Relation of neuroticism and resilience to posttraumatic stress disorder and posttraumaticgrowth in patients with burns during rehabilitation / 中国心理卫生杂志

Objective:To investigate the characteristics of posttraumatic stress disorder (PTSD) symptom and posttraumatic growth (PTG) in the patients with burns during rehabilitation, and the relationships among PTSD symptom, PTG, neuroticism and resilience.Methods:A cross-sectional study was carried out among 110 patients with burns during rehabilitation.The PTSD Check-list-Civilian Version (PCL-C), Posttraumatic Growth Inventory (PTGI), Five Factors Inventory-Neuroticism Subscale (FFI-N) and the 10-item Connor-Davidson Resilience Scale (CD-RISC) were used.Result:A significant effect of different groups of marital status (F=5.66, P=0.019), annual household income (F=7.97, P=0.006), and neuroticism (F=34.24, P＜0.001, Partial η2=0.259) on PCL-C scores.A significant effect of different groups of gender (F=6.44, P=0.013) and resilience (F=14.87, P＜0.001, Partial η2=0.132) were significant for PTG scores.There existed a significant interaction between neuroticism and resilience on PTG (F=4.47, P=0.037, Partial η2=0.044).Conclusion:Being married, low annual household income, and high levels of neuroticism were associated with high PTSD symptom levels.Being female and high levels of resilience were associated with high PTG levels.Resilience moderated the effect of neuroticism on PTSD symptoms.

Prevalência do transtorno de estresse pós-traumático em mães de recém-nascidos prematuros: atualização / Prevalence of post traumatic stress disorder in preterm infants's mothers: update

O Transtorno do Estresse Pós-Traumático (TEPT) é um agravo mental que pode ocorrer em resposta a eventos traumáticos na vida do indivíduo. Alguns estudos apontam que há relação do transtorno do estresse pós-traumático após o parto, quando este é considerado como parto de risco. O objetivo deste artigo é fornecer uma atualização da literatura sobre a prevalência do Transtorno de Estresse Pós-Traumático em mulheres que tiveram parto pré-termo. Para a identificação dos estudos, foram consultadas as bases de dados PubMed/Medline, Ibecs e Lilacs. Para os resultados da busca, a seleção inicial ocorreu pela leitura dos títulos encontrados, sendo descartados aqueles não tinham relação com o tema e período selecionados. O total de 18 estudos cumpriu com os critérios de inclusão deste artigo. A prevalência encontrada do Transtorno do Estresse Pós-Traumático após o parto foi entre 1,3% e 12,5%, e de 28% nos grupos de risco, como as mães de prematuros. O presente artigo de atualização aponta que há possível correlação entre o Transtorno do Estresse Pós-Traumático e o nascimento prematuro.(AU)

The Post-traumatic stress disorder (PTSD) is a mental illness that can occur in response to traumatic events in an individual's life. Some studies indicate that there is a relationship between PTSD after childbirth, when it is considered as risk childbirth. The aim of this article is to provide an update of the literature about the prevalence of Post Traumatic Stress Disorder and Prematurity. To identify the studies, the PubMed / Medline, Ibecs and Lilacs databases were consulted. For the search results, the initial selection occurred by reading the titles found, being discarded those that had no relation with the theme and period selected. In the total 18 studies met the inclusion criteria of this article. The prevalence of posttraumatic stress disorder after childbirth was between 1,3 and 12.5%, and 28% in the risk groups, such as mothers of premature infants. The present update article points out that there is a possible correlation between posttraumatic stress disorder and premature birth.(AU)

Molecular Neuroimaging in Posttraumatic Stress Disorder

Over the past decade, an increasing number of neuroimaging studies have provided insight into the neurobiological mechanisms of posttraumatic stress disorder (PSTD). In particular, molecular neuroimaging techniques have been employed in examining metabolic and neurochemical processes in PTSD. This article reviews molecular neuroimaging studies in PTSD and focuses on findings using three imaging modalities including positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetic resonance spectroscopy (MRS). Although there were some inconsistences in the findings, patients with PTSD showed altered cerebral metabolism and perfusion, receptor bindings, and metabolite profiles in the limbic regions, medial prefrontal cortex, and temporal cortex. Studies that have investigated brain correlates of treatment response are also reviewed. Lastly, the limitations of the molecular neuroimaging studies and potential future research directions are discussed.

