Cognitive processing of trauma cues in rape victims with post-traumatic stress disorder

Rape victims with post-traumatic stress disorder (PTSD) (n =12), rape victims without PTSD (n =12), and nontraumatized control subjects (n =12) performed a computerized Stroop color-naming task in which they named the colors of high-threat words (e.g., RAPE), moderate-threat words (e.g., CRIME), positive words (e.g., LOYAL), and neutral words (e.g., TYPICAL). In contrast to rape victims without PTSD and to nontraumatized control subjects, those with PTSD were slower to color-name high-threat words than moderate-threat, positive, and neutral words. Rape victims without PTSD nevertheless exhibited greater Stroop interference for high-threat words than did nontraumatized subjects. Interference for high-threat words was correlated with scores on the Impact of Events Scale —Intrusion subscale, but not with scores on the Avoidance subscale. These findings suggest that interference for trauma cues may provide a nonintrospective index of intrusive cognitive activity. Preparation of this article was supported, in part, by grants from the Henry and Ramsey Pevsner Fund in Neuropsychology and Behavioral Medicine and the American Association of University Women — Aurora, Illinois, Chapter awarded to Karen Lynn Cassiday, and National Institute of Mental Health grant MH43809 awarded to Richard J. McNally.This study was part of the first author's doctoral dissertation, conducted under the supervision of the second author. It was conducted when the authors were at the Department of Psychology, University of Health Sciences/The Chicago Medical School. A shorter version of this paper was presented at the annual meeting of the Association for Advancement of Behavior Therapy, San Francisco, November, 1990.     

Post-traumatic stress reactions among individuals with visual impairments: a systematic review

Purpose: To conduct a systematic review of post-traumatic stress reactions among individuals with visual impairment (VI).

Materials and methods: Qualitative and quantitative studies were identified through searches in MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, and Cochrane Libraries. The literature search was limited to humans, of English and Scandinavian languages and publication year between 1980 and 2017. Study quality was assessed for all the included studies and extracted data were synthesized using narrative analysis.

Results: Of 4235 records identified through literature search, eleven were included in the analyses. Results from the qualitative studies illustrated multiple physical, behavioral, emotional, and cognitive manifestations of trauma. Four out of five quantitative studies showed that various types of potentially traumatic events were significantly associated with mental health adversities (p?<?0.05). The prevalence of post-traumatic mental disorders was 4–21.2% for depression, 0.9% for dysthymia, and 32% for substance misuse. The quality of the reviewed studies was considered low to moderate.

Conclusion: Traumatic experiences appear to have a great impact on the mental health in people with visual impairment (VI) and these results highlight their need for mental health care. Future studies with higher methodological rigor are recommended.

• Implications for rehabilitation

• Visual impairment entails a greater susceptibility to some types of potentially traumatic events, especially threats in everyday life. This calls for a greater emphasis on safe community environments and universal design in public spaces.

• In rehabilitation after serious accidents or potentially traumatic events, professionals working with people with vision impairment should be aware of the different manifestations of post-traumatic stress responses and that some stress responses may cause additional disability.

• The high prevalence of traumatic events and their impact on mental health in individuals with visual impairments highlights a need of mental health care.

     

Trauma, PTSD and personality: the relationship between prolonged traumatization and personality impairments

Objective:  Chronic post-traumatic stress disorder (PTSD) has been associated with personality impairments involving externalized and internalized psychopathology. This study has explored the association between PTSD symptoms as consequences of prolonged torture experiences or early childhood trauma exposure and personality traits.
Method:  One hundred and sixty-one men were included: 36 Iraqi men refugees (mean age = 43.9, SD = 8.7) who had longstanding torture experiences as adults; 42 Swedish prisoners (mean age = 33.8, SD = 7), with early childhood trauma exposure; 31 Arab men refugees (mean age = 41.8, SD = 8.9) without self-reported torture or violence experiences; 52 non-traumatized Swedish males (mean age = 39.3, SD = 5.5). They were assessed for symptoms of PTSD or PTSD hypothetical clusters. Personality profile was assessed by the Karolinska Scales of Personality (KSP). Factor analysis with varimax rotation was conducted and yielded three factors: externalized, internalized and avoidance domains.
Results:  Individuals who suffered prolonged torture experiences or had early childhood trauma exposure showed impaired personality profiles in internalized and externalized domains. Individuals with or without PTSD showed significant differences p < 0.05 concerning: internalized, externalized and avoidance. anova and post-hoc analysis according to Scheffé showed that the prolonged torture group > early childhood trauma exposure > nontraumatized group.
Conclusion:  Prolonged torture experiences or early trauma exposure may impair personality formation by enhancing the effects of cognitive, affective and behavioural vulnerabilities.     

