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Sample records for adult traumatic events

  1. Cumulative exposure to traumatic events in older adults

    PubMed Central

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2014-01-01

    Objectives The present study examined the impact of cumulative trauma exposure on current posttraumatic stress disorder (PTSD) symptom severity in a nonclinical sample of adults in their 60s. The predictive utility of cumulative trauma exposure was compared to other known predictors of PTSD, including trauma severity, personality traits, social support, and event centrality. Method Community-dwelling adults (n = 2,515) from the crest of the Baby Boom generation completed the Traumatic Life Events Questionnaire, the PTSD Checklist, the NEO Personality Inventory, the Centrality of Event Scale, and rated their current social support. Results Cumulative trauma exposure predicted greater PTSD symptom severity in hierarchical regression analyses consistent with a dose-response model. Neuroticism and event centrality also emerged as robust predictors of PTSD symptom severity. In contrast, the severity of individuals’ single most distressing life event, as measured by self-report ratings of the A1 PTSD diagnostic criterion, did not add explanatory variance to the model. Analyses concerning event categories revealed that cumulative exposure to childhood violence and adulthood physical assaults were most strongly associated with PTSD symptom severity in older adulthood. Moreover, cumulative self-oriented events accounted for a larger percentage of variance in symptom severity compared to events directed at others. Conclusion Our findings suggest that the cumulative impact of exposure to traumatic events throughout the life course contributes significantly to post-traumatic stress in older adulthood above and beyond other known predictors of PTSD. PMID:24011223

  2. Potentially Traumatic Events, Posttraumatic Stress Disorder, and Depression among Adults in Puerto Rico

    PubMed Central

    Overstreet, Cassie; Berenz, Erin C.; Sheerin, Christina; Amstadter, Ananda B.; Canino, Glorisa; Silberg, Judy

    2016-01-01

    The aims of the current study were to examine the prevalence of potentially traumatic events (PTEs), posttraumatic stress disorder (PTSD; data available in males only), and depressive symptoms in a Puerto Rican sample of 678 adult caretakers (50% female) of twins participating in the Puerto Rican Infant Twin Study. The World Health Organization Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was utilized to assess rates of PTEs, PTSD, and depression among male participants while an abbreviated version of the CIDI 3.0 and the Mood and Feelings Questionnaire were administered to females to assess PTEs and depressive symptoms. Significantly more males than females reported exposure to a PTE (76.6% vs. 44.2%, χ2 = 64.44, p < 0.001). In males, endorsement of multiple PTEs was associated with increased level of PTSD symptomatology (β = 0.33, p < 0.001). With regard to depression, a similar dose-response relationship was found in both males and females, with depressive symptoms increasing as number of PTEs increased (βs = 0.15, 0.16, ps < 0.05). Exposure to an attack with a weapon was significantly associated with increased depression symptoms in both males and females (βs = 0.24, 0.20, ps < 0.01, respectively). These findings highlight the need for identification of putative risk and resilience factors among PTE-exposed individuals in Puerto Rico. PMID:27064295

  3. Specific traumatic events during childhood as risk factors for posttraumatic stress disorder development in adults.

    PubMed

    Schoedl, Aline F; Costa, Mariana P; Fossaluza, Victor; Mari, Jair J; Mello, Marcelo F

    2014-07-01

    To evaluate differences in early life events (ELE) on adult victims of severe interpersonal violence among patients who developed posttraumatic stress disorder (PTSD) and control group. Adult victims of interpersonal violence were evaluated to diagnose the presence of PTSD and ELE. 308 subjects were included, 141 in patient's group (PTSD+) and 167 in control group (PSTD-). PTSD+ group had more severe PTSD, depressive symptoms and higher ETI scores than PTSD- group. Patients in PTSD+ group had a more frequent history of ELE. Some ELE were more significant for the development of this predisposition. PMID:23520354

  4. Early traumatic events in psychopaths.

    PubMed

    Borja, Karina; Ostrosky, Feggy

    2013-07-01

    The relationship between diverse early traumatic events and psychopathy was studied in 194 male inmates. Criminal history transcripts were revised, and clinical interviews were conducted to determine the level of psychopathy using the Psychopathy Checklist-Revised (PCL-R) Form, and the Early Trauma Inventory was applied to assess the incidence of abuse before 18 years of age. Psychopathic inmates presented a higher victimization level and were more exposed to certain types of intended abuse than sociopathic inmates, while the sum of events and emotional abuse were associated with the PCL-R score. Our studies support the influence of early adverse events in the development of psychopathic offenders. PMID:23550705

  5. Traumatic Childhood Events and Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kerns, Connor Morrow; Newschaffer, Craig J.; Berkowitz, Steven J.

    2015-01-01

    Traumatic childhood events are associated with a wide range of negative physical, psychological and adaptive outcomes over the life course and are one of the few identifiable causes of psychiatric illness. Children with autism spectrum disorder (ASD) may be at increased risk for both encountering traumatic events and developing traumatic sequelae;…

  6. Traumatic Childhood Events and Autism Spectrum Disorder.

    PubMed

    Kerns, Connor Morrow; Newschaffer, Craig J; Berkowitz, Steven J

    2015-11-01

    Traumatic childhood events are associated with a wide range of negative physical, psychological and adaptive outcomes over the life course and are one of the few identifiable causes of psychiatric illness. Children with autism spectrum disorder (ASD) may be at increased risk for both encountering traumatic events and developing traumatic sequelae; however, this topic has been understudied. This review considers the rationale for examining traumatic events and related symptomology in individuals with ASD and summarizes the limited research on this topic. A conceptual framework for understanding the interplay of ASD, trauma and traumatic sequelae is proposed and recommendations for future research presented. PMID:25711547

  7. Traumatic events and tonic immobility.

    PubMed

    Bados, Arturo; Toribio, Lidia; García-Grau, Eugeni

    2008-11-01

    Tonic immobility is a basic defense strategy which has not been studied in depth in humans. Data suggest that it may be a relatively frequent phenomenon in victims of rape and sexual abuse, but its occurrence has not been systematically explored in other types of trauma. We carried out a retrospective study in a sample of 100 university students to establish whether tonic immobility varies depending on the nature of the worst trauma experienced, defined subjectively by each participant. Immobility was assessed using the Tonic Immobility Scale and traumas were assessed using the modified Traumatic Events Questionnaire. Seventy percent of the sample had experienced trauma of some kind. There were no significant differences in tonic immobility between different types of trauma (e.g., physical abuse, assault or aggression, serious accident), except that the mean tonic immobility score was significantly higher in the group with trauma due to physical/psychological or sexual abuse than in the group with trauma due to receiving news of the mutilation, serious injury, or violent or sudden death of a loved one. We conclude tentatively that tonic immobility may be typical not only of sexual traumas, but of other kinds of directly experienced traumas as well. PMID:18988436

  8. Traumatization in Deaf and Hard-of-Hearing Adult Psychiatric Outpatients

    ERIC Educational Resources Information Center

    Øhre, Beate; Uthus, Mette Perly; von Tetzchner, Stephen; Falkum, Erik

    2015-01-01

    Deaf and hard-of-hearing persons are at risk for experiencing traumatic events and such experiences are associated with symptoms of mental disorder. We investigated the prevalence of traumatic events and subsequent traumatization in adults referred to specialized psychiatric outpatient units for deaf and hard-of-hearing patients. Sixty-two…

  9. Traumatic Symptomatology Characteristics of Adult Children of Alcoholics.

    ERIC Educational Resources Information Center

    Hall, Cathy W.; Webster, Raymond E.

    2002-01-01

    Assesses traumatic experience symptomatology, resiliency factors, and stress among young adults who had experienced alcohol within their family of origin. Results indicated adult children of alcoholics had more self-reported stress, more difficulty initiating the use of mediating factors in response to life events, and more symptoms of personal…

  10. Assessing Traumatic Event Exposure: Comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for "DSM-IV"

    ERIC Educational Resources Information Center

    Peirce, Jessica M.; Burke, Christopher K.; Stoller, Kenneth B.; Neufeld, Karin J.; Brooner, Robert K.

    2009-01-01

    Post-traumatic stress disorder (PTSD) diagnosis requires first identifying a traumatic event, but very few studies have evaluated methods of potential traumatic event assessment and their impact on PTSD diagnosis. The authors compared a behaviorally specific comprehensive multiple-item traumatic event measure with a single-item measure to…

  11. Is Post-Traumatic Stress Disorder a Helpful Concept for Adults with Intellectual Disability?

    ERIC Educational Resources Information Center

    Mitchell, A.; Clegg, J.

    2005-01-01

    Research using the concept of Post-Traumatic Stress Disorder (PTSD) with adults with intellectual disability (ID)assumes they perceive and react to traumatic events in a similar way to non-disabled adults. Reactions to trauma displayed by children may be relevant to adults with ID as well. Two focus groups were held with professionals and…

  12. Traumatic Events among Undergraduate Students: Prevalence and Associated Symptoms

    ERIC Educational Resources Information Center

    Frazier, Patricia; Anders, Samantha; Perera, Sulani; Tennen, Howard; Tashiro, Ty; Park, Crystal; Tomich, Patricia

    2009-01-01

    This multisite study assessed the prevalence of exposure to traumatic events and associated symptoms among undergraduate students (N = 1,528) using online surveys. Most students (85%) reported having experienced a traumatic event in their lifetime (Time 1) and 21% reported experiencing an event over a 2-month period during college (Time 2). The…

  13. Autobiographical memory in adult offspring of traumatized parents with and without posttraumatic stress symptoms.

    PubMed

    Wittekind, Charlotte E; Jelinek, Lena; Moritz, Steffen; Muhtz, Christoph; Berna, Fabrice

    2016-08-30

    The present study examined potential transgenerational effects of trauma on autobiographical memory in adult offspring of elderly participants with and without PTSD symptoms who were exposed to an early trauma during childhood. As traumatization is associated with reduced memory specificity for past events, we hypothesized that offspring of traumatized parents might be exposed to a less elaborative narrative style, which, in turn, might result in less specific autobiographical memories in the offspring. Results show that autobiographical memory specificity did not differ significantly between adult offspring of traumatized elderly participants with PTSD symptoms, without PTSD symptoms, and non-traumatized elderly participants. PMID:27322841

  14. A Bridge between Traumatic Life Events and Losses by Death.

    ERIC Educational Resources Information Center

    Trolley, Barbara C.

    1994-01-01

    Provides support for connection between grief reactions and traumatic life events. Discusses reactions to life traumas (alcoholism, abuse, disability, divorce, infertility) within context of grief framework. Applies literature pertaining to responses to suicide and murder to traumatic life events. Discusses and dissolves proposed differences…

  15. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium

    PubMed Central

    Benjet, C.; Bromet, E.; Karam, E. G.; Kessler, R. C.; McLaughlin, K. A.; Ruscio, A. M.; Shahly, V.; Stein, D. J.; Petukhova, M.; Hill, E.; Alonso, J.; Atwoli, L.; Bunting, B.; Bruffaerts, R.; Caldas-de-Almeida, J. M.; de Girolamo, G.; Florescu, S.; Gureje, O.; Huang, Y.; Lepine, J. P.; Kawakami, N.; Kovess-Masfety, Viviane; Medina-Mora, M. E.; Navarro-Mateu, F.; Piazza, M.; Posada-Villa, J.; Scott, K. M.; Shalev, A.; Slade, T.; ten Have, M.; Torres, Y.; Viana, M. C.; Zarkov, Z.; Koenen, K. C.

    2016-01-01

    Background Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs. Method General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure. Results Over 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types – witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury – accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events. Conclusions Given the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization. PMID:26511595

  16. Childhood traumatic events and adolescent overgeneral autobiographical memory: Findings in a UK cohort

    PubMed Central

    Crane, Catherine; Heron, Jon; Gunnell, David; Lewis, Glyn; Evans, Jonathan; Williams, J. Mark G.

    2014-01-01

    Background Overgeneral autobiographical memory has repeatedly been identified as a risk factor for adolescent and adult psychopathology but the factors that cause such over-generality remain unclear. This study examined the association between childhood exposure to traumatic events and early adolescent overgeneral autobiographical memory in a large population sample. Methods Thirteen-year-olds, n = 5,792, participating in an ongoing longitudinal cohort study (ALSPAC) completed a written version of the Autobiographical Memory Test. Performance on this task was examined in relation to experience of traumatic events, using data recorded by caregivers close to the time of exposure. Results Results indicated that experiencing a severe event in middle childhood increased the likelihood of an adolescent falling into the lowest quartile for autobiographical memory specificity (retrieving 0 or 1 specific memory) at age 13 by approximately 60%. The association persisted after controlling for a range of potential socio-demographic confounders. Limitations Data on the traumatic event exposures was limited by the relatively restricted range of traumas examined, and the lack of contextual details surrounding both the traumatic event exposures themselves and the severity of children's post-traumatic stress reactions. Conclusions This is the largest study to date of the association between childhood trauma exposure and overgeneral autobiographical memory in adolescence. Findings suggest a modest association between exposure to traumatic events and later overgeneral autobiographical memory, a psychological variable that has been linked to vulnerability to clinical depression. PMID:24657714

  17. Stress and Traumatic Stress: How Do Past Events Influence Current Traumatic Stress among Mothers Experiencing Homelessness?

    ERIC Educational Resources Information Center

    Williams, Julie K.; Hall, James A.

    2009-01-01

    The purpose of this research was to evaluate the relationship between past traumatic events and the level of current traumatic stress among mothers experiencing homelessness. The data for this study were gathered from 75 homeless mothers between May 2006 and October 2006 using a cross-sectional survey design with purposive sampling. All mothers…

  18. Gender Differences in Traumatic Events and Rates of Post-Traumatic Stress Disorder among Homeless Youth

    ERIC Educational Resources Information Center

    Gwadz, Marya Viorst; Nish, David; Leonard, Noelle R.; Strauss, Shiela M.

    2007-01-01

    In the present report we describe patterns of traumatic events and Post-traumatic Stress Disorder (PTSD), both partial and full, among homeless youth and those at risk for homelessness, with an emphasis on gender differences. Participants were 85 homeless and at-risk youth (49% female) recruited from a drop-in center in New York City in 2000.…

  19. Tips for Survivors of a Traumatic Event: Managing Your Stress

    MedlinePlus

    ... for Survivors of a Traumatic Event Managing Your Stress Know When to Get Help Sometimes things become ... anger, or desires revenge; or shows signs of stress (listed on this page) for several days or ...

  20. Traumatization in Deaf and Hard-of-Hearing Adult Psychiatric Outpatients.

    PubMed

    Øhre, Beate; Uthus, Mette Perly; von Tetzchner, Stephen; Falkum, Erik

    2015-07-01

    Deaf and hard-of-hearing persons are at risk for experiencing traumatic events and such experiences are associated with symptoms of mental disorder. We investigated the prevalence of traumatic events and subsequent traumatization in adults referred to specialized psychiatric outpatient units for deaf and hard-of-hearing patients. Sixty-two patients were diagnosed with mental disorders and assessed for potential traumatic experiences in their preferred language and mode of communication using instruments translated into Norwegian Sign Language. All patients reported traumatic events, with a mean of 6.2 different types; 85% reported subsequent traumatization not significantly associated with either residential school setting or communicative competence of childhood caregivers. Traumatization patterns in both sexes were similar to those in hearing clinical samples. Findings indicate that psychiatric intake interviews should routinely assess potentially traumatic events and their impacts, and that mental health professionals working with deaf and hard-of-hearing patients should be able to treat trauma-related disorders. PMID:25852180

  1. PTSD Symptoms and Self-Rated Recovery among Adult Sexual Assault Survivors: The Effects of Traumatic Life Events and Psychosocial Variables

    ERIC Educational Resources Information Center

    Najdowski, Cynthia J.; Ullman, Sarah E.

    2009-01-01

    Prior research has demonstrated that self-blame is predictive of more posttraumatic stress disorder (PTSD) symptoms and poorer recovery (Frazier, 2003; Koss, Figueredo, & Prince, 2002), and perceived control over recovery is associated with less distress (Frazier, 2003) in adult sexual assault (ASA) survivors. A structural equation model was…

  2. Behavior Problems and Traumatic Events of Unaccompanied Refugee Minors.

    ERIC Educational Resources Information Center

    Sourander, Andre

    1998-01-01

    A study examined the traumatic events and behavior symptoms of 46 unaccompanied refugee minors waiting for placement in an asylum center in Finland. The children had experienced numerous losses, separations, persecution, and threats. About half were functioning within clinical or borderline range. Younger children had more severe psychiatric…

  3. Witnessing traumatic events and post-traumatic stress disorder: insights from an animal model

    PubMed Central

    Patki, Gaurav; Salvi, Ankita; Liu, Hesong; Salim, Samina

    2015-01-01

    It is becoming increasingly recognized that post-traumatic stress disorder (PTSD) can be acquired vicariously from witnessing traumatic events. Recently, we published an animal model called the “Trauma witness model” (TWM) which mimics PTSD-like symptoms in rats from witnessing daily traumatic events (social defeat of cage mate) [15]. Our TWM does not result in any physical injury. This is a major procedural advantage over the typical intruder paradigm in which it is difficult to delineate the inflammatory response of tissue injury and the response elicited from emotional distress. Using TWM paradigm, we examined behavioral and cognitive effects in rats [15] however, the long-term persistence of PTSD-like symptoms or a time-course of these events (anxiety and depression-like behaviors and cognitive deficits) and the contribution of olfactory and auditory stress vs visual reinforcement were not examined. This study demonstrates that some of the features of PTSD-like symptoms in rats are reversible after a significant time lapse of the witnessing of traumatic events. We also have established that witnessing is critical to the PTSD-like phenotype and cannot be acquired solely due to auditory or olfactory stresses. PMID:26044989

  4. Traumatic Events and Obsessive Compulsive Disorder in Children and Adolescents: Is There a Link?

    PubMed Central

    Lafleur, Daniel L.; Petty, Carter; Mancuso, Elizabeth; McCarthy, Katherine; Biederman, Joseph; Faro, Alyssa; Levy, Hannah C.; Geller, Daniel A.

    2011-01-01

    Background The extant literature supports an association between psychological trauma and development of OCD in adults, and this link is a plausible mediator for environment gene interactions leading to phenotypic expression of OCD. Objective To explore the relationship between OCD and traumatic life events in children and adolescents. Methods We examined the prevalence of traumatic life events and PTSD in a large sample of systematically assessed children with OCD. OCD symptoms and severity were assessed using the Children’s Yale Brown Obsessive Compulsive Scale (CY-BOCS) in those with and without concurrent PTSD. Results Rate of PTSD and trauma exposure was higher in children with OCD than in a comparable control group of non-OCD youth matched for age, gender and SES. Children with concurrent PTSD had more intrusive fears and distress and less control over their rituals than children with OCD but without PTSD. Total CY-BOCS scores were higher in those with concurrent PTSD. Specific type of OCD symptoms was not altered by a PTSD diagnosis. Conclusions A history of psychologically traumatic events may be over-represented in children with OCD. Given the need to search for non-genetic factors that may lead to onset of OCD, better and more systematic methods to obtain and quantify psychologically traumatic life events are needed in clinical populations. PMID:21295942

  5. Stroke Incidence Following Traumatic Brain Injury in Older Adults

    PubMed Central

    Albrecht, Jennifer S.; Liu, Xinggang; Smith, Gordon S.; Baumgarten, Mona; Rattinger, Gail B.; Gambert, Steven R.; Langenberg, Patricia; Zuckerman, Ilene H.

    2015-01-01

    Objective Following traumatic brain injury (TBI), older adults are at increased risk of hemorrhagic and thromboembolic events, but it is unclear whether the increased risk continues after hospital discharge. We estimated incidence rates of hemorrhagic and ischemic stroke following hospital discharge for TBI among adults ≥65 and compared them with pre-TBI rates. Participants 16,936 Medicare beneficiaries aged ≥65 with a diagnosis of TBI in any position on an inpatient claim between 6/1/2006 and 12/31/2009 who survived to hospital discharge. Design Retrospective analysis of a random 5% sample of Medicare claims data Main Measures Hemorrhagic stroke was defined as ICD-9 codes 430.xx-432.xx. Ischemic stroke was defined as ICD-9 codes 433.xx-435.xx, 437.0x, and 437.1x. Results There was a six-fold increase in the rate of hemorrhagic stroke following TBI compared to the pre-TBI period (adjusted Rate Ratio (RR) 6.5; 95% Confidence Interval (CI) 5.3, 7.8), controlling for age and sex. A smaller increase in the rate of ischemic stroke was observed (adjusted RR 1.3; 95% CI 1.2, 1.4). Conclusion Future studies should investigate causes of increased stroke risk post-TBI as well as effective treatments to reduce stroke risk and improve outcomes post-TBI among older adults. PMID:24816156

  6. Witnessing traumatic events causes severe behavioral impairments in rats.

    PubMed

    Patki, Gaurav; Solanki, Naimesh; Salim, Samina

    2014-12-01

    Witnessing a traumatic event but not directly experiencing it can be psychologically quite damaging. In North America alone, ∼30% of individuals who witness a traumatic event develop post-traumatic stress disorder (PTSD). While effects of direct trauma are evident, consequences of indirect or secondary trauma are often ignored. Also unclear is the role of social support in the consequences of these experiences. The social defeat paradigm, which involves aggressive encounters by a large Long-Evans male rat (resident) towards a smaller Sprague-Dawley male rat (intruder), is considered a rodent model of PTSD. We have modified this model to create a trauma witness model (TWM) and have used our TWM model to also evaluate social support effects. Basically, when an intruder rat is placed into the home cage of a resident rat, it encounters an agonistic behavior resulting in intruder subordination. The socially defeated intruder is designated the SD rat. A second rat, the cage mate of the SD, is positioned to witness the event and is the trauma witnessing (TW) rat. Experiments were performed in two different experimental conditions. In one, the SD and TW rats were cagemates and acclimatized together. Then, one SD rat was subjected to three sessions of social defeat for 7 d. TW rat witnessed these events. After each social defeat exposure, the TW and SD rats were housed together. In the second, the TW and SD rats were housed separately starting after the first defeat. At the end of each protocol, depression-anxiety-like behavior and memory tests were conducted on the SD and TW rats, blood withdrawn and specific organs collected. Witnessing traumatic events led to depression- and anxiety-like behavior and produced memory deficits in TW rats associated with elevated corticosterone levels. PMID:24887568

  7. Witnessing traumatic events causes severe behavioral impairments in rats

    PubMed Central

    Patki, Gaurav; Solanki, Naimesh; Salim, Samina

    2015-01-01

    Witnessing a traumatic event but not directly experiencing it can be psychologically quite damaging. In North America alone, ~30% of individuals who witness a traumatic event develop post-traumatic stress disorder (PTSD). While effects of direct trauma are evident, consequences of indirect or secondary trauma are often ignored. Also unclear is the role of social support in the consequences of these experiences. The social defeat paradigm, which involves aggressive encounters by a large Long–Evans male rat (resident) towards a smaller Sprague–Dawley male rat (intruder), is considered a rodent model of PTSD. We have modified this model to create a trauma witness model (TWM) and have used our TWM model to also evaluate social support effects. Basically, when an intruder rat is placed into the home cage of a resident rat, it encounters an agonistic behavior resulting in intruder subordination. The socially defeated intruder is designated the SD rat. A second rat, the cage mate of the SD, is positioned to witness the event and is the trauma witnessing (TW) rat. Experiments were performed in two different experimental conditions. In one, the SD and TW rats were cagemates and acclimatized together. Then, one SD rat was subjected to three sessions of social defeat for 7 d. TW rat witnessed these events. After each social defeat exposure, the TW and SD rats were housed together. In the second, the TW and SD rats were housed separately starting after the first defeat. At the end of each protocol, depression-anxiety-like behavior and memory tests were conducted on the SD and TW rats, blood withdrawn and specific organs collected. Witnessing traumatic events led to depression- and anxiety-like behavior and produced memory deficits in TW rats associated with elevated corticosterone levels. PMID:24887568

  8. HIV-related posttraumatic stress disorder: investigating the traumatic events.

    PubMed

    Theuninck, Anthony C; Lake, Nick; Gibson, Stuart

    2010-08-01

    This study examined the relationship between the experience of various HIV-related events (receiving the diagnosis, receiving treatment, experiencing physical symptoms, self-disclosing HIV positive status, and witnessing HIV-related death) and posttraumatic stress symptoms in a sample of 100 gay men living with HIV. Self-report data revealed that 65% met criteria for having experienced a traumatic event in accordance with the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) posttraumatic stress disorder (PTSD) criterion A. The experience of shame, humiliation, or guilt during an event was measured but not found to be a significant indicator of having been traumatized. A total of 33% qualified for a PTSD diagnosis. Stepwise multiple regression analysis showed that receiving medical treatment, experiencing physical symptoms, and witnessing HIV-related death were most associated with HIV-related PTSD symptoms. Given that multiple HIV-related events are potentially traumatic, the screening, assessment and treatment for HIV-related PTSD may need to be considered by HIV services. PMID:20632886

