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Complex posttraumatic stress disorder and dissociation in trauma-exposed Chinese adolescents: a latent class analysis. 受过创伤的中国青少年的复杂创伤后应激障碍和解离:潜类分析。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-05-29 DOI: 10.1080/20008066.2024.2351292
Li Wang, Haibo Fu, Hengjia Guo, Ping Liu, Yajie Bi, Shu Luo, Yuwei Han, Yuxuan Wang, Chengqi Cao

Background: Preliminary evidence provides support for the proposition that there is a dissociative subtype of Complex posttraumatic stress disorder (CPTSD). Research on this proposition would extend our knowledge on the association between CPTSD and dissociation, guide contemporary thinking regarding placement of dissociation in the nosology of CPTSD, and inform clinically useful assessment and intervention.Objectives: The present study aimed to investigate the co-occurring patterns of CPTSD and dissociative symptoms in a large sample of trauma exposed adolescents from China, and specify clinical features covariates of such patterns including childhood trauma, comorbidities with major depressive disorder (MDD) and generalized anxiety disorder (GAD), and functional impairment.Methods: Participants included 57,984 high school students exposed to the coronavirus disease 2019 (COVID-19) pandemic. CPTSD and dissociative symptoms, childhood traumatic experience, and functional impairment were measured with the Global Psychotrauma Screen for Teenagers (GPS-T). Major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Latent class analysis (LCA) was employed to test the co-occurring patterns of CPTSD and dissociative symptoms. Analysis of covariance (ANCOVA) and chi-square tests were respectively used to examine between-class differences in continuous and categorical clinical covariates.Results: A 5-class model emerged as the best-fitting model, including resilience, predominantly PTSD symptoms, predominantly disturbances in self-organization (DSO)symptoms, predominantly CPTSD symptoms, and CPTSD dissociative subtype classes. The CPTSD dissociative subtype class showed the lowest level of functioning and the highest rates of MDD, GAD and childhood trauma.Conclusions: Our findings provide initial empirical evidence supporting the existence of a dissociative subtype of CPTSD, and inform for further research and clinical practice on traumatized individuals.

背景:初步证据表明,复杂创伤后应激障碍(CPTSD)存在解离亚型。对这一命题的研究将扩展我们对 CPTSD 与解离之间关联的认识,指导当代关于将解离置于 CPTSD 分类学中的思考,并为临床有用的评估和干预提供信息:本研究旨在调查中国受创伤青少年中CPTSD和解离症状的共存模式,并明确这种模式的临床特征协变量,包括童年创伤、合并重性抑郁障碍(MDD)和广泛性焦虑障碍(GAD)以及功能障碍:研究对象包括57984名受到2019年冠状病毒病(COVID-19)大流行影响的高中生。通过全球青少年精神创伤筛查(GPS-T)测量了 CPTSD 和分离症状、童年创伤经历和功能障碍。重度抑郁症(MDD)和广泛性焦虑症(GAD)症状分别通过患者健康问卷-9(PHQ-9)和广泛性焦虑症-7(GAD-7)进行测量。采用潜类分析(LCA)来检验 CPTSD 和分离症状的共存模式。方差分析(ANCOVA)和卡方检验分别用于检验连续和分类临床协变量的类间差异:结果:一个五类模型成为最佳拟合模型,包括复原力、以创伤后应激障碍症状为主、以自我组织紊乱(DSO)症状为主、以 CPTSD 症状为主和 CPTSD 解离亚型类。CPTSD 解离亚型类别的功能水平最低,而 MDD、GAD 和童年创伤的发病率最高:我们的研究结果为支持 CPTSD 解离亚型的存在提供了初步的实证证据,并为针对创伤个体的进一步研究和临床实践提供了参考。
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引用次数: 0
Living with grief and thriving after loss: a qualitative study of Chinese parents whose only child has died. 在悲伤中生活,在失去孩子后茁壮成长:对独生子女夭折的中国父母的定性研究。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-11-01 DOI: 10.1080/20008066.2024.2418767
Xin Xu, Jun Wen, Wenli Qian, Ningning Zhou, Wanyue Jiang