A student-directed community project to support sexually abused women veterans suffering from post-traumatic stress disorder

While awareness of post-traumatic stress disorder (PTSD) and sexual abuse continues to grow, it has only been during the past few years that the military has realized the prevalence and impact of sexual abuse inflicted upon women while on active military duty. Though Veteran Administration (VA) agencies throughout the United States have given concerted attention to this problem, published resources specific to PTSD and military sexual abuse have been limited. In this article the authors present the results of a 2(1/2)-year endeavor to address the problem of PTSD and military sexual abuse at the Tulsa VA Outpatient Clinic. The project started with a research study and the subsequent initiation of a PTSD women veterans support group, and culminated in the development of resource manuals for both professional staff and women veterans.     

Whiplash and post-traumatic stress disorder

Purpose: This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed.

Method: A review of the literature on psychological consequences of motor vehicle accidents and on risk factors associated with developing chronic whiplash complaints is given. A case report is presented to illustrate the treatment strategy.

Results: Traffic accidents lead to psychological complaints more often than is realized in clinical practice. It is estimated that PTSD occurs in at least 25% of traffic accident victims who sustain physical injuries. This number is probably higher in patients with chronic whiplash complaints. The case report shows that improvement in relation with the post-traumatic stress symptoms can have a beneficial effect on coping with the chronic whiplash complaints.

Conclusions: The psychotherapeutic treatment of patients with chronic whiplash complaints and PTSD should be aimed primarily at coping with the trauma and not at the chronic pain complaints.     

汶川大地震受灾者创伤后应激症状及危险因素

目的:探讨大地震受灾者的心理健康状况、创伤后应激障碍(PTSD)症状及其影响因素,为心理救助及康复提供依据。方法:2008年四川汶川大地震1个月后,采用事件影响量表(IES)、症状自评量表(SCL-90)和受灾情况表对57例受灾者进行创伤后应激障碍症状、情绪障碍及人口学资料调查,根据诊断分为PTSD组与非PTSD组进行对照比较,并与60例医院健康体检人群进行对照比较。结果:①地震受灾组的IES总分、闯入因子、回避因子、警觉性因子、躯体化、抑郁、焦虑和其他项目因子分均高于正常对照组,差异有显著性意义(P<0.01),地震受灾组的SCL-90总分和抑郁因子分高于正常对照组,差异有显著性意义(P<0.05);②PTSD组的教育程度在小学及以下的比例、被困比例和伤残比例均高于非PTSD组,差异有显著性意义(P<0.05),PTSD组的一级亲属死亡比例、无家人支持比例均高于非PTSD组,差异有显著性意义(P<0.01)。结论:地震受灾者灾后1个月存在明显创伤后应激症状、躯体化、抑郁、焦虑、眠差等表现,心理救助和康复较为必要,应重点关注导致伤残、教育程度低、有被困经历、丧失亲人、缺少家庭支持的地震受灾个体。     

乳腺癌患者创伤后应激反应现状及其影响因素分析

目的：调查乳腺癌患者的创伤后应激反应现状,分析其影响因素。方法：采用一般资料调查表、中文版事件影响量表、心理一致感量表、积极应对方式量表对2021年1月至2021年8月于德阳市某三级甲等医院就诊的乳腺癌患者进行调查并分析。 结果：患者的创伤后应激反应分值为(32.70±17.44) 分；是否保留乳房、婚姻状况、职业情况、家庭月收入是患者创伤后应激反应的影响因素,能够解释总变异的35.7%。 结论：乳腺癌患者整体的创伤后应激反应水平较高；医护人员可根据影响因素分析结果,采取针对性强、个性化的心理干预措施,降低患者的乳腺癌创伤后应激反应,促进患者的心理健康发展。     