  9. PTSD symptoms in response to traumatic and non-traumatic events: the role of respondent perception and A2 criterion.

    PubMed

    Boals, Adriel; Schuettler, Darnell

    2009-05-01

    The current study attempted to replicate the unexpected findings by Gold, Marx, Soler-Baillo, and Sloan [Gold, S. D., Marx, B. P., Soler-Baillo, J. M., & Sloan, D. M. (2005). Is life stress more traumatic than traumatic stress? Journal of Anxiety Disorders, 19, 687-698] that non-traumatic events were associated with greater levels of PTSD symptoms than traumatic events. The current study had two notable methodological differences. First, we included A2 trauma criteria (a response of intense fear, helplessness, or horror) in addition to A1 trauma criteria (the event is life-threatening) in defining traumatic events. Second, A1 and A2 trauma criteria were based on participants' ratings, as opposed to classification by coders. Using this alternative methodology, results obtained were opposite of Gold et al. PTSD symptoms were greater for DSM-defined traumatic events in comparison to non-traumatic events. In addition, A1 trauma criterion had little to no relationship to PTSD symptoms when A2 criterion was considered. These results call into question the role of A1 trauma criterion and the definition of traumatic events. PMID:19013754

  10. Displacement, county social cohesion and depression after a large-scale traumatic event

    PubMed Central

    Lê, Félice; Tracy, Melissa; Norris, Fran H.; Galea, Sandro

    2013-01-01

    Background Depression is a common and potentially debilitating consequence of traumatic events. Mass traumatic events cause wide-ranging disruptions to community characteristics, influencing the population risk of depression. In the aftermath of such events, population displacement is common. Stressors associated with displacement may increase risk of depression directly. Indirectly, persons who are displaced may experience erosion in social cohesion, further exacerbating their risk for depression. Methods Using data from a population-based cross-sectional survey of adults living in the 23 southernmost counties of Mississippi (N = 708), we modeled the independent and joint relations of displacement and county-level social cohesion with depression 18–24 months after Hurricane Katrina. Results After adjustment for individual- and county-level sociodemographic characteristics and county-level hurricane exposure, joint exposure to both displacement and low social cohesion was associated with substantially higher log-odds of depression (b = 1.34 [0.86–1.83]). Associations were much weaker for exposure only to low social cohesion (b = 0.28 [−0.35–0.90]) or only to displacement (b = 0.04 [−0.80– 0.88]). The associations were robust to additional adjustment for individually perceived social cohesion and social support. Conclusion Addressing the multiple, simultaneous disruptions that are a hallmark of mass traumatic events is important to identify vulnerable populations and understand the psychological ramifications of these events. PMID:23644724

  11. Survivors' experiences of media coverage after traumatic injury events.

    PubMed

    Englund, Liselotte; Forsberg, Rebecca; Saveman, Britt-Inger

    2014-01-01

    Survivors' experiences of media at traumatic events, is still a limited research area. The aim of this study is to explore survivors' experiences of interacting with journalists and media coverage, including their experiences of being portrayed in the media, following two Swedish train crashes. Qualitative interviews were conducted with passengers from two train crashes in Sweden. A qualitative content analysis generated meaning units, subcategories, and categories. Survivors experienced interacting with journalists mainly in three ways: harmful, inconsequential, and helpful. Media content and personal media exposure was experienced in a similar way: uncomfortable, insignificant, and useful. Journalists and media coverage have a large impact on survivors' experiences following a traumatic event. It is important that emergency responders, such as ambulance nurses, are aware of how victims are affected by journalists' presence and the media coverage that follows so that negative outcomes can be reduced and the positive can be enhanced. The present study also shows that media coverage in the long term can become important pieces of information for the victim in order to understand and process the traumatic event. PMID:23684434

  12. Catastrophic events and older adults.

    PubMed

    Cloyd, Elizabeth; Dyer, Carmel B

    2010-12-01

    The plight of older adults during catastrophic events is a societal concern. Older persons have an increased prevalence of cognitive disorders, chronic illnesses, and mobility problems that limit their ability to cope. These disorders may result in a lack of mental capacity and the ability to discern when they should evacuate or resolve problems encountered during a catastrophe. Some older persons may have limited transportation options, and many of the elderly survivors are at increased risk for abuse, neglect, and exploitation. Recommendations for future catastrophic events include the development of a federal tracking system for elders and other vulnerable adults, the designation of separate shelter areas for elders and other vulnerable adults, and involvement of gerontological professionals in all aspects of emergency preparedness and care delivery, including training of frontline workers. Preparation through preevent planning that includes region-specific social services, medical and public health resources, volunteers, and facilities for elders and vulnerable adults is critical. Elders need to be protected from abuse and fraud during catastrophic events. A public health triage system for elders and other vulnerable populations in pre- and postdisaster situations is useful, and disaster preparedness is paramount. Communities and members of safety and rescue teams must address ethical issues before an event. When older adults are involved, consideration needs to be given to triage decision making, transporting those who are immobile, the care of older adults who receive palliative care, and the equitable distribution of resources. Nurses are perfectly equipped with the skills, knowledge, and training needed to plan and implement disaster preparedness programs. In keeping with the tradition of Florence Nightingale, nurses can assume several crucial roles in disaster preparedness for older adults. Nurses possess the ability to participate and lead community

  13. Toward assessing traumatic events and stress symptoms in preschool children from low-income families.

    PubMed

    Graham-Bermann, Sandra A; Howell, Kathryn; Habarth, Janice; Krishnan, Sandhya; Loree, Amy; Bermann, Eric A

    2008-04-01

    Traumatic events can seriously disrupt the development of preschool children. Yet few studies capture developmentally specific examples of traumas and the expression of distress for this age group. Mothers and teachers of 138 preschoolers from low-income families were interviewed about traumatic events and completed a new measure assessing their child's traumatic stress symptoms. They reported traumatic events as the death of a person, death of a pet, family violence, high conflict divorce, sudden family loss, accident or injury, and viewing the World Trade Center attack. Factor analysis of 17 trauma symptoms revealed three internally consistent and valid scales: Intrusions, Emotional Reactivity, and Fears, plus a Total omnibus score. Traumatic stress symptoms varied by the type of event. Scores were higher for traumatic events involving close family members than for distal events. PMID:18954185

  14. White Matter Abnormalities in Post-traumatic Stress Disorder Following a Specific Traumatic Event.

    PubMed

    Li, Lei; Lei, Du; Li, Lingjiang; Huang, Xiaoqi; Suo, Xueling; Xiao, Fenglai; Kuang, Weihong; Li, Jin; Bi, Feng; Lui, Su; Kemp, Graham J; Sweeney, John A; Gong, Qiyong

    2016-02-01

    Studies of posttraumatic stress disorder (PTSD) are complicated by wide variability in the intensity and duration of prior stressors in patient participants, secondary effects of chronic psychiatric illness, and a variable history of treatment with psychiatric medications. In magnetic resonance imaging (MRI) studies, patient samples have often been small, and they were not often compared to similarly stressed patients without PTSD in order to control for general stress effects. Findings from these studies have been inconsistent. The present study investigated whole-brain microstructural alterations of white matter in a large drug-naive population who survived a specific, severe traumatic event (a major 8.0-magnitude earthquake). Using diffusion tensor imaging (DTI), we explored group differences between 88 PTSD patients and 91 matched traumatized non-PTSD controls in fractional anisotropy (FA), as well as its component elements axial diffusivity (AD) and radial diffusivity (RD), and examined these findings in relation to findings from deterministic DTI tractography. Relations between white matter alterations and psychiatric symptom severity were examined. PTSD patients, relative to similarly stressed controls, showed an FA increase as well as AD and RD changes in the white matter beneath left dorsolateral prefrontal cortex and forceps major. The observation of increased FA in the PTSD group suggests that the pathophysiology of PTSD after a specific acute traumatic event is distinct from what has been reported in patients with several years duration of illness. Alterations in dorsolateral prefrontal cortex may be an important aspect of illness pathophysiology, possibly via the region's established role in fear extinction circuitry. Use-dependent myelination or other secondary compensatory changes in response to heightened demands for threat appraisal and emotion regulation may be involved. PMID:26981581

  15. White Matter Abnormalities in Post-traumatic Stress Disorder Following a Specific Traumatic Event

    PubMed Central

    Li, Lei; Lei, Du; Li, Lingjiang; Huang, Xiaoqi; Suo, Xueling; Xiao, Fenglai; Kuang, Weihong; Li, Jin; Bi, Feng; Lui, Su; Kemp, Graham J.; Sweeney, John A.; Gong, Qiyong

    2016-01-01

    Studies of posttraumatic stress disorder (PTSD) are complicated by wide variability in the intensity and duration of prior stressors in patient participants, secondary effects of chronic psychiatric illness, and a variable history of treatment with psychiatric medications. In magnetic resonance imaging (MRI) studies, patient samples have often been small, and they were not often compared to similarly stressed patients without PTSD in order to control for general stress effects. Findings from these studies have been inconsistent. The present study investigated whole-brain microstructural alterations of white matter in a large drug-naive population who survived a specific, severe traumatic event (a major 8.0-magnitude earthquake). Using diffusion tensor imaging (DTI), we explored group differences between 88 PTSD patients and 91 matched traumatized non-PTSD controls in fractional anisotropy (FA), as well as its component elements axial diffusivity (AD) and radial diffusivity (RD), and examined these findings in relation to findings from deterministic DTI tractography. Relations between white matter alterations and psychiatric symptom severity were examined. PTSD patients, relative to similarly stressed controls, showed an FA increase as well as AD and RD changes in the white matter beneath left dorsolateral prefrontal cortex and forceps major. The observation of increased FA in the PTSD group suggests that the pathophysiology of PTSD after a specific acute traumatic event is distinct from what has been reported in patients with several years duration of illness. Alterations in dorsolateral prefrontal cortex may be an important aspect of illness pathophysiology, possibly via the region's established role in fear extinction circuitry. Use-dependent myelination or other secondary compensatory changes in response to heightened demands for threat appraisal and emotion regulation may be involved. PMID:26981581

  16. The shared and specific relationships between exposure to potentially traumatic events and transdiagnostic dimensions of psychopathology.

    PubMed

    Sunderland, Matthew; Carragher, Natacha; Chapman, Cath; Mills, Katherine; Teesson, Maree; Lockwood, Emma; Forbes, David; Slade, Tim

    2016-03-01

    The experience of traumatic events has been linked to the development of psychopathology. Changing perspectives on psychopathology have resulted in the hypothesis that broad dimensional constructs account for the majority of variance across putatively distinct disorders. As such, traumatic events may be associated with several disorders due to their relationship with these broad dimensions rather than any direct disorder-specific relationship. The current study used data from 8871 Australians to test this hypothesis. Two broad dimensions accounted for the majority of relationships between traumatic events and mental and substance use disorders. Direct relationships remained between post-traumatic stress disorder and six categories of traumatic events in the total population and between drug dependence and accidents/disasters for males only. These results have strong implications for how psychopathology is conceptualized and offer some evidence that traumatic events are associated with an increased likelihood of experiencing psychopathology in general. PMID:26874292

  17. Association between traumatic events and post-traumatic stress disorder: results from the ESEMeD-Spain study

    PubMed Central

    Olaya, B.; Alonso, J.; Atwoli, L.; Kessler, R. C.; Vilagut, G.; Haro, J. M.

    2014-01-01

    Background The relative importance of traumatic events (TEs) in accounting for the social burden of post-traumatic stress disorder (PTSD) could vary according to cross-cultural factors. In that sense, no such studies have yet been conducted in the Spanish general population. The present study aims to determine the epidemiology of trauma and PTSD in a Spanish community sample using the randomly selected TEs method. Methods The European Study of the Epidemiology of Mental Disorders (ESEMeD)-Spain is a cross-sectional household survey of a representative sample of adult population. Lifetime prevalence of self-reported TEs and lifetime and 12-month prevalence of PTSD were evaluated using the World Health Organization (WHO) Composite International Diagnostic Interview. Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Results Road accident was the most commonly self-reported TE (14.1%). Sexual assault had the highest conditional risk of PTSD (16.5%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (36.4% of all cases) and sexual assault (17.2%). Being female and having a low educational level were associated with low risk of overall TE exposure and being previously married was related to higher risk. Being female was related to high risk of PTSD after experiencing a TE. Conclusions Having an accident is commonly reported among Spanish adults, but two TE are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden. PMID:24565167

  18. A prospective population based study of changes in alcohol use and binge drinking after a mass traumatic event*

    PubMed Central

    Cerdá, Magdalena; Tracy, Melissa; Galea, Sandro

    2010-01-01

    Few studies have assessed changes in alcohol use before and after a massive disaster. We investigated the contribution of exposure to traumatic events and stressors related to Hurricanes Katrina and Rita to alcohol use and binge drinking. We used data from the Panel Study of Income Dynamics collected in Mississippi, Louisiana and Alabama on adults aged 18–85 (n=439): 1) data from 1968–2005 on household income; 2) data from 2005 and 2007 on total number of drinks per year and number of days the respondent binged; and 3) data from 2007 on exposure to hurricane-related traumatic events and post-hurricane stressors. Exposure to each additional hurricane-related traumatic event was associated with 79.2 more drinks and 2.46 times higher odds of binge drinking for more days in the past year (95% CI: 1.09, 5.55), while more post-disaster stressors were associated with 16.5 more drinks and 1.23 times higher odds of binge drinking for more days in the past year (95% CI: 0.99, 1.51). Respondents who had followed a lower lifetime income trajectory and were exposed to more lifetime traumatic events experienced the highest risk of reporting increased alcohol use given exposure to hurricane-related traumatic events and post-hurricane stressors. Disaster-related traumatic events and the proliferation of post-disaster stressors may result in increased post-disaster alcohol use and abuse. Disaster-related exposures may have a particularly strong impact among individuals with a history of social and economic adversity, widening preexisting health disparities. PMID:20977977

  19. Intolerance of uncertainty as a predictor of post-traumatic stress symptoms following a traumatic event.

    PubMed

    Oglesby, Mary E; Boffa, Joseph W; Short, Nicole A; Raines, Amanda M; Schmidt, Norman B

    2016-06-01

    Intolerance of uncertainty (IU) has been associated with elevated post-traumatic stress symptoms (PTSS) in the extant literature. However, no research to date has investigated whether pre-trauma IU predicts PTSS following trauma exposure. The current study prospectively examined the relationship between IU and PTSS within a sample of individuals with various levels of exposure to a university campus shooting. We hypothesized that pre-trauma IU would predict elevated PTSS following a campus shooting, even after covarying for anxiety sensitivity (AS), a known correlate of PTSS. Participants included undergraduates (n=77) who completed a self-report battery in Introductory Psychology. After a campus shooting, they were invited to complete measures of PTSD symptoms and level of exposure to the shooting. As anticipated, results revealed pre-trauma IU as a significant predictor of elevated PTSS following the campus shooting. These results remained significant after covarying for pre-trauma levels of AS. Our results are the first to demonstrate that elevated pre-trauma levels of IU predict later PTSS following exposure to a traumatic event. This finding is discussed in terms of promising directions for future research and treatment strategies. PMID:26803928

  20. Post-Traumatic Blepharocele in an Adult

    PubMed Central

    Govindaraju, Venkatesh; Bharathi, Ravindra

    2013-01-01

    Cerebrospinal fluid (CSF) collection in the eyelid is known as blepharocele. It is rarely reported in adults. In this report, we describe one such patient who developed a non-resolving swelling of the left upper eyelid associated with mechanical ptosis following a head injury. He had fractures involving the left orbital rim and roof, and the medial and lateral walls. His left frontal sinus was hypoplastic. The diagnosis of CSF blepharocele was made based on clinical, biochemical and radiological findings. He underwent transcranial repair of the left frontobasal dural tear with a good recovery. PMID:23984042

  1. Incidence of Traumatic Events and Posttraumatic Psychological Symptoms among College Students.

    ERIC Educational Resources Information Center

    Lauterbach, Dean; Vrana, Scott R.

    Most research on posttraumatic stress disorder (PTSD) has been conducted on war veterans; little is known about the incidence of traumatic events, PTSD, and posttraumatic symptoms among other populations. This study was undertaken to assess the incidence of traumatic events of sufficient intensity to potentially cause PTSD among a sample of 440…

  2. Recovery from Mild Traumatic Brain Injury in Previously Healthy Adults.

    PubMed

    Losoi, Heidi; Silverberg, Noah D; Wäljas, Minna; Turunen, Senni; Rosti-Otajärvi, Eija; Helminen, Mika; Luoto, Teemu M; Julkunen, Juhani; Öhman, Juha; Iverson, Grant L

    2016-04-15

    This prospective longitudinal study reports recovery from mild traumatic brain injury (MTBI) across multiple domains in a carefully selected consecutive sample of 74 previously healthy adults. The patients with MTBI and 40 orthopedic controls (i.e., ankle injuries) completed assessments at 1, 6, and 12 months after injury. Outcome measures included cognition, post-concussion symptoms, depression, traumatic stress, quality of life, satisfaction with life, resilience, and return to work. Patients with MTBI reported more post-concussion symptoms and fatigue than the controls at the beginning of recovery, but by 6 months after injury, did not differ as a group from nonhead injury trauma controls on cognition, fatigue, or mental health, and by 12 months, their level of post-concussion symptoms and quality of life was similar to that of controls. Almost all (96%) patients with MTBI returned to work/normal activities (RTW) within the follow-up of 1 year. A subgroup of those with MTBIs and controls reported mild post-concussion-like symptoms at 1 year. A large percentage of the subgroup who had persistent symptoms had a modifiable psychological risk factor at 1 month (i.e., depression, traumatic stress, and/or low resilience), and at 6 months, they had greater post-concussion symptoms, fatigue, insomnia, traumatic stress, and depression, and worse quality of life. All of the control subjects who had mild post-concussion-like symptoms at 12 months also had a mental health problem (i.e., depression, traumatic stress, or both). This illustrates the importance of providing evidence-supported treatment and rehabilitation services early in the recovery period. PMID:26437675

  3. After the Storm: Enduring Differences in Mother-Child Recollections of Traumatic and Non-Traumatic Events.

    ERIC Educational Resources Information Center

    Ackil, Jennifer K.; Van Abbema, Dana L.; Bauer, Patricia J.

    2003-01-01

    Compared collective reminiscences of mothers and their 3- to 11-year-olds about a tornado and two nontraumatic events (one proceeding and one following the tornado) 4 months post-tornado and again 6 months later. Found that conversations about both traumatic and nontraumatic events varied with age. Children's tornado recollections were…

  4. Serial reproduction of traumatic events: does the chain unravel?

    PubMed

    Nahari, Galit; Sheinfeld, Vallery; Glicksohn, Joseph; Nachson, Israel

    2015-02-01

    Our goal in this paper is to show that a careful analysis of recall accuracy within a serial reproduction chain can add to a detailed qualitative analysis of the reproductions within the chain. The texts we chose are based on newspaper reports concerning current events, which are far from being mundane: reports of tragic events, even traumatic events. The participants were 216 students who were randomly assigned to 54 four-person reproduction chains, 18 for each of three 160-word texts. The reproduction chain is highly dependent on the recall accuracy of the first generation (i.e., the first participant in the reproduction chain). Thus, we argue (and show) that there should be a qualitative difference between chains starting off with a high level of recall accuracy from those starting off with a low level of recall accuracy. Our data-analytic approach is based on trend analysis, which we argue is an apt quantitative, holistic, dynamic, process-oriented type of analysis that is required in such research. PMID:25168856

  5. Adults' Event Recall: Is Context Enough?

    ERIC Educational Resources Information Center

    Ratner, Hilary Horn; Padgett, Robert J.

    In studies of retention of verbal material adults have repeatedly remembered less than younger adults have. A study was conducted which asked older adults to remember an experienced event, retention of experiences being considered a better indicator of functioning ability than retention of word lists. In an initial study, older adults' recall was…

  6. Impact of Traumatic Events on Coping Strategies and Their Effectiveness among Kurdish Children

    ERIC Educational Resources Information Center

    Punamaki, Raija-Leena; Muhammed, Abbas Hedayiet; Abdulrahman, Hemen Ahmed

    2004-01-01

    The aims were, first, to identify behavioural, cognitive, emotional, and social coping responses to traumatic and stressful situations, and second, to examine how the nature and severity of traumatic events are associated with coping dimensions. Third, the effectiveness of coping dimensions was evaluated for their ability to buffer the children's…

  7. Main traumatic events in Europe: PTSD in the European study of the epidemiology of mental disorders survey.

    PubMed

    Darves-Bornoz, Jean-Michel; Alonso, Jordi; de Girolamo, Giovanni; de Graaf, Ron; Haro, Josep-Maria; Kovess-Masfety, Viviane; Lepine, Jean-Pierre; Nachbaur, Gaëlle; Negre-Pages, Laurence; Vilagut, Gemma; Gasquet, Isabelle

    2008-10-01

    A potentially traumatic event (PTE) contributes to trauma through its frequency, conditional probability of posttraumatic stress disorder (PTSD), and experience of other PTEs. A cross-sectional survey was conducted, enrolling 21,425 adults nationally representative of six European countries. Using the WHO-Composite International Diagnostic Interview, 8,797 were interviewed on 28 PTEs and PTSD. Prevalence of 12-month PTSD was 1.1%. When PTSD was present, the mean number of PTEs experienced was 3.2. In a multivariate analysis on PTEs and gender, six PTEs were found to be more traumatic, and to explain a large percentage of PTSD, as estimated by their attributable risk of PTSD: rape, undisclosed private event, having a child with serious illness, beaten by partner, stalked, beaten by caregiver. PMID:18956444

  8. Secondary Traumatization among Adult Children of PTSD Veterans: The Role of Mother-Child Relationships

    ERIC Educational Resources Information Center

    Dinshtein, Yula; Dekel, Rachel; Polliack, Miki

    2011-01-01

    The study examined the level of secondary traumatization among adult children of Israeli war veterans with post-traumatic stress disorder (PTSD) as manifested in emotional distress, stress resulting from terrorist attacks, and capacity for intimacy. In addition, the role of the mother-child relationship as a moderator of these manifestations of…

  9. Traumatic brain injury: endocrine consequences in children and adults.

    PubMed

    Richmond, Erick; Rogol, Alan D

    2014-02-01

    Traumatic brain injury (TBI) is a common cause of death and disability in young adults with consequences ranging from physical disabilities to long-term cognitive, behavioral, psychological and social defects. Recent data suggest that pituitary hormone deficiency is not infrequent among TBI survivors; the prevalence of reported hypopituitarism following TBI varies widely among published studies. The most common cause of TBI is motor vehicle accidents, including pedestrian-car and bicycle car encounters, falls, child abuse, violence and sports injuries. Prevalence of hypopituitarism, from total to isolated pituitary deficiency, ranges from 5 to 90 %. The time interval between TBI and pituitary function evaluation is one of the major factors responsible for variations in the prevalence of hypopituitarism reported. Endocrine dysfunction after TBI in children and adolescents is common. Adolescence is a time of growth, freedom and adjustment, consequently TBI is also common in this group. Sports-related TBI is an important public health concern, but many cases are unrecognized and unreported. Sports that are associated with an increased risk of TBI include those involving contact and/or collisions such as boxing, football, soccer, ice hockey, rugby, and the martial arts, as well as high velocity sports such as cycling, motor racing, equestrian sports, skiing and roller skating. The aim of this paper is to summarize the best evidence of TBI as a cause of pituitary deficiency in children and adults. PMID:24030696

  10. [Management of stressing events and prevention of post-traumatic stress in the railroad setting].