Introduction: Chinese bereaved parents over the age of 49 who have lost their only child are known as shidu parents. This study aimed to explore their symptoms of prolonged grief disorder (PGD) and post-traumatic growth (PTG).Methods: Shidu parents who experienced the loss of their only child at least six months prior and had no biological or adopted children at the time of the study were recruited. Eleven shidu parents participated in individual interviews conducted in Mandarin via WeChat video or voice calls. The interview guide was developed by the first researcher and refined through discussions with doctoral students and a professor specializing in bereavement. Reflexive thematic analysis was used to analyse the data from the semi-structured interviews.Results: The interviewees (3 men and 8 women) were aged between 53 and 72 years, and the time since their child's loss ranged from 2.25 to 24 years. Four themes of PGD symptoms were identified: Separation distress, Cognitive, emotional, and behavioural symptoms, Somatic responses and Changes in grief responses. Subtheme of 'feelings of inferiority or shame' and 'somatic responses' were prominent among this group, potentially representing culturally relevant grief reactions. They also experienced genuine PTG that helped them adapt to life without the child: changes in self-perception, changes in interpersonal relationships, and a changed philosophy of life. The subtheme of 'living for self' emerged as a potentially unique PTG among shidu parents.Conclusion: Shidu parents share some important similarities with bereaved individuals across cultures, but also exhibit some unique characteristics. Considering their persistent intense grief, regular screening for grief severity, physical issues, and suicidal ideation is essential. Culturally sensitive interventions that acknowledge and validate their sense of inferiority or shame may be beneficial. Additionally, fostering PTG may support shidu parents in coping with their loss and adapting to life.

导言:中国49岁以上失去独生子女的父母被称为 "师徒父母"。本研究旨在探讨他们的长期悲伤障碍(PGD)和创伤后成长(PTG)症状:方法:招募了至少在六个月前经历过失去独生子女,且在研究期间没有亲生或领养子女的 "志都 "父母。11 位师都父母通过微信视频或语音电话以普通话参加了个别访谈。访谈指南由第一位研究者制定,并通过与博士生和一位专门研究丧亲之痛的教授的讨论加以完善。半结构式访谈的数据分析采用了反思性主题分析法:受访者(3 男 8 女)的年龄在 53 岁至 72 岁之间,他们失去孩子的时间从 2.25 年到 24 年不等。我们确定了四个 PGD 症状主题:分离痛苦、认知、情绪和行为症状、躯体反应和悲伤反应的变化。自卑感或羞耻感 "和 "躯体反应 "这两个副主题在该群体中非常突出,可能代表了与文化相关的悲伤反应。他们还经历了真正的 PTG,这有助于他们适应没有孩子的生活:自我认知的改变、人际关系的改变以及生活理念的改变。为自己而活 "这一子主题可能是师徒家长中独特的 PTG:师徒父母与不同文化背景下的丧亲者有一些重要的相似之处,但也表现出一些独特的特征。考虑到他们持续的强烈悲伤,定期筛查悲伤的严重程度、身体问题和自杀意念至关重要。承认并确认他们的自卑感或羞耻感的具有文化敏感性的干预措施可能是有益的。此外,培养 PTG 可帮助师徒父母应对丧亲之痛并适应生活。
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引用次数: 0
A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder. 关于辩证行为疗法变体治疗创伤后应激障碍疗效的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: 2024-10-01 DOI: 10.1080/20008066.2024.2406662
Karin Prillinger, Andreas Goreis, Sarah Macura, Carola Hajek Gross, Annika Lozar, Selina Fanninger, Anna Mayer, Claudia Oppenauer, Paul L Plener, Oswald D Kothgassner

