Risk factors and clinical nursing strategies of acute stress disorder in patients with liver cirrhosis, portal hypertension and upper gastrointestinal bleeding / 中国基层医药

Acute stress disorder is a transient mental disorder caused by sudden and unusual stressful life events or persistent difficulties in a period of time after acute traumatic events. Cirrhotic patients with portal hypertension complicated by upper gastrointestinal bleeding suffer from immediate or rapidly developing symptoms, which often lead to acute stress disorder. This review summarizes risk factors and clinical nursing strategies of acute stress disorder, so as to provide evidence for starting early intervention, strengthening clinical nursing, and improving prognosis and mood.

Frequency of acute stress disorder in health care workers of a tertiary level pediatric hospital during the National Safe Distance Strategy for COVID-19 prevention / Frecuencia de trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la Jornada Nacional de Sana Distancia para la prevención de la COVID-19

Abstract Background: Acute stress disorder (ASD) is one of the most frequent mental illnesses occurring during sanitary emergencies. This study aimed to estimate the frequency of ASD in health care workers of a tertiary level pediatric hospital during the coronavirus disease (COVID-19) pandemic. Methods: We conducted a cross-sectional study in which health care workers completed a virtual questionnaire, including sociodemographic information and the ASD scale. Results: We analyzed 206 questionnaires. The population was divided into three groups: attending physicians, medical residents, and nursing personnel. The frequency of health care workers who showed at least nine symptoms of ASD was 88.8%. No significant differences were found between the studied groups. Conclusions: ASD is a frequent condition in health care workers in the context of the COVID-19 pandemic. We need to investigate further and assess risk and protective factors for developing this and other psychopathologies in this population.

Resumen Introducción: El trastorno por estrés agudo es una de las enfermedades mentales más frecuentemente manifestadas en emergencias sanitarias. El objetivo de este estudio fue conocer la frecuencia con la que se presentó el trastorno por estrés agudo en el personal de salud de un hospital pediátrico de tercer nivel durante la epidemia de COVID-19. Método: Se realizó un estudio transversal en el que trabajadores de la salud contestaron un cuestionario virtual que incluyó datos sociodemográficos y la Escala de Trastorno por Estrés Agudo. Resultados: Se analizaron 206 encuestas. La población se dividió en tres grupos: médicos adscritos, residentes y personal de enfermería. El 88.8% de los trabajadores de la salud reportaron más de nueve síntomas de trastorno por estrés agudo. No se encontraron diferencias significativas entre los grupos de estudio. Conclusiones: Los síntomas del trastorno por estrés agudo son frecuentes en los trabajadores de la salud en el contexto de la COVID-19. Es necesario investigar acerca de los factores de riesgo y protectores asociados al desarrollo de esta y otras psicopatologías en dicha población.

Study on the relationship between acute stress disorder and symptom group in stroke patients with motor impairment / 中国综合临床

Objective:To explore the influence of symptom group of stroke patients with exercise disorder on acute stress disorder.Methods:Patients with stroke and motor impairment hospitalized in the Department of Neurology and surgery of North China University of technology from October 2018 to August 2019 were selected as the research objects.The general information of patients, brain injury subscale (BIS) and Stanford acute stress reaction questionnaire (SARSQ) were investigated by questionnaire.Results:A total of 324 patients with stroke and motor disorders were investigated.The demographic characteristics of education, age, degree of motor function, number of combined dysfunction and Activity Of Daily Living Scale(ADL) grade had effects on acute stress disorder, and the differences were statistically significant( P<0.05). The score of acute stress disorder in stroke patients with motor disorders was (99.60±13.69 ) points.From the highest to the lowest symptom group, the scores were obsessive symptom (11.35±2.71), depression (7.44±1.86), hostility (7.23±2.26), somatization (3.69±1.42) and psychosis (2.81±1.09). The results of correlation analysis showed that somatization, depression, obsessiveness, hostility and psychosis were positively correlated with the total score of acute stress disorder and the scores of each dimension ( r=0.164, 0.355, 0.329, 0.298, 0.279, all P<0.05), the symptoms were also positively correlated with all the dimensions of acute stress disorder(all P<0.05). Multiple linear regression analysis showed that age(Regression coefficient=7.682, 95% CI: 4.930-10.435, P<0.001), the number of combined dysfunction(Regression coefficient=3.937, 95% CI: 0.268-7.605, P=0.036), depression(Regression coefficient=1.662, 95% CI: 0.727-2.597, P=0.001) had influence on ASD of stroke patients. Conclusion:The level of acute stress disorder in stroke patients with motor impairment is on the high side, and the characteristics of symptom group are obvious, which has a positive correlation with acute stress disorder.Medical staff should pay attention to the characteristics of symptom group and acute stress reaction level of stroke patients with motor impairment, so as to provide targeted intervention strategies to avoid disease recurrence and improve the quality of life.