    PubMed

    del Nord, P

    2012-01-01

    The paper addresses the proper management of events that can lead to post traumatic stress, that are the situations where: the person experienced or witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others. This document results from a collation of the knowledge acquired by railway undertakings and infrastructure managers on the management and prevention of post-traumatic stress. Having surveyed the various strategies for the management of post-traumatic stress as these are applied in the participating countries, a number of recommendations and best practices were identified and these are presented in this guide. This guide comprises two parts: * A theoretical document comprising several parts: Part one deals with the fundamental notions involved in post-traumatic stress and potentially traumatic events; Part two deals with a strategy for managing potentially traumatic events and sets out a reference framework to this end. This strategy is broken down into five key phases: risk assessment, preparation and prevention, intervention, post-intervention and follow-up, appraisal, including reports from experience. Practical "check sheets" stating the key messages to be understood and/or the specific actions to be taken before, during or after a potentially traumatic event. These sheets are intended for operational staff, managers, directors and support workers. This guide was prepared by a working group under the supervision of the UIC Safety Platform's Occupational Health and Safety Group (OHSG). The working group brought together psychologists, occupational physicians, ergonomists, safety experts, managers and safety directors. It is the fruit of interdisciplinary collaboration, marrying the concerns, needs and knowledge of railway undertakings and infrastructure managers from a variety of European countries. PMID:23405657

  11. Nightmares and dissociative experiences: the key role of childhood traumatic events.

    PubMed

    Agargun, Mehmet Yucel; Kara, Hayrettin; Ozer, Omer Akil; Selvi, Yavuz; Kiran, Umit; Kiran, Songül

    2003-04-01

    In order to examine the co-occurrence of nightmares with dissociative experiences in the adolescent population and to demonstrate the impact of childhood traumatic events in this association, 292 undergraduate students were interviewed for childhood traumatic events. The Van Dream Anxiety Scale (VDAS) and Dissociative Experiences Scale (DES) were also administered to the subjects. For nightmares a 7.5% prevalence of 'often' and a 58.2% prevalence of 'sometimes' was found for college students. Nightmare prevalence was higher in women than in men. The rate of childhood traumatic experiences was higher in nightmare sufferers than in those who did not have nightmares. The subjects who had undergone physical and sexual abuse had higher VDAS global scores and item scores. When the DES scores of the subjects with nightmares were compared with that of those who had never reported nightmares, the subjects with nightmares had significantly higher scores on DES. The DES scores were also negatively correlated with duration of nightmares in subjects who had childhood traumatic experiences. These findings suggest that the subjects with childhood traumatic events failed to psychologically integrate their traumatic experiences and used dissociation as a coping strategy. PMID:12667159

  12. PTSD Symptoms Among Police Officers: Associations With Frequency, Recency, And Types Of Traumatic Events

    PubMed Central

    Hartley, Tara A.; Sarkisian, Khachatur; Violanti, John M.; Andrew, Michael E.; Burchfiel, Cecil M.

    2016-01-01

    Policing necessitates exposure to traumatic, violent and horrific events, which can lead to an increased risk for developing post-traumatic stress disorder (PTSD). The purpose of this study was to determine whether the frequency, recency, and type of police-specific traumatic events were associated with PTSD symptoms. Participants were 359 police officers from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004–2009). Traumatic police events were measured using the Police Incident Survey (PIS); PTSD was measured using the PTSD Checklist-Civilian Version (PCL-C). Associations between PIS and PTSD symptoms were evaluated using ANCOVA. Contrast statements were used to test for linear trends. Increased frequency of specific types of events were associated with an increase in the PCL-C score in women, particularly women with no history of prior trauma and those who reported having a high workload (p < 0.05). More recent exposure to seeing severely assaulted victims was associated with higher PCL-C scores in men (p < 0.02). In summary, the frequency of several traumatic events was associated with higher PTSD scores in women, while the recency of seeing victims of assault was associated with higher PTSD scores in men. These results may be helpful in developing intervention strategies to reduce the psychological effects following exposure and these strategies may be different for men and women. PMID:24707587

  13. Gender, Traumatic Events, and Mental Health Disorders in a Rural Asian Setting*

    PubMed Central

    Axinn, William G.; Ghimire, Dirgha J.; Williams, Nathalie E.; Scott, Kate M.

    2014-01-01

    Research shows a strong association between traumatic life experience and mental health and important gender differences in that relationship in the Western European Diaspora, but much less is known about these relationships in other settings. We investigate these relationships in a poor rural Asian setting that recently experienced a decade-long armed conflict. We use data from 400 adult interviews in rural Nepal. The measures come from World Mental Health survey instruments clinically validated for this study population to measure Depression, Post Traumatic Stress Disorder (PTSD), and Intermittent Explosive Disorder (IED). Our results demonstrate that traumatic life experience significantly increases the likelihood of mental health disorders in this setting and that these traumatic experiences have a larger effect on the mental health of women than men. These findings offer important clues regarding the potential mechanisms producing gender differences in mental health in many settings. PMID:24311755

  14. Memories of traumatic events in childhood fade after experiencing similar less stressful events: results from two natural experiments.

    PubMed

    Weems, Carl F; Russell, Justin D; Banks, Donice M; Graham, Rebecca A; Neill, Erin L; Scott, Brandon G

    2014-10-01

    The long-term stability of youth reports of traumatic events is largely unknown. Translational animal research suggests that there may be an alteration of memories for traumatic events via memory reconsolidation processes, whereas clinical research suggests memory alteration may occur through augmentation by negative emotions. In this report, 2 natural experiments test reconsolidation model and augmentation model predictions about the course of traumatic memories in youth. Data are from 2 prospective studies that assessed reports of an initial traumatic event (Hurricane Katrina) and tested recall both pre and post a similar event (Hurricane Gustav). In the 1st (Sample 1; n = 94, initial Grade 9 followed to 11), youth were assessed at 4 time points: Times 1-3 were 13, 20, and 26 months post-Katrina and then Time 4 was 5 months post-Hurricane Gustav. In the 2nd (Sample 2; n = 141, Grades 4 through 8), youth were assessed at 12 months pre-Gustav (Time 1; 24 months post-Katrina) and then again at 1 month (Time 2) and 8 months (Time 3) post-Gustav. Those with relatively high Gustav exposure showed more stability in their reports of Katrina exposure events, whereas in those with low Gustav exposure, reports of Katrina events decreased. Time spans between recall, age, gender, symptoms of posttraumatic stress disorder, or cognitive/learning ability did not explain changes in the reports. The study provides the 1st long-term data on the consistency of youth reports of disaster-related experiences and provides initial evidence for the ecological validity of memory reconsolidation theory applied to traumatic events in youth. PMID:25068536

  15. The Prevalence of Childhood Adversity among Healthcare Workers and Its Relationship to Adult Life Events, Distress and Impairment

    ERIC Educational Resources Information Center

    Maunder, Robert G.; Peladeau, Nathalie; Savage, Diane; Lancee, William J.

    2010-01-01

    Objective: We investigated the prevalence of childhood adversity among healthcare workers and if such experiences affect responses to adult life stress. Methods: A secondary analysis was conducted of a 2003 study of 176 hospital-based healthcare workers, which surveyed lifetime traumatic events, recent life events, psychological distress, coping,…

  16. Review of Acute Traumatic Closed Mallet Finger Injuries in Adults

    PubMed Central

    Salazar Botero, Santiago; Hidalgo Diaz, Juan Jose; Benaïda, Anissa; Collon, Sylvie; Facca, Sybille

    2016-01-01

    In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed. Tubiana's classification takes into account the size of the bony articular fragment and DIPJ subluxation. We propose to stage subluxated fractures as stage III if the subluxation is reducible with a splint and as stage IV if not. Left untreated, mallet finger becomes chronic and leads to a swan-neck deformity and DIPJ osteoarthritis. The goal of treatment is to restore active DIPJ extension. The results of a six- to eight-week conservative course of treatment with a DIPJ splint in slight hyperextension for tendon lesions or straight for bony avulsions depends on patient compliance. Surgical treatments vary in terms of the approach, the reduction technique, and the means of fixation. The risks involved are stiffness, septic arthritis, and osteoarthritis. Given the lack of consensus regarding indications for treatment, we propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which we treat with extra-articular pinning. PMID:27019806

  17. The meaning of traumatic events as described by nurses in ambulance service.

    PubMed

    Jonsson, Anders; Segesten, Kerstin

    2003-07-01

    Ambulance personnel are working with the injured and dead and are therefore exposed to a variety of stressors that can lead to the development of physical, psychological and social reactions. Stress among ambulance personnel can be regarded as a natural behaviour and reaction when experiencing a traumatic event. The aim of this phenomenological study is to uncover the essence of traumatic events experienced by Swedish ambulance personnel. Knowledge about such events contributes to the awareness of risk for post-traumatic stress symptom and serves as a platform for developing measures to handle such stress. In this study, written stories from 52 of 223 ambulance nurses and ambulance technicians describing an experienced traumatic event, are analysed by the method of van Kaam. Findings indicate that the nurses and technicians have a strong identification with the victims and it is impossible to prepare for events that are unforeseen and meaningless. To handle the overwhelming feelings of identification, the personnel have to gain understanding through talking about those feelings. Therefore it is important that ambulance management, following stressful events, provide the opportunity and time for ambulance personnel to share their feelings. Teaching ways of decreasing identification and emotional involvement with the victim may also be an effective preventive measure. PMID:12804611

  18. Racial discrimination, post traumatic stress, and gambling problems among urban Aboriginal adults in Canada.

    PubMed

    Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul; Parlee, Brenda

    2013-09-01

    Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events. PMID:22730152

  19. Future Concerns of Adult Siblings of Persons with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Degeneffe, Charles Edmund; Olney, Marjorie F.

    2008-01-01

    This study examined future concerns conveyed by adult siblings who provided regular caregiving support to their brothers and sisters with traumatic brain injury (TBI). The authors surveyed a national sample of 280 adult siblings of persons with TBI. Using a constant comparative approach to text analysis, the authors analyzed responses to the…

  20. Measuring the Severity of Negative and Traumatic Events

    PubMed Central

    Rubin, David C.; Feeling, Nicole

    2014-01-01

    We devised three measures of the general severity of events, which raters applied to participants’ narrative descriptions: 1) placing events on a standard normed scale of stressful events, 2) placing events into five bins based on their severity relative to all other events in the sample, and 3) an average of ratings of the events’ effects on six distinct areas of the participants’ lives. Protocols of negative events were obtained from two non-diagnosed undergraduate samples (n = 688 and 328), a clinically diagnosed undergraduate sample all of whom had traumas and half of whom met PTSD criteria (n = 30), and a clinically diagnosed community sample who met PTSD criteria (n = 75). The three measures of severity correlated highly in all four samples but failed to correlate with PTSD symptom severity in any sample. Theoretical implications for the role of trauma severity in PTSD are discussed. PMID:25309831

  1. Impact of Traumatic Life Events in a Community Sample of Toddlers

    ERIC Educational Resources Information Center

    Mongillo, Elizabeth A.; Briggs-Gowan, Margaret; Ford, Julian D.; Carter, Alice S.

    2009-01-01

    Toddlers may be at particularly high risk for a number of psychiatric, developmental and neurobiological consequences in the aftermath of trauma. The social and emotional impact of potentially traumatic life events experienced between 6 and 36-months of age was assessed in an epidemiological birth cohort of 18- to 36-month-olds from the Greater…

  2. Toward a Theory of Discontinuous Career Transition: Investigating Career Transitions Necessitated by Traumatic Life Events

    ERIC Educational Resources Information Center

    Haynie, J. Michael; Shepherd, Dean

    2011-01-01

    Career researchers have focused on the mechanisms related to career progression. Although less studied, situations in which traumatic life events necessitate a discontinuous career transition are becoming increasingly prevalent. Employing a multiple case study method, we offer a deeper understanding of such transitions by studying an extreme case:…

  3. Traumatic Events and Suicide-Related Outcomes among Mexico City Adolescents

    ERIC Educational Resources Information Center

    Borges, Guilherme; Benjet, Corina; Medina-Mora, Maria Elena; Orozco, Ricardo; Molnar, Beth E.; Nock, Matthew K.

    2008-01-01

    Background: We report the prevalence and associations between traumatic events and suicidal ideation, suicide plans and suicide attempts among Mexican adolescents. Methods: The data are from a representative multistage probability household survey of 3,005 adolescents aged 12 to 17 years residing in the Mexico City Metropolitan Area that was…

  4. Evidence-Based Psychosocial Treatments for Children and Adolescents Exposed to Traumatic Events

    ERIC Educational Resources Information Center

    Silverman, Wendy K.; Ortiz, Claudio D.; Viswesvaran, Chockalingham; Burns, Barbara J.; Kolko, David J.; Putnam, Frank W.; Amaya-Jackson, Lisa

    2008-01-01

    The article reviews the current status (1993-2007) of psychosocial treatments for children and adolescents who have been exposed to traumatic events. Twenty-one treatment studies are evaluated using criteria from Nathan and Gorman (2002) along a continuum of methodological rigor ranging from Type 1 to Type 6. All studies were, at a minimum, robust…

  5. Exposure to Potentially Traumatic Events in Early Childhood: Differential Links to Emergent Psychopathology

    ERIC Educational Resources Information Center

    Briggs-Gowan, Margaret J.; Carter, Alice S.; Clark, Roseanne; Augustyn, Marilyn; McCarthy, Kimberly J.; Ford, Julian D.

    2010-01-01

    Research NeedsObjective: To examine associations between exposure to potentially traumatic events (PTEs) and clinical patterns of symptoms and disorders in preschool children. Method: Two hundred and thirteen referred and non-referred children, ages 24 to 48 months (MN = 34.9, SD = 6.7 months) were studied. Lifetime exposure to PTEs (family…

  6. Children and Traumatic Events: Therapeutic Techniques for Psychologists Working in the Schools

    ERIC Educational Resources Information Center

    Little, Steven G.; Akin-Little, Angeleque; Gutierrez, Gabriel

    2009-01-01

    It is clear that exposure to traumatic events is not uncommon in childhood and adolescence, and psychologists working in schools should have some training in meeting the needs of this segment of the population. One intervention that has been empirically supported in the trauma field is Trauma-Focused Cognitive Behavior Therapy (TF-CBT). This…

  7. Measurement Differences from Rating Posttraumatic Stress Disorder Symptoms in Response to Differentially Distressing Traumatic Events

    ERIC Educational Resources Information Center

    Elhai, Jon D.; Fine, Thomas H.

    2012-01-01

    The authors explored differences in posttraumatic stress disorder (PTSD) symptoms as a result of rating symptoms from two separate, differentially distressing traumatic events. In an initial sample of 400 nonclinical participants, the authors inquired through a web survey about previous psychological trauma, instructing participants to nominate…

  8. Traumatic and Stressful Events in Early Childhood: Can Treatment Help Those at Highest Risk?

    ERIC Educational Resources Information Center

    Ippen, Chandra Ghosh; Harris, William W.; Van Horn, Patricia; Lieberman, Alicia F.

    2011-01-01

    Objective: This study involves a reanalysis of data from a randomized controlled trial to examine whether child-parent psychotherapy (CPP), an empirically based treatment focusing on the parent-child relationship as the vehicle for child improvement, is efficacious for children who experienced multiple traumatic and stressful life events (TSEs).…

  9. Exposure to Potentially Traumatic Life Events in Children with Special Needs

    ERIC Educational Resources Information Center

    Saylor, Conway F.; Macias, Michelle; Wohlfeiler, Melissa; Morgan, Larissa; Awkerman, Nora Grace

    2009-01-01

    A series of studies of potentially-traumatic life-events (PTLE) in children and youth with special needs (CSN) was conducted after parents of 102 CSN from interdisciplinary pediatric clinics listed PTLE at significantly higher rates on the Pediatric Emotional Distress Scale (PEDS) compared to parents 58 students with no diagnoses. Subsequent…

  10. Psychological Distress and Resources among Siblings and Parents Exposed to Traumatic Events

    ERIC Educational Resources Information Center

    Punamaki, Raija-Leena; Qouta, Samir; El Sarraj, Eyad; Montgomery, Edith

    2006-01-01

    We examined symmetries and asymmetries within family members' psychological distress and resources in general and when exposed to traumatic events in particular. PTSD [Posttraumatic Stress Disorder] and depressive symptoms indicated distress and resilient attitudes, and satisfaction with quality of life indicated resources. We also analysed…

  11. Effects of penetrating traumatic brain injury on event segmentation and memory.

    PubMed

    Zacks, Jeffrey M; Kurby, Christopher A; Landazabal, Claudia S; Krueger, Frank; Grafman, Jordan

    2016-01-01

    Penetrating traumatic brain injury (pTBI) is associated with deficits in cognitive tasks including comprehension and memory, and also with impairments in tasks of daily living. In naturalistic settings, one important component of cognitive task performance is event segmentation, the ability to parse the ongoing stream of behavior into meaningful units. Event segmentation ability is associated with memory performance and with action control, but is not well assessed by standard neuropsychological assessments or laboratory tasks. Here, we measured event segmentation and memory in a sample of 123 male military veterans aged 59-81 who had suffered a traumatic brain injury as young men, and 34 demographically similar controls. Participants watched movies of everyday activities and segmented them to identify fine-grained or coarse-grained events, and then completed tests of recognition memory for pictures from the movies and of memory for the temporal order of actions in the movies. Lesion location and volume were assessed with computed tomography (CT) imaging. Patients with traumatic brain injury were impaired on event segmentation. Those with larger lesions had larger impairments for fine segmentation and also impairments for both memory measures. Further, the degree of memory impairment was statistically mediated by the degree of event segmentation impairment. There was some evidence that lesions to the ventromedial prefrontal cortex (vmPFC) selectively impaired coarse segmentation; however, lesions outside of a priori regions of interest also were associated with impaired segmentation. One possibility is that the effect of vmPFC damage reflects the role of prefrontal event knowledge representations in ongoing comprehension. These results suggest that assessment of naturalistic event comprehension can be a valuable component of cognitive assessment in cases of traumatic brain injury, and that interventions aimed at event segmentation could be clinically helpful. PMID

  12. Gender, traumatic events, and mental health disorders in a rural Asian setting.

    PubMed

    Axinn, William G; Ghimire, Dirgha J; Williams, Nathalie E; Scott, Kate M

    2013-01-01

    Research shows a strong association between traumatic life experience and mental health and important gender differences in that relationship in the western European Diaspora; but much less is known about these relationships in other settings. We investigate these relationships in a poor rural Asian setting that recently experienced a decade-long armed conflict. We use data from 400 adult interviews in rural Nepal. The measures come from World Mental Health survey instruments clinically validated for this study population to measure depression, posttraumatic stress disorder, and intermittent explosive disorder. Our results demonstrate that traumatic life experience significantly increases the likelihood of mental health disorders in this setting, and that these traumatic experiences have a larger effect on the mental health of women than men. These findings offer important clues regarding the potential mechanisms producing gender differences in mental health in many settings. PMID:24311755

  13. Comparing factors associated with maternal and adolescent reports of adolescent traumatic event exposure.

    PubMed

    Johnson, Sharon D

    2014-06-01

    Existing research indicates that there is very little agreement between youth and their parents on youth trauma exposure and subsequent treatment. Few studies, however, have attempted to examine factors that may contribute to this lack of agreement. This study addressed this gap by examining youth and maternal-reported youth traumatic event exposure using a sample of 100 urban, African American adolescent-maternal dyads. Cumulative report of youth potentially traumatic event exposure (57%) was higher than youth (41%) and maternal (27%) reports. Findings indicate that there was agreement for sexual assault, being shot or stabbed, and auto accidents. Maternal depression was the only factor that was associated with both youth and maternal report of youth qualifying event. Other factors that distinguished youth reports included maternal event exposure, substance use disorder, antisocial personality behaviors, and youth reports of arguments with the mother and running away from home. Implications for reconciling reports of trauma exposure among youth and their mothers are discussed. PMID:24206543

  14. Pathways involving traumatic losses, worry about family, adult separation anxiety and posttraumatic stress symptoms amongst refugees from West Papua.

    PubMed

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick

    2015-10-01

    There is some evidence that adult separation anxiety disorder (ASAD) symptoms are closely associated with posttraumatic stress disorder (PTSD) amongst refugees exposed to traumatic events (TEs), but the pathways involved remain to be elucidated. A recent study suggests that separation anxiety disorder precedes and predicts onset of PTSD. We examined a path model testing whether ASAD symptoms and worry about family mediated the path from traumatic losses to PTSD symptoms amongst 230 refugees from West Papua. Culturally adapted measures were applied to assess TE exposure and symptoms of ASAD and PTSD. A structural equation model indicated that ASAD symptoms played an important role in mediating the effects of traumatic losses and worry about family in the pathway to PTSD symptoms. Although based on cross-sectional data, our findings suggest that ASAD symptoms may play a role in the path from traumatic losses to PTSD amongst refugees. We propose an evolutionary model in which the ASAD and PTSD reactions represent complementary survival responses designed to protect the individual and close attachments from external threats. PMID:26275507

  15. Adult sports-related traumatic brain injury in United States trauma centers.

    PubMed

    Winkler, Ethan A; Yue, John K; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E

    2016-04-01

    OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α < 0.05, and the Bonferroni correction for multiple comparisons was applied for each outcome analysis. RESULTS From 2003 to 2012, in total, 4788 adult sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic

  16. Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers

    PubMed Central

    Ogińska-Bulik, Nina

    2015-01-01

    The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event in their worksite were analyzed. The range of age of the participants was 21–57 years (M = 35.27; SD = 8.13). Polish versions of the Impact of Event Scale – Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive outcomes of the experienced event. A perceived social support scale was measured by the scale What support you can count on. The data obtained from the study revealed the negative dependence of social support from supervisors with PTSD symptoms and positive – social support from co-workers with post-traumatic growth. Moreover the results of the study indicate the positive relationship between negative and positive outcomes of experienced traumatic events in the workplace. Perceived social support plays a more important role in gaining benefits from trauma than preventing negative outcomes of the experienced traumatic event. Support from co-workers, compared to support from supervisors, has greater importance. PMID:26323770

  17. White matter integrity in highly traumatized adults with and without post-traumatic stress disorder.

    PubMed

    Fani, Negar; King, Tricia Z; Jovanovic, Tanja; Glover, Ebony M; Bradley, Bekh; Choi, Kisueng; Ely, Timothy; Gutman, David A; Ressler, Kerry J

    2012-11-01

    Prior structural imaging studies of post-traumatic stress disorder (PTSD) have observed smaller volumes of the hippocampus and cingulate cortex, yet little is known about the integrity of white matter connections between these structures in PTSD samples. The few published studies using diffusion tensor imaging (DTI) to measure white matter integrity in PTSD have described individuals with focal trauma rather than chronically stressed individuals, which limits generalization of findings to this population; in addition, these studies have lacked traumatized comparison groups without PTSD. The present DTI study examined microstructural integrity of white matter tracts in a sample of highly traumatized African-American women with (n=25) and without (n=26) PTSD using a tract-based spatial statistical approach, with threshold-free cluster enhancement. Our findings indicated that, relative to comparably traumatized controls, decreased integrity (measured by fractional anisotropy) of the posterior cingulum was observed in participants with PTSD (p<0.05). These findings indicate that reduced microarchitectural integrity of the cingulum, a white matter fiber that connects the entorhinal and cingulate cortices, appears to be associated with PTSD symptomatology. The role of this pathway in problems that characterize PTSD, such as inadequate extinction of learned fear, as well as attention and explicit memory functions, are discussed. PMID:22871912

  18. Multiple Traumatic Events and Psychological Distress : The South Africa Stress and Health Study

    PubMed Central

    Williams, Stacey L.; Williams, David R.; Stein, Dan J.; Seedat, Soraya; Jackson, Pamela B.; Moomal, Hashim

    2011-01-01

    Using nationally representative data from South Africa, we examine lifetime prevalence of traumas and multiple traumas (number of events). Employing multiple regression analysis, we study sociodemographic risk of trauma, and the association between trauma and distress. Results indicate most South Africans experience at least one traumatic event during their lives, with the majority reporting multiple. Consistent variation in risk is evident for gender and marital status but not other sociodemographics. Trauma is positively related to high distress, and findings also support a cumulative effect of trauma exposure. Individuals with the most traumas (6+) appear at five- times greater risk of high distress. This study highlights the importance of considering traumatic events in the context of other traumas in South Africa. PMID:17955545

  19. Overgeneral Autobiographical Memory and Traumatic Events: An Evaluative Review

    ERIC Educational Resources Information Center

    Moore, Sally A.; Zoellner, Lori A.

    2007-01-01

    Does trauma exposure impair retrieval of autobiographical memories? Many theorists have suggested that the reduced ability to access specific memories of life events, termed overgenerality, is a protective mechanism helping attenuate painful emotions associated with trauma. The authors addressed this question by reviewing 24 studies that assessed…

  20. Traumatic Life Events and Psychopathology in a High Risk, Ethnically Diverse Sample of Young Children: A Person-Centered Approach.