Sintomas de TEPT e trauma na infância em pacientes com transtorno da personalidade bordeline / Symptoms of ptsd and trauma in childhood in patients with borderline personality disorder / Síntomas de tept y trauma en la infancia en pacientes con trastorno límite de la personalidad

O transtorno da personalidade borderline (TPB) é o mais prevalente dentre todos os transtornos da personalidade, apresentando um percentual de 5,9% na população geral. O transtorno tem um impacto enorme na vida dos sujeitos, por isso a comunidade científica está voltada a estudar elementos relacionados a essa psicopatologia. Tendo isso em vista, os objetivos deste artigo foram: investigar a presença de sintomatologia pós-traumática e o histórico de trauma na infância em sujeitos com TPB. Para isso, foi realizado um estudo transversal, de caráter exploratório. Dessa forma, 22 sujeitos com diagnóstico de TPB preencheram um instrumento de rastreio para avaliar sintomas de TEPT. Foi encontrado que os pacientes com TPB apresentam diversos sintomas de TEPT, como dificuldade de concentração, lembranças intrusivas, tensão ao relembrar e evitação de lembranças.

The borderline personality disorder (BPD) is the most prevalent of all diagnostic personality disorders, presenting a percentage of 5.9% in the general population. The disorder has a huge impact in the life of the individuals, for this reason the scientific community is studying the relation elements of this psychopathology. The study’s purpose was to investigate the presence of posttraumatic symptomatology and history of childhood trauma. The work’s delineation was a transversal study with exploratory character. For these 22 borderline patients completed a screening task in order to evaluate symptoms of PTSD. It was found that the borderline patients presented several symptoms of PTSD, such as: difficulty in concentration, intrusive memories, tension in remembering and avoidance of memories.

El trastorno límite de la personalidad (TLP) es el más frecuente entre todos los trastornos de la personalidad, presentando un porcentaje de 5,9% en la población general. El trastorno tiene un gran impacto en la vida de los individuos, es por esto que la comunidad científica está dedicada a estudiar elementos relacionados con esta psicopatología. Considerando esto, los objetivos del presente artículo fueron: investigar la presencia de sintomatología post-traumática y el historial de trauma en la infancia de personas con TLP. Para esto, se realizó un estudio transversal con carácter exploratorio. De esa manera, 22 personas con TLP respondieron un formulario de acompañamiento para evaluar los síntomas de TEPT. Se encontró que los pacientes con TLP tienen muchos síntomas de TEPT, tales como: dificultad para concentrarse, recuerdos intrusivos, tensión al recordar y evitar recuerdos.

Peripheral Biomarker Candidates of Posttraumatic Stress Disorder

There is high variability in the manifestation of physical and mental health problems following exposure to trauma and disaster. Although most people may show a range of acute symptoms in the aftermath of traumatic events, chronic and persistent mental disorders may not be developed in all individuals who were exposed to traumatic events. The most common long-term pathological consequence after trauma exposure is posttraumatic stress disorder (PTSD). However, comorbid conditions including depression, anxiety disorder, substance use-related problems, and a variety of other symptoms may frequently be observed in individuals with trauma exposure. Post-traumatic syndrome (PTS) is defined collectively as vast psychosocial problems that could be experienced in response to traumatic events. It is important to predict who will continue to suffer from physical and mental health problems and who will recover following trauma exposure. However, given the heterogeneity and variability in symptom manifestations, it is difficult to find identify biomarkers which predict the development of PTSD. In this review, we will summarize the results of recent studies with regard to putative biomarkers of PTSD and suggest future research directions for biomarker discovery for PTSD.

