Relationship between emotional trauma and depression of college students: mediating effect of distress tolerance and rumination / 中华行为医学与脑科学杂志

Objective:To explore the relationship between emotional trauma and depressive symptoms.Methods:In November 2021, a total of 1 650 university students were assessed using scales including childhood trauma questionnaire (CTQ), distress tolerance scale (DTS), rumination response scale (RRS) and the depression anxiety stress scale (DASS). SPSS 20.0 and AMOS 25.0 software were used to analyze the data with Spearman correlation analysis, Mann-Whitney U test and mediation analysis. Results:The differences of DTS, RRS and DASS were significant between high and low trauma group(all P<0.01). Emotional trauma (16.70(6.09)) was negatively correlated with distress tolerance(10.95(2.15)) ( r=-0.26, P<0.01), and positively correlated with rumination(39.51(10.74)) and depression(4.93(5.76)) ( r=0.31, 0.38, both P<0.01). The testing of mediating effect indicated that emotional trauma had direct effect ( β=0.20, P<0.001) and indirect effect on depression through distress tolerance and rumination. Conclusion:Emotional trauma, distress tolerance and rumination are important factors influencing depression, and it could provide guidance for undergraduate psychological intervention of depression.

Estrutura interna da versão brasileira do Questionário de Estresse Traumático Secundário / Internal structure of the Secondary Traumatic Stress Questionnaire in Brazil / Estructura interna de la versión brasileña del Cuestionario de Estrés Traumático Secundario

O Estresse Traumático Secundário caracteriza-se por um conjunto de sintomas e condutas que se manifestam após a exposição indireta ao trauma. Profissionais que cuidam de pessoas traumatizadas estão susceptíveis ao transtorno. Este estudo examinou a estrutura interna da versão brasileira do Cuestionario de Estrés Traumático Secundario. Participaram 624 profissionais da saúde, acessados on-line. Para realização das análises fatoriais, a amostra foi dividida em dois grupos. Na análise exploratória, foram retidos 12 componentes, com cargas fatoriais entre 0,312 e 0,999. Os resultados da análise confirmatória revelaram que o modelo de doze fatores para 50 itens forneceu o melhor ajuste possível para os dados (RMSEA = 0,044; IC = 10%-90%; CFI = 0,949; TLI = 0,904) e índice de consistência interna geral do modelo foi de 0,91. Esses doze fatores foram distribuídos em quatro escalas (Antecedentes, Síndrome de Trauma Secundário, Personalidade e Consequências), com índices psicométricos relativamente baixos e uma nova organização dos itens das escalas do QETS, em contraste com a versão teórica original do instrumento. Sugere-se que novos estudos psicométricos analisem as escalas do questionário, separadamente, e investiguem outras categorias profissionais, especialmente na área dos serviços de emergências, além de estudos comparativos com amostras clínicas. (AU)

Secondary Traumatic Stress is characterized by a set of symptoms and behaviors that manifest themselves after the indirect exposure to the trauma. Professionals caring for traumatized people are susceptible to the disorder. This study examined the internal structure of the Brazilian version of the Cuestionario de Estrés Traumático Secundario. 624 health professionals participated, accessing the online questionnaire. To perform the factorial analysis, the sample was divided into two groups. In the exploratory analysis, 12 components were retained, with factorial loads between 0.312 and 0.999. The confirmatory analysis revealed a twelve-factor model for 50 items provided the best possible fit for the data (RMSEA = 0.044; CI = 10% -90%; CFI = 0.949; TLI = 0.904). However, at the end of the data discussion, 48 items remained in the model, and the overall internal consistency index of the model was 0.91. These twelve factors were distributed on four scales (Background, Secondary Trauma Syndrome, Personality and Consequences), with relatively low psychometric indices and a new organization of the items on the QETS scales in contrast to the theoretical framework in the the original instrument. It is suggested that new psychometric studies analyze the scales of the questionnaire separately and investigate other professional categories, especially in the area of emergency services and comparative studies with clinical samples. (AU)

