Early identification and influencing factors of post-traumatic stress disorder in high-stress rescue workers / 中华预防医学杂志

Objective: To explore the risk intensity and related influencing factors of post-traumatic stress disorder (PTSD) among high-stress rescue workers, and to provide effective tools for the risk assessment of PTSD in military rescue workers. Method: From June to August 2022, cluster sampling was used to select the high-stress rescue personnel of an Army department as the survey subjects. The acute Stress reaction (ASD) scale and PTSD checklist were used to evaluate the risk of PTSD in military rescue personnel. Multivariate logistic regression were used to analyze the influencing factors of PTSD. Results: The age of 4 460 subjects was (24.38±4.072) years old, including 4 396 males (98.6%). The positive rate of initial screening for ASD was 2.85% (127/4 460). The positive rate of PTSD was 0.67% (30/4 460). Multivariate logistic regression model analysis showed that female, older age, recent trauma exposure history, passive smoking and alcohol consumption were at higher risk of ASD, the values of OR (95%CI) were 4.183 (1.819-9.618), 6.278 (1.363-28.912), 3.094 (1.500-6.379), 2.059 (1.298-3.267) and 2.607 (1.614-4.211), respectively; Lower education level was associated with lower risk of ASD, OR (95%CI) was 0.593 (0.359-0.978); People who are older, thinner, have a history of mental illness, and drink alcohol were at higher risk for PTSD, the values of OR (95%CI) were 20.144 (2.459-165.043), 10.287 (2.218-47.700), 91.104 (8.592-965.980) and 2.866 (1.144-7.180), respectively. Conclusion: Gender, age, education level, passive smoking, alcohol consumption, past history of mental illness and body mass index may be related to the potential risk of PTSD in rescue workers,passive smoking, alcohol consumption, and weight controlling should be focused on to reduce potential risks of PTSD.

Long-term posttraumatic stress disorder in mine workers after a coalmining disaster

Abstract Background A coalmine disaster has occurred in Turkey on 13 May 2014, which caused the death of 301 miners. Objective This study aimed to determine the prevalence of posttraumatic stress disorder (PTSD) symptoms and the risk factors for PTSD among mine workers, 2 years after the coalmining disaster. Methods This was a cross-sectional survey conducted between June 2016 and July 2016 among mine workers who were the employees of either the mine where the accident occurred or three other mines in the same area. Sociodemographic data form and PTSD Symptom-Scale Self-Report (PSS-SR) were used to collect data. Results 672 mine workers participated in the study. At the time of the accident, 23.7% (n = 159) of them were in the mine where the accident occurred. The mean score on total PSS-SR was 4.27 (SD: ±4.49). Eighteen (2.7%) participants screened positive for PTSD. Logistic regression analysis revealed the significant risk factors for PTSD are: being single/divorced/widowed, having a chronic disease, having a family history of psychiatric illness and previously experiencing traumatic events more than one. Discussion Coalmining workers have considerably high prevalence rate of PTSD symptoms after a coalmining disaster. Assessing PTSD and associated risks is important for preventive mental health services.

Post-traumatic stress disorder among the staff of a mental health hospital: prevalence and risk factors

Background: Mental health service providers are frequently exposed to stress and violence in the line of duty. There is a dearth of data concerning the psychological sequelae of the frequent exposure to stress and violence, especially among those who work in resource-limited countries such as Botswana. Aim: To determine the prevalence and predictors of post-traumatic stress disorder (PTSD) among mental health workers in a tertiary mental health institute in Botswana. Setting: The study was conducted in Sbrana Psychiatric Hospital, which is the only referral psychiatric hospital in Botswana. Methods: The study used a descriptive cross-sectional design. A total of 201 mental health workers completed a researcher-designed psycho-socio-demographic questionnaire, which included one neuroticism item of the Big Five Inventory, and a PTSD Checklist-Civilian Version (PCL-C), which was used to assess symptoms of PTSD. Results: Majority of the study participants were general nurses (n = 121, 60.5%) and females (n= 122, 60.7%). Thirty-seven (18.4%) of the participants met the criteria for PTSD. Exposure to violence in the past 12 months (AOR = 3.26; 95% CI: 1.49­7.16) and high neuroticism score (AOR = 2.72; 95% CI: 1.19­6.24) were significantly associated with the diagnosis of PTSD among the participants. Conclusion: Post-traumatic stress disorder could result from stressful events encountered in the course of managing patients in mental health institutes and departments. Pre-placement personality evaluation of health workers to be assigned to work in psychiatric units and post-incident trauma counselling of those exposed to violence may be beneficial in reducing the occurrence of PTSD in mental hospital health care workers

