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Concept: Psychological trauma

170

PTSD symptoms were pervasive among children and adolescents after experiencing or exposure to traumatic events. Screening and diagnosis of PTSD symptoms is crucial in trauma-related research and practice. The 13-item Children’s Revised Impact of Event Scale (CRIES) has been demonstrated to be a valid and reliable tool to achieve this goal. This study was designed to examine the psychometric properties of the 13-item CRIES in a sample of Chinese debris flood victims.

Concepts: Psychological trauma, Exposure, Exposé, PTSD

165

Peritraumatic dissociation is one of the most critical acute responses to a traumatic experience, partly because it predicts subsequent posttraumatic stress disorder. Despite this, there is little understanding about the factors that influence peritraumatic dissociation. This study investigated the extent to which peritraumatic dissociation is predicted by the amount of perceived warning that participants had of the impact of the trauma.

Concepts: Psychological trauma, Posttraumatic stress disorder, Stress, Traumatology

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Rupture of the tibialis anterior tendon is uncommon and can occur spontaneously or following trauma. If suspected, it should be diagnosed promptly, enabling early surgical management and good restoration of function.

Concepts: English-language films, Psychological trauma, Tibialis anterior muscle, Tibialis posterior muscle

82

Emotional trauma is transmitted across generations. For example, children witnessing their parent expressing fear to specific sounds or images begin to express fear to those cues. Within normal range, this is adaptive, although pathological fear, such as occurs in posttraumatic stress disorder or specific phobias, is also socially transmitted to children and is thus of clinical concern. Here, using a rodent model, we report a mother-to-infant transfer of fear to a novel peppermint odor, which is dependent on the mother expressing fear to that smell in pups' presence. Examination of pups' neural activity using c-Fos early gene expression and (14)C 2-deoxyglucose autoradiography during mother-to-infant fear transmission revealed lateral and basal amygdala nuclei activity, with a causal role highlighted by pharmacological inactivation of pups' amygdala preventing the fear transmission. Maternal presence was not needed for fear transmission, because an elevation of pups' corticosterone induced by the odor of the frightened mother along with a novel peppermint odor was sufficient to produce pups' subsequent aversion to that odor. Disruption of axonal tracts from the Grueneberg ganglion, a structure implicated in alarm chemosignaling, or blockade of pups' alarm odor-induced corticosterone increase prevented transfer of fear. These memories are acquired at younger ages compared with amygdala-dependent odor-shock conditioning and are more enduring following minimal conditioning. Our results provide clues to understanding transmission of specific fears across generations and its dependence upon maternal induction of pups' stress response paired with the cue to induce amygdala-dependent learning plasticity. Results are discussed within the context of caregiver emotional responses and adaptive vs. pathological fears social transmission.

Concepts: Anxiety, Nervous system, Psychological trauma, Stress, Anxiety disorder, Social anxiety disorder, Phobia, Acrophobia

65

Nightmares are intensive dreams with negative emotional tone. Frequent nightmares can pose a serious clinical problem and in 2001, Tanskanen et al. found that nightmares increase the risk of suicide. However, the dataset used by these authors included war veterans in whom nightmare frequency - and possibly also suicide risk - is elevated. Therefore, re-examination of the association between nightmares and suicide in these data is warranted. We investigated the relationship between nightmares and suicide both in the general population and war veterans in Finnish National FINRISK Study from the years 1972 to 2012, a dataset overlapping with the one used in the study by Tanskanen et al. Our data comprise 71,068 participants of whom 3139 are war veterans. Participants were followed from their survey participation until the end of 2014 or death. Suicides (N = 398) were identified from the National Causes of Death Register. Frequent nightmares increase the risk of suicide: The result of Tanskanen et al. holds even when war experiences are controlled for. Actually nightmares are not significantly associated with suicides among war veterans. These results support the role of nightmares as an independent risk factor for suicide instead of just being proxy for history of traumatic experiences.

Concepts: Death, Participation, Demography, Data, Psychological trauma, Suicide, Veteran, Nightmare

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We developed computational models to predict the emergence of depression and Post-Traumatic Stress Disorder in Twitter users. Twitter data and details of depression history were collected from 204 individuals (105 depressed, 99 healthy). We extracted predictive features measuring affect, linguistic style, and context from participant tweets (N = 279,951) and built models using these features with supervised learning algorithms. Resulting models successfully discriminated between depressed and healthy content, and compared favorably to general practitioners' average success rates in diagnosing depression, albeit in a separate population. Results held even when the analysis was restricted to content posted before first depression diagnosis. State-space temporal analysis suggests that onset of depression may be detectable from Twitter data several months prior to diagnosis. Predictive results were replicated with a separate sample of individuals diagnosed with PTSD (Nusers = 174, Ntweets = 243,775). A state-space time series model revealed indicators of PTSD almost immediately post-trauma, often many months prior to clinical diagnosis. These methods suggest a data-driven, predictive approach for early screening and detection of mental illness.

Concepts: Diagnosis, Psychological trauma, Machine learning, Selective serotonin reuptake inhibitor, Cognitive behavioral therapy, Posttraumatic stress disorder, Sertraline, Supervised learning

55

Compassion fatigue (CF) is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS) and cumulative burnout (BO), a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing CF. This can impact standards of patient care, relationships with colleagues, or lead to more serious mental health conditions such as posttraumatic stress disorder (PTSD), anxiety or depression. A systematic review of the effectiveness of interventions to reduce CF in healthcare, emergency and community service workers was conducted. Thirteen relevant studies were identified, the majority of which were conducted on nurses (n = 10). Three included studies focused on community service workers (social workers, disability sector workers), while no studies targeting emergency service workers were identified. Seven studies reported a significant difference post-intervention in BO (n = 4) or STS (n = 3). This review revealed that evidence of the effectiveness of CF interventions in at-risk health and social care professions is relatively recent. Therefore, we recommend more research to determine how best to protect vulnerable workers at work to prevent not only CF, but also the health and economic consequences related to the ensuing, and more disabling, physical and mental health outcomes.

Concepts: Health care, Medicine, Sociology, Psychological trauma, Mental disorder, Posttraumatic stress disorder, Stress, Compassion fatigue

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To evaluate the effectiveness of current medical and psychological interventions for individuals at risk of sexually abusing children, both in known abusers and those at risk of abusing.

Concepts: Psychological trauma, Child abuse, Suffering, Sexuality

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Many women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women’s experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes.

Concepts: Family, Psychology, Childbirth, Mental health, Psychological trauma, Interpersonal relationship, Clinical psychology, Vagina

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Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their ‘worst.’ Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the ‘worst’ lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized.

Concepts: Domestic violence, Psychological trauma, Cognitive behavioral therapy, Posttraumatic stress disorder, Prolonged exposure therapy, Rape, United States Department of Veterans Affairs, Violence against women