El estrés traumático secundario se caracteriza por un conjunto de síntomas y conductas que se manifiestan después de la exposición indirecta al trauma. Los profesionales que cuidan a las personas traumatizadas son susceptibles al trastorno. Este estudio examinó estructura interna de la versión brasileña del Cuestionario de Estrés Traumático Secundario. Participaron 624 profesionales de la salud, accediendo al cuestionario online. Para la realización de los análisis factoriales la muestra fue dividida en dos grupos. En el análisis exploratorio, se retuvieron 12 componentes, con cargas factoriales entre 0.312 y 0.999. El análisis confirmatorio reveló que el modelo de doce factores para 50 ítems proporcionó el mejor ajuste posible para los datos (RMSEA = 0.044; IC = 10% -90%; CFI = 0.949; TLI = 0.904). Sin embargo, al final de la discusión de los datos quedaron 48 ítems en el modelo. El índice de consistencia interna general del modelo fue de 0,91. Estos doce factores se distribuyeron en cuatro escalas (Antecedentes, Síndrome de Trauma Secundario, Personalidad y Consecuencias), con índices psicométricos relativamente bajos y una nueva organización de los ítems en las escalas QETS, en contraste con la versión teórica original del instrumento. Se sugiere que nuevos estudios psicométricos analizan las escalas del cuestionario por separado e investiguen otras categorías profesionales, especialmente en el área de los servicios de emergencias y estudos comparativos con amostras clínicas. (AU)

Duncan Pedersen y el estudio integral de la Salud Mental Global / Duncan Pedersen and the integral study of Global Mental Health

Salud Mental Global (SMG), en tanto que conceptualización relativamente reciente de aspectos teóricos, clínicos y heurísticos de la enfermedad mental, su etiopatogenia, variantes y modalidades de manejo desde la perspectiva de salud pública a lo largo del mundo, es materia de esta breve revisión. Su elaboración se basa fundamentalmente en las contribuciones de Duncan Pedersen, renombrado psiquiatra, antropólogo e investigador argentino-canadiense, docente de la Universidad de McGill y autor de numerosos estudios en el Perú y en varios otros países, recientemente fallecido. Su afronte enfatizó enfoques objetivos en el uso de recursos propios o locales combinados, con sello genuinamente humanístico, con avances científicos, tecnológicos y financieros y programas de justicia social. Trauma y sus numerosas secuelas globales a nivel físico, emocional, individual y colectivo, constituyó un factor primum inter pares de este enfoque,conduciendo luego a hallazgos de psicopatologías adicionales, comprobaciones epidemiológicas y discrepancias a veces insalvables con las concepciones de la medicina de Occidente. Modalidades culturales de manejo, estudio de temas tales como tratamiento inter- y multidisciplinario, renovación de conceptos éticos, resiliencia y otros dentro y más allá de factores neurobiologicos inducirán soluciones sistemáticas y sostenibles a los problemas actuales y futuros de la SMG.

Global Mental Health (GMH), a relatively recent conceptualization of theoretical, clinical and heuristic aspects of mental illness, its etio-pathogenesis, variants and management modalities from the Public Health perspective across the world, is the subject of this brief review, primarily based on the contributions of Duncan Pedersen a recently deceased renowned Argentine-Canadian psychiatrist, anthropologist and researcher, Faculty member at McGill University and author of numerous studies in Perú and several other countries. His work emphasized objective and humanistically conceived approaches to the use of local resources in combination with scientific, technological and financial advances in the context of social justice-oriented programs. Trauma and its numerous global sequelae at physical, emotional, individual and collective levels, constituted a primum inter pares factor of this approach leading to the finding of additional psychopathologies, epidemiological proofs and, at times, powerful discrepancies with the principles of Western medicine. Culturally-based management modalities, and the study of topics such as interand multi-disciplinary treatment, renewal of ethic concepts, resilience and other within and beyond neurobiological factors will bring up systematic and sustainable solutions to current and future GMH problems.

Altered Function of Ventrolateral Prefrontal Cortex in Adolescents with Peer Verbal Abuse History

OBJECTIVE: Previous studies showing the association of exposure to peer (PeVA) and parental verbal abuse in childhood with structural alterations in the young adult brain suggest functional changes in adolescence. In this functional MRI study, we investigated the effects of exposure to PeVA, during elementary and middle school periods, on brain response to emotional words, in high school students. METHODS: An emotional Stroop task consisting of swear, negative, positive, and neutral words was performed during functional MRI scan for 23 subjects who were divided into low- and high exposure groups to PeVA. RESULTS: High-PeVA group had a higher depression score, greater left ventrolateral prefrontal cortex (VLPFC) activity, and higher left VLPFC-left hippocampus connectivity in swear word conditions. The VLPFC activity and left VLPFC-left hippocampus connectivity was negatively related to the severity of anxiety and depressive symptoms, respectively. CONCLUSION: These preliminary findings support the hypothesis that exposure to PeVA, during childhood, is an aversive stimulus associated with meaningful functional change in emotional regulation network, showing hypersensitivity to swear words, at middle adolescence.

