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Applying and Extending the Conservation of Resources (COR) Model to Trauma in U.S. Veterans 将资源保护(COR)模式应用和扩展到美国退伍军人的心理创伤中
Pub Date : 2024-01-25 DOI: 10.3390/traumacare4010003
Andrea Munoz, Samuel Girguis, Loren Martin, Michael Hollifield
This was a novel pilot study about the relationship between PTSD severity and resource gain and loss using the conservation of resources (COR) model with U.S. Veterans. Higher PTSD severity was predicted to be associated with greater resource loss scores, and lower PTSD scores were predicted to be associated with greater resource gain scores. The sample size was limited (N = 19) due to the COVID-19 outbreak. Veterans completed a demographic questionnaire, the Montreal Cognitive Assessment (MoCA), the Combat Exposure Scale (CES), the PTSD Symptom Scale–Interview (PSS-I), the Conservation of Resources–Evaluation (COR-E), and two additional open-ended questions. A statistically significant negative medium effect size was found between PTSD diagnosis and resource gain (r(17) = −0.42, p = 0.039, one-tailed). A large effect size in resource gain scores between PTSD and non-PTSD groups was also found (t(17) = 1.880, p = 0.077, d = 0.87), with the non-PTSD group reporting more gain of resources than the PTSD group. Post hoc tests revealed that the resource gain score of the mild PTSD group was significantly higher than that of the severe + very severe PTSD group (p = 0.034). Results suggest that resource gain, when compared to resource loss, was the strongest predictor for a non-PTSD diagnosis.
这是一项关于创伤后应激障碍严重程度与资源增益和损失之间关系的新型试点研究,采用的是美国退伍军人资源保护(COR)模型。根据预测,创伤后应激障碍严重程度越高,资源损失得分越高;创伤后应激障碍得分越低,资源获得得分越高。由于 COVID-19 的爆发,样本数量有限(N = 19)。退伍军人填写了一份人口统计学问卷、蒙特利尔认知评估(MoCA)、战斗暴露量表(CES)、创伤后应激障碍症状量表-访谈(PSS-I)、资源保护评估(COR-E)和另外两个开放式问题。在创伤后应激障碍诊断和资源获得之间发现了具有统计学意义的中度负效应(r(17) = -0.42,p = 0.039,单尾)。此外,还发现创伤后应激障碍组和非创伤后应激障碍组之间的资源获得得分存在较大效应(t(17) = 1.880,p = 0.077,d = 0.87),非创伤后应激障碍组比创伤后应激障碍组报告获得了更多的资源。事后检验显示,轻度创伤后应激障碍组的资源获得得分明显高于重度+极重度创伤后应激障碍组(p = 0.034)。结果表明,与资源损失相比,资源获得是非创伤后应激障碍诊断的最强预测因素。
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引用次数: 0
Post-Traumatic Stress Disorder and Blast Exposure in Active-Duty Military Service Members 现役军人中的创伤后应激障碍和爆炸暴露
Pub Date : 2024-01-21 DOI: 10.3390/traumacare4010002
A. Sekely, H. B. Malik, Kayla B. Miller, Yishi Wang, Antonio E. Puente
Objective: Active-duty military personnel in the current wars have experienced unique stressors that deviate from standard PTSD assessment and diagnosis. This situation calls for a refinement of military-related PTSD assessment. To this end, this study assessed the utility of the Trauma Symptom Inventory (TSI) in diagnosing PTSD among active-duty military personnel. The past literature has validated the TSI using populations with a small sample size. Hence, this study aimed to fill the gap by using a large sample size of 670 military members to examine whether the TSI is useful for military populations. Setting: Participants were referred to Carolina Psychological Health Services, in Jacksonville, North Carolina by military neurologists and other qualified medical officers from the Naval Hospital in Camp Lejeune, a military base located in Jacksonville, NC, for neuropsychological evaluation due to reported cognitive deficits related to military deployment (i.e., head injury due to exposure to blast injuries). Participants: Based on clinical diagnosis, comprehensive neuropsychological testing, and self-reported data, personnel were classified into four groups: blast exposure (n = 157), PTSD diagnosis (n = 90), both blast exposure and PTSD (n = 283), and neither blast exposure nor PTSD (n = 140), which helps provide a comprehensive picture of the utility of the TSI. Results: The TSI’s 10 clinical scales could distinguish between all groups. Discriminant function analysis showed that an optimally weighted combination of scales correctly predicted 66.67% of PTSD-positive cases and 35.11% of PTSD-negative cases. Conclusion: These findings provide support for the use of the TSI in the assessment of PTSD in active-duty military personnel. Due to the release of TSI-2, there is a need to replicate this data. However, the validity data has indicated a high concordance between the TSI and TSI-2, bolstering confidence in the current findings of the study.
