对创伤后应激障碍症状有效,但此类疗法对特定创伤评价的影响仍不甚了解:本研究调查了暴露疗法和基于互联网的认知重组疗法对阿拉伯语创伤后应激障碍参与者特定创伤评价的影响:334 名参与者接受了暴露疗法(167 人)或认知重组疗法(167 人)。在治疗前后对创伤后应激障碍症状严重程度(PCL-5)和特定创伤评价(TAQ)进行评估。采用多组变化模型分析了两种治疗方法内部和之间特定创伤评价的变化。创伤后应激障碍症状严重程度的变化与创伤评价的变化之间的关联采用皮尔逊积矩相关法进行评估。对于两种治疗方法,使用韦尔奇检验比较了有可靠改善和无可靠改善的参与者在特定创伤评价方面的变化。对 100 个多重估算数据集进行了分析:两种治疗方法都使羞愧、自责、恐惧、愤怒和疏远感发生了显著变化(所有 ps 均小于 .001)。只有认知重组疗法在背叛方面有显著变化(P < .001)。没有证据表明不同治疗方法在任何特定创伤评价方面存在差异。创伤后应激障碍症状严重程度的变化与创伤评价的变化有显著相关性(均 ps < .001)。在两种治疗方法中,创伤后应激障碍症状严重程度得到可靠改善的参与者与没有得到可靠改善的参与者相比,其特定创伤评价在治疗前和治疗后的变化明显更大。同样,只有认知重组疗法在背叛方面的差异显著:研究结果表明,两种治疗方法都能有效减少阿拉伯语创伤后应激障碍患者的创伤评价。创伤评价的改变似乎与创伤后应激障碍症状的改变有关:试验注册:德国临床试验注册标识符:DRKS00010245.
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引用次数: 0
How do you see me? The impact of perceived societal recognition on PTSD symptoms amongst Norwegian peacekeepers. 你们怎么看我?社会对挪威维和人员创伤后应激障碍症状的认知影响。
IF 5 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-04-29 DOI: 10.1080/20008066.2024.2314442
Anna Harwood-Gross, Andreas Espetvedt Nordstrand, Hans Jakob Bøe, Christer Lunde Gjerstad

Background: The peacekeeper role is different to that of traditional combat, however, peacekeepers, like combat soldiers, may also be exposed to high levels of dangerous and/or potentially morally injurious events (PMIEs).Objective: It was hypothesized that given the centrality of societal approval for the peacekeeping mission, in addition to the known relevance of perceived social support, perceived societal recognition would influence PTSD symptoms (PTSS) and depression. It was hypothesized that perceived societal recognition would moderate the effect of exposure to potentially traumatic events and PMIEs on psychological outcomes.Method: 8341, predominantly male, former UNIFIL peacekeepers, almost three decades following deployment, answered a survey to determine the impact of perceived social support and perceived societal recognition, on PTSS and depression symptoms. Hierarchical regression analyses were performed for PTSS and depression separately and moderation analysis was performed for perceived societal recognition.Results: Exposure to potentially traumatic events showed the greatest predictive value for PTSS and exposure to PMIEs and potentially traumatic events were equally predictive of depression symptoms. While perceived social support presented the strongest buffer for PTSS and depression symptoms following UNIFIL deployment, perceived societal recognition also significantly contributed to the prediction of both PTSS and depression symptoms. There was a weak moderation effect of perceived societal recognition on trauma type in the development of PTSS.Conclusions: Even decades following peacekeeping deployment, military experiences have a significant impact on psychological functioning. This impact is both from the types of events experienced and from the perception of social and societal support upon return home.