Post Traumatic Stress Disorder/PTSD in adolescent victims of sexual abuse: resilience and social support as protection factors / Síndrome do Estresse Pós-Traumático/PTSD em adolescentes vítimas de violência sexual: a resiliência e o suporte social como fatores de proteção

This analysis examined the contribution of personal, family (maternal and paternal support; sibling support) and extra-familiar (peer support; other adults) resilience to the prediction of clinical levels of PTSD symptoms in adolescents reporting sexual abuse. Controls were established for abuse-related variables (type of abuse, severity and multiple abuse) in a representative sample of high schools students in the province of Quebec. A total of 15.2% of adolescent females and 4.4% adolescent males in high school reported a history of sexual abuse in childhood. Sexually abused adolescent females (27.8%) were more likely than adolescent males (14.9%) to achieve scores with high clinical levels of PTSD. Hierarchical logistic regression revealed that over and above the characteristics of the sexual abuse experienced, resilience factors (maternal and peer support) contributed to the prediction of symptoms of PTSD attaining the clinical threshold. Alternative intervention and prevention practices geared to adolescent victims of sexual assault are discussed.

A presente análise explorou a contribuição da resiliência pessoal, familiar (apoio maternal e paternal, o apoio irmão) e extra-familiar (apoio dos pares, outro adulto) para a previsão de níveis clínicos de sintomas de Síndrome do Estresse Pós-Traumático (PTSD) em adolescentes que relataram abuso sexual, controlando-se variá veis relacionadas com o abuso (tipo de abuso, gravidade e abuso múltipla) em amostra representativa de alunos das escolas da província de Quebec. O total de 15,2% das meninas e 4,4 % dos meninos do ensino médio relataram uma história de abuso sexual infantil. Meninas abusadas sexualmente (27,8%) eram mais propensas, comparadas aos meninos (14,9%), para obter pontuação atingindo níveis clínicos de PTSD. A regressão logística hierárquica revelou que, para além das características do abuso sexual sofrido, fatores de resiliência (suporte materno e apoio dos pares) contribuíram para a predição de sintomas de PTSD que atingiram o limite clínico. São discutidas alternativas práticas de intervenção e de prevenção direcionadas a adolescentes vítimas de abuso sexual.

[Comparing the effectiveness of psychological debriefing, eye movement desensitization reprocessing, and imaginal exposure on treatment of chronic post-traumatic stress disorder]

Post-traumatic stress disorder [PTSD] is considered as one of the most prevalent disorder during the life time and can negatively influence the individual, family and social relationships of patients; so, prevention and treatment of this disorder is highly important. Eye movement desensitization and reprocessing [EMDR], psychological debriefing [PD], and imaginal exposure [IE] are some treatment but there is controversy about long effects of these treatments, especially among chronic patients. In a semi experimental study, a total of 54 adult male patients, based on Davidson scale and psychiatric diagnostic, were randomly selected, and then were divided into 3 equal therapy groups. All participants were evaluated before, after and 3 months after the treatment. Data were analyzed through the repeated variance and Duncan post-hoc tests. Psychological debriefing and eye movement desensitization and reprocessing were better than imaginal exposure in relief of chronic post-traumatic stress disorder signs and remaining the effectiveness in three months follow-up. It is concluded that all of the above methods are effective on chronic post-traumatic stress disorder and the efficacy of the therapeutic techniques would be still in force even after 3 months. Considering the importance of psychological interventions, it is necessary that such methods be taught to psychologists so that they can use them after traumatic accidents