Background: While there are well-established treatments for post-traumatic stress disorder (PTSD), these interventions appear to be less effective for individuals with comorbid borderline personality disorder (BPD) symptoms. Dialectical Behavior Therapy (DBT) for PTSD and DBT Prolonged Exposure (PE) are both effective interventions for treating these patients, but a comprehensive analysis evaluating the efficacy of these two interventions is lacking.Objective: To determine the effect sizes of PTSD-specific DBT treatments.Methods: We conducted a systematic review and pre-registered meta-analysis of the DBT literature for treating PTSD (osf.io/62rfq). Eligible trials and treatment evaluations published before September 2023 were searched in SCOPUS, PubMed, and the Cochrane Library databases. Thirteen articles were identified, and data were extracted for primary (PTSD symptoms) and secondary outcomes (BPD, depression, dissociation, non-suicidal self-injury [NSSI]). Treatment effects were calculated for randomised controlled trials, controlled clinical trials, and pre-post evaluations.Results: Overall, the studies involved 663 participants. Compared with control groups, PTSD-specific DBT treatments showed moderate effects in reducing PTSD symptom severity g = -0.69 (95% CI -1.03 to -0.34, p < .001) and depression g = -0.62 (95% CI -1.13 to -0.12, p = .016). Moreover, the pre-post changes showed an overall effect size for dissociative symptoms of g = -0.72 (95% CI -1.05 to -0.40, p < .001), for BPD-associated symptoms of g = -0.82 (95% CI -1.06 to -0.59, p < .001), and for NSSI frequency (g = -0.70, 95% CI -1.12 to -0.28, p = .001).Conclusions: Based on the results of our meta-analysis, DBT-PTSD and DBT PE were effective in reducing PTSD symptom severity and comorbid depressive symptoms. Further research on stage-based treatments should focus on systematically assessing NSSI, BPD symptoms, and suicidality.

背景:虽然创伤后应激障碍(PTSD)有成熟的治疗方法,但这些干预措施对合并有边缘型人格障碍(BPD)症状的患者似乎效果较差。针对创伤后应激障碍的辩证行为疗法(DBT)和DBT延长暴露疗法(PE)都是治疗这些患者的有效干预措施,但目前还缺乏对这两种干预措施疗效的全面分析评估:目的:确定 PTSD 特异性 DBT 治疗的效应大小:我们对治疗创伤后应激障碍的 DBT 文献(osf.io/62rfq)进行了系统回顾和预先注册的荟萃分析。我们在 SCOPUS、PubMed 和 Cochrane Library 数据库中检索了 2023 年 9 月之前发表的符合条件的试验和治疗评估。确定了 13 篇文章,并提取了主要结果(创伤后应激障碍症状)和次要结果(BPD、抑郁、解离、非自杀性自伤 [NSSI])的数据。计算了随机对照试验、临床对照试验和前后评价的治疗效果:这些研究共涉及 663 名参与者。与对照组相比,创伤后应激障碍特异性 DBT 治疗在降低创伤后应激障碍症状严重程度方面显示出中等效果 g = -0.69 (95% CI -1.03 to -0.34, p g = -0.62 (95% CI -1.13 to -0.12, p = .016)。此外,前后变化对分离症状的总体影响大小为 g = -0.72 (95% CI -1.05 to -0.40, p g = -0.82 (95% CI -1.06 to -0.59, p g = -0.70, 95% CI -1.12 to -0.28, p = .001):根据我们的荟萃分析结果,DBT-PTSD 和 DBT PE 能有效降低创伤后应激障碍症状的严重程度和合并抑郁症状。对基于阶段的治疗方法的进一步研究应侧重于系统评估 NSSI、BPD 症状和自杀倾向。
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引用次数: 0
Effects of childhood adversities on alexithymia features vary between sexes. Results of a prospective population study. 童年逆境对自闭症特征的影响因性别而异。一项前瞻性人口研究的结果。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-11 DOI: 10.1080/20008066.2024.2407256
Raimo K R Salokangas, Tiina From, Henri R W Salokangas, Lara Lehtoranta, Jaana Suvisaari, Seppo Koskinen, Jarmo Hietala, Matti Joukamaa, Max Karukivi