Traumatic stressors and post-traumatic stress disorder symptoms in headache patients

OBJECTIVE: The aim of this study was to assess the prevalence of significant traumatic stressors and post-traumatic stress disorder (PTSD) symptoms in a headache population. BACKGROUND: Several recent publications have emphasized the relationship between life stressors and/or daily hassles and recurrent headaches. However, little is known about the prevalence and impact of major traumatic stressors in patients with recurrent headaches. METHODS: Eighty patients with either migraine or tension-type headache completed a PTSD checklist. Data were compared with those from patients with chronic masticatory muscle pain of similar intensity and duration. RESULTS: Almost 64% of the headache patients reported one or more major traumatic stressors. This percentage was not significantly different from that of the comparison group, and fell within the broad range reported for exposure to traumatic stressors in epidemiologic studies with nonpatient populations. One out of 6 patients in the total headache sample, and 1 out of 4 of those reporting a traumatic stressor, reported symptoms suggestive of current PTSD. The prevalence of current PTSD-like symptomatology reported by the headache patients was comparable to that of the comparison group of the present study, but higher than that reported for the general population in the available literature printed in English. Traumatic stressors most often reported were not related to direct physical trauma, but rather associated with loss or serious illness of a loved one. CONCLUSION: Exposure to traumatic events in patients with a primary diagnosis of recurrent headaches is similar to that reported for chronic masticatory muscle pain patients or nonpatient populations. However, symptoms consistent with a diagnosis of current PTSD appear to be more frequent in patients with recurrent headaches than reported in the scientific literature printed in English for nonpatient populations. Screening for PTSD symptomatology is recommended as part of the routine clinical evaluation of headache.     

新型冠状病毒肺炎疫情对成都市某区医务人员创伤后压力的影响因素及特点

目的:探讨新型冠状病毒肺炎(COVID-19)疫情下成都市某区医护人员创伤后压力的影响因素。方法:采用线上问卷调查法,邀请医务人员在开展该院第1例疑似病例救治的1个月后填写问卷,共收到85份,问卷包括人口学资料及修订版事件影响量表。事件影响量表总分在35分及以上者初判创伤后应激障碍(PTSD)为阳性。结果:该区医务人员PTSD初筛阳性率为15.29%,医务人员回避分量表平均分显著低于侵入、高警觉性分量表平均分(P<0.01)。一线工作人员与非一线工作人员、不同性别及不同年龄间的事件影响量表(IES-R)3个分量表及总分间差异无显著统计学意义。不同工龄间IES-R总分差异有显著统计学意义(P<0.05),两两对比中,<10年工龄的医务人员在高警觉性分量表和总分上比10~20年的医务人员低(均P<0.05),在侵入、高警觉性分量表和总分上均比>20年工龄的医务人员低(均P<0.05)。结论:在疫情非严重地区,医务人员患PTSD的危险性随着工龄而增加,在早期临床心理实践中应多关心工龄在10年及以上的医务人员;在早期临床筛查中,尽量采用诊断性量表及面谈为主的方法,慎用修订版事件影响量表。     

Jaw symptoms and signs and the connection to cranial cervical symptoms and post-traumatic stress during the first year after a whiplash trauma

Purpose.?To estimate the prevalence of jaw symptoms and signs during the first year after a neck sprain in a car collision. Further, to determine their relationships to the localisation and grade of the initial neck symptoms and signs, headache, post-traumatic stress and crash characteristics.

Methods.?One hundred and forty-six adult subjects and crash characteristics were prospectively investigated in an in-depth study during 1997–2001. Head, neck, and jaw symptoms and signs were recorded within 5 weeks and after 1 year. Acute post-traumatic stress was estimated with the Impact of Event Scale-Revised (IES-R).