Prevención de sintomatologia postraumática en mujeres con cáncer de mama: un modelo de intervención narrativo / Prevention of posttraumatic symptomatology in women with breast cancer: a narrative intervention model

Esta investigación evalúa un programa grupal narrativo para la prevención de sintomatología postraumática y otras variables asociadas en mujeres recientemente diagnosticadas con cáncer de mama. Para ello se seleccionó a 32 mujeres diagnosticadas en los Hospitales Higueras de Talcahuano y Regional de Concepción; 14 de ellas fueron asignadas al grupo experimental y 18 al grupo control. Los resultados indican que el programa fue efectivo en la reducción de la sintomatología postraumática, sintomatología depresiva y sintomatología somática. No se encontraron diferencias significativas en la variable autoestima. Los puntajes obtenidos en sintomatología postraumática seguían descendiendo a los tres meses de seguimiento. Se analizan alcances y limitaciones de este estudio.

This study evaluates a group program narrative for the prevention of post-traumatic symptomatology and other associate variables in women recently diagnosed with breast cancer. 32 women diagnosed with this pathology in two Hospitals: Higueras of Talcahuano and Regional of Concepción were selected; 14 of them were assigned to experimental group and 18 to the control group. Results indicate that the program was effective in the reduction of the post-traumatic, depressive and somatic symptomatology. There were not significant differences in the self-esteem variable. The scores obtained in post-traumatic symptomatology continued descending three months follow up. The reaches and limitations of this study are analyzed.

Intervención de salud mental para niños expuestos al desastre en la comunidad de Iloca: experiencia de la Unidad de Psiquiatría Infantil de Clínica Alemana / Mental health intervention for children exposed to disaster in the Iloca community

Se explica los pasos seguidos para realizar una intervención en Salud Mental en la población de la zona costera de la I. Municipalidad de Licantén de la VII región de Chile posterior al terremoto/maremoto del 27 de Febrero del 2010 en la zona centro sur de Chile, por parte de la Unidad de Psiquiatría Infantil del Departamento de Pediatría de Clínica Alemana. Se destaca la importancia de la evaluación de la situación local, del trabajo en equipo, de la coordinación entre diversas entidades y la necesidad de generar (en los agentes de salud local y en la población) credibilidad, confianza y percepción de pertinencia de las acciones del equipo externo. Se muestra una intervención planificada con recursos mixtos privados, públicos y trabajo voluntario de profesionales. Se valoran también la capacidad de flexibilidad en la programación inicial, la constancia en las acciones y el plantear desde el inicio estrategias a corto, mediano y largo plazo.

The challenge of posttraumatic stress disorder prevention: how to survive a disaster? / El desafío de la prevención en estrés postraumático: ¿cómo sobrevivir a un desastre?

Victims of natural disasters are subject to severe stress and disruption and may manifest a pattern of dissociative and anxiety/depression symptoms. The trauma may impair the person's quality of life and disrupt social and other functioning. If symptoms last beyond a month following the traumatic event, PTSD may ensue. These adverse effects do not always disappear with time. Acute stress management is focused on ensuring safety and providing support, including assessment of coping resources and support networks. An additional role of early intervention is to detect individuals who require more complex intervention. The issues addressed in therapy include the need to correct unrealistic expectations, to deal with guilt and phobic reactions as well as family and network reorganization. Cognitive-behavioral treatments, such as exposure techniques or cognitive restructuring approaches, have been shown to work. At times, work with the family members may be necessary too. Challenges for the future are discussed.

Las víctimas de una catástrofe pueden sufrir estrés y alteraciones en la vida cotidiana, así como mostrar síntomas ansioso-depresivos y disociativos. El suceso traumático puede dañar la calidad de vida de las víctimas e interferir negativamente en su funcionamiento cotidiano. Si los síntomas se mantienen, puede aparecer un TEPT. El manejo del estrés agudo se centra en proporcionar seguridad y apoyo, así como en evaluar las estrategias de afrontamiento y las redes de apoyo social y en detectar a las personas necesitadas de un tratamiento más complejo. Los puntos abordados en la terapia están referidos a corregir las expectativas no realistas, a hacer frente al miedo y a la culpa y a reorganizar la vida familiar y social. Los tratamientos cognitivo-conductuales, tales como la exposición y la reestructuración cognitiva, han mostrado ser eficaces. A veces hay que trabajar también con la familia. Se analizan los retos de futuro.