PTSD and Related Factors among Dispatched Firefighters to Rescue Sites after the Great Japanese Earthquake (Running head: Dispatched Firefighters' PTSD) / 대한산업의학회지

OBJECTIVES: This study aims to investigate the risk of posttraumatic stress disorder (PTSD) and its related factors among firefighters dispatched to the rescue sites after the Great Japanese Earthquake in 2011. METHODS: Among 104 male firefighters dispatched to rescue sites after the Great Japanese Earthquake, 73 firefighters were assessed. The 73 firefighters completed questionnaires, which include general characteristics, an impact of event scale-revised Korean version (IES-R-K), a coping checklist, a scale of perceived social support, and a post-traumatic stress diagnostic scale (PDS). The data was analyzed to find factors related to PTSD risk. RESULTS: The mean value of age and work tenure in this study were 38.6 years (SD=5.7) and 11.6 years (SD=6.0), respectively. The number and rate of the PTSD high-risk group in dispatched firefighters in this study was 7 cases and 9.6% using IES-R-K, with an over 25-point cutoff score. The mean rank of tenure, 53.5 in the PTSD high-risk group (n=7), was significantly higher than that of 32.2 in the PTSD low-risk group (n=66). The mean rank of assessable support, 20.2 in the PTSD high-risk group was significantly lower than that of 38.7 in the PTSD low-risk group. In logistic analysis of model 1 including PDS in independent variables, were associated with being a PTSD high-risk group as in the following: higher PDS score (OR 2.18, 95% CI: 1.07~4.46), longer tenure (OR 3.42, 95% CI: 1.01~11.89), more using coping method (OR 1.35, 95% CI: 1.00~1.81), and lower perceptions of social support (OR 0.84, 95% CI: 0.72~0.97). In logistic analysis of model 2 without PDS in independent variables, more using coping method (OR 1.14, 95% CI: 1.01~1.28) and lower perceptions of social support (OR 0.95, 95% CI: 0.91~0.98) were associated with being a PTSD high-risk group. CONCLUSION: The PTSD high-risk group in dispatched firefighters indicated that their odds ratios were increased when they used more coping methods under specific stress conditions and had lower perceptions of social support. Therefore, for those, who might be dispatched to overseas, the psychological support approach should be considered to produce effective coping methods against traumatic events and to be aware of abundant resources for social support regarding the problem.

Controversias respecto de la conceptualización del trastorno de estrés postraumático / Controversies in regards to the conceptualization of the post-traumatic stress disorder

Las controversias respecto al TEPT, desde su formulación como categoría diagnóstica hasta el presente, han sido múltiples. Se han planteado interrogantes respecto de su estatus como concepto científico por los factores socio históricos que influyeron tanto en su origen como categoría como en la expansión de su empleo, así como cuestionamientos específicos a su validez de constructo. El concepto de evento traumático, la relación de causalidad entre evento traumático y consecuencias psicopatológicas, la especificidad que tendría la respuesta traumática, son parte relevante de esos cuestionamientos. El artículo presenta una visión de estas controversias y señala sus implicaciones para la comprensión y tratamiento de las consecuencias psicológicas de los eventos traumáticos.

The controversies respect to the PTSD, since its formulation as a diagnostic category up to the present, have been multiple. Questions have been posed in relationship to its status as a scientific concept because due to socio-historical factors that influenced in its origin as a category as well as in the expansion of its use. Also, queries have been raised concerning the validity of this construct. The concept of traumatic event, the causal relationship between the traumatic event and its psychopathological consequences, the specificity of the traumatic response, are relevant parts of these queries. The article presents an overview of these controversies and states its implications for the understanding and treatment of the psychological consequences of traumatic events.

