Posttraumatic Stress Disorder and the States-of-Mind Model: Evidence of Specificity

We conducted a study to examine whether the states-of-mind (SOM) model (Schwartz & Garamoni, 1986) could successfully differentiate between Vietnam combat veterans who suffered from posttraumatic stress disorder (PTSD) and Vietnam combat veterans who did not. Veterans completed a battery of questionnaires that assessed the balance of cognitions (SOM ratios), extent of combat exposure, and symptomatology. The results supported our predictions: After matching the groups according to combat exposure and controlling general psychopathology, we found that (a) the combat veterans who suffered from PTSD reported more maladaptive SOM than combat veterans who did not suffer from PTSD, and (b) maladaptive SOM related to intrusive, but not avoidant, PTSD symptomatology.     

初诊乳腺癌住院患者健康信息需求的研究

目的了解初诊乳腺癌住院患者信息需求的现状,并分析影响其健康信息需求的相关因素。方法 2009年5-12月采用便利抽样的方法选取3所三级甲等医院的初诊乳腺癌住院患者110例进行乳腺癌患者知识需求的问卷调查。结果住院初诊乳腺癌患者信息需求总分为（3.05±0.55）分;家庭人均收入对身体健康维度和总体信息需求有影响,家庭人均收入和是否疼痛对患者治疗与疾病维度的信息需求有影响,家庭人均收入和文化程度对患者家庭健康维度的信息需求有影响。结论护理人员在对初诊乳腺癌住院患者进行健康教育时,应根据患者的经济条件、症状和文化程度等提供有针对性的信息支持。     

Risk of Blindness Among Patients With Diabetes and Newly Diagnosed Diabetic Retinopathy

OBJECTIVETo evaluate the association between initial diabetic retinopathy (DR) severity/risk of blindness in patients with newly diagnosed DR/good vision in the U.S.RESEARCH DESIGN AND METHODSThis retrospective cohort study evaluated adult patients with good vision (20/40 or better) and newly diagnosed DR between 1 January 2013 and 31 December 2017 (index date) in the American Academy of Ophthalmology’s Intelligent Research in Sight (IRIS) Registry. The primary exposure of interest was DR severity at index: mild nonproliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR (PDR). The main outcome measure was development of sustained blindness (SB), defined as study eyes with Snellen visual acuity readings of 20/200 or worse at two separate visits ≥3 months apart that did not improve beyond 20/100.RESULTSAmong 53,535 eligible eyes (mean follow-up 662.5 days), 678 (1.3%) eyes developed SB. Eyes with PDR at index represented 10.5% (5,629 of 53,535) of the analysis population but made up 26.5% (180 of 678) of eyes that developed SB. Kaplan-Meier analysis revealed that eyes with moderate NPDR, severe NPDR, and PDR at index were 2.6, 3.6, and 4.0 times more likely, respectively, to develop SB after 2 years of DR diagnosis versus eyes with mild DR at index. In a Cox proportional hazards model adjusted for index characteristics/development of ocular conditions during follow-up, eyes with PDR had an increased risk of developing SB versus eyes with mild NPDR at index (hazard ratio 2.26 [95% CI 2.09−2.45]).CONCLUSIONSIn this longitudinal ophthalmologic registry population involving eyes with good vision, more advanced DR at first diagnosis was a significant risk factor for developing SB.     

强化糖尿病教育对新诊2型糖尿病患者焦虑抑郁状态的影响

目的：探讨强化糖尿病教育对新诊2型糖尿病患者焦虑、抑郁状态的影响。方法：用随机对照原则，将80例2型糖尿病患者随机分为强化教育组及常规教育组（各40例），应用焦虑自评量表（SAS）、抑郁自评量表（SDS）分别进行治疗前后测评，同时与正常人群对照。结果：教育后强化教育组患者糖化血红蛋白水平下降幅度大于常规教育组（P〈0．05）；强化教育组与常规教育组比较，抑郁、焦虑症状等问题得到改善。结论：强化糖尿病教育可更好地改善抑郁、焦虑症状及糖代谢情况。     