背景:维和人员的角色不同于传统意义上的作战人员,然而,维和人员与作战士兵一样,也可能面临高度危险和/或潜在的道德伤害事件(PMIEs):假设:除了已知的感知社会支持的相关性外,鉴于社会对维和任务的认可具有核心作用,感知社会认可将影响创伤后应激障碍症状(PTSS)和抑郁。方法:8 341 名主要为男性的前联黎部队维和人员在部署近三十年后回答了一项调查,以确定感知到的社会支持和感知到的社会认可对创伤后应激障碍症状和抑郁症状的影响。分别对创伤后应激障碍和抑郁症状进行了层次回归分析,并对感知到的社会认可度进行了调节分析:结果:暴露于潜在创伤事件对创伤后应激障碍和抑郁症状的预测价值最大,而暴露于PMIEs和潜在创伤事件对抑郁症状的预测价值相同。虽然感知到的社会支持对联黎部队部署后的创伤后应激障碍和抑郁症状具有最强的缓冲作用,但感知到的社会认可对预测创伤后应激障碍和抑郁症状也有显著作用。在 PTSS 的发展过程中,感知到的社会认可对创伤类型的调节作用较弱:结论:即使在部署维和行动数十年后,军事经历也会对心理功能产生重大影响。这种影响既来自于所经历事件的类型,也来自于回国后对社会和社会支持的感知。
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引用次数: 0
Depression after pregnancy loss: the role of the presence of living children, the type of loss, multiple losses, the relationship quality, and coping strategies. 妊娠丧子后的抑郁:有无在世子女、丧子类型、多重丧子、关系质量和应对策略的作用。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-08-14 DOI: 10.1080/20008066.2024.2386827
Stefanie Rita Balle, Christine Nothelfer, Roland Mergl, Sarah Miriam Quaatz, Svenja Hoffmann, Helena Hoffmann, Antje-Kathrin Allgaier, Kathryn Eichhorn

Background: Pregnancy loss (PL) is a common, yet rarely examined public health issue associated with an increased risk of impaired mental health, particularly depression.Objective: Previous research shows childlessness to be a correlate of depression after PL. First studies also indicate associations of the type of loss, multiple losses, relationship quality, and coping strategies with depression after the loss of a pregnancy. However, results are inconsistent and the few existing studies show methodological deficits. Therefore, we expect higher depression scores for women without living children, and we exploratively examine the associations between the type of loss, the number of losses, relationship quality, and coping strategies with depression scores for women who suffered a PL.Method: In an online setting, N = 172 women with miscarriage (n = 137) or stillbirth (n = 35) throughout the last 12 months completed the Patient Health Questionnaire (PHQ-D), Brief-COPE, and Partnerschaftsfragebogen (PFB), a German questionnaire measuring relationship quality.Results: In a multiple hierarchical regression analysis, stillbirth, β = 0.15, p = .035, presence of living children, β = -0.17, p = .022, and self-blame/emotional avoidance, β = 0.34, p < .001, are predictors of depression scores. However, there was no association between depression symptoms and other coping strategies, relationship quality, and multiple losses.Conclusions: Especially with regard to women who have no living children, have suffered a stillbirth, or are affected by self-blame/emotional avoidance, health care providers should monitor the presence of depressive symptoms. Our results indicate the need for specific instruments measuring coping style and relationship quality after PL, since the standard items of the PFB and the Brief-COPE seem inappropriate for this setting.

背景:妊娠损失(PL)是一个常见的公共健康问题,但很少有人对其进行研究,因为妊娠损失会增加心理健康受损的风险,尤其是抑郁症:目的:以往的研究表明,无子女是妊娠损失后抑郁的一个相关因素。首次研究还表明,失去妊娠的类型、多次失去妊娠、人际关系质量和应对策略与失去妊娠后的抑郁有关。然而,研究结果并不一致,现有的少数研究也存在方法上的缺陷。因此,我们预计无存活子女的女性抑郁得分较高,并探索性地研究了失去妊娠的女性的损失类型、损失次数、关系质量和应对策略与抑郁得分之间的关系:在网络环境中,N = 172 名在过去 12 个月中流产(n = 137)或死产(n = 35)的女性填写了患者健康问卷(PHQ-D)、Brief-COPE 和德国关系质量问卷 Partnerschaftsfragebogen(PFB):在多重分层回归分析中,死产(β = 0.15,p = .035)、有无在世子女(β = -0.17,p = .022)和自责/情感回避(β = 0.34,p 结论是:死产、有无在世子女、自责/情感回避和自责/情感回避对妇女的影响最大:特别是对于没有存活子女、死产或受自责/情感逃避影响的妇女,医疗服务提供者应监测其是否存在抑郁症状。我们的研究结果表明,有必要使用特定的工具来测量 PL 后的应对方式和人际关系质量,因为 PFB 和 Brief-COPE 的标准项目似乎不适合这种情况。
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引用次数: 0
Brief CBT-based psychological interventions to improve mental health outcomes in refugee populations: a systematic review and meta-analysis. 基于CBT的简短心理干预,改善难民群体的心理健康结果:系统回顾和荟萃分析。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-08-30 DOI: 10.1080/20008066.2024.2389702
Nadia A Daniel, Xin Liu, Elizabeth T Thomas, Emily Eraneva-Dibb, Al-Maz Ahmad, Carl Heneghan