Evaluation of BDNF levels in patients hospitalized for physical trauma at an emergency hospital in Porto Alegre, southern Brazil / Avaliação dos níveis de BDNF em pacientes hospitalizados por trauma físico em um hospital de emergência de Porto Alegre, sul do Brasil

Abstract Objective To assess the association between brain-derived neurotrophic factor (BDNF) levels and acute stress disorder (ASD) in patients who have suffered physical trauma. Methods Data were collected at an emergency hospital in Porto Alegre, state of Rio Grande do Sul, southern Brazil. Participants were over 18 years of age, victims of physical trauma, and had been hospitalized for a minimum of 48 hours. A total of 117 hospitalized patients who agreed to participate in the research were grouped according to the shift in which blood was collected (38 subjects from the morning shift and 79 from the afternoon shift), had their BDNF levels measured and responded to other questionnaires. Respondents were further grouped by age into three ranges: 18-30, 31-50 and 51-70 years. Results We found a significant difference in the distribution of BDNF between the two shifts in which blood samples were collected, with the afternoon group having higher BDNF levels (U = 1906.5, p = 0.018). A difference was observed only between the 18-30 group and the 51-70 group in the afternoon shift (Umorning = 1107, pmorning = 0.575; Uafternoon = 7175, pafternoon = 0.028). Conclusions The population whose blood samples were collected in the afternoon showed significantly higher values of BDNF compared to those of the morning shift. This same population presented lower BDNF levels when associated with ASD subtypes A1, A2, and A. We hypothesize that the lower values of BDNF measured in the morning shift were due to a response to the circadian cycle of cortisol, whose action inhibits the expression of serum neurotrophins.

Resumo Objetivo Verificar a associação entre os níveis de fator neurotrófico derivado do cérebro (brain-derived neurotrophic factor [BDNF]) e transtorno de estresse agudo (TEA) em pacientes que sofreram trauma físico. Métodos Os dados foram coletados em um hospital de emergência de Porto Alegre, Rio Grande do Sul, Brasil. Os participantes eram maiores de 18 anos, vítimas de trauma físico e estavam hospitalizados por um período mínimo de 48 horas. Um total de 117 pacientes hospitalizados que concordaram em participar da pesquisa foram agrupados de acordo com o turno de realização da coleta de sangue (38 sujeitos no turno da manhã e 79 sujeitos no turno da tarde), tiveram seus níveis de BDNF medidos e responderam a outros questionários. Os entrevistados também foram agrupados por idade em três faixas etárias: 18-30, 31-50 e 51-70 anos. Resultados Encontramos uma diferença significativa na distribuição de BDNF entre os turnos, sendo que o grupo da tarde apresentou níveis maiores de BDNF (U = 1906,5, p = 0,018). Houve diferença entre o grupo de 18-30 anos e o de 51-70 anos no turno da tarde (Umanhã = 1107, pmanhã = 0,575; Utarde = 7175, ptarde = 0,028). Conclusões A população cuja coleta ocorreu à tarde apresentou valores significativamente maiores de BDNF em relação à coleta do turno da manhã. Esta mesma população apresentou menores níveis dessa neurotrofina quando associada com os subtipos A1, A2 e A de TEA. É possível hipotetizar que os menores valores de BDNF aferidos na coleta do turno da manhã se devam a uma resposta ao ciclo circadiano do cortisol, cuja ação inibe a expressão de neurotrofinas séricas.