Atención psicológica postdesastres: más que un guarde la calma: una revisión de los modelos de las estrategias de intervención / Post-disaster psychological attention: more than a stay calm: a review of intervention strategics models

El presente artículo expone algunos de los conceptos que sobre las estrategias de atención posterior a desastres que han sido publicadas en los últimos 5 años en PsicoRedalyc y APA PsyArticles. De la revisión se destaca el hecho de que en habla hispana las publicaciones son mínimas en contraste con las más de 100 catástrofes ocurridas entre 2001 y 2010. Se presentan también modelos sistematizados sobre la experiencia de catástrofes ocurridas alrededor del mundo y de las que se han generado diferentes guías para la asistencia de los profesionales en salud mental a las víctimas. Se distingue una tendencia en la aplicación de técnicas propias de las terapias cognitivo-conductuales y un interés en la prevención del Trastorno de Estrés Post Traumático.

This article describes some of the concepts of care strategies after disasters that have been published over the past 5 years in PsicoRedalyc and APA PsyArticles. From the review highlights the fact that Hispanic publications are minimal in contrast to the more than 100 disasters occurred between 2001 and 2010. Systematized models are also presented on the experience of disasters occurring around the world and which have generated different guidelines for the care of mental health professionals to victims. It distinguishes a trend in the application of techniques of cognitive-behavioral therapy and an interest in the prevention of Post Traumatic Stress Disorder.

La experiencia de Peralillo: una intervención psicológica para el estado de emergencia / The experience in Peralillo: a psychological intervention for emergency situations

El trabajo presenta una intervención en Salud Mental destinada al apoyo emocional de los habitantes de Peralillo y sus alrededores, luego del terremoto que afectó a Chile en Febrero de 2010. Los objetivos fueron realizar actividades de prevención y contención emocional, asentado en las redes intersectoriales de la zona. El diseño de la Intervención contó con 24 voluntarios egresados, practicantes, académicos y profesionales afiliados a la Escuela de Psicología de la Usach, quienes realizaron un total de 14 visitas a la localidad. El alcance de la experiencia fue radial y con efecto dominó. Se realizaron atenciones individuales a 201 personas y 21 talleres de apoyo emocional grupal en espacios comunitarios (alcanzando a 332 personas), además de otras actividades específicas con funcionarios de Salud, prevención y psicoeducación en la Radio local, espacios públicos, salas de espera e intervenciones "puerta a puerta" en 36 hogares. Luego de un cierre de actividades, se evalúa la experiencia como exitosa en la implementación de un trabajo radial en coordinación con las redes de Salud Pública para hacer frente a la emergencia. Sin embargo, también surge la necesidad de abordar la prolongación del desastre en la medida que fuertes réplicas continúan. Se plantea como desafío para la disciplina clínica abordar las necesidades formativas que permitan hacer frente a nuevos desastres naturales, en función de esta experiencia.

This work presents a mental health intervention aiming at providing emotional support of the population of Peralillo and its surroundings, due to the earthquake that occurred in Chile on February, 2010. The goals were to implement prevention and emotional contention based on the contact with the local community network. The design included 24 volunteers affiliated to the School of Psychology (Usach), which participated in 14 visits to the area. The realm of the experience was radial and with a domino effect. 201 people were attended individually, 21 groups of emotional support were implemented (reaching 332 persons), in addition to other activities with health workers, prevention and education through the local radio, public spaces, waiting rooms, and door to door interventions in 36 homes. After concluding the intervention, the experience is regarded successful in terms of the radial coordination with the Public Health networks to face the emergency. Nevertheless, it is also necessary to consider the continuity of the disaster since strong aftershocks are still affecting the area. A new challenge to the clinical discipline will be to attend formative needs in the curricula to face future natural disasters based on this experience.