Introduction: Adverse childhood experiences (ACEs) associate with various mental disorders, including personality features. Our understanding of how ACEs influence alexithymia features in the general population is limited. In a prospective population setting, we studied whether ACEs associate with alexithymia, and the role of sex and emotional symptoms in this association.Methods: In a Finnish population-based prospective study, 3,142 individuals aged between 30 and 64 years completed eleven ACE questions and the Toronto Alexithymia Scale in 2000 and 2011, and the Hopkins Symptoms Checklist in 2011. The effect of ACEs on alexithymia and its subdomains - difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT) in 2000 and 2011 - was analysed using repeated measures ANOVA.Results: The number of ACEs and their main component, childhood social disadvantage, associated positively with total alexithymia scores and its subdomains DIF and DDF, and negatively with EOT. After controlling for the effect of depression and anxiety, the strength of these associations was reduced, but the effect of social disadvantage on DIF and EOT remained significant in females. Childhood family conflicts associated positively with DIF in males and negatively with EOT in females. Additionally, maternal mental problems associated positively with DIF and DDF in females.Discussion: In the general population, ACEs, particularly social disadvantage, are associated with adult alexithymia features. Alexithymia features, detectable from youth, may predispose individuals to emotional disturbances caused by childhood adversities. The effect of family conflicts and maternal mental problems on alexithymia features varies between sexes.

导言童年不良经历(ACE)与包括人格特征在内的各种精神障碍有关。我们对童年逆境经历如何影响普通人群的情感障碍特征的了解还很有限。在一项前瞻性人群调查中,我们研究了ACE是否与亚历山大症有关,以及性别和情绪症状在这种关联中的作用:在一项基于芬兰人口的前瞻性研究中,3142 名年龄在 30 至 64 岁之间的人分别在 2000 年和 2011 年填写了 11 个 ACE 问题和多伦多亚历山大症量表,并在 2011 年填写了霍普金斯症状核对表。采用重复测量方差分析法分析了2000年和2011年ACE对情感障碍及其子域--识别感受困难(DIF)、描述感受困难(DDF)和外向思维(EOT)--的影响:结果表明:ACE的数量及其主要组成部分--童年社会不利条件与情感缺失总分及其子域DIF和DDF呈正相关,而与EOT呈负相关。在控制了抑郁和焦虑的影响后,这些关联的强度有所降低,但在女性中,社会不利条件对 DIF 和 EOT 的影响仍然显著。童年时期的家庭冲突与男性的 DIF 呈正相关,而与女性的 EOT 呈负相关。此外,母亲的精神问题与女性的 DIF 和 DDF 呈正相关:讨论:在一般人群中,ACE,尤其是社会不利条件,与成年后的情感障碍特征有关。从青少年时期就能发现的亚历山大症特征,可能使个体容易因童年逆境而产生情绪障碍。家庭冲突和母亲精神问题对情感障碍特征的影响因性别而异。
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引用次数: 0
Cognitive factors as mediators of the relationship between childhood trauma and depression symptoms: the mediating roles of cognitive overgeneralisation, rumination, and social problem-solving. 认知因素是童年创伤与抑郁症状之间关系的中介:认知过度概括、反刍和社会问题解决的中介作用。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-03-04 DOI: 10.1080/20008066.2024.2320041
Zobeydeh Dehghan Manshadi, Hamid Taher Neshat-Doost, Laura Jobson

Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors - cognitive overgeneralisation, rumination and social problem-solving - as mediating factors in the relationship between childhood trauma and symptoms of depression.Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants (N = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling.Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies.Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problem-solving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma.

背景:童年创伤会对抑郁症产生直接和长期的负面影响。然而,有关影响这种关系的认知因素的问题仍然存在。本研究旨在探讨认知过度概括、反刍和社会问题解决这三个认知因素在童年创伤与抑郁症状之间关系中的中介作用:我们于 2023 年 3 月至 7 月在伊朗进行了一项横断面研究。患有抑郁症的参与者(N = 227;平均年龄为 32.44 ± 8.95 岁)完成了有关童年创伤、抑郁、自我概括、认知错误、记忆特异性、反刍和社会问题解决的测量。采用结构方程模型对概念模型进行了评估:结构方程模型表明,童年创伤对抑郁症状有直接的积极影响。童年创伤通过自我过度概括和反刍对抑郁症状有积极的间接影响,通过有效的社会问题解决策略对抑郁症状有消极的间接影响:研究结果表明,童年创伤的增加可能与抑郁症的升高有关,而自我概括、反刍和有效的社会问题解决策略可能在这种关系中扮演重要角色。这些研究结果对治疗有童年创伤史的抑郁症患者具有潜在的意义。
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引用次数: 0
Adult refugees' perspectives on the impact of trauma and post-migration hardships on learning. 成年难民对创伤和移民后艰辛对学习的影响的看法。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-01 DOI: 10.1080/20008066.2024.2403249
Janita Flem Tomren, Marianne Opaas