Lista de eventos traumáticos ocupacionais para profissionais de emergências: adaptação e validação / Checklist of occupational traumatic events for emergency professionals: Adaptation and validation / Lista de eventos traumáticos en el trabajo para los profesionales de emergência: adaptación y validación

O objetivo do presente artigo foi descrever o processo de adaptação e as características psicométricas da versão brasileira da lista de eventos traumáticos ocupacionais para profissionais de emergências (LET-PE). Profissionais de emergências (n=30) participaram da etapa de investigação de equivalência semântica da escala. Trabalhadores vinculados e não vinculados a serviços de emergências (n=75) e bombeiros (n=184) participaram dos estudos acerca das características psicométricas. Foram realizados teste­reteste (Bland-Altman) e comparações entre os grupos (teste t de Student). Os itens foram considerados de fácil compreensão por representantes da população-alvo. As comparações entre trabalhadores vinculados e não vinculados a serviços de emergências e bombeiros com e sem sintomas de Transtorno de Estresse Pós-traumático (TEPT) mostraram que a escala apresenta evidências de validade relacionadas a critérios externos. Os coeficientes teste­reteste foram satisfatórios. A versão brasileira da lista de eventos é compreensível e psicometricamente adequada para mensuração da exposição a situações traumáticas em serviços de emergências. A LET-PE contribuirá para os estudos sobre trauma ocupacional no Brasil.(AU)

The aim of the present paper was to describe the adaptation process and psychometric characteristics of the Brazilian version of the occupational traumatic events checklist for emergency professionals (LET-PE). Emergency professionals (n=30) participated in the semantic equivalence scale study. Workers related and not related to emergency services (n=75) and firefighters (n=184) participated in studies about the psychometric characteristics. Test-retest (Blend-Altman) and comparisons between groups (Student's t test) were performed. The items were considered easy to understand by individuals of the target population. Group comparisons between professionals related and not related to emergency services and firefighters with and without Post-traumatic stress disorder (PTSD) symptoms indicated that the scale shows validity evidences based on external criteria. Test-retest coefficients were satisfactory. Brazilian version of traumatic events checklist resulted in an understandable version and psychometrically suitable for measuring exposure to traumatic situations in emergency services. The LET-PE will contribute to studies on occupational trauma in Brazil.(AU)

El objetivo de este artículo es describir el proceso de adaptación y las propiedades psicométricas de la versión brasileña de la lista de eventos traumáticos en el trabajo para los profesionales de emergencia (LET-PE). Profesionales de la emergencia (n= 30) participaron en la etapa de obtención de equivalencia semántica. Trabajadores vinculados y no vinculadas a los servicios de emergencia (n=75) y bomberos (n=184) participaron en los estudios sobre las características psicométricas. Se realizaron análisis test-retest (Bland-Altman) y comparaciones entre los grupos (t de Student). La lista fue considerada fácil de entender por los representantes de la población. Las comparaciones entre trabajadores vinculados y no vinculados a los servicios de emergencia y bomberos con y sin síntomas de TEPT indicaron que la escala muestra evidencia de validez basada en criterios externos. Los coeficientes test-retest fueron satisfactorios. La versión brasileña de la lista de eventos es comprensible y psicométricamente adecuada para medir la exposición a situaciones traumáticas en los servicios de emergencia. El LET-PE contribuirá a las investigaciones sobre el trauma ocupacional en Brasil.(AU)

Impact of the worst school experiences in students: a retrospective study on trauma / Impacto das piores experiências escolares em estudantes: um estudo retrospectivo sobre trauma / Impacto de las peores experiencias en la escuela en estudiantes: un estudio retrospectivo sobre trauma

The literature indicates damage to students' mental health in cases of school violence. The aim of this retrospective study was to evaluate the psychological impact of school victimization in university students, and to analyze the association between PTSD symptoms and variables related to school victimization. 691 University students responded to the Portuguese version of the Student Alienation and Trauma Survey (SATS). Clinically significant scores in the subscales ranged from 4.7% (somatic symptoms) to 20% (hypervigilance), with frequent symptoms described in the literature resulting from school victimization, such as depression, hopelessness, cognitive difficulties, and traumatic event recollection. Additionally, 7.8% of participants presented PTSD symptoms after suffering their "worst school experience". Associations were found between PTSD symptoms and the level of distress after the experience, as well as the perceived benefits after the event, and duration. The results confirm the potential detrimental effects of school victimization, and may be useful to further investigations on this topic.