Predictores de sintomatología postraumática aguda y crecimiento post-estrés tras un accidente laboral reciente / Predictors of Acute Posttraumatic Symptoms and Post- Stress Growth After a Recent Work Accident

Resumen El propósito de este estudio fue evaluar un modelo predictivo de sintomatología postraumática aguda (SPT) y de crecimiento post-estrés (CPE) en trabajadores que sufrieron un accidente laboral reciente. Se encuestaron 246 trabajadores (23.2% mujeres) entre los 18 y los 73 años. Se encontró que los principales predictores de la SPT son: severidad subjetiva del evento, afrontamiento religioso negativo, reinterpretación positiva y rumiación de tipos intrusiva, negativa y deliberada. A su vez, los principales predictores de CPE fueron: rumiación deliberada y afrontamiento religioso positivo. Se realizó un análisis de sendero para evaluar un modelo en el cual la rumiación intrusiva y la deliberada cumplen una función mediadora, obteniendo adecuados índices de ajuste. Se plantea la necesidad de contar con un método de evaluación temprana de las respuestas psicológicas tras un accidente.

Abstract The aim of this study is to evaluate a predictive model of acute posttraumatic symptomatology (PTS) and post-stress growth (PSG) in workers who suffered a recent work accident. To this end, 246 workers (23.2% women) were surveyed, aged between 18 and 73 years. The main predictors of PTS were subjective severity of event, negative religious coping, positive reinterpretation, and intrusive, brooding and deliberate rumination. At the same time, the main predictors of PSG were deliberate rumination and positive religious coping. A path analysis was performed to evaluate a model in which intrusive and deliberate rumination fulfill a mediating function, obtaining adequate goodness-of-fix indices. The need to have a method of early evaluation of psychological responses after an accident is proposed.

Degree of social support in patients after coronary artery bypass grafting and its influence on acute stress disorder / 中国实用护理杂志

Objective To explore the degree of social support in patients after Coronary Artery Bypass Grafting(CABG) and its influence on Acute Stress Disorder (ASD), in order to provide theory evidence for nursing intervention. Methods From June 2017 to Mar 2018, 359 patients after CABG in Tangshan Workers Hospital were recruited for the study. Their general information were collected, SASRQ, SSRS and PSS-Fa were used for professional evaluation. Results The degree of social support in patients after CABG was at medium level, the total score of social support was (41.69±0.28), higher than the normal domestic value[(34.56 ± 3.73)score, n=128]; character (F=29.652), employment (t=6.526)and the type of health insurance (F=20.547)impacted on the degree of social support (P＜0.05). Total score of social support had negative correlation with SASRQ total score (r=-0.528, P＜0.05); character (β=0.262), family support (β=-0.281) and social support (β=-0.267) were picked in the regression equation (P＜0.05), the results showed that introversion was a risk factor for ASD in patients after CABG, high degree of family support and social support were protective factors for ASD in patients after CABG. Conclusions Social support of patients after CABG needs to be improved, so as to reduce the incidence of acute stress disorder.

Degree of social support in patients after coronary artery bypass grafting and its influence on acute stress disorder / 中国实用护理杂志

Objective@#To explore the degree of social support in patients after Coronary Artery Bypass Grafting(CABG) and its influence on Acute Stress Disorder (ASD), in order to provide theory evidence for nursing intervention.@*Methods@#From June 2017 to Mar 2018, 359 patients after CABG in Tangshan Workers Hospital were recruited for the study. Their general information were collected, SASRQ, SSRS and PSS-Fa were used for professional evaluation.@*Results@#The degree of social support in patients after CABG was at medium level, the total score of social support was (41.69±0.28), higher than the normal domestic value[(34.56±3.73)score, n=128]; character (F=29.652), employment (t=6.526)and the type of health insurance (F=20.547)impacted on the degree of social support (P<0.05). Total score of social support had negative correlation with SASRQ total score (r=-0.528, P<0.05); character (β=0.262), family support (β=-0.281) and social support (β=-0.267) were picked in the regression equation (P<0.05), the results showed that introversion was a risk factor for ASD in patients after CABG, high degree of family support and social support were protective factors for ASD in patients after CABG.@*Conclusions@#Social support of patients after CABG needs to be improved, so as to reduce the incidence of acute stress disorder.