Background: Research shows that adult refugees' well-being and future in the reception country heavily depend on successfully learning the host language. However, we know little about how adult learners from refugee backgrounds experience the impact of trauma and adversity on their learning.Objective: The current study aims to investigate the perspectives of adult refugee learners on whether and how trauma and other adversity affect their learning.Methods: We conducted in-depth interviews with 22 adult refugees (10 women) attending the Norwegian Introduction Programme (NIP). The participants came from six Middle Eastern, Central Asian, and African countries. Two questionnaires were included, one about past stressful life events (SLESQ-Revised), and one about mental health symptoms and current psychological distress following potentially traumatic experiences (PCL-5).Results: Participants held varying beliefs about trauma's impact on learning: that it had a constant impact, that it was situational, or that it had no impact. Other aspects they brought up as having an essential effect on learning and school attendance include psychological burdens from past and present school experiences, and post-migration hardships such as loneliness, depression, ongoing violence, and negative social control. Post-migration trauma and hardships exacerbated the burden of previous trauma and were frequently associated with a greater negative influence on learning.Conclusion: This study adds new insights from adult refugee learners themselves into how post-migration hardships as well as trauma can impact their learning, and the importance of recognising their struggles. A safe space is required for refugees to open up about their difficulties in life and with learning. This knowledge can be used to enhance teaching practices, foster better teacher-student relationships, and inform policy-making decisions, ultimately benefiting both individuals and society.

背景:研究表明,成年难民在接收国的福祉和未来在很大程度上取决于能否成功学习东道国语言。然而,我们对来自难民背景的成年学习者如何体验创伤和逆境对其学习的影响知之甚少:本研究旨在调查成年难民学习者对创伤和其他逆境是否以及如何影响其学习的看法:我们对参加挪威入门课程(NIP)的22名成年难民(10名女性)进行了深入访谈。参与者来自六个中东、中亚和非洲国家。调查问卷包括两份,一份是关于过去的生活压力事件(SLESQ-修订版),另一份是关于潜在创伤经历后的心理健康症状和当前的心理困扰(PCL-5):结果:关于创伤对学习的影响,参与者持有不同的看法:认为创伤会持续影响学习,认为创伤是情境性的,或者认为创伤不会影响学习。他们认为对学习和出勤率有重要影响的其他方面包括过去和现在的学校经历所造成的心理负担,以及移民后的困难,如孤独、抑郁、持续的暴力和消极的社会控制。移民后的创伤和苦难加重了之前的创伤负担,往往对学习产生更大的负面影响:这项研究从成年难民学习者自身的角度,对移民后的困难和创伤如何影响他们的学习,以及认识到他们的挣扎的重要性,提出了新的见解。难民们需要一个安全的空间来敞开心扉,讲述他们在生活和学习中遇到的困难。这些知识可用于加强教学实践,促进更好的师生关系,并为决策提供信息,最终使个人和社会受益。
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引用次数: 0
Gaza's hidden crisis: adults, children, and generations of psychological torment to come. 加沙隐藏的危机:成人、儿童和未来几代人的心理折磨。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-23 DOI: 10.1080/20008066.2024.2416824
Arash Javanbakht

For more than a year, the world has been exposed to the ongoing conflict in Gaza, and the destruction, medical devastation, and the death toll of this crisis. What has been largely missing from the picture, has been an attention to the long-term mental health impact of the ongoing trauma among the Palestinian civilians and the Israeli hostages in Gaza. This article anticipates the enduring generational impact of war trauma on mental health of the civilians in Gaza, drawing from the author's clinical and research experiences of Iraqi, Syrian, Afghan, African, and Ukrainian war-exposed civilians, refugees, and survivors of torture. Across most different studies, war exposure leads to PTSD in nearly 30-50% of adult civilians, and similar rates of depression and anxiety. Civilians in Gaza, facing daily horrors and a profound sense of helplessness, are likely experiencing even greater psychological distress. Children, significantly affected during critical developmental stages, are at risk of long-term mental and physical health issues. The psychological, cultural, and epigenetic aspects of the intergenerational transmission of trauma can lead to psychological torment across generations. Addressing the mental health needs of these populations is crucial to mitigating the profound and lasting impact of war.