Background: Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events.Objective: To summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees.Method: We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4.Results: 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD -1.12, 95% CI -1.72 to -0.52), 20 studies on depression (SMD -1.04, 95% CI -1.97 to -0.11), and 24 studies on PTSD (SMD -0.82, 95% CI -1.20 to -0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI -0.94 to 1.42) across 4 studies, -0.73 (95% CI -2.14 to 0.68) across 9 studies, and 0.29 (95% CI -0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively.Conclusion: Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people's mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings' generalisability.

背景:难民、寻求庇护者和境内流离失所者由于经历创伤和压力事件,心理健康问题的负担很重:总结现有证据,分析简短心理干预(小于 3 个月)对改善难民心理健康结果(包括抑郁、焦虑和创伤后应激障碍 (PTSD) 相关症状)的效果:我们检索了 Medline、EMBASE、PsycINFO、CINAHL 和 Global Index Medicus 从开始到 2023 年 12 月 19 日的资料。我们纳入了使用任何认知行为疗法(CBT)或基于 CBT 的短期疗法(< 3 个月)的对照研究,这些研究报告了干预前后的心理健康结果。我们使用随机效应进行了荟萃分析,得出了汇总统计结果。证据质量采用 Cochrane Risk of Bias (RoB2) 和 ROBINS-I 工具进行评估。本研究已在开放科学框架(Open Science Framework)上注册,DOI 10.17605/OSF.IO/9CXU4.Results:检索了 37 份出版物中 34 项符合条件的研究,其中 33 项研究共 4479 名参与者被纳入荟萃分析。通过对 13 项焦虑结果研究(SMD-1.12,95% CI -1.72 至 -0.52)、20 项抑郁研究(SMD-1.04,95% CI -1.97 至 -0.11)和 24 项创伤后应激障碍研究(SMD -0.82,95% CI -1.20 至 -0.45)的分析,所有三个领域的即时心理健康结果均有总体改善。然而,在3至6个月的随访中,心理健康结果分析显示与基线相比没有显著变化,4项研究的SMD为0.24(95% CI -0.94至1.42),9项研究的SMD为-0.73(95% CI -2.14至0.68),12项研究的焦虑、抑郁和创伤后应激障碍的SMD分别为0.29(95% CI -0.94至1.53):低质量的证据显示,简短的心理干预对难民和境内流离失所者的心理健康有积极的直接影响。结论:低质量的证据显示,简短的心理干预措施对难民和境内流离失所者的心理健康有积极的直接影响,但这些影响在短期的后续治疗中不会持续。即使在亚群体中,异质性也很高,这影响了我们研究结果的普遍性。
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引用次数: 0
Long-term effects of dialectical behaviour therapy for posttraumatic stress disorder and cognitive processing therapy 9 months after treatment termination. 针对创伤后应激障碍的辩证行为疗法和认知处理疗法在治疗终止 9 个月后的长期效果。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-09-02 DOI: 10.1080/20008066.2024.2393061
Ruben Vonderlin, Kathlen Priebe, Meike Müller-Engelmann, Thomas Fydrich, Regina Steil, Patricia A Resick, Christian Schmahl, Petra Lindauer, Nikolaus Kleindienst, Martin Bohus