Prevención de trastorno de estrés postraumático en supervivientes del terremoto de Chile de febrero de 2010: una propuesta de intervención narrativa / Prevention of disorder of posttraumatic stress in survivors of the earthquake of Chile of February, 2010: an offer of narrative intervention

Tras el terremoto y tsunami que afectaron a la zona centro sur de Chile el 27 de febrero de 2010, se hace necesario anticipar las consecuencias psicológicas que este tipo de desastres provoca en la población. El presente trabajo revisa los resultados de distintos estudios a nivel mundial a fin de conocer estas consecuencias, centrándose principalmente en el Trastorno de Estrés Postraumático [TEPT], sus características particulares, prevalencia, factores de riesgo e intervenciones utilizadas para su prevención y tratamiento. A continuación, se propone un modelo de intervención narrativa, enriquecido por los aportes de los estudios sobre expresión emocional y apoyo social en la prevención de este trastorno. Esta propuesta se ha probado anteriormente con éxito para la prevención del TEPT y sintomatología asociada en mujeres con cáncer de mama.

After the earthquake and tsunami that struck the south-central Chile on February 27, 2010, it is necessary to anticipate the psychological consequences of disasters such causes in the population. This paper reviews the results of various studies worldwide in order to understand these consequences, focusing mainly on posttraumatic stress disorder [PTSD], their characteristics, prevalence, risk factors and interventions used for prevention and treatment. Then, we propose a model of narrative intervention, enriched by the contributions of studies on emotional expression and social support in the prevention of this disorder. This proposal has been tried before successfully for the prevention of PTSD and associated symptoms in women with breast cancer.

Chile se pone de pie otra vez: [editorial] / Chile: standing up again: [editorial]

One of the biggest earthquakes recorded in human history has recently devastated a large part of the Chilean territory and, followed by a Tsunami, destroyed cities, seaports, fishermen’s coves, bridges, and countryside houses. This cataclysm affected a large proportion of our population, leaving homeless families, no working tools for work places, hospitals, schools, public buildings, museums. However, the loss of human Uves was small compared to similar disasters. It destroyed part of the national heritage as well as damaged people's living conditions. A national movement started immediately to help and recover, and international resources, both human and technological were also set in motion. As after previous earthquakes in Chile, young M.D.'s and medical students were organized in voluntary groups backed by institutions or by their own organizations and went from large cities as Santiago and others to provide medical and psychological care to those in most need. Young members and students of other health professions (nurses, physical therapists, etc.) were included in these groups or worked in their own ones. National and international experience indicates that the forthcoming months require special care of psychological reactions and sequel (posttraumatic stress symptoms) and health consequences after water pollution, restrictions in housing and deteriorated sanitary conditions. Nevertheless, our country will stand up once more.

[Effectiveness of psycho-social support intervention in Qazvin earthquake survivors]

Psycho-social consequences and effects of natural disasters are important issues, but it has been paid little attention in our country. This research aims to study the effectiveness of psycho-social support intervention in Qazvin earthquake survivors in 2003. In this research, about 389 of participated in meetings such as children and adults were assessed in order to determine the effectiveness of psycho-social support services for the injured before intervention and a year after providing services by 10 clinical psychologists. The control group was selected from unaffected areas in Qazvin province. The research was done by using different questionnaires such as 28 questions of public health; Rutter behavioral disorder; and questionnaire of stress disorder symptoms of Watson and Yule after disaster. After receiving services, psycho-pathological disorders among people at age 15 or over were 33/5% [45% before intervention] in the experimental group and it was 23/1% [34/1% before intervention] in children [under the age of 15]. Psychological support services could relieve significantly stress disorder symptoms after disasters in two groups. Psycho-social support services to the injured can greatly minimize stress disorder symptoms after stressful disasters and psycho-pathological mental disorders among survivors and also prevent the prevalence of social problems in them