    PubMed

    Hagan, Melissa J; Sulik, Michael J; Lieberman, Alicia F

    2016-07-01

    Studies of the association between traumatic experiences and psychopathology in early childhood have primarily focused on specific types of events (e.g., sexual abuse) or aggregated different types of events without differentiating among them. We extend this body of work by investigating patterns of traumatic event exposure in a high-risk, ethnically diverse sample of children ages 3-6 (N = 211; 51 % female) and relating these different patterns to parents' reports of child externalizing, internalizing, and post-traumatic stress symptomatology. Using latent class analysis, which divides a heterogeneous population into homogenous subpopulations, we identified three patterns of traumatic events based on parents' responses to an interview-based assessment of trauma exposure in young children: (1) severe exposure, characterized by a combination of family violence and victimization; (2) witnessing family violence without victimization; and (3) moderate exposure, characterized by an absence of family violence but a moderate probability of other events. The severe exposure class exhibited elevated internalizing and post-traumatic stress symptoms relative to the witness to violence and moderate exposure classes, controlling for average number of traumatic events. Results highlight the need for differentiation between profiles of traumatic life event exposure and the potential for person-centered methods to complement the cumulative risk perspective. PMID:26354023

  1. Variability of ICU Use in Adult Patients With Minor Traumatic Intracranial Hemorrhage

    PubMed Central

    Nishijima, Daniel K.; Haukoos, Jason S.; Newgard, Craig D.; Staudenmayer, Kristan; White, Nathan; Slattery, David; Maxim, Preston C.; Gee, Christopher A.; Hsia, Renee Y.; Melnikow, Joy A.; Holmes, James F.

    2013-01-01

    Study objective Patients with minor traumatic intracranial hemorrhage are frequently admitted to the ICU, although many never require critical care interventions. To describe ICU resource use in minor traumatic intracranial hemorrhage, we assess (1) the variability of ICU use in a cohort of patients with minor traumatic intracranial hemorrhage across multiple trauma centers, and (2) the proportion of adult patients with traumatic intracranial hemorrhage who are admitted to the ICU and never receive a critical care intervention during hospitalization. In addition, we evaluate the association between ICU admission and key independent variables. Methods A structured, historical cohort study of adult patients (aged 18 years and older) with minor traumatic intracranial hemorrhage was conducted within a consortium of 8 Level I trauma centers in the western United States from January 2005 to June 2010. The study population included patients with minor traumatic intracranial hemorrhage, defined as an emergency department (ED) Glasgow Coma Scale (GCS) score of 15 (normal mental status) and an Injury Severity Score less than 16 (no other major organ injury). The primary outcome measure was initial ICU admission. The secondary outcome measure was a critical care intervention during hospitalization. Critical care interventions included mechanical ventilation, neurosurgical intervention, transfusion of blood products, vasopressor or inotrope administration, and invasive hemodynamic monitoring. ED disposition and the proportion of ICU patients not receiving a critical care intervention were compared across sites with descriptive statistics. The association between ICU admission and predetermined independent variables was analyzed with multivariable regression. Results Among 11,240 adult patients with traumatic intracranial hemorrhage, 1,412 (13%) had minor traumatic intracranial hemorrhage and complete ED disposition data (mean age 48 years; SD 20 years). ICU use within this

  2. Prejudice-Related Events and Traumatic Stress Among Heterosexuals and Lesbians, Gay Men and Bisexuals

    PubMed Central

    Alessi, Edward J.; Martin, James I.; Gyamerah, Akua; Meyer, Ilan H.

    2013-01-01

    This mixed-methods study examined associations between prejudice events and posttraumatic stress disorder (PTSD) among 382 lesbians, gays, and bisexuals (LGB) and 126 heterosexuals. Using the Composite International Diagnostic Interview, we assessed PTSD but relaxed Criterion A1, that is, allowed prejudice events that did not involve threat to life or physical integrity to also qualify as traumatic. First, we tested whether exposure to prejudice events differed with respect to sexual orientation and race. White LGBs were more likely than White heterosexuals to encounter a prejudice event, but Black and Latino LGBs were no more likely than White LGBs to experience a prejudice event. Second, we used qualitative analysis to examine the prejudice events that precipitated relaxed Criterion A1 PTSD among 8 participants. Two specific themes emerged: the need to make major changes and compromised sense of safety and security following exposure to the prejudice event. PMID:24348008

  3. Have You Lived through a Very Scary and Dangerous Event? A Real Illness: Post-Traumatic Stress Disorder (PTSD).

    ERIC Educational Resources Information Center

    National Inst. of Mental Health (DHHS), Bethesda, MD.

    A description of post-traumatic stress disorder (PTSD) is presented to help bring to light the symptoms that may occur after a traumatic event. The paper's question and answer format provides an easy way to share information about PTSD. Following the definition, an explanation is given of how PTSD starts and how long it lasts. Information is…

  4. Attachment and coping as facilitators of posttraumatic growth in Turkish university students experiencing traumatic events.

    PubMed

    Arikan, Gizem; Karanci, Nuray

    2012-01-01

    This study was designed to explore the role of attachment and coping as facilitators of posttraumatic growth (PTG) in a sample of Turkish university students who experienced traumatic life events. Participants who reported a traumatic event from a list were asked to choose the most distressing one; to answer questions related to the impact of the trauma; and to fill out measures of attachment styles, ways of coping, and PTG. PTG was regressed on gender, trauma-related factors, attachment styles, and coping styles in order to examine the associations with PTG. Felt helplessness and horror, fatalistic coping, and optimistic coping were significant predictors of PTG. Fatalistic coping partially mediated the relationship between attachment anxiety and PTG. PMID:22375808

  5. Posttraumatic Stress among Young Urban Children Exposed to Family Violence and Other Potentially Traumatic Events

    PubMed Central

    Crusto, Cindy A.; Whitson, Melissa L.; Walling, Sherry N.; Feinn, Richard; Friedman, Stacey R.; Reynolds, Jesse; Amer, Mona; Kaufman, Joy S.

    2014-01-01

    This study examines the relationship between the number of types of traumatic events experienced by children 3 to 6 years old, parenting stress, and children’s posttraumatic stress (PTS). Parents/caregivers provided data for 154 urban children admitted into community-based mental health and/or developmental services. By parent/caregiver report, children experienced an average of 4.9 different types of potentially traumatic events. Nearly one-quarter of the children evidenced clinically significant PTS. PTS was positively and significantly related to family violence and other family-related trauma exposure, nonfamily violence/trauma exposure, and parenting stress. Additionally, parenting stress partially mediated the relationship between family violence/trauma exposure and PTS. This study highlights the need for early violence/trauma exposure screening in help-seeking populations so that appropriate interventions are initiated. PMID:21171132

  6. Humor, Rapport, and Uncomfortable Moments in Interactions with Adults with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Kovarsky, Dana; Schiemer, Christine; Murray, Allison

    2011-01-01

    We examined uncomfortable moments that damaged rapport during group interactions between college students in training to become speech-language pathologists and adults with traumatic brain injury. The students worked as staff in a community-based program affiliated with a university training program that functioned as a recreational gathering…

  7. Outcome Benchmarks for Adaptations of Research-Supported Treatments for Adult Traumatic Stress

    ERIC Educational Resources Information Center

    Rubin, Allen; Parrish, Danielle E.; Washburn, Micki

    2016-01-01

    This article provides benchmark data on within-group effect sizes from published randomized controlled trials (RCTs) that evaluated the efficacy of research-supported treatments (RSTs) for adult traumatic stress. Agencies can compare these benchmarks to their treatment group effect size to inform their decisions as to whether the way they are…

  8. Association between witnessing traumatic events and psychopathology in the South African Stress and Health Study

    PubMed Central

    Platt, Jonathan; Williams, David R.; Stein, Dan J.; Koenen, Karestan C.

    2016-01-01

    Background The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders. Methods Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders. Results Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders. Conclusion Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected. PMID:25773525

  9. Traumatic events and trauma-related psychopathology in former drug cartel soldiers in Rio de Janeiro: A pilot study.

    PubMed

    Bojahr, Lisa S; van Emmerik, Arnold A P

    2016-01-01

    This pilot study investigated the occurrence of traumatic events and trauma-related psychopathology in former drug cartel soldiers (FDCS) in Rio de Janeiro. Furthermore, the authors examined the relationship between the number of traumatic events and symptom severity, and compared symptom severity in perpetrators versus victims of traumatic events. They found high exposure rates to traumatic events, with 83.5% of the FDCS (n = 97) and 57.9% of the controls (n = 95) having experienced more than 5 events. FDCS had higher mean scores for trauma exposure, posttraumatic stress (PTS), depressive symptoms, and general mental health problems, compared to controls. More FDCS than controls satisfied DSM-IV symptom criteria for posttraumatic stress disorder (36.4% vs. 15.8%) and reported severe depressive symptoms (25.8% vs. 8.3%). The number of traumatic events was strongly related to PTS among FDCS (r = .48). Furthermore, more FDCS than controls (23.7% vs. 10.5%) identified themselves as a perpetrator of 1 or more traumatic events. Among FDCS, perpetrators reported more PTS than victims. It is concluded that being a (former) drug cartel soldier is associated with elevated trauma exposure and severe trauma-related psychopathology. PMID:25793319

  10. Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study

    PubMed Central

    2010-01-01

    Background People who experience traumatic events have an increased risk of developing a range of mental disorders. Appropriate early support from a member of the public, whether a friend, family member, co-worker or volunteer, may help to prevent the onset of a mental disorder or may minimise its severity. However, few people have the knowledge and skills required to assist. Simple guidelines may help members of the public to offer appropriate support when it is needed. Methods Guidelines were developed using the Delphi method to reach consensus in a panel of experts. Experts recruited to the panels included 37 professionals writing, planning or working clinically in the trauma area, and 17 consumer or carer advocates who had been affected by traumatic events. As input for the panels to consider, statements about how to assist someone who has experienced a traumatic event were sourced through a systematic search of both professional and lay literature. These statements were used to develop separate questionnaires about possible ways to assist adults and to assist children, and panel members answered either one questionnaire or both, depending on experience and expertise. The guidelines were written using the items most consistently endorsed by the panels across the three Delphi rounds. Results There were 180 items relating to helping adults, of which 65 were accepted, and 155 items relating to helping children, of which 71 were accepted. These statements were used to develop the two sets of guidelines appended to this paper. Conclusions There are a number of actions which may be useful for members of the public when they encounter someone who has experienced a traumatic event, and it is possible that these actions may help prevent the development of some mental health problems in the future. Positive social support, a strong theme in these guidelines, has some evidence for effectiveness in developing mental health problems in people who have experienced traumatic

  11. Impact of traumatic events on posttraumatic stress disorder among Danish survivors of sexual abuse in childhood.

    PubMed

    Elklit, Ask; Christiansen, Dorte M; Palic, Sabina; Karsberg, Sidsel; Eriksen, Sara Bek

    2014-01-01

    Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder. PMID:25256036

  12. SLC6A4 methylation modifies the effect of number of traumatic events on risk for posttraumatic stress disorder

    PubMed Central

    Koenen, Karestan C.; Uddin, Monica; Chang, Shun Chiao; Aiello, Allison E.; Wildman, Derek E.; Goldmann, Emily; Galea, Sandro

    2011-01-01

    Background Posttraumatic stress disorder (PTSD) is a common and debilitating mental disorder that occurs following exposure to a traumatic event. However, most individuals do not develop PTSD following even a severe trauma, leading to a search for new variables—such as genetic and other molecular variation— associated with vulnerability and resilience in the face of trauma exposure. Method We examined whether serotonin transporter (SLC6A4) promoter genotype and methylation status modified the association between number of traumatic events experienced and PTSD in a subset of 100 individuals from the Detroit Neighborhood Health Study. Results Number of traumatic events was strongly associated with risk of PTSD. Neither SLC6A4 genotype or nor methylation status were associated with PTSD in main effects models. However, SLC6A4 methylation levels modified the effect of number of traumatic events on PTSD after controlling for SLC6A4 genotype. Persons with more traumatic events were at increased risk for PTSD but only at lower methylation levels. At higher methylation levels, individuals with more traumatic events were protected from this disorder. This interaction was observed whether the outcome was PTSD diagnosis, symptom severity, or number of symptoms. Conclusions Gene-specific methylation patterns may offer potential molecular signatures of increased risk for and resilience to PTSD. PMID:21608084

  13. Traumatic atlantoaxial rotatory fixation associated with C2 articular facet fracture in adult patient: Case report

    PubMed Central

    Bellil, Mehdi; Hadhri, Khaled; Sridi, Maamoun; Kooli, Mondher

    2014-01-01

    Traumatic atlantoaxial rotatory fixation is a very rare injury in adults which is often misdiagnosed initially. Its combination with C2 fractures is predominated by dens lesions. Therapeutic management is challenging because of the difficulty to achieve optimal reduction and permanent stability. We report a rare case of traumatic atlantoaxial rotatory fixation in a 56-year-old women associated with C2 articular facet fracture successfully treated by conservative means after patient-awake manual reduction with optimal functional and radiographic outcome. PMID:25558147

  14. Reduced N400 Semantic Priming Effects in Adult Survivors of Paediatric and Adolescent Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Knuepffer, C.; Murdoch, B. E.; Lloyd, D.; Lewis, F. M.; Hinchliffe, F. J.

    2012-01-01

    The immediate and long-term neural correlates of linguistic processing deficits reported following paediatric and adolescent traumatic brain injury (TBI) are poorly understood. Therefore, the current research investigated event-related potentials (ERPs) elicited during a semantic picture-word priming experiment in two groups of highly functioning…

  15. A care planning strategy for traumatic life events in community mental health and inpatient psychiatry based on the InterRAI assessment instruments.

    PubMed

    Mathias, Krista; Hirdes, J P; Pittman, D

    2010-12-01

    Clinical triggers from the Traumatic Life Events Clinical Assessment Protocol (CAP) identify individuals who might benefit from formal services or additional supports targeted towards trauma treatment. The Traumatic Life Events CAP identifies two groups who have experienced one or more potentially traumatic life events: (1) those who are in immediate danger due to current abuse/criminal victimization; (2) those who have experienced one or more traumatic events that evoked an intense sense of horror or fear. Descriptive analysis was conducted across psychiatric hospital and community-based mental health service settings to compare the two triggered groups to those without traumatic experiences (the not-triggered group). The Traumatic Life Events CAP identified subpopulations with unrecognized and untreated traumatic-stress-related symptoms, which are of great concern for those in community-based mental health services who are in immediate danger due to current abuse. PMID:20449657

  16. Traumatic Spondylolisthesis of the Axis Vertebra in Adults.

    PubMed

    Schleicher, Philipp; Scholz, Matti; Pingel, Andreas; Kandziora, Frank

    2015-08-01

    Study Design Narrative review. Objective To elucidate the current concepts in diagnosis and treatment of traumatic spondylolisthesis of the axis. Methods Literature review using PubMed, Google Scholar, and Cochrane databases. Results The traumatic spondylolisthesis of the axis accounts to 5% of all cervical spine injuries and is defined by a bilateral separation of the C2 vertebral body from the neural arch. The precise location of the fracture line may vary widely. For understanding the pathobiomechanics, the involvement of the C2-C3 disk is essential. Although its synonym "hangman's fracture" suggests an extension moment as primary injury mechanism, flexion moments are also proven to cause such fracture morphology. The axial force vector (distraction versus compression) is thought to have a significant effect on the neurologic involvement. The most widely accepted classifications, according to Effendi and modified by Levine, regard the displacement of the C2 vertebral body and possible locking of the facet joints. For decisions on conservative versus surgical therapy, a definitive statement about the stability is essential. The stability is determined by involvement of the C2-C3 disk and longitudinal ligaments, which frequently cannot be assessed by X-ray or computed tomography alone. The assessment of this soft tissue injury therefore requires additional imaging either by magnetic resonance imaging to display the disk and longitudinal ligaments or dynamic fluoroscopy to assess functional behavior of the C2-C3 motion segment. If stability is proven, an immobilization of the cervical spine in a semirigid cervical collar is sufficient. Unstable lesions require surgical stabilization. The standard procedure is an anterior C2-C3 diskectomy and fusion, because of the lower morbidity of the anterior approach and the motion preservation between C1 and C2. In rare cases (irreducible locked facet joints, the necessity of decompression of the vertebral artery

  17. Adult Traumatic Atlantoaxial Rotatory Fixation: A Case Report

    PubMed Central

    Min Han, Zaw; Akeda, Koji; Matsubara, Takao

    2014-01-01

    We presented a very rare case of adult Fielding type I atlantoaxial rotatory fixation (AARF). We performed awake manual reduction of the dislocation without need for anesthesia, achieving excellent outcomes, and no previous reports have described awake reduction without the need for anesthesia. AARF in this case was attributed to excessive extension and rotation forces applied to the cervical spine. For the management of adult Fielding type I AARF, early diagnosis and early reduction may lead to excellent outcomes. PMID:24716063

  18. Toward a theory of discontinuous career transition: investigating career transitions necessitated by traumatic life events.

    PubMed

    Haynie, J Michael; Shepherd, Dean

    2011-05-01

    Career researchers have focused on the mechanisms related to career progression. Although less studied, situations in which traumatic life events necessitate a discontinuous career transition are becoming increasingly prevalent. Employing a multiple case study method, we offer a deeper understanding of such transitions by studying an extreme case: soldiers and Marines disabled by wartime combat. Our study highlights obstacles to future employment that are counterintuitive and stem from the discontinuous and traumatic nature of job loss. Effective management of this type of transitioning appears to stem from efforts positioned to formulate a coherent narrative of the traumatic experience and thus to reconstruct foundational assumptions about the world, humanity, and self. These foundational assumptions form the basis for enacting future-orientated career strategies, such that progress toward establishing a new career path is greatest for those who can orientate themselves away from the past (trauma), away from the present (obstacles to a new career), and toward an envisioned future career positioned to confer meaning and purpose through work. PMID:21090884

  19. Child and Caregiver Concordance of Potentially Traumatic Events Experienced by Orphaned and Abandoned Children

    PubMed Central

    Guru Rajan, Divya; Shirey, Kristen; Ostermann, Jan; Whetten, Rachel; O’Donnell, Karen; Whetten, Kathryn

    2013-01-01

    Exposure to trauma is associated with significant emotional and behavioral difficulties among children (Perepletchikova & Kaufman, 2010). Overall, reports of trauma and violence experienced by children are discrepant from those of their caregivers (Lewis et al., 2012). Even less is known about the extent of concordance between orphans and their caregivers. This study examines the correlates of concordance in reported traumatic experiences between 1,269 orphaned and abandoned children (OAC) and their caregivers. The OAC lived in family-settings in 5 low and middle income countries and were part of a longitudinal study, “Positive Outcomes for Orphans” (POFO) that enrolled children aged 6 to 12 at baseline. By examining concordance with respect to specific types of trauma reported, this study expands the understanding of who reports which types of traumas experienced by orphaned and abandoned children, thereby improving the potential to provide targeted interventions for children who have experienced such events. In this study, children and caregivers were asked separately if the child had experienced different types of potentially traumatic events. Children were significantly more likely to report physical abuse, sexual abuse and family violence than were caregivers. Caregivers were significantly more likely than children to report natural disasters and accidents. High levels of concordance were found in the reporting of wars, riots, killings, and deaths in the family. The impacts of trauma on behavior and mental health are profound, and highly effective interventions targeting sequelae of childhood trauma are currently being developed for use in low resource areas. Findings from this study demonstrate that it is feasible to conduct screening for potentially traumatic events utilizing child self-report in resource limited settings and that child self-report is crucial in evaluating trauma, particularly family violence and physical or sexual assault. PMID:25379051

  20. The experience of traumatic events disrupts the measurement invariance of a posttraumatic stress scale

    PubMed Central

    Lommen, Miriam J. J.; van de Schoot, Rens; Engelhard, Iris M.

    2014-01-01

    Studies that include multiple assessments of a particular instrument within the same population are based on the presumption that this instrument measures the same construct over time. But what if the meaning of the construct changes over time due to one's experiences? For example, the experience of a traumatic event can influence one's view of the world, others, and self, and may disrupt the stability of a questionnaire measuring posttraumatic stress symptoms (i.e., it may affect the interpretation of items). Nevertheless, assessments before and after such a traumatic event are crucial to study longitudinal development of posttraumatic stress symptoms. In this study, we examined measurement invariance of posttraumatic stress symptoms in a sample of Dutch soldiers before and after they went on deployment to Afghanistan (N = 249). Results showed that the underlying measurement model before deployment was different from the measurement model after deployment due to invariant item thresholds. These results were replicated in a sample of soldiers deployed to Iraq (N = 305). Since the lack of measurement invariance was due to instability of the majority of the items, it seems reasonable to conclude that the underlying construct of PSS is unstable over time if war-zone related traumatic events occur in between measurements. From a statistical point of view, the scores over time cannot be compared when there is a lack of measurement invariance. The main message of this paper is that researchers working with posttraumatic stress questionnaires in longitudinal studies should not take measurement invariance for granted, but should use pre- and post-symptom scores as different constructs for each time point in the analysis. PMID:25477835

  1. Exposure to Traumatic Events and Posttraumatic Stress Disorder in France: Results From the WMH Survey.

    PubMed

    Husky, Mathilde M; Lépine, Jean-Pierre; Gasquet, Isabelle; Kovess-Masfety, Viviane

    2015-08-01

    This study examined the prevalence of traumatic events and the conditional probability of posttraumatic stress disorder (PTSD) associated with both specific and broad classes of events in a nationally representative sample from France. The sample (N = 1,436) was a part of the European Study of the Epidemiology of Mental Disorders Survey (ESEMeD), under the WHO World Mental Health Surveys-2000 initiative. Overall, exposure to any traumatic event was 72.7%, which appeared to be lower than what has been reported in Sweden (80.8%), similar to data from the Netherlands (71.1%), and higher than what has been reported in Spain (54.0%), Italy (56.1%), Northern Ireland (60.6%) or the U.S (55.9%). Lifetime prevalence of PTSD was 3.9%, lower than in the United States (7.8%), Sweden (5.6%), or Northern Ireland (8.8%), but higher than in Spain (2.2%) or Italy (2.4%). Being beaten up by a romantic partner (25.0%), having a child with serious illness (23.5%), and rape (21.5%) were associated with the highest risk of PTSD. The average duration of PTSD was 5.3 years (0.2-28.1). The burden of PTSD in France appeared to come from the consequences of violence and social network events suggesting that prevention efforts might focus on limiting the occurrence of exposure to avoidable events such as violence as well as provide support for persons exposed to social network events. PMID:26179388

  2. Prejudice Events and Traumatic Stress among Heterosexuals and Lesbians, Gay Men and Bisexuals

    PubMed Central

    Alessi, Edward J.; Martin, James I.; Gyamerah, Akua; Meyer, Ilan H.