The correlation between symptom clusters and acute stress disorder in patients with brain injury / 中华行为医学与脑科学杂志

Objective To explore the relationship between brain injury related symptom groups and acute stress disorder( ASD). Methods Totally 301 patients with brain injury hospitalized in the Affiliated Hospital of North China University of Technology from March 2017 to March 2018 were recruited. The pa-tients were assessed by Stanford Acute Stress Response Questionnaire ( SASRQ), Brain Trauma Subscale (BIS) and Pittsburgh Sleep Quality Index (PSQI). Results The prevalence of acute stress disorder pa-tients with brain injury was 46. 51% (140/301). The SASRQ score of all patients with brain injury was (70. 78±28. 00). Univariate analysis showed that there were significant differences in age (χ2= 4. 172,P=0. 041),personality type (χ2= 57. 281,P<0. 001),sleep quality ( χ2= 70. 785,P<0. 001),hospitalization frequency (χ2= 43. 547,P<0. 001),depression,obsessive-compulsive and hostile symptoms between pa-tients with and without ASD ( P<0. 05). The scores of depression and obsessive-compulsive symptoms were significantly correlated with SASRQ scores(P<0. 05). The scores of hostility symptoms were significantly cor-related with SASRQ scores except for patients who lost their temper uncontrollably ( r=0. 176-0. 698,P<0. 05). Personality ( OR=0. 243,95% CI=0. 142-0. 415),sleep disorders( OR=0. 072,95% CI=0. 029-0. 178),hospitalization times(OR=0. 129,95%CI=0. 054-0. 306),depressive symptoms( OR=1. 260,95% CI=1. 061-1. 497),obsessive-compulsive symptoms(OR=1. 419,95%CI=1. 239-1. 625) and hostile symp-toms(OR=1. 253,95%CI=1. 058-1. 482) were the influencing factors of ASD in patients with brain injury (P<0. 05). Conclusion The incidence of ASD is higher in patients with brain injury. Personality type,hos-pitalization,sleep quality,depressive symptoms,obsessive-compulsive symptoms and hostile symptoms are the influencing factors,which should be paid more attention.

A cross sectional study of socio-demographic profile and acute stress disorder in suicidal burn patients

Background: The experience of being burnt and the treatment that follows for the survivors are one of the most frightening and painful experience known to humanity. It carries a huge psychological burden on patients. Acute stress disorder which occurs in the first month and post-traumatic stress disorder that occurs after one month are more common after burns than other forms of injury. Aim and objectives: To study socio demographic profile in suicidal attempters by burns, to access for acute stress reaction in those patients. Materials and methods: A total of 60 cases of suicidal burns patients fulfilling criteria for study were taken. Semi -structured proforma for socio demographic and clinical variables were used. Becks suicidal intent scale and impact of event scale were administered to the patients. The data was analyzed using SPSS. Results: There was high preponderance of female subjects in the study and mostly of the patients belonged to lower socio economic status in the study. Most of the subjects were either illiterates or having primary education and belongs to nuclear family. There was high percentage of marital disharmony and strained inter personal relationship in the subjects. Almost all were deep burns in the study and most common vehicle used was kerosene. Patient of high risk group had more risk of developing acute stress reaction and post-traumatic stress disorders than in medium risk group. High risk group had more scores on both intrusive and avoidance subscale of impact of event scale. Conclusion: There was high preponderance of female subjects in the study. There was higher representation of lower socio economic status in the study. Most of the subjects were either illiterates or having primary education. Many of the subjects belonged to nuclear family. There was high percentage of marital disharmony and strained inter personal relationship in the subjects. Patient of J. Mayurnath Reddy, CH. Siva Kumar. A cross sectional study of socio-demographic profile and acute stress disorder in suicidal burn patients. IAIM, 2019; 6(7): 17-27. Page 18 high risk group had more risk of developing acute stress reaction and post-traumatic stress disorders than in medium risk group. High risk group had more scores on both intrusive and avoidance subscale of impact of event scale.