目的:当前战争中的现役军人经历了与标准创伤后应激障碍评估和诊断不同的独特压力。这种情况要求对与军队相关的创伤后应激障碍评估进行改进。为此,本研究评估了创伤症状量表(TSI)在诊断现役军人创伤后应激障碍方面的实用性。过去的文献使用样本量较小的人群对 TSI 进行了验证。因此,本研究旨在通过使用 670 名军人的大样本量来检验 TSI 是否对军人群体有用,从而填补这一空白。研究环境:参与者由北卡罗来纳州杰克逊维尔勒让营海军医院(位于北卡罗来纳州杰克逊维尔的一个军事基地)的军事神经科医生和其他合格的医务人员转介到北卡罗来纳州杰克逊维尔的卡罗莱纳心理健康服务机构进行神经心理学评估,因为据报告,参与者的认知缺陷与军事部署有关(即因暴露于爆炸伤害而导致头部受伤)。参与者:根据临床诊断、综合神经心理学测试和自我报告的数据,参与者被分为四组:爆炸暴露(157 人)、创伤后应激障碍诊断(90 人)、爆炸暴露和创伤后应激障碍(283 人)以及既无爆炸暴露也无创伤后应激障碍(140 人),这有助于全面了解 TSI 的实用性。结果:TSI 的 10 个临床量表可以区分所有组别。判别函数分析表明,经过优化加权的量表组合可正确预测 66.67% 的创伤后应激障碍阳性病例和 35.11% 的创伤后应激障碍阴性病例。结论这些研究结果为使用 TSI 评估现役军人的创伤后应激障碍提供了支持。由于 TSI-2 的发布,有必要复制这些数据。不过,有效性数据表明 TSI 和 TSI-2 高度一致,增强了人们对当前研究结果的信心。
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引用次数: 0
A Comparative Gender Analysis of Injury Characteristics, Treatments and Outcomes among Persons Seeking Emergency Care in Kigali, Rwanda 卢旺达基加利急诊患者受伤特征、治疗和结果的性别比较分析
Pub Date : 2023-12-19 DOI: 10.3390/traumacare4010001
Lise Mumporeze, Chantal Uwamahoro, D. Uwamahoro, Aly Beeman, Destry Jensen, O. Y. Tang, Enyonam Odoom, S. Jarmale, S. Garbern, Catalina González Marqués, Andrew Stephen, A. Aluisio
In high-income nations, gender has been associated with injury characteristics. This study evaluated injury epidemiology and care based on gender at the Centre Hospitalier Universitaire de Kigali in Rwanda. Patients presenting to the emergency department with acute injuries were prospectively enrolled from 27 January–28 June 2020, and descriptive statistics were performed with comparisons between males and females. Of 601 patients, 25.6% were female and 74.4% were male. There were gender differences in the mechanism of injury, with females more likely to be injured in falls (43.5% versus 23.0%, p = 0.001); meanwhile, males were more likely to suffer road traffic accidents (52.6% versus 39.6%, p = 0.006). The severity of injury was similar between genders based on the mean Kampala Trauma Score (14.4 versus 14.7, p = 0.09). Females were more likely to have been transported by prehospital services (87.7% versus 72.9%, p = 0.001), and less likely to receive acute treatment during the first six hours of care (67.5% versus 78.1%, p = 0.009). There was no significant difference in mortality between females and males (2.0% versus 1.3%, p = 0.568). This study highlights differences in the epidemiology and care between males and females presenting for emergency injury care in Rwanda. These findings can inform future research and developments in gender-centered healthcare delivery.
在高收入国家,性别与伤害特征有关。这项研究评估了卢旺达基加利大学医院中心基于性别的伤害流行病学和护理。2020 年 1 月 27 日至 6 月 28 日期间,急诊科对急性损伤患者进行了前瞻性登记,并对男性和女性进行了描述性统计和比较。在601名患者中,25.6%为女性,74.4%为男性。在受伤机制上存在性别差异,女性更容易在跌倒中受伤(43.5% 对 23.0%,p = 0.001);同时,男性更容易在道路交通事故中受伤(52.6% 对 39.6%,p = 0.006)。根据坎帕拉创伤评分的平均值(14.4 对 14.7,p = 0.09),两性受伤的严重程度相似。女性更有可能被院前服务转运(87.7% 对 72.9%,p = 0.001),而且在最初六小时内接受急性治疗的可能性较小(67.5% 对 78.1%,p = 0.009)。女性和男性的死亡率没有明显差异(2.0% 对 1.3%,p = 0.568)。这项研究强调了卢旺达男性和女性在流行病学和急诊伤害护理方面的差异。这些发现可为今后以性别为中心的医疗服务研究和发展提供参考。
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引用次数: 0
Exploring the Increased Risk of Post-Traumatic Stress Following a Sexual Assault: Implications for Individuals Who Identify as a Sexual Minority 探索性攻击后创伤后应激风险的增加:对性少数群体的影响
Pub Date : 2023-12-17 DOI: 10.3390/traumacare3040029
Jodie Murphy-Oikonen, J. Vis, Rachel Egan
Decades of research have enhanced our understanding of the psychological impact of sexual victimization, including risk factors through which post-traumatic stress disorder (PTSD) manifests. Research on sexual assault and PTSD predominately reflects the experience of heterosexual women, yet sexual minorities are both at increased risk of sexual assault and suffer greater negative health outcomes from it. In these cases, PTSD is linked to a clearly identifiable cause, thereby making it possible to identify individuals at risk, enhance interventions immediately following the traumatic event, and offer services to mitigate further harm. This narrative review explores the potential risk factors for PTSS and PTSD among individuals who experience sexual assault and identify as a sexual minority. Knowledge of these compounding risk factors among service providers will assist in obtaining sexual assault disclosures in a sensitive and supportive manner, leading to the provision of early interventions to mitigate the risks of developing PTSD following sexual assault. The findings suggest that empirical investigation is urgently required to develop evidence-informed practices in providing targeted interventions for sexual and gender minorities following a sexual assault and mitigating further adverse health outcomes.