    2013-01-01

    This mixed-methods study examined associations between prejudice events and posttraumatic stress disorder (PTSD) among 382 lesbians, gays, and bisexuals (LGB) and 126 heterosexuals. Using the Composite International Diagnostic Interview, we assessed PTSD with a relaxed Criterion A1; that is, we allowed events that did not involve threat to life or physical integrity to also qualify as traumatic. We first assessed whether exposure to prejudice-related qualifying events differed with respect to participants’ sexual orientation and race. We found that White LGBs were more likely than White heterosexuals to encounter a prejudice-related qualifying event, and among LGBs, Black and Latino LGBs were no more likely than White LGBs to experience this type of event. We then used qualitative analysis of participants’ brief narratives to examine prejudice events that precipitated Relaxed Criterion A1 PTSD among 8 participants. Two themes emerged: (a) the need to make major changes and (b) compromised sense of safety and security following exposure to the prejudice event. PMID:24415898

  3. Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients

    PubMed Central

    Sodeke-Gregson, Ekundayo A.; Holttum, Sue; Billings, Jo

    2013-01-01

    Background Therapists who work with trauma clients are impacted both positively and negatively. However, most studies have tended to focus on the negative impact of the work, the quantitative evidence has been inconsistent, and the research has primarily been conducted outside the United Kingdom. Objectives This study aimed to assess the prevalence of, and identify predictor variables for, compassion satisfaction, burnout, and secondary traumatic stress in a group of UK therapists (N=253) working with adult trauma clients. Method An online questionnaire was developed which used The Professional Quality of Life Scale (Version 5) to assess compassion satisfaction, burnout, and secondary traumatic stress and collect demographics and other pertinent information. Results Whilst the majority of therapists scored within the average range for compassion satisfaction and burnout, 70% of scores indicated that therapists were at high risk of secondary traumatic stress. Maturity, time spent engaging in research and development activities, a higher perceived supportiveness of management, and supervision predicted higher potential for compassion satisfaction. Youth and a lower perceived supportiveness of management predicted higher risk of burnout. A higher risk of secondary traumatic stress was predicted in therapists engaging in more individual supervision and self-care activities, as well as those who had a personal trauma history. Conclusions UK therapists working with trauma clients are at high risk of being negatively impacted by their work, obtaining scores which suggest a risk of developing secondary traumatic stress. Of particular note was that exposure to trauma stories did not significantly predict secondary traumatic stress scores as suggested by theory. However, the negative impact of working with trauma clients was balanced by the potential for a positive outcome from trauma work as a majority indicated an average potential for compassion satisfaction. PMID

  4. Disability associated with exposure to traumatic events: results from a cross-sectional community survey in South Sudan

    PubMed Central

    2013-01-01

    Background There is a general lack of knowledge regarding disability and especially factors that are associated with disability in low-income countries. We aimed to study the overall and gender-specific prevalence of disability, and the association between exposure to traumatic events and disability in a post-conflict setting. Methods We conducted a cross-sectional community based study of four Greater Bahr el Ghazal States, South Sudan (n = 1200). The Harvard Trauma Questionnaire (HTQ) was applied to investigate exposure to trauma events. Disability was measured using the Washington Group Short Measurement Set on Disability, which is an activity-based scale derived from the WHO’s International Classification of Disability, Functioning and Health. Results The estimated prevalence of disability (with severe difficulty) was 3.6% and 13.4% for disability with moderate difficulties. No gender differences were found in disability prevalence. Almost all participants reported exposure to at least one war-related traumatic event. The result of a hierarchical regression analysis showed that, for both men and women, exposure to traumatic events, older age and living in a polygamous marriage increased the likelihood of having a disability. Conclusions The finding of association between traumatic experience and disability underlines the precariousness of the human rights situation for individuals with disability in low-income countries. It also has possible implications for the construction of disability services and for the provision of health services to individuals exposed to traumatic events. PMID:23672785

  5. Rehabilitation for Adults with Traumatic Brain Injury: Where Will We Be Clinically in 2026?

    PubMed

    Turkstra, Lyn S

    2016-08-01

    In 10 years, there might be fewer adults who need rehabilitation after traumatic brain injury because of advances in injury prevention and very early treatment. For adults who do need rehabilitation, assessment might include biosensor recordings in their everyday communication contexts, and home practice might be delivered by a robot that can be programmed to mimic target characteristics of human behavior. These advances in science and technology will enhance rehabilitation, but it will always be our responsibility as speech-language pathologists to advocate for our patients and clients and support them in achieving the best possible quality of communication life. PMID:27232097

  6. [Posttraumatic stress disorder in patients with neurogenic amnesia for the traumatic event].

    PubMed

    Podoll, K; Kunert, H J; Sass, H

    2000-10-01

    The development of symptoms of posttraumatic stress disorder (PTSD) in patients with neurogenic amnesia for the traumatic event is recorded in 2 own patients and in 19 cases from the clinical literature. With a single exception, all patients were accident victims with closed head injuries. Only about three quarters of the patients completely fulfilled DSM-III-R criteria of PTSD. Nineteen patients displayed involuntary conscious memories of aspects of the traumatic event (presenting as recurrent intrusive thoughts, images or dreams) co-existent with a complete or partial lack of voluntary conscious memories of the trauma, suggesting that different memory systems and distinct brain mechanisms subserve these phenomena. The said clinical observations are discussed against the background of current neuropsychological models of multiple memory systems. The recorded cases demonstrate that declarative episodic memory is not necessary for symptoms of PTSD to emerge, whereas preserved functions of non-declarative memory systems represent a sufficient condition for the development of PTSD symptoms. PMID:11103682

  7. Targeting different pathophysiological events after traumatic brain injury in mice: Role of melatonin and memantine.

    PubMed

    Kelestemur, Taha; Yulug, Burak; Caglayan, Ahmet Burak; Beker, Mustafa Caglar; Kilic, Ulkan; Caglayan, Berrak; Yalcin, Esra; Gundogdu, Reyhan Zeynep; Kilic, Ertugrul

    2016-01-26

    The tissue damage that emerges during traumatic brain injury (TBI) is a consequence of a variety of pathophysiological events, including free radical generation and over-activation of N-methyl-d-aspartate-type glutamate receptors (NMDAR). Considering the complex pathophysiology of TBI, we hypothesized that combination of neuroprotective compounds, targeting different events which appear during injury, may be a more promising approach for patients. In this context, both NMDAR antagonist memantine and free radical scavenger melatonin are safe in humans and promising agents for the treatment of TBI. Herein, we examined the effects of melatonin administered alone or in combination with memantine on the activation of signaling pathways, injury development and DNA fragmentation. Both compounds reduced brain injury moderately and the density of DNA fragmentation significantly. Notably, melatonin/memantine combination decreased brain injury and DNA fragmentation significantly, which was associated with reduced p38 and ERK-1/2 phosphorylation. As compared with melatonin and memantine groups, SAPK/JNK-1/2 phosphorylation was also reduced in melatonin/memantine combined animals. In addition, melatonin, memantine and their combination decreased iNOS activity significantly. Here, we provide evidence that melatonin/memantine combination protects brain from traumatic injury, which was associated with decreased DNA fragmentation, p38 phosphorylation and iNOS activity. PMID:26639427

  8. Impact of traumatic events and organizational response. A study of bank robberies.

    PubMed

    Miller-Burke, J; Attridge, M; Fass, P M

    1999-02-01

    This study explored how experiencing a traumatic event in the workplace affects employee physical health, mental health, personal functioning, and work performance. Post-event use of health care services and the effectiveness of critical incident stress debriefing sessions and other coping interventions were also examined. A retrospective self-report methodology and mailed survey were used with 141 employees of 42 different bank branches that had recently been robbed. The results found that most employees had multiple negative consequences from experiencing a bank robbery while at work. Psychological, physical, work, and personal areas were all affected by the robbery. Furthermore, more threatening incidents were associated with more severe consequences. Critical incident stress debriefing interventions delivered after robbery were rated as helpful by 78% of employees who attended. The implications for health care providers and organizations are discussed. PMID:10029951

  9. The inoculating role of previous exposure to potentially traumatic life events on coping with prolonged exposure to rocket attacks: A lifespan perspective.

    PubMed

    Palgi, Yuval; Gelkopf, Marc; Berger, Rony

    2015-06-30

    Relatively little research have addressed the effect of prolonged exposure to rocket attacks with a lifespan perspective and only a handful of these studies focused on the effect of this exposure as a function of aging. The present study examined the effects of seven years of rocket attacks fired toward the south of Israel on adult participants of different ages. We examined whether potentially traumatic life events (PTLEs) unrelated to rocket attacks moderated the association between post-traumatic stress (PTS) symptoms and age. Data were obtained from a 2007 telephone survey using the Random Digit Dialing method and including 343 individuals (76.7% participation rate). Exposure to rockets, PTLEs, global distress, and post-traumatic symptomatology were assessed. Older age was associated with a higher level of PTS symptoms. Higher PTLE levels attenuated the association between age and PTS symptoms. Our results suggest that age is a risk factor for developing PTS symptoms under prolonged exposure to rocket attacks. However, previous levels of exposure to other negative events, as well as gender, appear to inoculate a person to stress, thus modulating the age-PTS association. PMID:25863821

  10. Lifetime incidences of traumatic events and mental health among children affected by HIV/AIDS in rural China.

    PubMed

    Li, Xiaoming; Barnett, Douglas; Fang, Xiaoyi; Lin, Xiuyun; Zhao, Guoxiang; Zhao, Junfeng; Hong, Yan; Zhang, Liying; Naar-King, Sylvie; Stanton, Bonita

    2009-09-01

    Cross-sectional data were gathered from 1,625 children (M age = 12.85, SD = 2.21) which included 755 AIDS orphans, 466 vulnerable children, and 404 comparison children. Participants completed self-report measures of exposure to traumatic events, and psychosocial adjustment including behavior problems, depression, self-esteem, and future orientation. AIDS orphans and vulnerable children reported experiencing a higher total occurrence, density, duration, initial impact and lasting impact of traumatic events compared to comparison children. Scores reflecting adjustment were lower among orphans and vulnerable children than among comparison children. Both orphan status and traumatic events contributed unique variance in the expected direction to the prediction of psychosocial adjustment. The data in the current study suggested that children affected by HIV/AIDS in China are exposed to more trauma and suffer more adjustment problems than children who do not experience HIV/AIDS in their families. PMID:20183657

  11. Untangling Psychiatric Comorbidity in Young Children Who Experienced Single, Repeated, or Hurricane Katrina Traumatic Events

    PubMed Central

    Scheeringa, Michael S.

    2014-01-01

    Background In individuals with posttraumatic stress disorder (PTSD), 70%-90% have at least one comorbid non-PTSD disorder. Objective This study tested several hypotheses to untangle comorbidity issues. Following McMillen et al. (2002), we hypothesized that few non-PTSD disorders would arise following traumatic events in children with substantial PTSD symptoms. Second, Repeated Events victims would show more internalizing and externalizing problems compared to Single Event and Hurricane Katrina victims. Third, we aimed to replicate in young children the finding from older populations that exposure to multiple events, not the type of event, would predict severity of symptoms. These results would inform speculations that repeated and prolonged traumas produce greater symptom complexity. Methods Children 3-6 years of age were recruited for three types of trauma: Single (n=62), Hurricane Katrina (n=85), and Repeated Events (n=137), and assessed with caregiver reports from a diagnostic interview. Results Overall, 95% of children who developed new non-PTSD disorders following traumas also had substantial PTSD symptoms. The Katrina and Repeated Events groups showed more diagnoses of oppositional defiant disorder compared to the Single Event group, but groups did not differ on PTSD, depression, anxiety, or attention-deficit/hyperactivity disorder. Cumulative number of events was the only significant predictor of PTSD symptoms, while type of trauma and total occurrences of traumas did not predict additional variance. Conclusion These data provide empirical support for targeting interventions on PTSD following traumas and disasters. The homogeneity of outcomes across types of traumas provides little empirical support for speculations that repeated and prolonged traumas produce greater symptom complexity. PMID:26213455

  12. Adolescent traumatic stress experience results in less robust conditioned fear and post-extinction fear cue responses in adult rats.

    PubMed

    Moore, Nicole L T; Gauchan, Sangeeta; Genovese, Raymond F

    2014-05-01

    Early exposure to a traumatic event may produce lasting effects throughout the lifespan. Traumatic stress during adolescence may deliver a distinct developmental insult compared with more-often studied neonatal or juvenile traumatic stress paradigms. The present study describes the lasting effects of adolescent traumatic stress upon adulthood fear conditioning. Adolescent rats were exposed to a traumatic stressor (underwater trauma, UWT), then underwent fear conditioning during adulthood. Fear extinction was tested over five conditioned suppression extinction sessions three weeks later. The efficacies of two potential extinction-enhancing compounds, endocannabinoid reuptake inhibitor AM404 (10mg/kg) and M1 muscarinic positive allosteric modulator BQCA (10mg/kg), were also assessed. Finally, post-extinction fear responses were examined using a fear cue (light) as a prepulse stimulus. Rats traumatically stressed during adolescence showed blunted conditioned suppression on day 1 of extinction training, and AM404 reversed this effect. Post-extinction startle testing showed that fear conditioning eliminates prepulse inhibition to the light cue. Startle potentiation was observed only in rats without adolescent UWT exposure. AM404 and BQCA both ameliorated this startle potentiation, while BQCA increased startle in the UWT group. These results suggest that exposure to a traumatic stressor during adolescence alters developmental outcomes related to stress response and fear extinction compared to rats without adolescent traumatic stress exposure, blunting the adulthood fear response and reducing residual post-extinction fear expression. Efficacy of pharmacological interventions may also vary as a factor of developmental traumatic stress exposure. PMID:24491436

  13. Self-Reported Physical Health Associations of Traumatic Events in Medical and Dental Outpatients

    PubMed Central

    Raja, Sheela; Hannan, Susan M.; Boykin, Derrecka; Orcutt, Holly; Hamad, Judy; Hoersch, Michelle; Hasnain, Memoona

    2015-01-01

    Abstract The purpose of this cross-sectional study was to understand the prevalence and severity of health-related sequelae of traumatic exposure in a nonpsychiatric, outpatient sample. Self-report surveys were completed by patients seeking outpatient medical (n = 123) and dental care (n = 125) at a large, urban academic medical center. Results suggested that trauma exposure was associated with a decrease in perceptions of overall health and an increase in pain interference at work. Contrary to prediction, a history of interpersonal trauma was associated with less physical and emotional interference with social activities. A history of trauma exposure was associated with an increase in time elapsed since last medical visit. Depression and anxiety did not mediate the relationship between trauma history and medical care. Based on these results, clinical and research implications in relation to the health effects of trauma are discussed. The results suggest that routine screening for traumatic events may be important, particularly when providers have long-term relationships with patients. PMID:25929906

  14. Socioeconomic Disparity in Inpatient Mortality Following Traumatic Injury in Adults

    PubMed Central

    Ali, Mays T.; Hui, Xuan; Hashmi, Zain G.; Dhiman, Nitasha; Scott, Valerie K.; Efron, David; Schneider, Eric B.; Haider, Adil H.

    2013-01-01

    Background Prior studies have demonstrated that race and insurance status predict inpatient trauma mortality, but have been limited by their inability to adjust for direct measures of socioeconomic status (SES) and comorbidities. Our study aims to identify whether a relationship exists between SES and inpatient trauma mortality, after adjusting for known confounders. Methods Trauma patients aged 18–65 years with Injury Severity Scores (ISS) ≥ 9 were identified using the 2003–2009 Nationwide Inpatient Sample. Median household income (MHI) by zip code, available by quartiles, was used to measure SES. Multiple logistic regression analyses were performed to determine odds of inpatient mortality by MHI quartile, adjusting for ISS, type of injury, comorbidities, and patient demographics. Results 267,621 patients met inclusion criteria. Patients in lower wealth quartiles had significantly higher unadjusted inpatient mortality compared with the wealthiest quartile. Adjusted odds of death were also higher compared with the wealthiest quartile for Q1 (OR 1.13, 95% CI 1.06–1.20), Q2 (OR 1.09, 95% CI 1.02–1.17), and Q3 (OR 1.11, 95% CI 1.04–1.19). Conclusions Median household income predicts inpatient mortality after adult trauma, even after adjusting for race, insurance status, and comorbidities. Efforts to mitigate trauma disparities should address SES as an independent predictor of outcomes. PMID:23972652

  15. Brief Report: The Relationship between Post-Traumatic Stress Disorder Symptoms and Overgeneral Autobiographical Memory in Older Adults

    ERIC Educational Resources Information Center

    Robinson, Sarah R.; Jobson, Laura A.

    2013-01-01

    Objective: The aim of this study was to investigate the relationship between post-traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults. Method: Older adult trauma survivors (N = 23) completed the Autobiographical Memory Test, Posttraumatic Stress Diagnostic Scale, and Addenbrooke's Cognitive…

  16. Examining the link between traumatic events and delinquency among juvenile delinquent girls: A longitudinal study

    PubMed Central

    Marsiglio, Mary C.; Chronister, Krista M.; Gibson, Brandon; Leve, Leslie D.

    2014-01-01

    Researchers have postulated associations between childhood trauma and delinquency, but few have examined the direction of these relationships prospectively and, specifically, with samples of delinquent girls. The purpose of this study was to examine the relationship between traumatic events and delinquency for girls in the juvenile justice system using a cross-lagged model. Developmental differences in associations as a function of high school entry status were also examined. The sample included 166 girls in the juvenile justice system who were mandated to community-based out-of-home care due to chronic delinquency. Overall, study results provide evidence that trauma and delinquency risk pathways vary according to high school entry status. Implications for future research and practice are discussed. PMID:25580179

  17. [Writing therapy after traumatic events: therapeutic approaches and mechanisms of change].

    PubMed

    Knaevelsrud, Christine; Böttche, Maria

    2013-09-01

    The (written) disclosure of information, thoughts and emotions of individually significant tops is associated with positive effects on well-being and the psychological health. The applicability of expressive writing as a psychotherapeutic intervention for stress reactions after stressful/traumatic life events were also intensely discussed in the clinical context. However, structural and content-related variation of the initial writing paradigm resulted in significantly different effects on general psychological health and posttraumatic stress symptoms.This overview provides current findings to application and efficacy of expressive writing respectively writing therapy for posttraumatic stress disorder. Mechanisms of expressive writing (inhibition, habituation, construction of a coherent narrative, emotion regulation, social integration) are analyzed with regard to their relevance concerning PTSD. Finally, potentials for application in the clinical practice are discussed. PMID:24122310

  18. An Examination of Exposure to Traumatic Events and Symptoms and Strengths for Children Served in a Behavioral Health System of Care

    ERIC Educational Resources Information Center

    Whitson, Melissa L.; Connell, Christian M.; Bernard, Stanley; Kaufman, Joy S.

    2012-01-01

    The present study examined how exposure to traumatic events affects children with severe emotional disturbance who are being served in a school-based system of care. Multilevel growth curve models were used to examine the relationships between a child's history of traumatic events (physical abuse, sexual abuse, or domestic violence) and behavioral…

  19. Helping Children and Youth Who Have Experienced Traumatic Events. National Children's Mental Health Awareness Day--May 3, 2011. HHS Publication Number SMA-11-4642

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2011

    2011-01-01

    Childhood exposure to traumatic events is a major public health problem in the United States. Traumatic events can include witnessing or experiencing physical or sexual abuse, violence in families and communities, loss of a loved one, refugee and war experiences, living with a family member whose caregiving ability is impaired, and having a…

  20. [Frequency and Type of Traumatic Events in Children and Adolescents with a Posttraumatic Stress Disorder].

    PubMed

    Loos, Sabine; Wolf, Saskia; Tutus, Dunja; Goldbeck, Lutz

    2015-01-01

    The risk for children and adolescents to be exposed to a potentially traumatic event (PTE) is high. The present study examines the frequency of PTEs in children and adolescents with Posttraumatic Stress Disorder (PTSD), the type of index trauma, and its relation to PTSD symptom severity and gender. A clinical sample of 159 children and adolescents between 7-16 years was assessed using the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). All reported PTEs from the checklist were analyzed according to frequency. The index events were categorized according to the following categories: cause (random vs. intentional), relation to offender (intrafamilial vs. extrafamilial), patient's role (victim, witness or vicarious traumatization), and type of PTE (physical or sexual violence). Relation between categories and PTSD symptom severity and sex were analyzed with inferential statistics. On average participants reported five PTEs, most frequently physical violence without weapons (57.9%), loss of loved person through death (45.9%), and sexual abuse/assaults (44%). The most frequent index traumata were intentional (76.7%). Regarding trauma type, there was a significant difference concerning higher symptom severity in children and adolescents who experienced sexual abuse/assault compared to physical violence (t=-1.913(109), p=0.05). A significantly higher symptom severity was found for girls compared to boys for the trauma categories extrafamilial offender (z=-2,27, p=0.02), victim (z=-2,11, p=0,04), and sexual abuse/assault (z=-2,43, p=0,01). Clinical and diagnostic implications are discussed in relation to the amendments of PTSD diagnostic criteria in DSM-5. PMID:26493483

  1. Psychological Effect of an Analogue Traumatic Event Reduced by Sleep Deprivation

    PubMed Central

    Porcheret, Kate; Holmes, Emily A.; Goodwin, Guy M.; Foster, Russell G.; Wulff, Katharina

    2015-01-01

    Study Objective: To examine the effect of sleep deprivation compared to sleep, immediately after experimental trauma stimuli on the development of intrusive memories to that trauma stimuli. Design: Participants were exposed to a film with traumatic content (trauma film). The immediate response to the trauma film was assessed, followed by either total sleep deprivation (sleep deprived group, N = 20) or sleep as usual (sleep group, N = 22). Twelve hours after the film viewing the initial psychological effect of the trauma film was measured and for the subsequent 6 days intrusive emotional memories related to the trauma film were recorded in daily life. Setting: Academic sleep laboratory and participants' home environment. Participants: Healthy paid volunteers. Measurements and results: On the first day after the trauma film, the psychological effect as assessed by the Impact of Event Scale – Revised was lower in the sleep deprived group compared to the sleep group. In addition, the sleep deprived group reported fewer intrusive emotional memories (mean 2.28, standard deviation [SD] 2.91) compared to the sleep group (mean 3.76, SD 3.35). Because habitual sleep/circadian patterns, psychological health, and immediate effect of the trauma film were similar at baseline for participants of both groups, the results cannot be accounted for by pre-existing inequalities between groups. Conclusions: Our findings suggest that sleep deprivation on one night, rather than sleeping, reduces emotional effect and intrusive memories following exposure to experimental trauma. Citation: Porcheret K, Holmes EA, Goodwin GM, Foster RG, Wulff K. Psychological effect of an analogue traumatic event reduced by sleep deprivation. SLEEP 2015;38(7):1017–1025. PMID:26118556

  2. Source localization of an event-related potential marker of executive attention following mild traumatic brain injury.

    PubMed

    Rogers, Jeffrey M; Donnelly, James; Wilson, Peter H

    2015-10-21

    Recent research suggests that intact performance on an executive attention task after mild traumatic brain injury (mTBI) reflects functional adaptation within neural networks, rather than recovery of premorbid modes of information processing. However, it is unclear whether this compensation includes the recruitment of alternative neural processing resources. The current study used source localization analysis to determine the location and timing of activated brain areas involved in the generation of an event-related potential (ERP) component marker of executive attention in 10 adults with mTBI and in 10 matched healthy controls. In both groups the cerebral sources of the late processing negativity component of the ERP waveform elicited during the Paced Auditory Serial Addition Task were localized to the left ventrolateral prefrontal cortex and right dorsal anterior cingulate cortex. Timing of the dipole moments was consistent with previous reports of the relative contributions of subregions of the frontal cortex critically involved in aspects of executive attention control. Finally, whereas abnormal intensity of ERP activation has recently been related to the achievement of normal levels of performance after mTBI, abnormal sources of cerebral activation do not appear to be a feature of the compensatory response. PMID:26302255

  3. Assessing Posttraumatic Stress Disorder with or without Reference to a Single, Worst Traumatic Event: Examining Differences in Factor Structure

    ERIC Educational Resources Information Center

    Elhai, Jon D.; Engdahl, Ryan M.; Palmieri, Patrick A.; Naifeh, James A.; Schweinle, Amy; Jacobs, Gerard A.

    2009-01-01

    The authors examined the effects of a methodological manipulation on the Posttraumatic Stress Disorder (PTSD) Checklist's factor structure: specifically, whether respondents were instructed to reference a single worst traumatic event when rating PTSD symptoms. Nonclinical, trauma-exposed participants were randomly assigned to 1 of 2 PTSD…

  4. PTSD and Comorbid Disorders in a Representative Sample of Adolescents: The Risk Associated with Multiple Exposures to Potentially Traumatic Events

    ERIC Educational Resources Information Center

    Macdonald, Alexandra; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    Objective: This study compared the impact of multiple exposures to potentially traumatic events (PTEs), including sexual victimization, physical victimization, and witnessed violence, on posttraumatic stress disorder (PTSD) and comorbid conditions (i.e., major depressive episode [MDE], and substance use [SUD]). Methods: Participants were a…

  5. Lifetime Incidences of Traumatic Events and Mental Health among Children Affected by HIV/AIDS in Rural China

    ERIC Educational Resources Information Center

    Li, Xiaoming; Barnett, Douglas; Fang, Xiaoyi; Lin, Xiuyun; Zhao, Guoxiang; Zhao, Junfeng; Hong, Yan; Zhang, Liying; Naar-King, Sylvie; Stanton, Bonita

    2009-01-01

    Cross-sectional data were gathered from 1,625 children (M age = 12.85, SD = 2.21) which included 755 AIDS orphans, 466 vulnerable children, and 404 comparison children. Participants completed self-report measures of exposure to traumatic events, and psychosocial adjustment including behavior problems, depression, self-esteem, and future…

  6. Affective and behavioral changes following exposure to traumatic events: the moderating effect of religiosity on avoidance behavior among students studying under a high level of terror event exposure.

    PubMed

    Korn, Liat; Zukerman, Gil

    2011-12-01

    The goals of this study were to examine the development of affective and behavioral changes following exposure to traumatic events among Israeli students studying under a high level of terror event exposure and to assess the effects of religiosity on those changes development. A questionnaire was administered to 770 students in the Ariel University Center in Judea and Samaria. Higher levels of terror exposure were associated with higher levels of avoidance behavior, subjective feelings of insecurity, and emotional distress. Higher religiosity moderated avoidance behavior, even when controlling for the level of objective exposure to terror events exposure, but had no influence on subjective sense of insecurity, or the level of emotional distress. These findings suggest that religiosity moderates behavioral changes development after traumatic event exposure mainly by reducing avoidance behavior. PMID:21660614

  7. Schema Driven Construction of Future Autobiographical Traumatic Events: The Future is Much More Troubling than the Past

    PubMed Central

    Rubin, David C.