Results.?Jaw symptoms were initially reported by three men (5%) and three women (4%), and subsequently developed in eight women (10%) during the following year. Jaw signs were noted initially in 53 subjects (37%) and in 28 subjects (24%) after 1 year, without difference between sexes, and more often after low-speed impacts. Headache in females, cranial cervical symptoms, pronounced neck problems, post-traumatic stress and whiplash-associated disorders (WAD) grade II–III after rear-end impacts were related to jaw signs during the acute phase. After 1 year, jaw signs were related to residual neck problems, headache and post-traumatic stress.

Conclusions.?Jaw symptoms are seldom reported during the acute phase after a whiplash trauma. Women more often than men develop jaw symptoms during the first year. Jaw symptoms and signs may develop also after low-speed impacts, especially after rear-end collisions. Jaw symptoms and signs should be observed after whiplash trauma, especially in those with headache, pronounced neck problems, cranial neck symptoms and post-traumatic stress.     

国内外脑卒中病人创伤后应激障碍研究的文献计量学分析

目的:了解国内外脑卒中病人创伤后应激障碍(post-traumatic stress disorder,PTSD)相关研究的现状及存在的问题,为今后该领域的研究提供参考依据。方法:检索PubMed、中国知网、万方、维普等数据库中发表的有关脑卒中病人PTSD研究的文献,检索时间为1998年1月—2021年4月,提取文献题目、期刊名称、发表年份、文献类型、关键词、基金资助情况、第一作者等信息,采用SPSS 22.0、Nvivo 20.0等软件进行统计及文献计量学分析。结果:纳入文献49篇,随着年份的推移,发文量在逐年上升。发文机构共有41家,19篇文献有基金支持。发表文献的期刊共40种,平均每种期刊发表文献1.225篇。共有6种文献研究类型,国内和国外文献均以描述性研究为主(39篇,79.6%)。结论:国内外文献研究类型较为单一,缺少有效的干预措施缓解脑卒中病人PTSD严重程度,同时对于脑卒中病人出现PTSD的发病机制仍在探索中。未来需要更多的学者和基金支持,进行更深入的研究和探讨。     

妊娠压力在产妇社会支持与产后创伤后应激障碍间的中介效应

目的:探讨妊娠压力在产妇社会支持与产后创伤后应激障碍间的作用机制,为产妇心理健康的早期筛查和干预提供参考。方法:采用便利抽样法,选取2019年11月—2020年1月上海市某三甲妇产科专科医院的1 178名进行产后检查的产妇作为研究对象,采用一般情况调查表、围生期创伤后应激障碍问卷、中文版领悟社会支持量表和妊娠压力量表对...     

空降兵的心理应激及影响因素研究

目的探讨空降兵的心理应激及其影响因素。方法采用自制一般资料问卷、心理社会应激调查表、人格特征评定量表和社会支持评定量表,对空降兵某部官兵1 038人进行问卷调查。结果多元回归分析结果显示,人际关系、气候情况、业余爱好、休息情况、内外向、神经质、客观支持、对支持的利用度是空降兵心理应激的影响因素。讨论在进行空降兵心理健康干预时,应充分考虑人格和社会支持及人际关系、气候情况、业余爱好和休息状况等影响因素。     

军人创伤后应激障碍与适应障碍的视觉和听觉诱发电位研究

目的 探讨军人创伤后应激障碍和适应障碍的视觉诱发电位和听觉诱发电位的特征。方法 对33例创伤后应激障碍患者和34例适应障碍患者及30名健康军人(对照组),应用Nicolet Bravo型脑电生理仪及光、声刺激,完成视觉诱发电位和听觉诱发电位检测。结果 应激障碍组和适应障碍组Cz脑区视觉诱发电位／P2波幅较对照组为低,应激障碍组Pz脑区视觉诱发电位／P3波幅分别较对照组和适应障碍组为低;应激障碍组Oz脑区听觉诱发电位／P3潜伏期较对照组延迟,Cz脑区听觉诱发电位／P2波幅分别较对照组和适应障碍组为低,Cz脑区听觉诱发电位／P3波幅分别较对照组和适应障碍组为高。结论 应激障碍和适应障碍的诱发电位有一定的特征,值得进一步随访观察。     