人文关怀对新诊2型糖尿病患者焦虑、抑郁状态的影响

目的探讨人文关怀对新诊2型糖尿病患者焦虑、抑郁状态的影响。方法用随机对照原则,将80例新诊2型糖尿病患者随机分为人文关怀组及常规教育组(各40例),应用焦虑自评量表(SAS),抑郁自评量表(SDS)分别进行干预前后测评,同时与正常人群对照。结果人文关怀组与常规教育组比较,抑郁、焦虑症状等问题得到改善(p0.05);人文关怀组患者糖化血红蛋白水平下降幅度大于常规教育组(p0.05),差异均具有统计学意义。结论人文关怀可更好地改善抑郁、焦虑症状及糖代谢情况。     

The Effectiveness of Transdiagnostic Applications of Competitive Memory Training (COMET) on Low Self-Esteem and Comorbid Depression: A Meta-analysis of Randomized Controlled Trials

Cognitive Therapy and Research - Low self-esteem is a relevant transdiagnostic condition in the etiology, manifestation, and aggravation of different types of psychopathology. While low self-esteem...     

Posttraumatic Stress Disorder and Posttraumatic Growth Among Adult Survivors of Wenchuan Earthquake After 1 Year: Prevalence and Correlates

This study investigates the prevalence and predictors for posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) in adult survivors 1 year after the 2008 Wenchuan earthquake. Questionnaires were used to collect the data. PTSD was assessed using the PTSD Check List-Civilian (PCL-C), and PTG was assessed using the Post Traumatic Growth Inventory (PTGI). A total of 2,300 individuals were involved in the survey with 2,080 completing the questionnaire, a response rate of 90.4%. The PTSD prevalence estimate in this study was found to be 40.1%, and the prevalence for PTG among the participants was measured at 51.1%. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. In the conclusions, possible explanations for the findings and implications for future research are discussed.     

强化糖尿病健康教育对胰岛素治疗的初诊糖尿病患者效果的影响

[目的]了解强化糖尿病(DM)教育对胰岛素治疗的初诊2 型糖尿病(T2DM)患者效果的影响.[方法]将100例初诊T2DM患者随机分成两组各50例,均予胰岛素降糖治疗,对照组予以常规糖尿病宣教,干预组同时给予强化DM健康教育,比较治疗前后及两组治疗后抑郁自评量表(SDS)评分,糖尿病相关知识得分及血糖等相关指标的变化....     

Structure of Posttraumatic Stress Disorder Symptoms in Pain and Pain-Free Patients Scheduled for Major Surgery

Factor-analytic studies of the structure of posttraumatic stress disorder (PTSD) symptoms have yielded inconsistent results. One of the reasons for the inconsistency may be that PTSD is highly comorbid with other disorders; the observed factor structure might depend on the particular comorbid disorder. One such disorder is chronic pain. The goal of the present study was to investigate whether PTSD symptom structure differs between pain and pain-free patients scheduled to undergo major surgery. Four hundred and forty-seven patients who were approached 7 to 10 days prior to scheduled surgery completed the PTSD Checklist-Civilian (PCL-C) Version and the Current Pain and Pain History Questionnaire; the latter was used to divide patients into pain (N = 175) and pain-free (N = 272) groups. Results showed that in pain-free patients, PTSD symptoms were best expressed as 2 symptom clusters (re-experiencing/avoidance; emotional numbing/hyperarousal) accounting for 52.4% of the variance. In pain patients, PTSD symptoms were best expressed as a single symptom cluster accounting for 51.1% of the variance. These results suggest different interrelationships among PTSD symptoms in these 2 populations. Results reflect the need for (1) controlling for pain in studies looking at PTSD-symptom expression and (2) further research on PTSD-symptom expression in pain populations.

Perspective

These results may have important implications for research on the comorbidity between PTSD and chronic pain, as well as for treatment of PTSD symptoms in patients presenting with pain problems.     