Background: The complexity of posttraumatic stress disorder (PTSD) symptoms related to childhood abuse (CA) present challenges for effective psychotherapeutic treatment. Consequently, there is great interest in the long-term effectiveness of psychological treatments for this population.Objective: This study aims to investigate the long-term outcomes of Dialectical Behaviour Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT) 9 months after treatment termination.Method: This is a long-term analysis from a randomised-controlled trial of DBT-PTSD versus CPT (registration number DRKS00005578). Initially, 193 individuals with CA-related PTSD were randomly allocated to receive either DBT-PTSD (n = 98) or CPT (n = 95). The primary outcome the Clinician-administered PTSD-Scale for DSM-5 (CAPS-5) was administred at baseline, treatment completion (15 months post-randomization) and at the 9-month follow-up. Secondary outcomes included self-reported PTSD severity (PCL-5), dissociation (DSS), severity of borderline symptoms (BSL-23), and psychosocial functioning (GAF).Results: No significant changes were observed in the primary (CAPS) and all other outcomes from post-intervention to 9-months follow-up in both the DBT-PTSD (CAPS: Mpost  = 15.60, Mfollow-up  = 14.93) and CPT group (CAPS: Mpost = 18.80, Mfollow-up = 17.41). Between-group analyses at 9-months follow-up were significantly in favour of DBT-PTSD compared to CPT with small to medium effect sizes on all outcomes ranging from d = 0.35 on the CAPS to d = 0.57 on the BSL-23 and GAF.Conclusions: Our results indicate that treatment effects of psychotherapy addressing complex presentations of PTSD persist 9 months after treatment termination. In addition, the superiority of DBT-PTSD as compared to CPT found at treatment termination, was confirmed at 9-months follow-up.Trial registration: German Clinical Trials Register identifier: DRKS00005578..

背景:与童年虐待(CA)相关的创伤后应激障碍(PTSD)症状十分复杂,给有效的心理治疗带来了挑战。因此,人们非常关注心理治疗对这一人群的长期疗效:本研究旨在调查创伤后应激障碍的辩证行为疗法(DBT-PTSD)和认知加工疗法(CPT)在治疗终止 9 个月后的长期疗效:这是一项DBT-PTSD与CPT随机对照试验(注册号为DRKS00005578)的长期分析。最初,193 名与 CA 相关的创伤后应激障碍患者被随机分配接受 DBT-PTSD (98 人)或 CPT(95 人)治疗。主要结果是在基线、治疗结束(随机分配后 15 个月)和 9 个月随访时使用 DSM-5 临床医师管理创伤后应激障碍量表(CAPS-5)。次要结果包括自我报告的创伤后应激障碍严重程度(PCL-5)、解离(DSS)、边缘症状严重程度(BSL-23)和心理社会功能(GAF):DBT-PTSD组(CAPS:Mpost = 15.60,Mfollow-up = 14.93)和CPT组(CAPS:Mpost = 18.80,Mfollow-up = 17.41)的主要结果(CAPS)和所有其他结果从干预后到9个月随访期间均未观察到明显变化。9个月随访的组间分析结果显示,DBT-PTSD组明显优于CPT组,在所有结果上都有小到中等的效应大小,从CAPS的d = 0.35到BSL-23和GAF的d = 0.57:我们的研究结果表明,针对创伤后应激障碍复杂表现的心理疗法的治疗效果在治疗终止 9 个月后仍然存在。此外,与CPT相比,DBT-PTSD在治疗终止时的优越性在9个月的随访中得到了证实:试验注册:德国临床试验注册标识符:DRKS00005578.
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引用次数: 0
Temporal and spatial convergence: the major depressive disorder burden attributed to intimate partner violence against women. 时空交汇:亲密伴侣暴力侵害妇女行为导致的重度抑郁障碍负担。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-02 DOI: 10.1080/20008066.2024.2386226
Pengfei Guo, Rizhen Wang, Jiacheng Li, Yinghua Qin, Nan Meng, Linghan Shan, Huan Liu, Jingjing Liu, Qunhong Wu

Background: There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.Method: This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.Results: In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.Conclusions: The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.