Measuring child exposure to violence and mental health reactions in epidemiological studies: challenges and current issues / Criança, violência e saúde: desafios e questões atuais

Este artigo examina os desafios e perspectivas atuais envolvidos na mensuração da exposição a diferentes tipos de violência e problemas de saúde mental em crianças e adolescentes. Instrumentos padronizados apropriados para estudos epidemiológicos, selecionados com base em sua relevância na literatura, são brevemente descritos e comentados. A avaliação de exposição à violência em crianças pode dizer respeito a um evento específico (como sequestro) ou um contexto específico (como guerra) ou mesmo um determinado tipo de exposição (como violência física intrafamiliar). A avaliação da saúde mental infantil após a exposição à violência tradicionalmente concentrou-se na avaliação do transtorno de estresse pós-traumático (TEPT) - freqüentemente avaliado através de escalas não-diagnósticas. Porém, outras reações psicológicas podem ocorrer e instrumentos que podem ser usados para avaliar estas reações também são descritos neste artigo. Dois tópicos de importância emergente - a avaliação de prejuízo funcional e do pesar traumático em crianças - são também apresentados. Instrumentos culturalmente apropriados são essenciais para a identificação de problemas de saúde mental em crianças após a exposição à violência.

This paper examines challenges and current issues involved in measuring exposure to different types of violence which are associated mental health problems in children and adolescents. Standardized measures suitable for epidemiological studies, selected based on their relevance in the current literature, are briefly described and commented. The assessment of child's exposure to violence may focus on a specific event (e.g., kidnapping), a specific context (e.g., war) or even of a certain type of exposure (e.g., intrafamilial physical violence). The assessment of child mental health after exposure to violence has traditionally focused on posttraumatic stress disorder (PTSD) - most frequently measured through non-diagnostic scales. However, other mental health reactions may be present and screening as well as diagnostic instruments which may be used to assess these reactions are also described. Two issues of emerging importance - the assessment of impairment and of traumatic grief in children - are also presented. Availability of culturally appropriate instruments is a crucial step towards proper identification of child mental health problems after exposure to violence.

THE MORPHOLOGICAL ANALYSIS OF APOPTOSIS IN HIPPOCAMPUS OF POSTTRAUMATIC STRESS DISORDER RATS AND THE EXPRESSION OF APOPTOSIS-RELATED GENES / 解剖学报

Objective To investigate relationships between the expression of Bcl-2,Bax protein and neuronal apoptosis in hippocampus of posttraumatic stress disorder(PTSD) rats.Methods The SPS-method was used to set up the rat PTSD models.There were five groups:after SPS 1d,4d,7d,14d groups and control group.Apoptotic cells were detected by electron microscopy and TUNEL method.The expressions of Bcl-2 and Bax proteins were detected with immunohistochemistry,double fluorescent,confocal laser scanning microscopy and Western blotting.Results Apoptotic cells were present in hippocampus of PTSD rats.The number of apoptotic cells increased with the development of PTSD and peaked on the 7th day after SPS,then decreased gradually.The expression of Bcl-2 protein peaked on the 4th day after SPS and Bax protein peaked on the 7th day after SPS,then decreased gradually.The ratio of Bcl-2/Bax increased at the beginning and then gradually decreased.Conclusion The neuronal apoptosis in hippocampus of PTSD rats may be one of reasons inducing hippocampus atrophy.The increase of Bcl-2 and Bax protein and the change of Bcl-2/Bax ratio would play an important role in regulating the hippocampal neuronal survival or death during posttraumatic stress disorder.

Posttraumatic Stress Disorder Among Occupational Accident Patients / 신경정신의학

OBJECTIVES: This study was conducted to assess the development of posttraumatic stress disorder (PTSD) after occupational physical injuries and the risk factors in occupational accident patients for PTSD. METHODS: Forty-seven occupational accident patients with physical injuries were administered BDI, STAI I and II, SCL-90-R, IES and questionnaires for risk factors and Clinician-Administered PTSD Scale(CAPS). RESULTS: 1) 12 patients(25%) were diagnosed as PTSD. 2) The BDI, STAI I and II and IES scores are significantly high(<0.05) in PTSD group than non-PTSD group. 3) The subscales of SCL-90-R, with an exception of PAR subscale, showed higher scores(<0.05) in PTSD group. 4) The loss of consciousness(LOC) was only significant risk factor in the occupational accident-related factors(<0.05). CONCLUSION: The results of this study show the development of PTSD among occupational accident patients. The loss of consciousness(LOC) was the only signiticant risk factor for PTSD in occupational accident patients.