Acute stress symptoms and related factors of traffic accident survivors / 中国心理卫生杂志

Objective:Traffic accidents is one of the most common causes of acute stress disorder (ASD), and it will affect the health of patients.This study aimed to investigate the acute stress symptoms and related factors in traffic accident survivors.Methods:A cross-sectional survey was conducted.The general information questionnaire, Acute Stress Disorders Scale (ASDS), Patient health questionnaire-9 (PHQ-9) and Patient' s Health Questionnaire (PHQ-15) were used to investigate survivors in admission 2-30 days.Results:Fourteen survivors had acute stress symptoms in 63 (22.2％) survivors.Stepwise multiple regression analysis showed that survivors with depression, more serious physical symptoms and whether alone when the accident happened was a common experience accounted for 66.8％ of the survivors' acute stress disorder.Conclusion:This study suggests the detection of acute stress symptoms in traffic accident survivors is higher, and there is a correlation with survivors' depression, physical symptoms, and whether alone when the accident happened.Acute stress symptoms could be screened in time for survivors with depressive and severe somatic symptoms.

Three years after Typhoon Ondoy until Habagat rains: Prevalence of acute stress disorder and post-traumatic stress disorder among residents of Barangay Tumana, Marikina: A cross-sectional analytical study

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to determine the prevalence of Acute Stress Disorder and Post Traumatic Stress Disorder among residents of Barangay Tumana, Marikina exposed to Typhoon Ondoy in September 2009 and Habagat rains in August 2012.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> The Acute Stress Disorder Scale (ASDS) and Impact of Events Scale-Revised (IESR) were administered to 212 subjects. Trauma history was also obtained. When screened positive for Acute Stress Disorder (ASD) and/or Post Traumatic Stress Disorder (PTSD), a confirmatory diagnosis was done through psychiatric clinical interview.</p><p style="text-align: justify;"><strong>RESULTS:</strong> The study showed a prevalence rate of 10% for ASD and 5% for PTSD. Co-morbid ASD and PTSD were seen in 4% of the subjects. Frequency and type of prior traumatic events were not significantly different among subjects who were positive or negative for ASD/PTSD diagnoses.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> There was a significant prevalence of ASD/PTSD diagnoses among residents exposed to Typhoon Ondoy and Habagat, thus the need for developing a means of early detection and immediate therapeutic intervention in Filipino communities exposed to natural disasters.</p>

The application experience of Neuman System Model on a case of acute stress disorder after severe blast injury / 中国实用护理杂志

Objective To investigate the effects of Neuman System Model on acute stress disorder after severe blast injury. Methods In the nursing course of a severe blast injury patient, by using Neuman SystemModel, we evaluated the patient′s stress source according to five aspects, including physiology, psychology, society culture, development and spirit, and then through drafting the intervention program with the patient together, he was guided to take part in the management of their own symptoms, cognitive therapy was undertaken, and his parents were also assisted to create an effective supporting system. What′s more, level Ⅲ Neuman preventive measures were taken in the septal fibrosis and bridging. Results Satisfying results were acquired after sixty days′ interventions. The patient could almost properly face the blast injury, and discharge healthily. Conclusion Neuman System Model is really helpful in relieving the acute stress disorder of severe blast injury patients, so as to promote rehabilitation physically and mentally.

Effects of family function, resilience and focal lesion characteristics on acute stress disorder in patients with cerebral injury / 重庆医学

Objective To investigate the status quo of the cerebral injury in patients with acute stress disorder (ASD) and the impact of family function,mental toughness,and the characteristics of brain lesions on it.Methods A total of 349 patients were enrolled from North China University of Science and Technology affiliated hospital neurology department and neurosurgery department from May 2016 to November 2016 and they were tested with Stanford Acute Stress Reaction Questionnaire (SASRQ),the family function assessment scale (APGAR),Chinese version of mental toughness scale (CD-RISC).Results 349 cases of patients with SASRQ score (57.21±44.97),8 to 39 160 people (45.8％),40 to 56 85 people (24.4％),57 to 150 104 people (29.8％).The results showed that whether the hemiplegia (β=-0.030),family function (β=-0.032),mental toughness (β=0.886),disturbing degree (β=0.052),bad days (β=0.060)were picked in the regression equation (P＜0.05).Conclusion There were obvious acute stress symptoms in patients with brain injury.The individuals who have family dysfunction,the worse the psychological resilience and the higher the disturbance degree of the patients with hemiplegia,may be likely to get acute stress disorder.