背景:亲密伴侣暴力与重度抑郁症之间存在密切的因果关系,这在一定程度上危及妇女一生的安全,并可能影响后代的发展。国际社会已将解决亲密伴侣暴力问题及由此造成的精神疾病负担列为重中之重。对于亲密伴侣暴力导致的重度抑郁症,需要从时间趋势和空间分布两方面收集数据,以反映幸存者的优先事项和期望:本研究从《2019 年全球疾病负担》(Global Burden of Disease 2019)中获取了亲密伴侣暴力导致的重度抑郁症的原始残疾调整生命年(DALYs)信息。利用估算的年度百分比变化和双向固定效应模型,对1990年至2019年的年龄标准化残疾调整生命年率进行了二次时空分析:2019年,重度抑郁障碍女性的残疾调整寿命年数损失(316万)占全球因亲密伴侣暴力造成的残疾调整寿命年数损失的37.18%。亲密伴侣暴力导致的重度抑郁障碍年龄标准化残疾调整寿命年数损失率为每10万人108.57年。最高的年龄段集中在绝经过渡期(45-55 岁),每 100 000 人中有 133.61 人,尤其分布在乌干达(每 100 000 人中有 429.31 人)。从 1990 年到 2019 年,早期生殖期(15-19 岁)的年龄标准化残疾调整寿命年数比率呈上升趋势,这主要是由马来西亚(每年 3.73%)推动的。此外,年龄标准化残疾调整寿命年数比率初始水平较高的国家比初始水平较低的国家增长更快:结论:亲密伴侣暴力导致的重度抑郁症负担显示出生物和空间上的不平等,应优先针对处于生育早期和更年期过渡阶段的弱势妇女采取干预措施。应实施和发展政治、社会文化和医疗相结合的措施,以预防暴力和治疗重度抑郁症。
{"title":"Temporal and spatial convergence: the major depressive disorder burden attributed to intimate partner violence against women.","authors":"Pengfei Guo, Rizhen Wang, Jiacheng Li, Yinghua Qin, Nan Meng, Linghan Shan, Huan Liu, Jingjing Liu, Qunhong Wu","doi":"10.1080/20008066.2024.2386226","DOIUrl":"10.1080/20008066.2024.2386226","url":null,"abstract":"<p><p><b>Background:</b> There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.<b>Method:</b> This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.<b>Results:</b> In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.<b>Conclusions:</b> The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictors and (in-)stability of ICD-11 complex posttraumatic stress disorder in older adults: findings from a longitudinal study in Switzerland. 老年人 ICD-11 复杂创伤后应激障碍的预测因素和(不)稳定性:瑞士一项纵向研究的结果。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-01-23 DOI: 10.1080/20008066.2023.2299618
Milan Rusmir, Shauna L Rohner, Andreas Maercker, Aileen N Salas Castillo, Myriam V Thoma

Objective: There is a lack of research on complex post-traumatic stress disorder (CPTSD) in older individuals, with little known about the temporal course of CPTSD. Therefore, this study assessed and compared the demographic characteristics, adverse childhood experiences (ACE), and well-being of Swiss older adults with and without probable CPTSD. The (in-)stability of probable CPTSD was also examined in relation to the predictive value of various emotion-related factors.Methods: A longitudinal study was conducted in Switzerland with N = 213 participants (Mage = 69.98 years, SD = 10.61; 45.5% female). Data was collected via face-to-face assessments at baseline and follow-up, 21 months apart. The German version of the International Trauma Questionnaire was used to screen for (C)PTSD. Standardized instruments were used to assess ACE as well as the predictors anger, embitterment, emotion regulation, and meaning in life.Results: From the total sample, n = 16 participants (7.5%) were identified as having probable CPTSD, with only five of these (31.25%) having probable CPTSD at both baseline and follow-up. Individuals with and without probable CPTSD differed significantly regarding age and employment status. Significant predictors of probable CPTSD were anger (β = 0.16), embitterment (β = 0.06), cognitive reappraisal (β = -0.41), and the presence of meaning in life (β = -0.10).Conclusions: Probable CPTSD appears to be relatively unstable over the course of a 21-month period in older individuals. The links between CPTSD and emotion-related predictors highlight potential targets for intervention.