一年多来,全世界都在关注加沙持续不断的冲突,以及这场危机造成的破坏、医 疗毁坏和死亡人数。然而,人们对加沙的巴勒斯坦平民和以色列人质所遭受的长期精神创伤所带来的长期心理健康影响的关注,却在很大程度上缺失了。本文根据作者对伊拉克、叙利亚、阿富汗、非洲和乌克兰受战争影响的平民、难民和酷刑幸存者的临床和研究经验,预测了战争创伤对加沙平民心理健康的长期影响。在大多数不同的研究中,战争暴露导致近 30-50%的成年平民患上创伤后应激障碍,抑郁症和焦虑症的发病率也类似。加沙的平民每天都面临着恐怖和深深的无助感,他们的心理压力可能更大。儿童在关键的成长阶段受到严重影响,有可能出现长期的身心健康问题。创伤代代相传所带来的心理、文化和表观遗传方面的问题会导致跨代的心理折磨。满足这些人群的心理健康需求对于减轻战争的深远和持久影响至关重要。
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引用次数: 0
Communication on familial suicide: development of the Family Communication on Suicide Questionnaire. 就家庭自杀问题进行沟通:编制自杀问题家庭沟通问卷。
IF 4.2 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-01-01 Epub Date: 2024-10-17 DOI: 10.1080/20008066.2024.2411887
Sonja Radde, Stefan Gutwinski, Keith Harris, Meryam Schouler-Ocak, Felix Bermpohl, Konrad Schnabel, Frauke Stuke, Jonathan Henssler

Introduction: Each suicide affects about five close family members, potentially heightening risk for psychopathology and suicide. Communication style is a key factor in mental health and psychosocial wellbeing of families. Family communication after suicide, however, is insufficiently conceptualised and studied. This study aimed to identify different factors of familial communication after suicide of a relative and to develop a questionnaire assessing the functionality of familial communications following the suicide of a family member.Method: Through literature review, categories for the functionality of family communication after a familial suicide were developed. Items assessing family communication strategies were formulated and reviewed for comprehensibility and classification. Based on this review, the FCSQ (Family Communication on Suicide Questionnaire) was then tested in a multistep exploratory factor analysis on a cohort of suicide-bereaved relatives, utilising principal axis factor extraction. Construct validity of the FCSQ was assessed through correlation analysis and internal consistency via coefficient alpha.Results: Fifty-nine participants were enrolled in the study. Psychometric analyses indicated that family communication after a suicide can be divided into three factors, Honest and Emotional, Derogatory, and Stigmatising. Honest and Emotional formed functional communications, while Derogatory and Stigmatising communications formed two dysfunctional dimensions.Conclusions: The FCSQ is a first-of-a-kind questionnaire to assess functionality of family communications after suicide. Factor analysis indicated good factor structure and internal consistency, especially regarding functional communication patterns, while the Derogatory factor requires further analysis. This questionnaire has the potential to fill a crucial gap in clinical and research practice and can help to identify families and family members at risk after the experience of a family suicide.

引言每一起自杀事件都会影响到约五名近亲属,潜在地增加了心理变态和自杀的风险。沟通方式是影响家庭心理健康和社会心理福祉的关键因素。然而,对自杀后家庭沟通的概念和研究还不够充分。本研究旨在确定亲属自杀后家庭沟通的不同因素,并编制一份问卷,评估家庭成员自杀后家庭沟通的功能:方法:通过文献综述,对家人自杀后家庭沟通的功能进行了分类。制定了评估家庭沟通策略的项目,并对其可理解性和分类进行了审查。在此基础上,利用主轴因子提取法,对一组自杀遗属进行了多步骤探索性因子分析,并对 FCSQ(自杀家庭沟通问卷)进行了测试。通过相关性分析评估了 FCSQ 的结构有效性,并通过阿尔法系数评估了其内部一致性:59名参与者参加了研究。心理测量分析表明,自杀后的家庭沟通可分为三个因子:诚实和情感、贬低和污名化。诚实和情感构成了功能性沟通,而诋毁和污名化构成了两个功能失调维度:FCSQ是首个评估自杀后家庭沟通功能的问卷。因子分析表明,该问卷具有良好的因子结构和内部一致性,尤其是在功能性沟通模式方面。该问卷有可能填补临床和研究实践中的一个重要空白,并有助于识别遭遇家庭自杀后的高危家庭和家庭成员。
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引用次数: 0
Heightened response to positive facial cues as a potential marker of resilience following childhood adversity. 对积极面部暗示的反应增强是童年逆境后复原力的潜在标志。
IF 5 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-02-06 DOI: 10.1080/20008066.2024.2309783
Mattia I Gerin, Essi Viding, Louise Neil, Diana J N Armbruster-Genc, Ze Freeman, Molly Sharp, Harriet Phillips, Eamon J McCrory