    2013-01-01

    Research on future episodic thought has produced compelling theories and results in cognitive psychology, cognitive neuroscience, and clinical psychology. To integrate these using basic concepts and methods from autobiographical memory research, 76 undergraduates remembered past and imagined future positive and negative events that had or would have a major impact on them. Correlations of the online ratings of visual and auditory imagery, emotion, and other measures demonstrated that individuals used the same processes to the same extent to remember past and construct future events. These measures predicted the theoretically important metacognitive judgment of past reliving and future ‘preliving’ in similar ways. Future negative events had much higher scores than past negative events on standardized tests of reactions to traumatic events, scores in the range that would qualify for a diagnosis of posttraumatic stress disorder (PTSD), which was replicated (n = 52) to check for order effects. Consistent with earlier work, future events had less sensory vividness. Thus, the imagined symptoms of future events were unlikely to be caused by sensory vividness. To confirm this, 63 undergraduates produced numerous added details between two constructions of the same negative future events, removing deficits in rated vividness with no increase in the standardized tests of reactions to traumatic events. Neuroticism predicted individuals’ reactions to negative past events but did not predict imagined reactions to future events. This set of novel methods and findings are interpreted in the contexts of the literatures of episodic future thought, autobiographical memory, PTSD, and classic schema theory. PMID:23607632

  8. Rejecting familiar distracters during recognition in young adults with traumatic brain injury and in healthy older adults.

    PubMed

    Ozen, Lana J; Skinner, Erin I; Fernandes, Myra A

    2010-05-01

    The most common cognitive complaint reported by healthy older adults and young adults with traumatic brain injury (TBI) is memory difficulties. We investigated the effects of normal aging and the long-term effects of TBI in young adults on the susceptibility to incorrectly endorse distracter information on a memory test. Prior to a study phase, participants viewed a "pre-exposure" list containing distracter words, presented once or three times, and half of the target study words. Subsequently, during the study phase, all target words were presented such that, across lists, study words were viewed either once or three times. On the recognition test, TBI and older adult participants were more likely to falsely endorse "pre-exposed" distracter words viewed three times as being from the target study list, compared to non-head-injured young controls. Normal aging and head injury in young may similarly compromise one's ability to reject highly familiar, but distracting, information during recognition. Older adult and TBI participants were also slower to complete the Trail Making task and had poorer output on a Digit Span task, suggesting these two populations share a deficit in executive function and working memory. Similar changes in frontal lobe function may underlie these shared cognitive deficits. PMID:20211048

  9. Interaction between the MTHFR C677T polymorphism and traumatic childhood events predicts depression.

    PubMed

    Lok, A; Bockting, C L H; Koeter, M W J; Snieder, H; Assies, J; Mocking, R J T; Vinkers, C H; Kahn, R S; Boks, M P; Schene, A H

    2013-01-01

    Childhood trauma is associated with the onset and recurrence of major depressive disorder (MDD). The thermolabile T variant of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism (rs1801133) is associated with a limited (oxidative) stress defense. Therefore, C677T MTHFR could be a potential predictor for depressive symptomatology and MDD recurrence in the context of traumatic stress during early life. We investigated the interaction between the C677T MTHFR variant and exposure to traumatic childhood events (TCEs) on MDD recurrence during a 5.5-year follow-up in a discovery sample of 124 patients with recurrent MDD and, in an independent replication sample, on depressive symptomatology in 665 healthy individuals from the general population. In the discovery sample, Cox regression analysis revealed a significant interaction between MTHFR genotype and TCEs on MDD recurrence (P=0.017). Over the 5.5-year follow-up period, median time to recurrence was 191 days for T-allele carrying patients who experienced TCEs (T+ and TCE+); 461 days for T- and TCE+ patients; 773 days for T+ and TCE- patients and 866 days for T- and TCE- patients. In the replication sample, a significant interaction was present between the MTHFR genotype and TCEs on depressive symptomatology (P=0.002). Our results show that the effects of TCEs on the prospectively assessed recurrence of MDD and self-reported depressive symptoms in the general population depend on the MTHFR genotype. In conclusion, T-allele carriers may be at an increased risk for depressive symptoms or MDD recurrence after exposure to childhood trauma. PMID:23900311

  10. Different neural modifications underpin PTSD after different traumatic events: an fMRI meta-analytic study.

    PubMed

    Boccia, Maddalena; D'Amico, Simonetta; Bianchini, Filippo; Marano, Assunta; Giannini, Anna Maria; Piccardi, Laura

    2016-03-01

    Post-traumatic stress disorder (PTSD) is an anxiety condition that can develop after exposure to trauma such as physical or sexual assault, injury, combat-related trauma, natural disaster or death. Although an increasing number of neurobiological studies carried out over the past 20 years have allowed clarifying the neural substrate of PTSD, the neural modifications underpinning PTSD are still unclear. Here we used activation likelihood estimation meta-analysis (ALE) to determine whether PTSD has a consistent neural substrate. We also explored the possibility that different traumatic events produce different alterations in the PTSD neural network. In neuroimaging studies of PTSD, we found evidence of a consistent neural network including the bilateral insula and cingulate cortex as well as the parietal, frontal and limbic areas. We also found that specific networks of brain areas underpin PTSD after different traumatic events and that these networks may be related to specific aspects of the traumatic events. We discuss our results in light of the functional segregation of the brain areas involved in PTSD. PMID:25913645

  11. Traumatic Brain Injury Activation of the Adult Subventricular Zone Neurogenic Niche.

    PubMed

    Chang, Eun Hyuk; Adorjan, Istvan; Mundim, Mayara V; Sun, Bin; Dizon, Maria L V; Szele, Francis G

    2016-01-01

    Traumatic brain injury (TBI) is common in both civilian and military life, placing a large burden on survivors and society. However, with the recognition of neural stem cells in adult mammals, including humans, came the possibility to harness these cells for repair of damaged brain, whereas previously this was thought to be impossible. In this review, we focus on the rodent adult subventricular zone (SVZ), an important neurogenic niche within the mature brain in which neural stem cells continue to reside. We review how the SVZ is perturbed following various animal TBI models with regards to cell proliferation, emigration, survival, and differentiation, and we review specific molecules involved in these processes. Together, this information suggests next steps in attempting to translate knowledge from TBI animal models into human therapies for TBI. PMID:27531972

  12. Traumatic inferior hip dislocation: a rare adult case with ipsilateral bifocal hip fracture

    PubMed Central

    El Hajj Moussa, Majd; Tawk, Charbel; Hoyek, Fadi; Lahoud, Jean-Claude

    2016-01-01

    Inferior dislocation is a rare type of hip dislocation, especially in adults. Few cases have been reported; most of them were isolated. This is the case of a traumatic adult hip dislocation after a road traffic accident. Reduction was made under general anaesthesia; a CT-Scan after the reduction showed a bifocal non-displaced hip fracture. In this article, we present a small review of the literature and we discuss the possible mechanism of hip dislocation. We found through our case study that this condition is not exclusive to children and CT-Scan is mandatory after the reduction of hip dislocation to eliminate any associated injury. To our knowledge, a bifocal hip fracture has not previously been documented, in the English language literature. PMID:27141043

  13. Traumatic Brain Injury Activation of the Adult Subventricular Zone Neurogenic Niche

    PubMed Central

    Chang, Eun Hyuk; Adorjan, Istvan; Mundim, Mayara V.; Sun, Bin; Dizon, Maria L. V.; Szele, Francis G.

    2016-01-01

    Traumatic brain injury (TBI) is common in both civilian and military life, placing a large burden on survivors and society. However, with the recognition of neural stem cells in adult mammals, including humans, came the possibility to harness these cells for repair of damaged brain, whereas previously this was thought to be impossible. In this review, we focus on the rodent adult subventricular zone (SVZ), an important neurogenic niche within the mature brain in which neural stem cells continue to reside. We review how the SVZ is perturbed following various animal TBI models with regards to cell proliferation, emigration, survival, and differentiation, and we review specific molecules involved in these processes. Together, this information suggests next steps in attempting to translate knowledge from TBI animal models into human therapies for TBI. PMID:27531972

  14. Use of the adult attachment projective picture system in psychodynamic psychotherapy with a severely traumatized patient

    PubMed Central

    George, Carol; Buchheim, Anna

    2014-01-01

    The following case study is presented to facilitate an understanding of how the attachment information evident from Adult Attachment Projective Picture System (AAP) assessment can be integrated into a psychodynamic perspective in making therapeutic recommendations that integrate an attachment perspective. The Adult Attachment Projective Picture System (AAP) is a valid representational measure of internal representations of attachment based on the analysis of a set of free response picture stimuli designed to systematically activate the attachment system (George and West, 2012). The AAP provides a fruitful diagnostic tool for psychodynamic-oriented clinicians to identify attachment-based deficits and resources for an individual patient in therapy. This paper considers the use of the AAP with a traumatized patient in an inpatient setting and uses a case study to illustrate the components of the AAP that are particularly relevant to a psychodynamic conceptualization. The paper discusses also attachment-based recommendations for intervention. PMID:25140164

  15. Exposures to war-related traumatic events and post-traumatic stress disorder symptoms among displaced Darfuri female university students: an exploratory study

    PubMed Central

    2012-01-01

    Background With the deaths of hundreds of thousands and the displacement of up to three million Darfuris, the increasingly complex and on-going war in Darfur has warranted the need to investigate war-related severity and current mental health levels amongst its civilian population. The purpose of this study is to explore the association between war-related exposures and assess post-traumatic stress disorder (PTSD) symptoms amongst a sample of Darfuri female university students at Ahfad University for Women (AUW) in Omdurman city. Methods An exploratory cross-sectional study among a representative sample of Darfuri female university students at AUW (N = 123) was conducted in February 2010. Using an adapted version of the Harvard Trauma Questionnaire (HTQ), war-related exposures and post-traumatic stress disorder (PTSD) symptoms were assessed. Means and standard deviations illustrated the experiential severity of war exposure dimensions and PTSD symptom sub-scales, while Pearson correlations tested for the strength of association between dimensions of war exposures and PTSD symptom sub-scales. Results Approximately 42 % of the Darfuri participants reported being displaced and 54 % have experienced war-related traumatic exposures either as victims or as witnesses (M = 28, SD = 14.24, range 0 – 40 events). Also, there was a strong association between the experiential dimension of war-related trauma exposures and the full symptom of PTSD. Moreover, the refugee-specific self-perception of functioning sub-scale within the PTSD measurement scored a mean of 3.2 (SD = .56), well above the 2.0 cut-off. Conclusions This study provides evidence for a relationship between traumatic war-related exposures and symptom rates of PTSD among AUW Darfuri female students. Findings are discussed in terms of AUW counseling service improvement. PMID:22863107

  16. Parental Substance Abuse As an Early Traumatic Event. Preliminary Findings on Neuropsychological and Personality Functioning in Young Drug Addicts Exposed to Drugs Early

    PubMed Central

    Parolin, Micol; Simonelli, Alessandra; Mapelli, Daniela; Sacco, Marianna; Cristofalo, Patrizia

    2016-01-01

    Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic events. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequelae at the neuro-behavioral level. Second, parents' addiction often entails a childrearing environment characterized by poor parenting skills, disadvantaged contexts and adverse childhood experiences (ACEs), leading to dysfunctional outcomes. Young adults born from/raised by parents with drug problems and diagnosed with a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved three groups, each consisting of 15 young adults (aged 18–24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterized by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions (EF); personality disorders were also common but did not differentiate them from non-exposed youth with SUDs. Alternative multi-focused prevention and

  17. Parental Substance Abuse As an Early Traumatic Event. Preliminary Findings on Neuropsychological and Personality Functioning in Young Drug Addicts Exposed to Drugs Early.

    PubMed

    Parolin, Micol; Simonelli, Alessandra; Mapelli, Daniela; Sacco, Marianna; Cristofalo, Patrizia

    2016-01-01

    Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic events. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequelae at the neuro-behavioral level. Second, parents' addiction often entails a childrearing environment characterized by poor parenting skills, disadvantaged contexts and adverse childhood experiences (ACEs), leading to dysfunctional outcomes. Young adults born from/raised by parents with drug problems and diagnosed with a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved three groups, each consisting of 15 young adults (aged 18-24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterized by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions (EF); personality disorders were also common but did not differentiate them from non-exposed youth with SUDs. Alternative multi-focused prevention and

  18. Traumatic Brain Injury among Older Adults at Level I and II Trauma Centers

    PubMed Central

    Cuthbert, Jeffrey P.; Whyte, John; Corrigan, John D.; Faul, Mark; Harrison-Felix, Cynthia

    2013-01-01

    Abstract Individuals 65 years of age and over have the highest rates of traumatic brain injury (TBI)-related hospitalizations and deaths, and older adults (defined variably across studies) have particularly poor outcomes after TBI. The factors predicting these outcomes remain poorly understood, and age-specific care guidelines for TBI do not exist. This study provides an overview of TBI in older adults using data from the National Trauma Data Bank (NTDB) gathered between 2007 and 2010, evaluates age group-specific trends in rates of TBI over time using U.S. Census data, and examines whether routinely collected information is able to predict hospital discharge status among older adults with TBI in the NTDB. Results showed a 20–25% increase in trauma center admissions for TBI among the oldest age groups (those >=75 years), relative to the general population, between 2007 and 2010. Older adults (>=65 years) with TBI tended to be white females who have incurred an injury from a fall resulting in a “severe” Abbreviated Injury Scale (AIS) score of the head. Older adults had more in-hospital procedures, such as neuroimaging and neurosurgery, tended to experience longer hospital stays, and were more likely to require continued medical care than younger adults. Older age, injury severity, and hypotension increased the odds of in-hospital death. The public health burden of TBI among older adults will likely increase as the Baby Boom generation ages. Improved primary and secondary prevention of TBI in this cohort is needed. PMID:23962046

  19. Coping with stressful or traumatic events: what aspects of trauma reactions are associated with health outcomes?

    PubMed

    Boals, Adriel; Riggs, Shelley A; Kraha, Amanda

    2013-04-01

    The presence of posttraumatic stress disorder (PTSD) symptoms has been shown to be related to a number of health outcomes. In the current study, we explored which specific aspects of PTSD are most related to health measures. The associations between the specific DSM-IV-TR PTSD criteria (criteria A-F) and five indicators of health and well-being--physical health symptoms, quality of life, mental health, depression and negative affect--were examined. The sample consisted of 711 undergraduates. A non-clinical sample was recruited so there would be variability in the various criteria for PTSD. Multiple regression analyses revealed that the hyperarousal (criterion D) was the most consistent and strongest predictor of outcomes. However, the F criterion (causes significant impairment) predicted additional variance in quality of life, depression and negative affect. These results suggest that it is not just the mere frequency of trauma symptoms that affect well-being but also the disruptive capability of these symptoms. In addition, follow-up analyses indicated that hyperarousal mediated the association between the A2 criterion (traumatic response) and all five outcome measures. These results underscore the importance of the hyperarousal criterion, while also suggesting the need for increased attention to the F criterion when considering the impact of stressful events on health and well-being. PMID:22888078

  20. Child Sexual Abuse, Post-Traumatic Stress Disorder, and Substance Use: Predictors of Revictimization in Adult Sexual Assault Survivors

    ERIC Educational Resources Information Center

    Ullman, Sarah E.; Najdowski, Cynthia J.; Filipas, Henrietta H.

    2009-01-01

    This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N = 555) completed two surveys a year apart. Child sexual abuse…

  1. The Wechsler Adult Intelligence Scale-III and Malingering in Traumatic Brain Injury: Classification Accuracy in Known Groups

    ERIC Educational Resources Information Center

    Curtis, Kelly L.; Greve, Kevin W.; Bianchini, Kevin J.

    2009-01-01

    A known-groups design was used to determine the classification accuracy of Wechsler Adult Intelligence Scale-III (WAIS-III) variables in detecting malingered neurocognitive dysfunction (MND) in traumatic brain injury (TBI). TBI patients were classified into the following groups: (a) mild TBI not-MND (n = 26), (b) mild TBI MND (n = 31), and (c)…

  2. No association between cumulative traumatic experiences and sex in risk for posttraumatic stress disorder among human immunodeficiency virus-positive adults.

    PubMed

    Morris, Tanya; Naidoo, Pamela; Cloete, Karen J; Harvey, Justin; Seedat, Soraya

    2013-06-01

    This study examined the association between the type and number of traumatic experiences and the conditional risk for posttraumatic stress disorder (PTSD), stratified by sex, in human immunodeficiency virus (HIV). We evaluated 465 (114 male and 350 female) HIV-positive adults attending HIV clinics in Cape Town, South Africa. Demographic and clinical data were collected, and the participants were screened for current PTSD and traumatic event exposure using the Mini-International Neuropsychiatric Interview and the Life Events Checklist, respectively. The highest attributable risk for PTSD was derived from sexual assault (17.4%) and transport accidents (16.9%). Only sexual assault was significantly (p = 0.002) associated with current PTSD. Although sex had no effect on the prediction of current PTSD, HIV-infected men tended to experience more lifetime traumas than HIV-infected women, with the men having significantly higher rates of exposure than women to physical assault (p = 0.018) and assault with a weapon (p = 0.001). These data highlight the importance of considering trauma type in contributing to the burden of PTSD in HIV-infected adults. PMID:23689195

  3. Teaching dental students to interact with survivors of traumatic events: development of a two-day module.

    PubMed

    Raja, Sheela; Rajagopalan, Chelsea F; Kruthoff, Mariela; Kuperschmidt, Alexandra; Chang, Priscilla; Hoersch, Michelle

    2015-01-01

    Dentists are likely to treat patients who have experienced a wide range of traumatic life events, including child abuse and neglect, domestic violence, sexual assault, elder abuse, and exposure to combat. In order to effectively treat survivors of traumatic events, dentists must understand how these patients may present in oral health settings, the basic mandated reporting requirements related to abuse and neglect, and communication strategies to help engage trauma survivors in dental treatment. A traditional lecture-format educational module on trauma-informed care was developed and implemented for second-year dental students (N=92) at one U.S. dental school, after which a needs assessment was performed (all 92 students participated). This assessment then informed development of an enhanced module for the subsequent group of second-year dental students (N=102) at the same school. The revised (final) module was more interactive in nature, expanded to multiple sessions, and included more discussion of mandated reporting and appropriate dentist-patient communication in relation to traumatic events. All 102 students participated in assessments of the revised module. Comparison of pre and post tests and needs assessments between the initial and final modules indicated that the extended, more interactive final module was more effective in meeting the educational objectives. Results showed that the final module increased the students' knowledge in the health-related manifestations of traumatic events and slightly improved their confidence levels in treating survivors of trauma. Dentists who are prepared to deliver trauma-informed care may help individual patients feel more at ease and increase engagement in regular preventive care. Suggestions for future educational efforts in this area are discussed. PMID:25576552

  4. Traumatic Brain Injury Causes Aberrant Migration of Adult-Born Neurons in the Hippocampus

    PubMed Central

    Ibrahim, Sara; Hu, Weipeng; Wang, Xiaoting; Gao, Xiang; He, Chunyan; Chen, Jinhui

    2016-01-01

    Traumatic brain injury (TBI) promotes neural stem/progenitor cell (NSC) proliferation in an attempt to initiate innate repair mechanisms. However, all immature neurons in the CNS are required to migrate from their birthplace to their final destination to develop into functional neurons. Here we assessed the destination of adult-born neurons following TBI. We found that a large percentage of immature neurons migrated past their normal stopping site at the inner granular cell layer (GCL), and became misplaced in the outer GCL of the hippocampal dentate gyrus. The aberrant migration of adult-born neurons in the hippocampus occurred 48 hours after TBI, and lasted for 8 weeks, resulting in a great number of newly generated neurons misplaced in the outer GCL in the hippocampus. Those misplaced neurons were able to become mature and differentiate into granular neurons, but located ectopically in the outer GCL with reduced dendritic complexity after TBI. The adult-born neurons at the misplaced position may make wrong connections with inappropriate nearby targets in the pre-existing neural network. These results suggest that although stimulation of endogenous NSCs following TBI might offer new avenues for cell-based therapy, additional intervention is required to further enhance successful neurogenesis for repairing the damaged brain. PMID:26898165

  5. Event-related brain potentials - Comparison between children and adults

    NASA Technical Reports Server (NTRS)

    Courchesne, E.

    1977-01-01

    The reported investigation shows that nontarget stimuli which are infrequently presented and deviate from the background elicit Nc and Pc waves in children. The same stimuli elicit P3 waves in adults. The scalp distribution of P3 waves in adults appears to vary with the ease of stimulus recognition or the degree of stimulus novelty. However, the Nc and Pc distributions in children do not seem to vary with these factors. The differences between children and adults in event-related potentials suggest corresponding differences in the mode of processing employed by each when rare, deviant stimuli are encountered

  6. [Sequential traumatization, trauma-related disorders and psychotherapeutic approaches in war-traumatized adult refugees and asylum seekers in Germany].

    PubMed

    Böttche, Maria; Heeke, Carina; Knaevelsrud, Christine

    2016-05-01

    The impact of war and violence on the mental and physical health of the civilian population is immense. Traumatization is often experienced sequentially, which leads to a higher risk for developing trauma-related disorders (PTSD, depression, chronic pain).Refugees traumatized by war experience specific stressors related to their status of residence (e. g., application hearing, length of the asylum procedure). Together with limited access to health care, these constitute additional risk factors for developing somatic and psychological illnesses.Adequate treatment for this highly vulnerable group requires a multimodal approach facilitated by translators. According to the S3 guidelines (S3-Richtlinien), trauma-adapted psychotherapeutic treatment has to be complemented by the activities of social workers, by medical treatment, and by legal advice. PMID:27072498

  7. Reduced N400 semantic priming effects in adult survivors of paediatric and adolescent traumatic brain injury.

    PubMed

    Knuepffer, C; Murdoch, B E; Lloyd, D; Lewis, F M; Hinchliffe, F J

    2012-10-01

    The immediate and long-term neural correlates of linguistic processing deficits reported following paediatric and adolescent traumatic brain injury (TBI) are poorly understood. Therefore, the current research investigated event-related potentials (ERPs) elicited during a semantic picture-word priming experiment in two groups of highly functioning individuals matched for various demographic variables and behavioural language performance. Participants in the TBI group had a recorded history of paediatric or adolescent TBI involving injury mechanisms associated with diffuse white matter pathology, while participants in the control group never sustained any insult to the brain. A comparison of N400 Mean Amplitudes elicited during three experimental conditions with varying semantic relatedness between the prime and target stimuli (congruent, semantically related, unrelated) revealed a significantly smaller N400 response in the unrelated condition in the TBI group, indicating residual linguistic processing deviations when processing demands required the quick detection of a between-category (unrelated) violation of semantic expectancy. PMID:22819620

  8. The Neuropsychological Profile of Comorbid Post-Traumatic Stress Disorder in Adult ADHD.

    PubMed

    Antshel, Kevin M; Biederman, Joseph; Spencer, Thomas J; Faraone, Stephen V

    2014-02-24

    Objective: ADHD and post-traumatic stress disorder (PTSD) are often comorbid yet despite the increased comorbidity between the two disorders, to our knowledge, no data have been published regarding the neuropsychological profile of adults with comorbid ADHD and PTSD. Likewise, previous empirical studies of the neuropsychology of PTSD did not control for ADHD status. We sought to fill this gap in the literature and to assess the extent to which neuropsychological test performance predicted psychosocial functioning, and perceived quality of life. Method: Participants were 201 adults with ADHD attending an outpatient mental health clinic between 1998 and 2003 and 123 controls without ADHD. Participants completed a large battery of self-report measures and psychological tests. Diagnoses were made using data obtained from structured psychiatric interviews (i.e., Structured Clinical Interview for DSM-IV, Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version). Results: Differences emerged between control participants and participants with ADHD on multiple neuropsychological tests. Across all tests, control participants outperformed participants with ADHD. Differences between the two ADHD groups emerged on seven psychological subtests including multiple Wechsler Adult Intelligence Scale-Third edition and Rey-Osterrieth Complex Figure Test measures. These test differences did not account for self-reported quality of life differences between groups. Conclusion: The comorbidity with PTSD in adults with ADHD is associated with weaker cognitive performance on several tasks that appear related to spatial/perceptual abilities and fluency. Neuropsychological test performances may share variance with the quality of life variables yet are not mediators of the quality of life ratings. (J. of Att. Dis. XXXX; XX(X) XX-XX). PMID:24567364

  9. Secondary traumatization among ex-POWs' adult children: the mediating role of differentiation of the self.

    PubMed

    Zerach, Gadi

    2015-03-01

    The aversive impact of combat and parents' combat-induced posttraumatic stress disorder on young children has been examined in a few studies. However, the long-term toll of war captivity on secondary traumatization (ST) and the mediating role of differentiation of the self remain unknown. This study examined ST symptoms and differentiation of the self (DS) among adult children of former prisoners of war (ex-POW's children) who were compared with adult children of comparable veterans (controls' children). Furthermore, I examined the mediating role of DS dimensions in the association between exposure to stress and ST symptoms. Participants were Israeli ex-POW's children (n = 98) and controls' children (n = 90), whose fathers fought in the 1973 Yom Kippur War. Results showed that ex-POW's children reported a higher number of ST symptoms and lower levels of emotional cutoff differentiation compared with controls' children. Emotional cutoff was also found to mediate the association between research group and ST symptoms. Among ex-POW's children, emotional cutoff and emotional reactivity dimensions mediated the association between exposure to stress stemming from fathers' behaviors and ST symptoms. Forty years after the war ended, the experience of living with ex-POWs is associated with ex-POW's children ST symptoms. PMID:25793696

  10. [A case of ectopic ureterocele in a male adult found during examination of a traumatic injury].

