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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。
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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
Cultural psychological factors in posttraumatic symptom development and expression: a study protocol. 创伤后症状发展和表现中的文化心理因素:研究方案。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-06-25 DOI: 10.1080/20008066.2024.2364998
David J Eberle, Andreas Maercker, Yafit Levin, Celestin Mutuyimana, Jun Wen, Nino Makhashvili, Darejan Javakhishvili, Ana Papava, Xinyi Yu, Wenli Qian, Jianping Wang, Stephen Asatsa, Rahel Bachem

Introduction: Cultural factors were shown to be particularly relevant for the development and expression of posttraumatic stress. Recently, the concept of cultural scripts of trauma has been introduced, which proposes that trauma sequelae elements may be sequentially linked and specifically associated with cultural factors. Furthermore, a cascade model is proposed, including trauma exposure, demographic characteristics, cultural affiliation, and trauma-related value orientations as influencing factors of posttraumatic development. The purpose of this Network Project is to investigate cultural psychological factors that contribute to the expression of posttraumatic stress.Methods: The present Network Project implements a mixed methods approach and will be conducted in 5 different study sites, including Switzerland, Israel, Georgia, China, and East Africa. In sub-study I, the cultural scripts of traumatic stress inventories (CSTIs) will be developed. These scales provide a pool of trauma sequelae elements for each cultural group. For this purpose, focus groups with trauma survivors and trauma experts will be conducted and analysed using qualitative research methods. Sub-study II implements a validation analysis of the CSTIs and the empirical investigation of a cultural cascade model. This quantitative approach will include a larger sample of individuals who experienced traumatic life events.Discussion: This contribution is timely and enriches the knowledge of trauma and culture. Future publications of this Network Project will address trauma sequelae from a cultural perspective and provide diagnostic and psychotherapeutic implications.

简介文化因素被证明与创伤后应激反应的发展和表现特别相关。最近,人们提出了 "创伤文化脚本 "的概念,认为创伤后遗症的要素可能与文化因素有顺序的联系和具体的关联。此外,还提出了一个级联模型,包括创伤暴露、人口特征、文化归属和与创伤相关的价值取向,这些都是创伤后发展的影响因素。本网络项目旨在研究导致创伤后应激表现的文化心理因素:本网络项目采用混合方法,将在瑞士、以色列、格鲁吉亚、中国和东非等 5 个不同的研究地点进行。子研究 I 将开发创伤压力文化脚本清单(CSTIs)。这些量表为每个文化群体提供了创伤后遗症要素库。为此,将与创伤幸存者和创伤专家进行焦点小组讨论,并采用定性研究方法进行分析。子研究 II 将对 CSTI 进行验证分析,并对文化级联模型进行实证调查。这种定量研究方法将包括更多经历过创伤性生活事件的个人样本:这一贡献非常及时,丰富了有关创伤和文化的知识。该网络项目未来的出版物将从文化角度探讨创伤后遗症,并提供诊断和心理治疗方面的启示。
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引用次数: 0
Eye Movement Desensitization and Reprocessing (EMDR) treatment in the medical setting: a systematic review. 医疗环境中的眼动脱敏和再处理疗法(EMDR):系统综述。
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-05-15 DOI: 10.1080/20008066.2024.2341577
Helen P A Driessen, Sid Morsink, Jan J V Busschbach, Witte J G Hoogendijk, Leonieke W Kranenburg

Background: Literature points towards the potential benefits of the application of Eye Movement and Desensitization Processing (EMDR)-therapy for patients in the medical setting, with cancer and pain being among the domains it is applied to. The field of applying EMDR-therapy for patients treated in the medical setting has evolved to such an extent that it may be challenging to get a comprehensive overview.Objective: This systematic literature review aims to evaluate the use and effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in patients treated in the medical setting.Methods: We performed a literature search following the PRISMA guidelines. Studies were included if the effectiveness of EMDR-therapy was assessed in adult patients treated in a medical setting. Excluded were patients exclusively suffering from a mental health disorder, without somatic comorbidity. A risk of bias analysis was performed. This review was registered on PROSPERO (CRD42022325238).Results: Eighty-seven studies, of which 26 (pilot)-RCTs were included and categorized in 14 medical domains. Additionally, three studies focusing on persistent physical complaints were included. Most evidence exists for its application in the fields of oncology, pain, and neurology. The overall appraisal of these studies showed at least moderate to high risks of bias. EMDR demonstrated effectiveness in reducing symptoms in 85 out of 87 studies. Notably, the occurrence of adverse events was rarely mentioned.Conclusions: Overall, outcomes seem to show beneficial effects of EMDR on reducing psychological and physical symptoms in patients treated in a medical setting. Due to the heterogeneity of reported outcomes, effect sizes could not be pooled. Due to the high risk of bias of the included studies, our results should be interpreted with caution and further controlled high-quality research is needed.