Posttraumatic Stress Disorder among Spouses of Patients Discharged from the Intensive Care Unit after Six Months

The Intensive Care Unit (ICU) can be traumatic, not only for patients, but also their closest relatives, especially spouses. Within Botswana, a developing country with very few ICUs and not so sophisticated machinery or a generalised lack of counselling for relatives, the ICU experience can be more traumatic. This study reports on the proportion of spouses who continued to experience mental distress, including the incidence of posttraumatic stress disorder, at six months after the discharge of their spouse from an intensive care unit. Mixed data collected approaches were used on a convenience sample of 28 spouses of patients who had been hospitalised at the Princess Marina Hospital ICU, Gaborone, Botswana, in the six months prior to the interview sessions. Participants were interviewed six months after the discharge of their spouse from the Intensive Care Unit using the PCL-S (PTSD Checklist). All the patients had been mechanically ventilated and had been hospitalised in the ICU for more than three days. Fifteen spouses reported intrusive memories of ICU and avoided reminders of the experience six months later. Ten spouses reported feeling anxious for a short while after their spouse's discharge but that they had come to terms with the experience. In order to mitigate the trauma experienced by spouses the study suggests that pre- and post-counselling for close relatives, especially spouses, should be implemented at the point of hospitalisation, during admission, and after discharge for a period of at least six months.     

Validating the Psychometric Characteristics of the Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) in a Chinese Context

Background

Perinatal posttraumatic stress disorder (PPTSD) is a common stress-induced mental disorder worldwide. The Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) is an excellent questionnaire that measures the symptoms of PPTSD, but has not been translated into Chinese yet.

Dreams of the Dead Among Cambodian Refugees: Frequency,Phenomenology, and Relationship to Complicated Grief and Posttraumatic Stress Disorder

The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975–1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol Pot period. Past month frequency was correlated with PG severity (r = .59) and PTSD severity (r = .52). The dreams were almost always deeply upsetting because the dreams indicated the deceased to be in a difficult spiritual state. Dreams of the deceased as a central component of PG and PTSD among Cambodian refugees is discussed.     

新诊断2型糖尿病患者氧化应激状况及短期胰岛素泵强化治疗的影响

【目的】观察初诊2型糖尿病（T2DM）患者体内氧化应激改变及短期持续皮下胰岛素输注（CSII）治疗对患者氧化应激状况的影响。[方法]60例初诊T2DM患者接受为期2周的CSII治疗,于治疗前、后分别测定血清活性氧活力（ROS）、丙二醛（MDA）、谷胱甘肽（GSH）、超氧化物歧化酶（SOD）,同时测定T2DM患者空腹胰岛素水平,采用稳态模型计算胰岛β细胞功能（HOMA-β）。【结果】①T2DM患者ROS、MDA明显增高,GSH、SOD明显降低。②ROS、MDA与HOMA—β呈负相关,GSH、SOD与HOMA—β呈正相关。③CSII治疗2周后,ROS、MDA明显降低,GSH、SOD明显增高,同时HOMA-β亦明显增高。[结论]T2DM患者体内氧化应激明显增强。短期CSII除迅速降低血糖外,还具有降低T2DM患者氧化应激水平,保护胰岛口细胞功能。     

Influence of Depression on State and Trait Anger in Veterans with Posttraumatic Stress Disorder

Anger is one of the most important symptoms of posttraumatic stress disorder (PTSD), and is associated with many of the adverse correlates of PTSD. Researchers have proposed theories to explain the relationship between anger and PTSD, but no study to date has examined the mediating role of depression. The purpose of this study was to explore the mediating effects of current major depression disorder (MDD), as well as PTSD numbing and dysphoria symptom clusters (King et al. 1998; Simms et al. 2002) on the relationship between PTSD and anger. There were 98 participants in the study, and all were male veterans with combat-related PTSD taking part in a clinical trial. Results indicated that MDD partially mediated the relationship between PTSD and state anger, while numbing and dysphoria clusters partially mediated the relationships between other PTSD symptom clusters and trait anger. Implications for the treatment of anger in veterans with PTSD are discussed.     

Chemotherapy Use,End-of-Life Care,and Costs of Care Among Patients Diagnosed With Stage IV Pancreatic Cancer

Context

For patients with metastatic cancer and limited life expectancy, potential benefits of chemotherapy must be balanced against harms to quality of life near death and increased out-of-pocket costs of care.