数十年的研究加深了我们对性侵犯的心理影响的理解,包括创伤后应激障碍(PTSD)表现的风险因素。有关性侵犯和创伤后应激障碍的研究主要反映的是异性恋女性的经历,然而,性少数群体遭受性侵犯的风险更高,其健康受到的负面影响也更大。在这些情况下,创伤后应激障碍与可明确识别的原因有关,因此可以识别高危人群,在创伤事件发生后立即加强干预,并提供服务以减轻进一步的伤害。这篇叙述性综述探讨了遭受性侵犯并被认定为性少数群体的人群中出现创伤后应激障碍和创伤后应激障碍的潜在风险因素。服务提供者对这些复合风险因素的了解将有助于以敏感和支持性的方式获取性侵犯信息,从而提供早期干预措施,以降低性侵犯后出现创伤后应激障碍的风险。研究结果表明,急需开展实证调查,以制定有实证依据的做法,在性侵犯发生后为性取向和性别少数群体提供有针对性的干预措施,并减轻进一步的不良健康后果。
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引用次数: 0
Raising Voice at School: Preliminary Effectiveness and Community Experience of Culture and Practice at an Australian Trauma-Responsive Specialist School 提高学校的声音:澳大利亚创伤应对专科学校文化与实践的初步效果和社区体验
Pub Date : 2023-12-16 DOI: 10.3390/traumacare3040028
J. Avery, E. Galvin, Joanne Deppeler, Helen Skouteris, Justin Roberts, Heather Morris
The aim of this study is three-fold: (1) to explore multiple community member views of core elements of trauma-responsive practice at a specialist school; (2) to explore impact on student wellbeing and learning outcomes, and educator experiences of their workplace; and (3) to explore insights into implementation challenges and enablers. This study uniquely incorporates four participant cohorts: parents or caregivers, educators, and community agencies involved with school students and their families. It utilises a mixed-methods approach with an emphasis on the voice of participants and their lived experience of a trauma-responsive specialist school. The data identify a trauma-responsive school culture, high staff satisfaction, improved student wellbeing and attendance, and progress towards learning goals. Reflective analytic themes centre on a collective experience of the school as a connected community, emphasising relationships, safety, collaboration, mutuality, voice, and empowerment. Findings show that the practices most valued across the cohorts centre on the collective experience of the school as a connected community, emphasising relationships, safety, deep listening, collaboration, mutuality, voice, and empowerment. Trauma-informed principles frame the discussion and implications for equity-focused trauma-responsive practice and policy development. Implications for practice and policy development are discussed.
本研究的目的有三个方面:(1)探讨多个社区成员对一所专科学校创伤应对实践核心要素的看法;(2)探讨对学生福祉和学习成果的影响,以及教育工作者对其工作场所的体验;(3)探讨对实施挑战和推动因素的见解。本研究独特地纳入了四组参与者:家长或看护人、教育工作者以及与在校学生及其家庭有关的社区机构。研究采用了混合方法,重点关注参与者的心声以及他们在创伤应对专业学校的生活体验。研究数据显示,学校文化能够对创伤做出反应,教职员工满意度高,学生的福利和出勤率得到改善,并在实现学习目标方面取得了进展。反思分析的主题集中于学校作为一个相互联系的社区的集体体验,强调关系、安全、协作、相互性、发言权和赋权。研究结果表明,各组最受重视的做法以学校作为一个相互联系的社区的集体体验为中心,强调关系、安全、深入倾听、协作、相互性、发言权和赋权。创伤知情原则为以公平为重点的创伤应对实践和政策制定提供了讨论框架和意义。讨论了对实践和政策制定的影响。
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引用次数: 0
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