Acute stress disorder and defense mechanisms: a study of physical trauma patients admitted to an emergency hospital / Transtorno de estresse agudo e mecanismos de defesa: pesquisa com pacientes que sofreram trauma físico atendidos em um hospital de emergência

Abstract Introduction: Acute stress disorder (ASD) encompasses a set of symptoms that can arise in individuals after exposure to a traumatic event. This study assessed the defense mechanisms used by victims of physical trauma who developed ASD. Method: This was a controlled cross-sectional study of 146 patients who suffered physical trauma and required hospitalization. A structured questionnaire was used to evaluate ASD symptoms based on DSM-5 diagnostic criteria, in addition to the Defense Style Questionnaire (DSQ). Results: Ten participants (6.85%) received a positive diagnosis of ASD, and 136, (93.15%) a negative diagnosis. The majority of the sample consisted of men with median age ranging from 33.50 to 35.50. The most prevalent defense mechanisms among the 10 patients with ASD were cancellation and devaluation, which belong to the neurotic and immature factors, respectively. Positive associations between the presence of symptoms from criterion B of the DSM-5 and defense mechanisms from the DSQ were found. These included the mechanisms of undoing, projection, passive aggression, acting out, autistic fantasy, displacement, and somatization. Conclusion: Patients with ASD employed different defense mechanisms such as undoing and devaluation when compared to patients not diagnosed with ASD. These results mark the importance of early detection of ASD symptoms at a preventative level, thereby creating new possibilities for avoiding exacerbations related to the trauma, which represents an important advance in terms of public health.

Resumo Introdução: O transtorno de estresse agudo (TEA) reúne um conjunto de sintomas que pode surgir nos indivíduos após exposição a um evento traumático. Este estudo verificou a relação entre o estilo defensivo e o desenvolvimento de TEA e seus sintomas em uma amostra de pacientes que sofreram trauma físico. Métodos: Este estudo transversal controlado envolveu 146 pacientes que sofreram trauma físico e necessitaram hospitalização. Um questionário estruturado foi utilizado para avaliar sintomas de TEA, baseado nos critérios diagnósticos do DSM-5, além do Questionário de Estilo Defensivo (Defense Style Questionnaire - DSQ). Resultados: Dez (6,85%) pacientes tiveram diagnóstico positivo para TEA, e 136 (93,15%), diagnóstico negativo. A maioria da amostra foi composta por homens com idade mediana variando de 33,50 a 35,50. Nos 10 pacientes positivos para TEA, destacou-se a maior utilização de mecanismos de defesa de anulação e desvalorização, pertencentes ao fator neurótico e ao fator imaturo, respectivamente. Foram observadas associações positivas entre presença de sintomas de TEA do critério B do DSM-5 e os mecanismos de defesa do DSQ, sobretudo nos mecanismos de anulação, projeção, agressão passiva, acting out, fantasia autística, deslocamento e somatização. Conclusão: Pacientes com TEA utilizaram mais mecanismos de defesa do tipo anulação e desvalorização quando comparados aos pacientes sem diagnóstico de TEA. Ressalta-se a importância da detecção precoce de sintomas de TEA a fim de evitar outros agravos relacionados ao trauma, o que representa uma importante evolução em termos de saúde pública.