背景:文献指出,眼动与脱敏处理(EMDR)疗法对医疗环境中的患者具有潜在的益处,癌症和疼痛是其应用的领域之一。将EMDR疗法应用于医疗环境中的患者治疗的领域已经发展到如此程度,以至于要对其进行全面概述可能具有挑战性:本系统性文献综述旨在评估眼动脱敏和再处理疗法(EMDR)在医疗机构治疗患者中的应用和效果:我们按照 PRISMA 指南进行了文献检索。如果EMDR疗法对在医疗机构接受治疗的成年患者的有效性进行了评估,则纳入相关研究。排除仅患有精神疾病、无躯体合并症的患者。进行了偏倚风险分析。本综述已在 PROSPERO(CRD42022325238)上注册:结果:共纳入 87 项研究,其中 26 项(试验性)RCT 研究,分为 14 个医疗领域。此外,还纳入了 3 项关于持续性身体不适的研究。大多数证据表明,该疗法适用于肿瘤学、疼痛学和神经学领域。对这些研究的总体评估显示,至少存在中度到高度的偏倚风险。在 87 项研究中,有 85 项研究表明 EMDR 能有效减轻症状。值得注意的是,不良事件的发生很少被提及:总体而言,研究结果似乎表明,EMDR 对减少在医疗环境中接受治疗的患者的心理和生理症状有好处。由于报告结果的异质性,无法汇总效应大小。由于纳入的研究存在较高的偏倚风险,因此应谨慎解释我们的结果,并需要进一步开展高质量的对照研究。
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引用次数: 0
A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD. 一项试验性随机对照研究,旨在调查南非青少年集体睡眠干预(SAASI)对青少年睡眠和创伤后应激障碍的影响。
IF 5 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-05-22 DOI: 10.1080/20008066.2024.2350217
Jaco Rossouw, Sharain Suliman, Jani Nothling, Carl Lombard, Erine Bröcker, Maryke Hewett, Candice Simmons, Gillian W Shorter, Soraya Seedat, Melissa E Milanak, Cherie Armour

Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = -2.18, p = .029), mean slope = -0.2 (95% CI: -0.37 to -0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: -22.43 to -0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.

背景:在南非青少年中,遭受创伤和由此导致的创伤后应激障碍的发生率很高。睡眠障碍是创伤后应激障碍患者最常遇到的困难之一。本研究考察了南非青少年集体睡眠干预对创伤后应激障碍症状严重程度和睡眠障碍的可行性和初步疗效:61名被诊断患有创伤后应激障碍和睡眠障碍的青少年被随机分配(1:1)到一个睡眠干预(SAASI)个人课程和四个小组课程或对照组。参与者完成了 DSM5 儿童创伤后应激障碍症状量表(CPSS-5)和匹兹堡睡眠质量指数(PSQI)以及其他睡眠和精神方面的测量。该试验已在泛非试验注册中心(PACTR202208559723690)注册:结果:随着时间的推移,两组的 PSQI 分数都有明显但相似的下降,表明总体上没有干预效果(Wald 检验 = -2.18,p = .029),平均斜率 = -0.2 (95% CI: -0.37 to -0.02) (p = .583)。在 CPSS-5 中,组间交互作用也不显著(p = .291)。尽管总体结果如此,但随着时间的推移,CPSS-SR-5评分的平均差异却在增加,治疗后组间差异为-9.10(95%CI:-18.00至-0.21),p = .045,1个月随访对比为-11.22(95%CI:-22.43至-0.03),p = .049,这表明干预组的创伤后应激障碍症状严重程度比对照组下降得更多。干预组(10 人;32%)和对照组(8 人;26.7%)的辍学率均高于预期。辍学主要与学业或旅行有关:早期研究结果表明,有睡眠障碍和创伤后应激障碍的青少年在接受集体睡眠干预(SAASI)后,其睡眠质量和创伤后应激障碍症状的严重程度有双重改善的趋势。因此,有必要通过一项具有详细保留计划的、有适当动力的 RCT 进行进一步调查。
{"title":"A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD.","authors":"Jaco Rossouw, Sharain Suliman, Jani Nothling, Carl Lombard, Erine Bröcker, Maryke Hewett, Candice Simmons, Gillian W Shorter, Soraya Seedat, Melissa E Milanak, Cherie Armour","doi":"10.1080/20008066.2024.2350217","DOIUrl":"10.1080/20008066.2024.2350217","url":null,"abstract":"<p><p><b>Background:</b> Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.<b>Method:</b> Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).<b>Results:</b> There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = -2.18, <i>p</i> = .029), mean slope = -0.2 (95% CI: -0.37 to -0.02) (<i>p</i> = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), <i>p</i> = .045 and the 1-month follow-up contrast - 11.22 (95%CI: -22.43 to -0.03), <i>p</i> = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (<i>n</i> = 10; 32%) and control (<i>n</i> = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.<b>Conclusions:</b> Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2350217"},"PeriodicalIF":5.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075840","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
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
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
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 PSYCHIATRY 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
期刊
European Journal of Psychotraumatology
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