研究目的目前缺乏对老年人复杂创伤后应激障碍(CPTSD)的研究,对 CPTSD 的时间进程也知之甚少。因此,本研究评估并比较了患有和未患有疑似 CPTSD 的瑞士老年人的人口统计学特征、童年不良经历 (ACE) 和幸福感。此外,还结合各种情绪相关因素的预测价值,对可能患有 CPTSD 的(不)稳定性进行了研究:在瑞士进行了一项纵向研究,共有 213 名参与者(年龄 = 69.98 岁,SD = 10.61;45.5% 为女性)。在基线期和随访期(相隔 21 个月)通过面对面评估收集数据。德文版国际创伤问卷用于筛查(C)创伤后应激障碍。标准化工具用于评估 ACE 以及愤怒、苦恼、情绪调节和生活意义等预测因素:在所有样本中,n = 16 名参与者(7.5%)被确定为可能患有 CPTSD,其中只有 5 人(31.25%)在基线和随访时都有可能患有 CPTSD。可能患有 CPTSD 的人与未患有 CPTSD 的人在年龄和就业状况方面存在显著差异。预测可能患有 CPTSD 的重要因素是愤怒(β = 0.16)、苦恼(β = 0.06)、认知重估(β = -0.41)和生活意义的存在(β = -0.10):结论:可能患有 CPTSD 的老年人在 21 个月内似乎相对不稳定。CPTSD 与情绪相关预测因素之间的联系凸显了潜在的干预目标。
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引用次数: 0
Beyond trauma: a review of content and linguistic characteristics of nontrauma narratives in posttraumatic stress disorder. 超越创伤:创伤后应激障碍非创伤叙事的内容和语言特点回顾。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-17 DOI: 10.1080/20008066.2024.2407733
Aubrey A Knoff, Jennifer J Vasterling, Mieke Verfaellie

Background: Using narratives to reflect on experiences, emotions, and thoughts is associated with better health, enhanced mood, and improved symptoms of posttraumatic stress disorder (PTSD). Prior research examining narrative characteristics thought to reflect cognitive styles associated with PTSD has focused on trauma narratives, but the characteristics of nontrauma narratives in relation to PTSD are not fully understood.Objective: We reviewed the PTSD literature examining linguistic characteristics of nontrauma narratives, focusing on affective content, personal pronouns, and cognitive processing words.Method: We searched online databases for both laboratory and social media studies examining these characteristics of nontrauma narratives in relation to PTSD diagnostic status and/or PTSD symptom severity.Results: Following SWiM guidelines [Campbell et al., 2020. Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. British Medical Journal, 368, l6890], there was moderate evidence for differential use of emotion words in nontrauma narratives in relation to PTSD symptom cluster severity. More severe avoidance/numbing symptoms were associated with greater use of negative emotion words and less use of positive emotion words. Results were mixed for other linguistic elements reviewed.Conclusions: Differential use of emotional language in trauma narratives generalises to nontrauma narratives in individuals with PTSD. Additional research is needed to elucidate the use of personal pronouns and cognitive processing words in nontrauma narratives.

背景:使用叙述来反思经历、情绪和想法与改善健康、提高情绪和改善创伤后应激障碍(PTSD)症状有关。之前对被认为反映与创伤后应激障碍相关的认知方式的叙述特征的研究主要集中在创伤叙述上,但对与创伤后应激障碍相关的非创伤叙述的特征还不完全了解:我们回顾了研究非创伤叙事语言特点的创伤后应激障碍文献,重点关注情感内容、人称代词和认知加工词:我们在网上数据库中搜索了实验室研究和社交媒体研究,这些研究考察了非创伤叙事的这些特征与创伤后应激障碍诊断状态和/或创伤后应激障碍症状严重程度的关系:根据 SWiM 指南[坎贝尔等人,2020 年。系统综述中的无荟萃分析(SWiM)综合:报告指南。英国医学杂志》(British Medical Journal),368,l6890],有中等程度的证据表明,非创伤叙事中情绪词的不同使用与创伤后应激障碍症状群的严重程度有关。更严重的回避/麻木症状与更多地使用消极情绪词和较少使用积极情绪词有关。对其他语言要素的研究结果不一:结论:创伤后应激障碍患者在创伤叙事中情感语言使用的差异会延伸到非创伤叙事中。需要进行更多的研究来阐明非创伤叙事中人称代词和认知加工词的使用情况。
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引用次数: 0
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European Journal of Psychotraumatology
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