A literatura indica a existência de danos para a saúde mental de estudantes em casos de violência no contexto escolar. O objetivo deste estudo retrospectivo foi avaliar o impacto psicológico da vitimização escolar em estudantes universitários e analisar a associação dos sintomas de TEPT com variáveis relacionadas à vitimização. No total, 691 estudantes universitários responderam à Escala sobre Experiências Traumáticas em Estudantes. Escores clinicamente significativos nas subescalas variaram de 4,7% (sintomas somáticos) a 20% (hipervigilância), sendo frequentes sintomas descritos na literatura resultantes de vitimização, como: depressão, desesperança, dificuldades cognitivas e rememoração do evento traumático. Adicionalmente, 7,8% apresentaram sintomas de TEPT após a sua pior experiência escolar. Foram encontradas associações entre os sintomas de TEPT e o incômodo sentido após a experiência, benefícios percebidos após o evento e duração do mesmo. Tais dados indicam o potencial nocivo das experiências de vitimização escolar, podendo contribuir para futuras pesquisas em tal área.

La literatura indica que casos de violencia en el contexto escolar causan daños a la salud mental de los estudiantes. El objetivo de este estudio retrospectivo fue evaluar el impacto psicológico de la victimización escolar en estudiantes universitarios y analizar la asociación de los síntomas de TEPT con variables relacionadas a la victimización. Un total de 691 estudiantes universitarios respondieron a la Escala de Experiencias Traumáticas en los Estudiantes. Puntuaciones clínicamente significativas en las subescalas oscilaron entre el 4,7% (síntomas somáticos) y el 20% (hipervigilancia), y se encontraran síntomas frecuentes descritos en la literatura resultante de victimización, tales como: depresión, desesperanza, problemas cognitivos y recuerda excesiva del evento traumático. Además, el 7,8% tenía síntomas de TEPT un mes después de su peor experiencia escolar. Se encontraran asociaciones con los síntomas de TEPT y el malestar que se siente después de la experiencia; beneficios percibidos después del evento y su duración. Los resultados indican el potencial nocivo de las experiencias de victimización escolar y pueden contribuir a investigaciones futuras.

The Psychometric Properties of the Korean Version of the Verbal Abuse Questionnaire in University Students

OBJECTIVE: The aim of the present study was to examine the psychometric properties of the Korean Verbal Abuse Questionnaire (K-VAQ) that consists of 15 items related with life-time verbal aggression exposure. METHODS: A total of 5814 university students who agreed to take part in the study completed the K-VAQ, the Korean version of the Life Event CheckList (LEC-K) and Impact of Event Scale-Revised (K-IES-R). Internal consistency was checked by using item-total item correlation and Cronbach's alpha coefficient. Exploratory and confirmatory factor analyses were performed, and convergent and concurrent validity levels were examined. Finally, a cluster analysis was conducted to verify the validity of the cutoff point of the K-VAQ. RESULTS: The Cronbach's alpha correlation coefficient was 0.9. The K-VAQ showed a single factor structure which explained 55.34% of the total variance. The K-VAQ was significantly associated with the LEC-K (r=0.24) and K-IES-R (r=0.28), indicating good convergent validity and concurrent validity. The cluster analysis provided four clusters of trauma experiences: high, moderate, low, and minimal, with K-VAQ ranges of 43-81, 20-42, 7-19, and 0-6, respectively. In a further investigation, a K-VAQ score of 40 was found to be the appropriate cutoff point to delineate the highly verbally abused group, as used in the previous studies. A sum of 36.5% of the highly verbally abused group reported to show substantial symptoms of PTSD (K-IES-R score >22). CONCLUSION: The present findings suggest that the K-VAQ has good psychometric properties for assessing verbal aggression among the Korean population.