Background: Childhood maltreatment profoundly influences social and emotional development, increasing psychiatric risk. Alterations in the implicit processing of threat-related cues following early abuse and neglect represent a marker of mental health vulnerability. Less is known about how early adversity influences the perception of positive social cues, despite their central role in establishing and maintaining social interactions and their association with better mental health outcomes.Methods: The sample consisted of 42 children and adolescents with substantiated childhood maltreatment experiences and 32 peers (mean age 13.3), matched on age, pubertal status, gender, socioeconomic status, ethnicity, and cognitive ability. A computerised experimental task assessed the perceived emotional intensity of positive (happy) and negative (fearful) facial expressions. Mental health symptoms were measured via self- and parental reports, and perceived social support was self-reported.Results: The experience of abuse and neglect was associated with heightened perceived intensity of positive facial cues. Cross-sectional post-hoc moderation and mediation analyses, employing a model-building approach, revealed that in maltreatment-exposed participants: (i) their increased response to positive facial cues was associated with lower symptoms; (ii) the presence of social support accounted for their heightened perceived intensity of positive facial cues; (iii) the presence of social support putatively contributed to lower symptoms by increasing the perceived intensity of positive facial cues. No group differences in perceived intensity of negative expressions were observed.Conclusions: These findings provide fresh insight into how positive faces are processed following maltreatment experience in childhood. Maltreatment experience was found to be associated with heightened perceived intensity of happy faces, which in turn was associated with better mental health and greater levels of social support. This suggests that heightened saliency of positive emotions acts protectively in children with maltreatment experience.

背景:童年时期的虐待行为会严重影响儿童的社交和情感发育,从而增加患精神病的风险。早期遭受虐待和忽视后,对威胁相关线索的内隐处理发生了改变,这是精神健康易受攻击的一个标志。早期逆境如何影响对积极社交线索的感知,尽管这些线索在建立和维持社会交往中起着核心作用,而且与更好的心理健康结果有关,但人们对此知之甚少:样本包括 42 名有确凿童年虐待经历的儿童和青少年以及 32 名同龄人(平均年龄 13.3 岁),他们的年龄、青春期状况、性别、社会经济地位、种族和认知能力均匹配。一项计算机化的实验任务评估了积极(快乐)和消极(恐惧)面部表情的感知情绪强度。心理健康症状通过自我报告和父母报告进行测量,感知到的社会支持通过自我报告进行测量:结果:虐待和忽视的经历与积极面部暗示的感知强度增加有关。采用建立模型的方法进行的横截面事后调节和中介分析表明,遭受虐待的参与者:(i) 对积极面部暗示的反应增强与症状减轻有关;(ii) 社会支持的存在是他们对积极面部暗示感知强度增强的原因;(iii) 社会支持的存在通过增强对积极面部暗示的感知强度,可能有助于减轻症状。在消极表情的感知强度方面没有观察到任何群体差异:这些研究结果为我们提供了新的视角,让我们了解在童年时期遭受虐待后,正面表情是如何被处理的。研究发现,虐待经历与快乐面孔的感知强度增加有关,而快乐面孔的感知强度增加又与更好的心理健康和更高的社会支持水平有关。这表明,积极情绪的显著性增强对有虐待经历的儿童具有保护作用。
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引用次数: 0
Effect of trauma on asylum seekers and refugees receiving a WHO psychological intervention: a mediation model. 创伤对接受世界卫生组织心理干预的寻求庇护者和难民的影响:中介模型。
IF 5 2区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2024-06-03 DOI: 10.1080/20008066.2024.2355828
Riccardo Serra, Marianna Purgato, Federico Tedeschi, Ceren Acartürk, Eirini Karyotaki, Ersin Uygun, Giulia Turrini, Hildegard Winkler, Irene Pinucci, Johannes Wancata, Lauren Walker, Mariana Popa, Marit Sijbrandij, Maritta Välimäki, Markus Kösters, Michela Nosè, Minna Anttila, Rachel Churchill, Ross G White, Tella Lantta, Thomas Klein, Thomas Wochele-Thoma, Lorenzo Tarsitani, Corrado Barbui