Spiritual intelligence dimensions and life regard index in Iranian veterans suffering post-traumatic stress disorder with and without substance abuse history

Post-traumatic stress disorder (PTSD) among some combatants was one of the Iran–Iraq War problems. Moreover, this disorder has a high comorbidity with other kinds of disorders like substance abuse as in the case of some Iran–Iraq War veterans. This study examined the effect of some individual psychological factors on these veterans' substance abuse. Among these factors, this study seeks to find the existence of difference between spiritual intelligence and life regard index of veterans with no history of substance abuse comparing with veterans with substance abuse history. Therefore, 120 PTSD veterans hospitalized in Shahid Rajaee Hospital in Isfahan, Iran, were studied during a 9-month period. Half were with and half were without substance abuse; they were also matched on demographic characteristics. There was a significant difference between spiritual intelligence and life regard index and also spiritual life and fulfillment sub-scales of those with history of substance abuse and those without. Conversely, no significant difference was observed on sub-scales of understanding, relationship with the Origin of Essence and fulfillment. Therefore, it can be concluded that dimensions of spiritual intelligence and positive life regard development could help to deter substance abuse, as well as accelerate recovery.     

严重创伤患者的个性与应激障碍关系的研究

目的探讨严重创伤患者的个性与应激障碍的关系,为创伤患者的整体护理提供有效的科学护理依据。方法采用艾森克个性问卷(EPQ)对179例创伤患者进行个性测定,并分析患者个性与应激障碍发病情况和应激障碍症状消失时间的关系。结果外向情绪不稳定型个性的患者创伤后应激障碍的发生率最高,占75.40%,内向情绪不稳定型应激障碍症状消失的时间最长,为36.0±13.1 d。结论根据患者个性特征采取相适应的心理干预,可减少创伤患者的应激障碍及促进病程的转归。     

The mediating role of early maladaptive schemas on relations between post-traumatic stress disorder symptom severity and illicit substance use disorder

Background: This study examines the role of Early Maladaptive Schemas (EMS) on relations between Post-traumatic stress disorder (PTSD) symptoms and illicit substance use.

Objectives: We assumed that EMS play a mediating role in the pathways from PTSD symptom severity to illicit substance use.

Method: We used the composite score from the Addiction Severity Index to assess illicit substance use severity, the PTSD Checklist Specific to determine PTSD symptom severity, and the Young Schema Questionnaire – Short Form, Second Edition to measure the number of hyperactivated EMS. The sample consisted of 35 patients receiving social and medical care for illicit substance use problems in three French drug centers.

Results: The results showed that the number of hyperactivated EMS is an intermediate variable playing a mediating role between PTSD symptom severity and illicit substance use. Results indicating full mediation. Conclusion. Future research perspectives on this question are discussed as well as the clinical repercussions of these results on the current models of management of illicit drug users.     

Dependency and self-criticism as moderators of interpersonal and achievement stress: The role of initial dysphoria

Previous research has suggested that dependency and self-criticism may increase adverse reactions to interpersonal and achievement negative life events. However, there has been insufficient attention to the rival hypothesis that these effects may result from preexisting symptoms. What appears to be a stress-enhancing effect for dependency or self-criticism may actually be a stress-enhancing effect for prior distress. This research was a prospective investigation of the role of preexisting dysphoria, dependency, and self-criticism in increasing negative reactions to interpersonal and achievement negative life events. Controlling for initial dysphoria in a prospective design, dependent subjects displayed greater increases in dysphoria following interpersonal events, but not achievement events. Highly self-critical subjects also exhibited greater increases in dysphoria following interpersonal events and displayed a trend for achievement events. However, dysphoric persons displayed greater increases in dysphoria following interpersonal, but not achievement events, suggesting that some of the observed effects for dependency and self-criticism could result from prior dysphoria. When the greater vulnerability of dysphoric persons to interpersonal events was controlled statistically, the ability of cognitive variables to predict reactivity to interpersonal events was reduced substantially.