Prevención de secuelas psicológicas en niños con quemaduras graves / Prevention of psychological sequelae in severely burnt children

con el objetivo de evaluar la incidencia del Trastorno de estrés Agudo (T.E.A.) y el trastorno de Estrés postraumático (T.E.P.T.) en niños con quemaduras graves, se realizó una primera evaluación del niño en el primer mes de sucedido el evento traumático (período 1) y dos evaluaciones más en el período 2 (2do. y 3er. mes) y en el período 3 4to y 5to. mes). Dado que no existe un instrumento validado para el estudio de T.E.A y T. E.P.T., se diseñaron dos entrevistas psicológicas basadas en los criterios del Manual diagnóstico y estadístico de los trastornos mentales (DSM IV). Se estudiaron 69 niños con quemaduras graves (grupo I, II, III y IV, según clasificación de Garces), edad de 0 a 15 años (mediana 4 años), 43 por ciento F y 57 por ciento M. Los resultados fueron los siguientes: en el periodo 1, 18 por ciento de los pacientes presentaron T.E.A. y 82 por ciento Sintomatología poliforfa. En este período treinta (30) pacientes fueron no evalubles, dado que estaban en Asistencia Respiratoria Mecánica. En el perído 2; 8 por ciento de los pacientes presentaron T.E.P.T.; 92 por ciento sintomatología polimorfa. cinco (5) pacientes fueron no evaluables, dado que continuaban ARM. En el período 3; 28 por ciento presentó Sintomatología Polimorfa y el resto ningún trastorno emocional. Todos los pacientes fueron evaluados. Se realizaron intervenciones psicoeducativas, graficas y dramatizaciones con el niño (adaptadas al estado clínico del mismo). Conclusión: los resultados sugieren que la evaluación e intervenciones psicológicas tempranas de niños que vivieron un evento traumático podrían tener un efecto preventivo de secuelas psicológicas tempranas de niños que vivieron un evento traumático podrían tener un efecto preventivo de secuelas psicológicas asociadas al evento.

HIV infection, sexual abuse and social support in Jamaican adolescents referred to a psychiatric service / La infección por VIH, el abuso sexual y el apoyo social en adolescentes jamaicanos referidos a los servicios psiquiátricos

BACKGROUND: Children and adolescents with HIV/AIDS often have psychological/psychiatric issues that require specialist intervention. We explored whether HIV infection acquired through sexual abuse led to particularly negative psychiatric outcomes and whether good social support is a protective factor in the development of undesirable psychiatric sequelae. METHODS: This study consists of a case series of five persons referred from the Paediatric Infectious Diseases Clinic to the Child Psychiatry Clinic, both at the University Hospital of the West Indies (UHWI) in Jamaica, during July 1 to November 30, 2005. The patients were clinically assessed and diagnosed by a psychiatrist using the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM IV) criteria. Cases were compared according to gender, age, likely route of HIV infection, level of family/social support and nature of psychiatric outcome. RESULTS: Adolescents who acquired HIV infection through sexual abuse reported more intense feelings of sadness and suicidal ideations. Those with good social support reported less intense feelings of sadness with no suicidal ideations and were more optimistic about their future regardless of the route of acquisition. Two of three adolescents who acquired HIV infection through sexual abuse and one of two who was perinatally infected required ongoing supportive psychotherapy to augment their social support, the characteristic most associated with favourable outcome. CONCLUSION: Both sexual abuse and HIV/AIDS are likely to have negative psychological consequences in children and adolescents. This psychological impact may be intensified when HIV infection results from sexual assault as opposed to other methods of transmission. The findings support the practice of providing HIV prophylaxis to all sexual assault victims of known or suspected HIV-positive perpetrators and of encouraging utilization of existing social support networks.