    PubMed

    Sakamoto, Yuuichi; Hyoudou, Youji; Okamoto, Masayuki; Yamada, Yuji; Takechi, Yosizumi

    2004-04-01

    We report a case of ectopic ureterocele in a male adult found during examination of a traumatic injury. A 26-year-old man sustained a blow to his left back during a football game and was admitted to the hospital with a complaint of abdominal pain. The computed tomographic scan showed a huge cystic mass in the retroperitoneum. A cystoscope revealed a large bulge from the left ureteral orifice to the bladder neck and another ureteral orifice distal to the bulge. Retrograde pyelography revealed an ectopic ureterocele showing a complete duplication, a lateral deviation of the left ureter and a bladder deviation to the right. An ectopic ureteral orifice was opening in the posterior urethra. An ureteral catheter inserted into this orifice revealed a dilated left ureter from the upper half of the kidney. Because the function of left upper of kidney was maintained, a transurethral incision was performed. Vesicoureteral reflux remained, but the postoperative course was uneventful. We discuss 11 cases of ectopic ureterocele in male adults including this case. PMID:15188616

  11. Chronic diseases and life events accounted for 2-18 % population attributable risks for adult hearing loss: UK Adult Psychiatric Morbidity Survey, 2007.

    PubMed

    Shiue, Ivy

    2016-01-01

    Links between chronic diseases and hearing loss in adults have emerged. However, previous investigations were not complete, and the role of life events was unclear. Therefore, it was aimed to examine the relationships of common chronic diseases and life events and adult hearing loss in a country-wide and population-based study. Data were retrieved from UK Adult Psychiatric Morbidity Survey, 2007, being cross-sectional, including demographics, self-reported prior health conditions and hearing loss (ever and in the last 12 months), and several major life events. Analyses included Chi square test, t test, logistic regression model, and population attributable risk estimation. People who had prior health conditions including cancer, migraine, dementia, depression, cataracts, chronic bronchitis, allergy, bowel problem, bladder problem, arthritis, muscle problem or skin problem tended to report hearing loss than their counterparts. People who have experienced major life events including post-traumatic stress disorder, serious illness of close relatives, death of family, serious problems with friends, major financial crisis, valuables stolen, being bullied, violence at home, sexual abuse or running away from home were also more likely to experience ever hearing loss problem or that in the last 12 months. 2.0-13.1 % adult hearing loss could be delayed or prevented by managing chronic diseases while 4.1-18.1 % might be delayed or prevented by minimizing the negative effects of life events. Chronic diseases and life events were associated with hearing loss in adults. Better managing lifestyle to minimize detrimental impacts in future health and nursing programs would be suggested. PMID:25575844

  12. Peer influence on event reports among adolescents and young adults.

    PubMed

    McGuire, Katherine; London, Kamala; Wright, Daniel B

    2011-08-01

    When two or more people witness an event together, the event report from one person can influence others' reports. In the current study we examined the role of age and motivational factors on peer influence regarding event reports in adolescents and young adults. Participants (N=249) watched a short video of a robbery then answered questions with no co-witness information or with information believed to be from a co-witness. Public and private response conditions were included to explore motivations for peer influence. Co-witness information influenced participants' responses, although the effect was equally strong in the private and the public co-witness conditions. Peer influence on event reports was steady across a large age range (11- to 25-year-olds). PMID:21919594

  13. Post traumatic stress disorder and coping in a sample of adult survivors of the Italian earthquake.

    PubMed

    Cofini, V; Carbonelli, A; Cecilia, M R; Binkin, N; di Orio, F

    2015-09-30

    The aim was to investigate the prevalence of post traumatic stress disorder (PTSD) in people who had left their damaged homes and were still living in temporary housing more than a year after the April 2009 L'Aquila (Italy) earthquake. In addition, we evaluated the differences in coping strategies implemented by persons who had and who did not have PTSD. A cross-sectional prevalence study was carried out on a sample of 281 people aged >18 years and living in temporary housing after the earthquake. The questionnaires used include the Davidson Trauma Scale and the Brief Cope. The prevalence of PTSD was 43%. Women and the non-employed were more vulnerable to PTSD, while, age and level of education were not associated with PTSD. Those with PTSD symptoms often employed maladaptive coping strategies for dealing with earthquake and had the highest scores in the domains of denial, venting, behavioral disengagement, self-blame. By contrast, those without PTSD generally had more adaptive coping mechanisms. Adults who were living in temporary housing after the earthquake experienced high rates of PTSD. The difference in coping mechanisms between those who have PTSD and those who do not also suggests that they influence the likeliness of developing PTSD. PMID:26162658

  14. Detection of Growth Hormone Deficiency in Adults with Chronic Traumatic Brain Injury.

    PubMed

    Kreber, Lisa A; Griesbach, Grace S; Ashley, Mark J

    2016-09-01

    This study examined the prevalence of growth hormone deficiency (GHD) in patients with traumatic brain injury (TBI) during the post-acute phase of recovery and whether GHD was associated with increased disability, decreased independence, and depression. A secondary objective was to determine the accuracy of insulin-like growth factor-1 (IGF-1) levels in predicting GHD in patients with TBI. Anterior pituitary function was assessed in 235 adult patients with TBI through evaluation of fasting morning hormone levels. GH levels were assessed through provocative testing, specifically the glucagon stimulation test. GHD was diagnosed in a significant number of patients, with 45% falling into the severe GHD (≤3 μg/L) category. IGF-1 levels were not predictive of GHD. Patients with GHD were more disabled and less independent compared with those patients who were not GHD. Those patients with more severe GHD also showed decreased levels of cortisol and testosterone. Symptoms of depression were also more prevalent in this group. In addition, patients with severe GHD had delayed admission to post-acute rehabilitation. This study confirms the high prevalence of GHD in patients with TBI and the necessity to monitor clinical symptoms and perform provocative testing to definitively diagnose GHD. PMID:26414093

  15. Neurobehavioural treatment for obsessive-compulsive disorder in an adult with traumatic brain injury.

    PubMed

    Arco, Lucius

    2008-01-01

    Although obsessive-compulsive disorder has been reported as one of many anxiety-related sequelae of brain injury, few empirical data of its responsiveness to psychological intervention are available. In this study, a single participant changing criterion experimental design was used to evaluate a neurobehavioural intervention for compulsive behaviour of an adult with severe traumatic brain injury. The participant, a man aged 24 years, had sustained frontal-temporal lobe brain trauma 12 months earlier, and presented with compulsive counting and voiding of bladder. The neurobehavioural intervention consisted of regular in-home consultations, self-regulation procedures including self-recording of compulsive behaviour, stress-coping strategies, errorless remediation, social reinforcement, and gradual fading of intervention. Baseline showed counting occurred on average 80% of daily hourly intervals, and voiding 12 times per day. Intervention produced elimination of compulsive counting, acceptable voiding at 8 times per day, and reports of the participant's satisfaction with intervention methods and outcomes. At 6 months follow-up, counting remained at zero levels, and voiding had decreased further to 7 times per day. PMID:18058389

  16. Adverse Outcomes Among Homeless Adolescents and Young Adults Who Report a History of Traumatic Brain Injury

    PubMed Central

    Harpin, Scott B.; Grubenhoff, Joseph A.; Rivara, Frederick P.

    2014-01-01

    Objectives. We examined the prevalence of self-reported traumatic brain injury (TBI) among homeless young people and explored whether sociodemographic characteristics, mental health diagnoses, substance use, exposure to violence, or difficulties with activities of daily living (ADLs) were associated with TBI. Methods. We analyzed data from the Wilder Homelessness Study, in which participants were recruited in 2006 and 2009 from streets, shelters, and locations in Minnesota that provide services to homeless individuals. Participants completed 30-minute interviews to collect information about history of TBI, homelessness, health status, exposure to violence (e.g., childhood abuse, assault), and other aspects of functioning. Results. Of the 2732 participating adolescents and young adults, 43% reported a history of TBI. Participants with TBI became homeless at a younger age and were more likely to report mental health diagnoses, substance use, suicidality, victimization, and difficulties with ADLs. The majority of participants (51%) reported sustaining their first injury prior to becoming homeless or at the same age of their first homeless episode (10%). Conclusions. TBI occurs frequently among homeless young people and is a marker of adverse outcomes such as mental health difficulties, suicidal behavior, substance use, and victimization. PMID:25122029

  17. Detection of Growth Hormone Deficiency in Adults with Chronic Traumatic Brain Injury

    PubMed Central

    Griesbach, Grace S.; Ashley, Mark J.

    2016-01-01

    Abstract This study examined the prevalence of growth hormone deficiency (GHD) in patients with traumatic brain injury (TBI) during the post-acute phase of recovery and whether GHD was associated with increased disability, decreased independence, and depression. A secondary objective was to determine the accuracy of insulin-like growth factor-1 (IGF-1) levels in predicting GHD in patients with TBI. Anterior pituitary function was assessed in 235 adult patients with TBI through evaluation of fasting morning hormone levels. GH levels were assessed through provocative testing, specifically the glucagon stimulation test. GHD was diagnosed in a significant number of patients, with 45% falling into the severe GHD (≤3 μg/L) category. IGF-1 levels were not predictive of GHD. Patients with GHD were more disabled and less independent compared with those patients who were not GHD. Those patients with more severe GHD also showed decreased levels of cortisol and testosterone. Symptoms of depression were also more prevalent in this group. In addition, patients with severe GHD had delayed admission to post-acute rehabilitation. This study confirms the high prevalence of GHD in patients with TBI and the necessity to monitor clinical symptoms and perform provocative testing to definitively diagnose GHD. PMID:26414093

  18. Figurative language processing after traumatic brain injury in adults: a preliminary study.

    PubMed

    Yang, Fanpei Gloria; Fuller, Jerome; Khodaparast, Navid; Krawczyk, Daniel C

    2010-06-01

    Figurative speech (e.g., proverb, irony, metaphor, and idiom) has been reported to be particularly sensitive to measurement of abstract thinking in patients who suffer from impaired abstraction and language abilities. Metaphor processing was investigated with fMRI in adults with moderate to severe post-acute traumatic brain injury (TBI) and healthy age-matched controls using a valence-judgment task. We hypothesized that TBI patients would display decreased activation of the left inferior frontal gyrus (LIFG), which is considered central to semantic memory retrieval and abstract thought, in comparison with healthy controls. We also predicted that decreased activation in TBI individuals would correlate with their behavioral response times. A whole-brain analysis across the two participant groups revealed that patients did not strongly engage frontal and temporal regions related to semantic processing for novel metaphor comprehension, whereas control participants exhibited more intensive and concentrated activation within frontal and temporal areas. A region of interest (ROI) analysis verified that the LIFG was underactivated in TBI patients compared to controls across all conditions. TBI patients' impaired abstraction of novel stimuli may stem from reduced prefrontal control of semantic memory as well as disrupted interconnectivity of prefrontal cortex with other regions. PMID:20230844

  19. Working Together to Make Sense of the Past: Mothers' and Children's Use of Internal States Language in Conversations about Traumatic and Nontraumatic Events

    ERIC Educational Resources Information Center

    Bauer, Patricia J.; Stark, Emily N.; Lukowski, Angela F.; Rademacher, Jennifer; Van Abbema, Dana L.; Ackil, Jennifer K.

    2005-01-01

    Mother-child conversations about a devastating tornado and about 2 nontraumatic events were examined to determine whether there were (a) differences in use of internal states language when talking about traumatic and nontraumatic events and (b) similarities in mothers' and children's use of internal states language. At Session 1, which took place…

  20. TRAUMATIC EVENTS ASSOCIATED WITH POSTTRAUMATIC STRESS DISORDER: THE ROLE OF RACE/ETHNICITY AND DEPRESSION

    PubMed Central

    Lipsky, Sherry; Kernic, Mary A.; Qiu, Qian; Hasin, Deborah S.

    2015-01-01

    This study sought to examine specific types of potentially traumatic experiences as predictors of posttraumatic stress disorder (PTSD) and the moderating effect of race/ethnicity and major depressive disorder (MDD) among non-Hispanic White, non-Hispanic Black, and Hispanic U.S. women. The study sample was drawn from two waves of the National Epidemiologic Surveys of Alcohol and Related Conditions. Sexual assault, intimate partner violence, and childhood trauma were the strongest predictors of PTSD compared to the reference group (indirect/witnessed trauma). Similar patterns were revealed across racial/ethnic groups, although the estimates were most robust among White women. Findings also suggest that MDD moderates the effect of traumatic experiences on PTSD. PMID:26620827

  1. Traumatic Events Associated With Posttraumatic Stress Disorder: The Role of Race/Ethnicity and Depression.

    PubMed

    Lipsky, Sherry; Kernic, Mary A; Qiu, Qian; Hasin, Deborah S

    2016-08-01

    This study sought to examine specific types of potentially traumatic experiences as predictors of posttraumatic stress disorder (PTSD) and the moderating effect of race/ethnicity and major depressive disorder (MDD) among non-Hispanic White, non-Hispanic Black, and Hispanic U.S. women. The study sample was drawn from two waves of the National Epidemiologic Surveys of Alcohol and Related Conditions. Sexual assault, intimate partner violence, and childhood trauma were the strongest predictors of PTSD compared with the reference group (indirect/witnessed trauma). Similar patterns were revealed across racial/ethnic groups, although the estimates were most robust among White women. Findings also suggest that MDD moderates the effect of traumatic experiences on PTSD. PMID:26620827

  2. The lifetime experience of traumatic events is associated with hair cortisol concentrations in community-based children.

    PubMed

    Simmons, Julian G; Badcock, Paul B; Whittle, Sarah L; Byrne, Michelle L; Mundy, Lisa; Patton, George C; Olsson, Craig A; Allen, Nicholas B

    2016-01-01

    Adversity early in life can disrupt the functioning of the hypothalamic-pituitary-adrenal axis (HPAA) and increase risk for negative health outcomes. Recent research suggests that cortisol in scalp hair represents a promising measure of HPAA function. However, little is known about the relationship between early exposure to traumatic events and hair cortisol concentrations (HCC) in childhood, a critical period of HPAA development. The current study measured HCC in scalp hair samples collected from 70 community-based children (14 males, mean age=9.50) participating in the Imaging Brain Development in the Childhood to Adolescence Transition Study (iCATS). Data were also collected on lifetime exposure to traumatic events and current depressive symptoms. Lifetime exposure to trauma was associated with elevated HCC; however, HCC was not associated with current depressive symptoms. Consistent with some prior work, males were found to have higher HCC than females, although results should be treated with caution due to the small number of males who took part. Our findings suggest that hair cortisol may represent a biomarker of exposure to trauma in this age group; however, further study is necessary with a particular focus on the characterization of trauma and other forms of adversity. PMID:26529051

  3. Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys

    PubMed Central

    Stein, Dan J.; Chiu, Wai Tat; Hwang, Irving; Kessler, Ronald C.; Sampson, Nancy; Alonso, Jordi; Borges, Guilherme; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; He, Yanling; Kovess-Masfety, Viviane; Levinson, Daphna; Matschinger, Herbert; Mneimneh, Zeina; Nakamura, Yosikazu; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Scott, Kate M.; Tomov, Toma; Viana, Maria Carmen; Williams, David R.; Nock, Matthew K.

    2010-01-01

    Background Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. Methodology/Principal Findings Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. Conclusions/Significance This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the

  4. Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with borderline personality disorder and healthy controls.

    PubMed

    Bandelow, Borwin; Krause, Joana; Wedekind, Dirk; Broocks, Andreas; Hajak, Göran; Rüther, Eckart

    2005-04-15

    Patients with borderline personality disorder (BPD) were compared with a healthy control group with regard to traumatic life events during childhood. The patients (n=66) and controls (n=109) were investigated using a comprehensive retrospective interview with 203 questions about childhood traumatic life events, parental attitudes, family history of psychiatric disorders and birth risk factors. The frequency of reports of traumatic childhood experiences was significantly higher in patients than in controls, including sexual abuse, violence, separation from parents, childhood illness, and other factors. On a 0- to 10-point "severe trauma scale," patients had significantly more severe traumatic events (mean score=3.86, SD=1.77) than control subjects (0.61, SD=0.93). Only four (6.1%) of the BPD patients, but 67 (61.5%) of the controls did not report any severe traumatic events at all. Compared with controls, patients described the attitude of their parents as significantly more unfavorable in all aspects. Patients reported significantly higher rates of psychiatric disorders in their families in general, especially anxiety disorders, depression, and suicidality. Among birth risk factors, premature birth was reported more often in BPD subjects. In a logistic regression model of all possible etiological factors examined, the following factors showed a significant influence: familial neurotic spectrum disorders, childhood sexual abuse, separation from parents and unfavorable parental rearing styles. The present data support the hypothesis that the etiology of BPD is multifactorial and that familial psychiatric disorders and sexual abuse are contributing factors. PMID:15840418

  5. Exposure to war-related traumatic events, prevalence of PTSD, and general psychiatric morbidity in a civilian population from Southern Lebanon.

    PubMed

    Farhood, Laila; Dimassi, Hani; Lehtinen, Tuija

    2006-10-01

    The South of Lebanon has experienced prolonged armed conflict. The current study aims to investigate the degree of exposure to traumatic events and prevalence of posttraumatic stress disorder (PTSD) and nonspecific general psychiatric morbidity in a civilian population from the South of Lebanon. The design was cross-sectional with random sampling. War-related traumatic events and symptoms of PTSD were assessed by the Harvard Trauma Questionnaire and general psychiatric morbidity by the General Health Questionnaire (GHQ-28). Almost all participants, 97.7%, had experienced, witnessed, or heard of a war-related traumatic event. Current PTSD prevalence was 29.3%. PTSD symptoms correlated highly with GHQ-28 symptoms, r = .73 (p < .0001). The present study indicates a need for psychological interventions in the population and studies to assess such interventions. PMID:16946115

  6. Development and psychometric properties of an informant assessment scale of theory of mind for adults with traumatic brain injury.

    PubMed

    Zhang, Dengke; Pang, Yanxia; Cai, Weixiong; Fazio, Rachel L; Ge, Jianrong; Su, Qiaorong; Xu, Shuiqin; Pan, Yinan; Chen, Sanmei; Zhang, Hongwei

    2016-08-01

    Impairment of theory of mind (ToM) is a common phenomenon following traumatic brain injury (TBI) that has clear effects on patients' social functioning. A growing body of research has focused on this area, and several methods have been developed to assess ToM deficiency. Although an informant assessment scale would be useful for examining individuals with TBI, very few studies have adopted this approach. The purpose of the present study was to develop an informant assessment scale of ToM for adults with traumatic brain injury (IASToM-aTBI) and to test its reliability and validity with 196 adults with TBI and 80 normal adults. A 44-item scale was developed following a literature review, interviews with patient informants, consultations with experts, item analysis, and exploratory factor analysis (EFA). The following three common factors were extracted: social interaction, understanding of beliefs, and understanding of emotions. The psychometric analyses indicate that the scale has good internal consistency reliability, split-half reliability, test-retest reliability, inter-rater reliability, structural validity, discriminate validity and criterion validity. These results provide preliminary evidence that supports the reliability and validity of the IASToM-aTBI as a ToM assessment tool for adults with TBI. PMID:25849662

  7. Post-traumatic stress symptoms and adult attachment: A 24 year longitudinal study

    PubMed Central

    Franz, Carol E.; Lyons, Michael J.; Spoon, Kelly M.; Hauger, Richard L.; Jacobson, Kristen C.; Lohr, James B.; McKenzie, Ruth; Panizzon, Matthew S.; Thompson, Wesley K.; Tsuang, Ming T.; Vasilopoulos, Terrie; Vuoksimaa, Eero; Xian, Hong; Kremen, William S.

    2014-01-01

    Objectives Attachment theory has become a key framework for understanding responses to and consequences of trauma across the life course. We predicted that more severe post traumatic stress (PTS) symptoms at age 37 would be associated with insecure attachment at age 55 and with worse PTS symptoms 24 years later at age 61, and that age 55 attachment would mediate the influence of earlier PTS symptoms on later symptoms. Design Data on PTS self-reported symptoms were available for 975 community-dwelling participants from the longitudinal Vietnam Era Twin Study of Aging (VETSA) at ages 37 and 61. At age 55, participants completed the Experiences in Close Relationships Inventory, a measure of adult attachment. Results PTS symptoms at ages 37 and 61 correlated r=.43 (p<.0001). Multiple mediation models found significant direct effects of age 37 PTS symptoms on age 61 PTS symptoms (β=.26; 95% confidence interval: .19; .33). Anxious and avoidant attachment at age 55 predicted PTS symptoms at age 61 (rs=.34 and .25; ps<.0001, respectively) and also significantly mediated PTS symptoms over time, showing that insecure attachment increased PTS severity. Participants with higher age 37 PTS symptoms were more likely to have a history of divorce; marital status did not mediate PTS. Conclusions Analyses demonstrate the persistence of PTS symptoms from early midlife into early old age. Mediation analyses revealed that one path through which PTS symptoms persisted was indirect, through their influence on attachment insecurity. This study provides insight into ongoing interconnections between psychological and interpersonal responses to stress. PMID:24636844

  8. Post-traumatic stress disorder symptomatology and alcohol use among HIV-seropositive adults in Haiti

    PubMed Central

    Dévieux, Jessy G.; Malow, Robert M.; Attonito, Jennifer M.; Jean-Gilles, Michèle; Rosenberg, Rhonda; Gaston, Stéphanie; Saint-Jean, Gilbert; Deschamps, Marie-Marcelle

    2013-01-01

    Psychological trauma resulting from natural disasters can negatively affect the health of persons living with HIV/AIDS (PLWH). This study examined relationships of alcohol use and exposure to the 2010 Haiti earthquake on symptoms of post-traumatic stress disorder (PTSD) among HIV-positive adults enrolled in an intervention study. Baseline data was collected from male and female PLWH, 19–56 years old on: alcohol consumption and related harms; anxiety; and coping strategies used to deal with HIV. Two to three months post-earthquake, data was collected from 104 of the study participants on PTSD and earthquake-related impacts. Most participants had less than secondary education (66%) and very low income (92% ≤ H$10,000 or ≤ US$1,250/year). Over two-thirds of participants felt at some point that they should cut down on drinking. Fifty two (50.5 %) met criteria for PTSD. More than 83% lost their belongings and 64% had someone close to them hurt or killed during the earthquake. Bivariate analysis showed that women, younger participants, those who lost all belongings, and those with greater overall alcohol impact were more likely to report PTSD symptoms. In the multivariate model, participants more likely to meet PTSD criteria (p<0.05) were those who reported feeling a need to cut down on drinking (OR=3.14, [CI=1.16, 8.49]) and participants who used behavioral disengagement as a coping mechanism (OR=1.49, [CI=1.15, 1.92]). Following a natural disaster, it is important to address trauma-related mental health needs of PLWH—particularly women and individuals who abuse alcohol. PMID:23373569

  9. Retrospective Analysis of Levetiracetam Compared to Phenytoin for Seizure Prophylaxis in Adults with Traumatic Brain Injury

    PubMed Central

    Caballero, G. Christina; Hughes, Darrel W.; Maxwell, Pamela R.; Green, Kay; Gamboa, Conrado D.; Barthol, Colleen A.