Background: Scalable psychological interventions such as the WHO's Self-Help Plus (SH+) have been developed for clinical and non-clinical populations in need of psychological support. SH+ has been successfully implemented to prevent common mental disorders among asylum seekers and refugees who are growing in number due to increasing levels of forced migration. These populations are often exposed to multiple, severe sources of traumatisation, and evidence of the effect of such events on treatment is insufficient, especially for non-clinical populations.Objective: We aim to study the effect of potentially traumatic experiences (PTEs) and the mediating role of symptoms of posttraumatic stress disorder (PTSD) on the improvement following SH+.Method: Participants allocated to SH+ who received at least three sessions (N = 345) were extracted from two large, randomised, European prevention trials involving asylum seekers and refugees. Measures of distress, depression, functional impairment, and post-traumatic stress symptoms were administered at baseline and 6 months post-intervention, together with measures of well-being and quality of life. Adjusted models were constructed to examine the effect of PTEs on post-intervention improvement. The possible mediating role of PTSD symptoms in this relationship was then tested.Results: Increasing numbers of PTEs decreased the beneficial effect of SH+ for all measures. This relationship was mediated by symptoms of PTSD when analysing measures of well-being and quality of life. However, this did not apply for measures of mental health problems.Conclusions: Exposure to PTEs may largely reduce benefits from SH+. PTSD symptomatology plays a specific, mediating role on psychological well-being and quality of life of participants who experienced PTE. Healthcare professionals and researchers should consider the role of PTEs and PTSD symptoms in the treatment of migrants and refugees and explore possible feasible add-on solutions for cases exposed to multiple PTEs.

背景:针对需要心理支持的临床和非临床人群开发了可推广的心理干预措施,如世界卫生组织的自助加(SH+)。SH+ 已成功用于预防寻求庇护者和难民中常见的精神障碍,由于被迫移民的人数不断增加,这些人的数量也在不断增加。这些人群通常会遭受多重、严重的心理创伤,而有关此类事件对治疗影响的证据并不充分,尤其是对非临床人群而言:我们旨在研究潜在创伤经历(PTEs)的影响,以及创伤后应激障碍(PTSD)症状对 SH+ 后病情改善的中介作用:方法:从两项涉及寻求庇护者和难民的大型欧洲随机预防试验中抽取了至少接受过三次 SH+ 治疗的参与者(N = 345)。在基线和干预后 6 个月,对苦恼、抑郁、功能障碍和创伤后应激症状进行了测量,同时还对幸福感和生活质量进行了测量。建立了调整模型,以检验创伤后应激症状对干预后改善的影响。然后检验了创伤后应激障碍症状在这种关系中可能起到的中介作用:结果:PTEs 数量的增加降低了 SH+ 对所有测量指标的有益影响。在分析幸福感和生活质量时,创伤后应激障碍症状对这种关系起到了中介作用。然而,这并不适用于精神健康问题的测量:结论:暴露于 PTEs 可能会在很大程度上减少 SH+ 的益处。创伤后应激障碍症状对经历过 PTE 的参与者的心理健康和生活质量起着特殊的调节作用。医疗保健专业人员和研究人员应考虑 PTEs 和创伤后应激障碍症状在移民和难民治疗中的作用,并为暴露于多种 PTEs 的病例探索可行的附加解决方案。
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引用次数: 0
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European Journal of Psychotraumatology
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