Survey or degree of medical nurse's acute stress disorder from death of cancer patients and its related factors / 现代临床护理

Objective To study the psychological stress level of medical nurses when the hospitalized cancer patients died and to investigate the related factors.Methods Toally 72 medical nurses on duty who encountered cancer patient's death between May 2013 to November 2015 were enrolled in the study.SCL-90 was used to investigate the mental stress levels in the medical nurses on days 3 and 7 after the patient's death,which were compared with the norm.The correlations between psychological stress level and related factors were studied.Results The score by SCL-90 on day 3 was significantly higher than that on day 7 (147.15±29.09 vs.133.62±20.37,t=6.64,P=0.00).Compared to the norm,the scores on 9 dimensions of SCL-90 were significantly different 3 days after the patient's death;dimensions of SCL-90 were significantly different 7 days after parternt's death (P＜0.05).Professional working was factor for medical nurse's acute stress disorder.Conclusion Cancer patients' deaths render huge impact on medical nurses,with acute stress disorder most manifest.In order to improve the the psychological quality of nurses,especially the young and inexperienced ones,we have to enhance the death education,helping them to seek for social support.

Resilience characteristics in patients with traumatic fracture and its influence on acute stress disorder / 中华行为医学与脑科学杂志

Objective To explore the resilience characteristics of the traumatic fracture patients and its influence on acute stress disorder(ASD),and provide the basis for improving the population's ability to cope with stressful events and resilience level for clinic.Methods 440 cases of traumatic fracture patients hospitalized in Tangshan Second Hospital were selected in this study.All subjects were assessed with SAS-RQ,CD-RISC,AIS-ISS,VAS and the general condition of investigations.Results The resilience level of traumatic fracture patients was at the middle,the resilience total score was(51.13±14.81) points,and lower than that of the national norm(t=-20.217,P＜0.01).Sex,age,personality and injury severity had the impact on resilience (P＜0.05).Resilience dimensions and total scores had negative correlation with SASRQ dimen sions and its total score (r=-0.587--0.739,P＜0.01).High-leveled resilience patients have lower ASD scores and lighter symptoms(P＜ 0.05).The multivariate analysis appeaed that resilience and the degree of pain were the main factors affecting ASD (P＜ 0.05).Conclusion The resilience level of the traumatic frac ture patients should be further improved and the construction of resilience should be strengthened in order to prevent the occurrence of ASD.

The characteristic of top-down attentional control of children with acute stress disorder / 中华行为医学与脑科学杂志

Objective To investigate the characteristic of top-down attentional control of acute stress disorder children.Methods According to SCID-IV-TR,23 acute stress disorder children were chosen as the experinent group and 23 normal children were chosen as the control group.They were asked to perform a visual search task.Results (1) The reaction time of acute stress disorder children((1 253±158)ms) was significantly longer than normal children's((1 194± 146) ms) (P＜0.05).(2) The reaction time of valid condition((1 172± 144) ms)was significantly shorter than neutral condition ((1 229± 156) ms) and invalid condition ((1 269± 157) ms) (P＜0.05),there was no difference of reaction time between neutral condition((1 229± 156)ms) and invalid condition ((1 269±157)ms) (P＞0.05).(3) The reaction time of simple display condition((1 182±127)ms) was significantlv shorter than complex display condition ((1 264± 177)ms) (P＜0.01).Conclusion The performance of acute stress disorder children on top-down attentional control is less than normal children,the reason is that inhibiting capacity of acute stress disorder children is lower than normal children.It indicates that trauma event have negative influence on children's inhibiting capacity.

Application of Stanford Acute Stress Reaction Questionnaire in Trauma Fracture / 中国康复理论与实践