ANTECEDENTES: Tanto niños como adolescentes que sufren de VIH/SIDA, tienen a menudo problemas psicológicos/psiquiátricos que requieren intervención especializada. El presente trabajo explora si la infección por VIH adquirida por abuso sexual condujo a resultados psiquiátricos particularmente negativos y si el buen apoyo social constituye un factor de protección en el desarrollo de secuelas psiquiátricas indeseables. MÉTODOS: Este estudio consiste en una serie de casos de cinco personas referidos a la Clínica Infantil de Psiquiatría desde la Clínica Pediátrica de Enfermedades Infeccionas, ambas en el Hospital Universitario de West Indies (HUWI) en Jamaica, desde julio 1 hasta noviembre 30 de 2005. Los pacientes fueron evaluados clínicamente y diagnosticados por un psiquiatra usando criterios del Manual Diagnóstico y Estadístico de los Trastornos Mentales, cuarta edición (DSM IV). Los casos fueron comparados de acuerdo con la edad, el género, la ruta probable de la infección por VIH, el nivel de apoyo familiar/social, y la naturaleza del resultado psiquiátrico. RESULTADOS: Adolescentes que adquirieron la infección del VIH por abuso sexual, reportaron sentimientos más intensos de tristeza e ideas suicidas. Aquellos con buen apoyo social reportaron sentimientos menos intensos de tristeza sin ideas suicidas y no tenían optimismo acerca de su futuro con independencia de cual fuera la ruta de su adquisición. Dos de los tres adolescentes que adquirieron la infección del VIH por abuso sexual y uno de dos que estaba infectado perinatalmente necesitaron psicoterapia de apoyo continua a fin de aumentar su apoyo social, la característica más asociada con resultados favorables. CONCLUSIÓN: Tanto el abuso sexual como el VIH/SIDA tienden a tener consecuencias psicológicas negativas en niños y adolescentes. Este impacto psicológico negativo puede ser intensificado cuando la infección por VIH se produce como consecuencia de un asalto sexual, en comparación con otros métodos de transmisión sexual. Los hallazgos respaldan la práctica de ofrecer profilaxis de VIH a todas las víctimas de asaltos sexuales por parte de perpetradores de los que se sabe o sospecha que son VIH positivos, así como estimular la utilización de las redes de apoyo social existentes.

Cognitive-behavioral intervention for young tsunami victims.

OBJECTIVE: To evaluate the efficacy of the cognitive-behavioral intervention provided to children by volunteer professionals in a tsunami-hit area in Thailand. The intervention was aimed to prevent the severe development of post traumatic stress symptoms, and to help the children who might recover spontaneously to do so more quickly. MATERIAL AND METHOD: One hundred and sixty children in Ranong province voluntarily participated in 2-days group activities on the 57h day after the tsunami. The manualized intervention had been designed based on cognitive-behavioral model. Three domains of post traumatic stress reactions were targeted, intrusion, arousal, and avoidance. The Children's Impact of Events Scale (13) (CRIES-13) was completed by the participants before and 2 weeks after the intervention. RESULTS: The program was generally well understood by the children. No difference in CRIES scores was observed before and after the children entered the intervention program. However when the sample was categorized into two groups, the group that was more likely to develop PTSD showed a significant reduction in the scores, whereas a significant increase in the scores was evident in the other group. CONCLUSION: The findings supported the efficacy of cognitive-behavioral intervention in the children who were prone to develop PTSD. The program needed to be adapted to suit the religious, socio-economic, and cultural background of the sample. The unchanged Avoidance scores in the present study were possibly explained by the general feeling that a tsunami might happen again and the parental involvement. The increase of post-intervention scores in otherwise normal sample, though not exceeding the cut-off raised some concern, and possibly the need for screening before the intervention.

Relatar emoções transforma as emoções relatadas?: um questionamento do paradigma de Pennebaker com implicações para a prevenção de transtorno de estresse pós-traumático / To report emotions trasforms the reported emotions?: questioning Pennebaker's paradigm as to its implications for the prevention of post-traumatic stress

Pessoas muitas vezes sentem um alívio depois de ter compartilhado emoções relacionadas a um trauma. Porém não há dados claros que indicam que estas emoções realmente são transformadas por este ato de compartilhar. A pesquisa empírica acerca dos efeitos do compartilhamento verbal de emoções gerou resultados contra-intuitivos e dificilmente interpretáveis. Isto é o caso tanto na psicologia experimental social quanto na pesquisa clínica acerca da prevenção de estresse pós-traumático. Uma releitura crítica desses resultados realça lacunas que merecem atenção da pesquisa. Questões referentes à relação entre esquiva experiencial e compartilhamento de emoções e principalmente ao que a pessoa aprende enquanto relatando as suas emoções, precisavam ser examinadas em mais detalhe