Objective To discuss the application of Chinese version of Stanford Acute Stress Reaction Questionnaire (SASRQ) in trau-matic fracture patients. Methods 96 patients with traumatic fracture in the Second Hospital of Tangshan City were recruited in the early stage. All the subjects were assessed with SASRQ in 2 weeks after trauma for the first time, and then they were assessed with SASRQ for the second time after an interval of 2 days. 496 patients with traumatic fracture completed SASRQ and Abbreviated Injury Scale-Injury Se-verity Score (AIS-ISS) assessment. Results The Cronbach's alpha was 0.930 in SASRQ, and were 0.729~0.812 in each dimension (P<0.01). Test-retest reliability at 2-day intervals was 0.980 (P<0.01). 133 cases (26.8%) were detected with acute stress disorder (ASD). According to a single entry≥3 as a positive screening, 31.7%suffered separation symptoms, 49.6%suffered re-experience traumatic symptoms, 39.5%suffered avoidance symptoms, 75.6%suffered symptoms of anxiety or increased awareness. The scores of SASRQ (t=37.807, P<0.05) and each dimension (t=36.503, 29.019, 31.111, 19.369, respectively, P<0.001) was significantly higher in the ASD positive group than in the neg-ative group. There was significantly difference in the score of SASRQ and each dimension in different age groups (F=112.319, 94.109, 95.099, 103.291, 61.497, respectively, P<0.001), the acute stress symptoms were lighter in the older group than in the other groups. There was significantly difference in the score of SASRQ and each dimension between men and women (t=7.707,-6.190,-8.944,-7.221,-9.949, respectively, P<0.001), the acute stress symptoms were lighter in men than women. There was sig-nificantly difference in the score of SASRQ and each dimension in different trauma types (F=68.516, 44.464, 59.725, 48.966, 54.827, P<0.001), the acute stress symptoms were severer in the traffic accident patients group than in the other groups. There was significantly differ-ence in the score of SASRQ and each dimension in different trauma degrees (F=63.584, 69.704, 51.569, 43.669, 33.911, respectively, P<0.001), the acute stress symptoms were lighter in the lighter group than in the other groups. Conclusion There is a high incidence and clear gender and age differences of ASD in patients with traumatic fracture.

Treatment Response of Affect Regulation Group Therapy for Recently Traumatized School Children / 신경정신의학

OBJECTIVES: The aim of this study was to investigate the treatment effect and predictors of response of affect regulation group therapy (ARGT) delivered to a group of recently traumatized children. METHODS: A total of 464 school children, who had witnessed or confronted a tragic accident at school, were given a single-session of affect regulation group therapy, that which included psychoeducation and affect regulation elements from eye movement desensitization and reprocessing. Of 213 children whose with initial score of Subject Unit of Disturbance Scale (SUDS) score over 4, we compared pre- and post-treatment scores and performed conducted the responder vs. non-responder comparison. The pPost-traumatic disorder (PTSD) symptom scores measured by using Child Reaction to Traumatic Events Scale-Revised (CRTES-R), demographic variables, and clinical variables were considered. RESULTS: Affect regulation group therapy was effective for children who had experienced an acute traumatic event (t=16.3, p<0.001). Baseline SUDS score of for non-responder were was significantly higher (t=-2.89, p<0.001) and CRTES-R score approached a level of significance level (t=-1.72, p=0.09). However, results of logistic regression analysis identified showed that the pretreatment SUDS score was the only significant predictor of non-response. CONCLUSION: Affect regulation group therapy appeared to be effective for children who had undergone experienced an acute traumatic event. And in addition, the survivors' subjective distress was more important to treatment response than severity of PTSD symptoms severity.

The prevalence and the predictive factors of acute stress disorder among survivors of road traffic accidents / 中华行为医学与脑科学杂志

ObjectiveTo investigate and analyze the prevalence and risk factors of acute stress disorder (ASD) among survivors of road traffic accidents.MethodsA total of 206 participants ( 168 men,38 women) were administrated with the acute stress disorder scale (ASDS) 2 to 23 days after the traffic accidents.ResultsThere was a total of 61 (29.6％) possible ASD patients among all participants.Women had more serious ASD symptoms than men (male:36.70 ± 11.42; female:41.18 ± 12.58; P＜ 0.05 ),the married's ASD symptom severity was higher than the single's ( married:38.37 ± 11.94 ; single/widowed/divorced:30.86 ± 8.37 ; P ＜ 0.01 ),people with low degree of education had more severe ASD symptoms than the people who had high degree of education (P＜0.05) ; being elder( r=0.43,P＜0.01 ),having fear / helpless / horror experience of accident ( r=0.21,P＜ 0.01 ) were significantly correlated with the severity of ASD symptoms.According to linear regression analysis,age could positively predicted ASD symptoms ( β =0.29,P ＜ 0.01 ) too.ConclusionASD is a common mental problems among Chinese survivors of road traffic accident,and the main predictive factors of ASD include gender,age,marital status,the degree of education,whether there is fear / helpless / horror experience of accident.