    2013-01-01

    Background: Phenytoin is standard of care for seizure prophylaxis following traumatic brain injury (TBI). Levetiracetam, an alternative antiepileptic drug, is utilized for seizure prophylaxis despite limited data supporting its use. Objective: Our primary outcome was post-TBI seizure activity measured by electroencephalogram (EEG) for levetiracetam versus phenytoin. Secondary outcomes were length of intensive care unit (ICU) stay, requirement for additional antiepileptic drugs (AED), and drug and monitoring costs. Methods: A retrospective review was performed of patients admitted to neurosurgical or surgical trauma ICU. Adult patients with at least 1 day of EEG monitoring were included. Patients were excluded if they had history of epilepsy, prior TBI, less than 48 hours of AED therapy, or additional AED prior to EEG monitoring. Results: A total 90 patients met inclusion criteria, with 18 receiving levetiracetam and 72 receiving phenytoin. Prevalence of EEG-confirmed seizure activity was similar between the levetiracetam and phenytoin groups (28% vs 29%; P = .99). ICU length of stay (13 vs 18 days; P = .28), time to EEG-confirmed seizure activity (4 vs 6 days; P = .24), and duration of seizure prophylaxis (9 vs 14 days; P = .18) were also similar. The median daily cost of levetiracetam therapy was $43 compared to $55 for phenytoin therapy and monitoring (P = .08). When all anticonvulsant therapy and monitoring were included, costs were lower for the levetiracetam group ($45 vs $83; P = .02). Conclusion: Levetiracetam may provide an alternative treatment option for seizure prevention in TBI patients in the ICU. Total antiepileptic drug and monitoring costs were lower for levetiracetam patients. PMID:24421550

  10. Management of traumatic cataract in adults at a reference center in Mexico City.

    PubMed

    Serna-Ojeda, Juan Carlos; Cordova-Cervantes, Jorge; Lopez-Salas, Miriam; Abdala-Figuerola, Alberto Carlos; Jimenez-Corona, Aida; Matiz-Moreno, Humberto; Chavez-Mondragon, Eduardo

    2015-08-01

    The purpose of the study was to determine the clinical presentation, mode of injury, surgical, and postoperative outcomes in adult patients with traumatic cataract. This is a clinical, observational, and retrospective study with review of records of patients in the period 2010-2012. Eighty patients were included, of whom 67 (83.75 %) were male. The mean age at presentation was 46 years (range 18-82 years). Sixty-four patients (80 %) had a closed-globe blunt ocular trauma and 16 (20 %) had an open-globe penetrating trauma. Seventy-seven (96.25 %) patients underwent phacoemulsification; 13.7 % (n = 11) required placement of capsular tension rings and 22.5 % (n = 18) automated anterior vitrectomy. In 53 % of the cases the intraocular lens (IOL) was placed in the capsular bag. Forty-seven patients (58.75 %) achieved a best-corrected visual acuity of 20/40 or better. In 57 (71.25 %) the final refraction was obtained, with a mean spherical equivalent of -0.56D (range -3.50D to +2.00 D). The improvement in visual acuity was significantly higher when the IOL was placed in the capsular bag compared to when it was placed in the sulcus (average difference of 0.667, p = 0.001). The most common mechanism of trauma is closed globe. Phacoemulsification was the procedure most common performed, with the IOL placed most commonly in the capsular bag. The final best-corrected visual acuity in most patients was 20/40 or better. Placing the IOL in the capsular bag represented an improvement in visual acuity compared to placement in the sulcus. PMID:25028216

  11. Re-experiencing traumatic events in PTSD: new avenues in research on intrusive memories and flashbacks

    PubMed Central

    Brewin, Chris R.

    2015-01-01

    Posttraumatic flashbacks, consisting of the intrusive re-experiencing of traumatic experiences in the present, have been more clearly defined for the first time in DSM-5 and have been identified as a unique symptom of posttraumatic stress disorder in the proposed ICD-11 diagnostic criteria. Relatively little research into flashbacks has been conducted, however, and new research efforts are required to understand the cognitive and biological basis of this important symptom. In addition, there is considerable scope for research into how flashbacks should be assessed and into flashbacks occurring in different contexts, such as psychosis or intensive care. PMID:25994019

  12. Traumatic brain injury and age at onset of cognitive impairment in older adults.

    PubMed

    Li, Wei; Risacher, Shannon L; McAllister, Thomas W; Saykin, Andrew J

    2016-07-01

    There is a deficiency of knowledge regarding how traumatic brain injury (TBI) is associated with age at onset (AAO) of cognitive impairment in older adults. Participants with a TBI history were identified from the Alzheimer's disease neuroimaging initiative (ADNI 1/GO/2) medical history database. Using an analysis of covariance (ANCOVA) model, the AAO was compared between those with and without TBI, and potential confounding factors were controlled. The AAO was also compared between those with mild TBI (mTBI) and moderate or severe TBI (sTBI). Lastly, the effects of mTBI were analyzed on the AAO of participants with clinical diagnoses of either mild cognitive impairment (MCI) or Alzheimer's disease (AD). The AAO for a TBI group was 68.2 ± 1.1 years [95 % confidence interval (CI) 66.2-70.3, n = 62], which was significantly earlier than the AAO for the non-TBI group of 70.9 ± 0.2 years (95 % CI 70.5-71.4, n = 1197) (p = 0.013). Participants with mTBI history showed an AAO of 68.5 ± 1.1 years (n = 56), which was significantly earlier than the AAO for the non-TBI group (p = 0.032). Participants with both MCI and mTBI showed an AAO of 66.5 ± 1.3 years (95 % CI 63.9-69.1, n = 45), compared to 70.6 ± 0.3 years for the non-TBI MCI group (95 % CI 70.1-71.1, n = 935) (p = 0.016). As a conclusion, a history of TBI may accelerate the AAO of cognitive impairment by two or more years. These results were consistent with reports of TBI as a significant risk factor for cognitive decline in older adults, and TBI is associated with an earlier AAO found in patients with MCI or AD. PMID:27007484

  13. Functional gene polymorphisms in the serotonin system and traumatic life events modulate the neural basis of fear acquisition and extinction.

    PubMed

    Hermann, Andrea; Küpper, Yvonne; Schmitz, Anja; Walter, Bertram; Vaitl, Dieter; Hennig, Jürgen; Stark, Rudolf; Tabbert, Katharina

    2012-01-01

    Fear acquisition and extinction are crucial mechanisms in the etiology and maintenance of anxiety disorders. Moreover, they might play a pivotal role in conveying the influence of genetic and environmental factors on the development of a (more or less) stronger proneness for, or resilience against psychopathology. There are only few insights in the neurobiology of genetically and environmentally based individual differences in fear learning and extinction. In this functional magnetic resonance imaging study, 74 healthy subjects were investigated. These were invited according to 5-HTTLPR/rs25531 (S+ vs. L(A)L(A); triallelic classification) and TPH2 (G(-703)T) (T+ vs. T-) genotype. The aim was to investigate the influence of genetic factors and traumatic life events on skin conductance responses (SCRs) and neural responses (amygdala, insula, dorsal anterior cingulate cortex (dACC) and ventromedial prefrontal cortex (vmPFC)) during acquisition and extinction learning in a differential fear conditioning paradigm. Fear acquisition was characterized by stronger late conditioned and unconditioned responses in the right insula in 5-HTTLPR S-allele carriers. During extinction traumatic life events were associated with reduced amygdala activation in S-allele carriers vs. non-carriers. Beyond that, T-allele carriers of the TPH2 (G(-703)T) polymorphism with a higher number of traumatic life events showed enhanced responsiveness in the amygdala during acquisition and in the vmPFC during extinction learning compared with non-carriers. Finally, a combined effect of the two polymorphisms with higher responses in S- and T-allele carriers was found in the dACC during extinction. The results indicate an increased expression of conditioned, but also unconditioned fear responses in the insula in 5-HTTLPR S-allele carriers. A combined effect of the two polymorphisms on dACC activation during extinction might be associated with prolonged fear expression. Gene-by-environment interactions

  14. Livestock/Animal Assets Buffer the Impact of Conflict-Related Traumatic Events on Mental Health Symptoms for Rural Women

    PubMed Central

    Glass, Nancy; Perrin, Nancy A.; Kohli, Anjalee; Remy, Mitima Mpanano

    2014-01-01

    Background In the context of multiple adversities, women are demonstrating resilience in rebuilding their futures, through participation in microfinance programs. In addition to the economic benefits of microfinance, there is evidence to suggest that it is an effective vehicle for improving health. Methods The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention, Pigs for Peace (PFP), on health and economic outcomes with households in 10 villages in eastern Democratic Republic of Congo. The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study. Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms. Findings The majority of women are 25 years or older, married, have on average 4 children in the home and have never attended school. Nearly 50% of women report having at least one livestock/animal asset at baseline. Over the past 10 years, women report on average more than 4 (M = 4.31, SD 3·64) traumatic events (range 0–18). Women reported symptoms consistent with PTSD with a mean score of ·2.30 (SD = 0·66range 0–4) and depression with a mean score of 1.86 (SD  = 0·49, range 0–3.47). The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD (p = 0·021) and depression (p = 0·002) symptom models. Interpretation The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict. The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women's health. Trial Registration clinicaltrials.gov NCT02008708 PMID

  15. Bounce Back: Effectiveness of an Elementary School-Based Intervention for Multicultural Children Exposed to Traumatic Events

    PubMed Central

    Langley, Audra K.; Gonzalez, Araceli; Sugar, Catherine A.; Solis, Diana; Jaycox, Lisa

    2015-01-01

    Objective To evaluate the feasibility and acceptability of a school-based intervention for diverse children exposed to a range of traumatic events, and to examine its effectiveness in improving symptoms of posttraumatic stress, depression, and anxiety. Method Participants were 74 school children (grades 1-5) and their primary caregivers. All participating students endorsed clinically significant posttraumatic stress symptoms. School clinicians were trained to deliver Bounce Back, a 10-session cognitive-behavioral group intervention. Children were randomized to Immediate or Delayed (3-month waitlist) Intervention. Parent- and child-report of posttraumatic stress and depression, and child report of anxiety symptoms, were assessed at baseline, 3 months, and 6 months. Results Bounce Back was implemented with excellent clinician fidelity. Compared to children in the Delayed condition, children who received Bounce Back immediately demonstrated significantly greater improvements in parent- and child-reported posttraumatic stress and child-reported anxiety symptoms over the 3-month intervention. Upon receipt of the intervention, the Delayed intervention group demonstrated significant improvements in parent- and child-reported posttraumatic stress, depression, and anxiety symptoms. The Immediate treatment group maintained or showed continued gains in all symptom domains over the 3-month follow-up period (6 month assessment). Conclusions Findings support the feasibility, acceptability, and effectiveness of the Bounce Back intervention as delivered by school-based clinicians for children with traumatic stress. Implications are discussed. PMID:26302251

  16. Late cognitive event-related potentials in adult Down's syndrome.

    PubMed

    Vieregge, P; Verleger, R; Schulze-Rava, H; Kömpf, D

    1992-12-15

    Event-related electroencephalogram (EEG) potentials (ERPs) using two different tasks were measured in 14 adults with Down's syndrome (DS; mean age 32 years) without clinically detectable cognitive decline. Two groups, young healthy (YH) and old healthy (OH) adults, served as controls. In the oddball task, DS had prolonged N1 and earlier P2 latencies than the control groups. P3 latency was delayed in comparison to YH. In the PushWait task, P3 latency was later in DS than in YH and OH. In both tasks, DS showed a marked amplitude shift towards positivity overlapping the N1-P2 complex and seemingly also P3: The P3 amplitude evoked by target tones and by "Push" was shifted towards anterior sites resulting in a Cz maximum. Changes of the N1 latency and amplitude in DS may be related to enhanced arousal during stimulus processing, indicating a possible defect of central inhibitory mechanisms. The study suggests that differentiated ERP procedures provide information on adult DS cognition exceeding those given by mere P3 latency measurements. Such procedures may be useful in the evaluation of the cognitive decline due to precocious aging or Alzheimer-type dementia in DS. PMID:1477192

  17. Traumatic events, posttraumatic stress disorder, attachment style, and working alliance in a sample of people with psychosis.

    PubMed

    Picken, Alicia L; Berry, Katherine; Tarrier, Nicholas; Barrowclough, Christine

    2010-10-01

    There is a high incidence of trauma and posttraumatic stress disorder (PTSD) in people with a diagnosis of psychosis. Sequelae of trauma may affect the ability to engage in both attachment and therapeutic relationships. This study investigated associations between trauma histories, PTSD, attachment styles, and working alliance in a sample of 110 individuals with psychosis and substance misuse. Anxious attachment was associated with number of interpersonal traumas and PTSD reported, but there were no associations between trauma and alliance. There were discrepancies in number of traumatic events reported by care coordinators and patients. The findings of this study highlight the potential use of attachment theory in working with trauma and PTSD in psychosis. PMID:20921870

  18. Mental states as part of countertransference responses in psychotherapists facing reports of traumatic events of mourning and sexual violence.

    PubMed

    Goldfeld, Patricia; Terra, Luciana; Abuchaim, Claudio; Sordi, Anne; Wiethaeuper, Daniela; Bouchard, Marc-Andrè; Mardini, Victor; Baumgardt, Rosana; Lauerman, Marta; Ceitlin, Lúcia Helena

    2008-09-01

    The study aims to compare the mental states and countertransference responses of 92 psychodynamically oriented psychotherapists, male and female, experienced and inexperienced, facing written reports of real patients who experienced traumatic events. Two vignettes were presented: one of a sexual violence, the other the sudden death of a significant person. The Mental States Rating System (MSRS; Bouchard, Picard, Audet, Brisson, & Carrier, 1998), the MSRS Self-Report (Goldfeld & Bouchard, 2004), and the Inventory of Countertransference Behavior (ICB; Friedman & Gelso, 2000) were used. Results showed that the mourning vignette led to more reflective responses (MSRS) and the rape case was associated with more negative countertransference reactions (ICB). Female participants were more reflective (MSRS); male therapists used less mentalized states (MSRS Self-Report) and expressed more negative reactions (ICB) for both scenarios. Experienced therapists showed more positive reactions on the ICB. The construct validity of the instruments is discussed in relation to the findings. PMID:18816003

  19. Psychometric Properties of the Child’s Reaction to Traumatic Events Scale-Revised in English and Lugandan

    PubMed Central

    Napper, Lucy E.; Fisher, Dennis G.; Jaffe, Adi; Jones, Russell T.; Lamphear, Vivian S.; Joseph, Lisa; Grimaldi, Elizabeth M.

    2014-01-01

    Brief and age-appropriate measures of trauma-related symptoms are useful for identifying children in need of clinical services. The current study examines the psychometric properties of the 23-item Child’s Reaction to Traumatic Events Scale-Revised (CRTES-R). The CRTES-R includes subscales assessing hyperarousal, avoidance and intrusion. To date, no studies have examined the psychometric properties of this revised measure or cross-cultural differences in its factor structure. Two samples of (a) children (ages 6–21) who had experienced a hurricane in the USA or Grenada (N = 135), and (b) Ugandan children (ages 8–17) who had experienced a variety of traumatic events (N = 339) completed the CRTES-R in English or Lugandan. Confirmatory factor analysis supported an empirically adjusted model with three modified latent factors in both the English (χ2/df = 1.34, CFI = .90, RMSEA = .05) and Lugandan samples (χ2/df = 1.45, CFI = .93, RMSEA = .04). Although the analysis supported separate hyperarousal, avoidance and intrusion subscales, the items that loaded on each factor differed from the original CRTES-R subscales. The English version of the CRTES-R showed good concurrent validity with the Kauai Recovery Index measure of trauma symptoms. Those using the CRTES-R to assess children’s experiences of the different symptom types should consider using the empirically-derived subscales described in this paper; however, those who wish to capture a broad spectrum of PTSD symptoms should consider using all the original CRTES-R items and calculating a total score. PMID:26085785

  20. Descriptive Epidemiology of Traumatic Injuries in 18890 Adults: a 5-Year-Study in a Tertiary Trauma Center in Iran

    PubMed Central

    Mehrpour, Saeed Reza; Nabian, Mohammad Hossein; Oryadi Zanjani, Leila; Foroughmand-Araabi, Mohammad-Hadi; Shahryar Kamrani, Reza

    2015-01-01

    Background: Basic epidemiological data can provide estimates when discussing disease burden and in the planning and provision of healthcare strategies. There is little quantitative information in the literature regarding prevalence of traumatic injuries from developing countries. Objectives: The aim of the current preliminary study was to reveal the prevalence and age and gender distribution of various traumatic injuries in a tertiary referral orthopedic hospital in Iran. Patients and Methods: In a prospective descriptive study, all traumatic injured patients attending the Orthopedic Trauma Unit of our center in a five year period were included. Demographic details, the cause of injury, injury classification and treatment were recorded. For each of the five-year age groups and each gender we calculated the numbers with fractures, dislocations, soft tissue injuries, ligamentous injuries and lacerations and derived average age and gender-specific prevalence as well as seasonal variations. Results: A total of 18890 adults were admitted, 13870 (73.4%) males and 5020 (26.6%) females. There were 8204 (43.4%) fractures. The male fracture age distribution curve was unimodal and there was a detectable bimodal pattern in females. Under 65 years males are 3 times more likely to sustain a fracture than females which decreases to equal risk over the age of 65. The most common fracture site was distal radius/ulna (13.8%), followed by tibial diaphysis (8.8%), proximal femur (7.8%), finger phalanges (6.4%), metacarpals (6%) and metatarsals (5.9%). There were seasonal variations in fracture incidence with peaks in February, March and October. The least number of fractures occurred in June. Conclusions: The risk of traumatic injuries is higher among specific age groups with different patterns emerging for men and women. Thus, the descriptive epidemiology will provide useful information for treatment or injury prevention strategies, resource allocation, and training priorities. PMID

  1. The Role of Traumatic Event History in Non-Medical Use of Prescription Drugs among a Nationally Representative Sample of US Adolescents

    ERIC Educational Resources Information Center

    McCauley, Jenna L.; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Kenneth J.; Resnick, Heidi S.; Hanson, Rochelle F.; Smith, Daniel W.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    Background: Building on previous research with adolescents that examined demographic variables and other forms of substance abuse in relation to non-medical use of prescription drugs (NMUPD), the current study examined potentially traumatic events, depression, posttraumatic stress disorder (PTSD), other substance use, and delinquent behavior as…

  2. Tips for Talking with and Helping Children and Youth Cope after a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2012

    2012-01-01

    Children and youth can face emotional strains after a traumatic event such as a car crash or violence. Disasters also may leave them with long-lasting harmful effects. When children experience a trauma, watch it on TV, or overhear others discussing it, they can feel scared, confused, or anxious. Young people react to trauma differently than…

  3. Development and Psychometric Evaluation of a New Assessment Method for Childhood Maltreatment Experiences: The Interview for Traumatic Events in Childhood (ITEC)

    ERIC Educational Resources Information Center

    Lobbestael, Jill; Arntz, Arnoud; Harkema-Schouten, Petra; Bernstein, David

    2009-01-01

    Objective: We conducted a comprehensive assessment of the reliability and validity of the Interview for Traumatic Events in Childhood (ITEC, Lobbestael, Arntz, Kremers, & Sieswerda, 2006), a retrospective, semi-structured interview for childhood maltreatment. The ITEC aims to yield dimensional scores for severity of experiences of different…

  4. Traumatic Exposure History as a Risk Factor for Chronic Pain in Adult Patients with Sickle Cell Disease.

    PubMed

    Works, Teresa; Jones, Sasia; Grady, James; Andemariam, Biree

    2016-02-01

    This article describes the impact of the integration of a licensed clinical social worker (LCSW) with expertise in behavioral health on identification of risk factors for chronic pain in a cohort of adults with sickle cell disease. Authors conducted a retrospective chart review of all visits to the adult sickle cell center during the first six months of LCSW integration. Demographics, clinical history, and LCSW notes were reviewed. Overall, 71 patients were introduced to the LCSW; 55 percent of them had chronic pain. Patients with chronic pain were older, used opioids daily, took hydroxyurea, reported higher daily pain scores, and underwent more acute care visits and hospitalizations for pain with longer stays. Fifty-eight (81 percent) patients requested concrete social work services such as transportation and housing. Thirty-two patients (55 percent) expressed a desire for mental health counseling while receiving concrete services. Twenty-two (69 percent) of these patients self-disclosed at least one traumatic experience. In fact, a statistically significant relationship between chronic pain and a history of trauma was identified (p = 0.001). Results suggest that sickle cell patients should receive clinical social work services to assess for traumatic exposures that may influence chronic pain. PMID:26946885

  5. Emergency Department Visits by Adults for Psychiatric Medication Adverse Events

    PubMed Central

    Hampton, Lee M.; Daubresse, Matthew; Chang, Hsien-Yen; Alexander, G. Caleb; Budnitz, Daniel S.

    2015-01-01

    IMPORTANCE In 2011, an estimated 26.8 million US adults used prescription medications for mental illness. OBJECTIVE To estimate the numbers and rates of adverse drug event (ADE) emergency department (ED) visits involving psychiatric medications among US adults between January 1, 2009, and December 31, 2011. DESIGN AND SETTING Descriptive analyses of active, nationally representative surveillance of ADE ED visits using the National Electronic Injury Surveillance System–Cooperative Adverse Drug Event Surveillance system and of drug prescribing during outpatient visits using the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. PARTICIPANTS Medical records from national probability samples of ED and outpatient visits by adults 19 years or older were reviewed and analyzed. EXPOSURES Antidepressants, antipsychotics, lithium salts, sedatives and anxiolytics, and stimulants. MAIN OUTCOMES AND MEASURES National estimates of ADE ED visits resulting from therapeutic psychiatric medication use and of psychiatric medication ADE ED visits per 10 000 outpatient visits at which psychiatric medications were prescribed. RESULTS From 2009 through 2011, there were an estimated 89 094 (95% CI, 68 641–109 548) psychiatric medication ADE ED visits annually, with 19.3% (95% CI, 16.3%–22.2%) resulting in hospitalization and 49.4% (95% CI, 46.5%–52.4%) involving patients aged 19 to 44 years. Sedatives and anxiolytics, antidepressants, antipsychotics, lithium salts, and stimulants were implicated in an estimated 30 707 (95% CI, 23 406–38 008), 25 377 (95% CI, 19 051–31 704), 21 578 (95% CI, 16 599–26 557), 3620 (95% CI, 2311–4928), and 2779 (95% CI, 1764–3794) respective ADE ED visits annually. Antipsychotics and lithium salts were implicated in 11.7 (95% CI, 10.1–13.2) and 16.4 (95% CI, 13.0–19.9) ADE ED visits per 10 000 outpatient prescription visits, respectively, compared with 3.6 (95% CI, 3.2–4.1) for sedatives

  6. Script-event representation in patients with severe traumatic brain injury.

    PubMed

    Allain, Philippe; Fasotti, Luciano; Roy, Arnaud; Chauviré, Valérie; Etcharry-Bouyx, Frédérique; Le Gall, Didier

    2012-10-01

    The aim of the present study was to examine the syntactic and semantic dimensions of script representation in patients with structural damage within the cerebral cortex following a severe traumatic brain injury (TBI). Forty TBI patients and 38 healthy control subjects (HC) were asked to sort cards describing actions belonging to eight scripts according to the script to which they belonged and according to their order of execution. Each script included actions which were low in centrality and distinctiveness (NCA & NDA), and high in centrality (CA), distinctiveness (DA), and CA and DA. Actions were presented in three conditions. In the scripts with headers (SH) condition, the actions were given with each script header written on a separate card. In the scripts without headers condition (SwH) no script header was provided. In the scripts with distractor header (SDH) condition, the actions were given with each script header and a distractor header written on separate cards. The results showed that performance of TBI patients was significantly lower in all conditions. Overall, TBI patients made significantly more sequencing and sorting errors (for all types of actions) than HC subjects. These data are consistent with the view that TBI produces impairment of both the syntactic and semantic dimensions of script representation. PMID:21689812

  7. Structural Dissociation of Attentional Control and Memory in Adults with and without Mild Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Niogi, Sumit N.; Mukherjee, Pratik; Ghajar, Jamshid; Johnson, Carl E.; Kolster, Rachel; Lee, Hana; Suh, Minah; Zimmerman, Robert D.; Manley, Geoffrey T.; McCandliss, Bruce D.

    2008-01-01

    Memory and attentional control impairments are the two most common forms of dysfunction following mild traumatic brain injury (TBI) and lead to significant morbidity in patients, yet these functions are thought to be supported by different brain networks. This 3 T magnetic resonance diffusion tensor imaging (DTI) study investigates whether…

  8. Child, Adolescent, and Young Adult Community Integration after a Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Barton, Barbara; Brouwers, Lynn; Ruoff, Janis; Trudel, Tina M.; Valnes, Betsy; Elias, Eileen; Pines, Hayley

    2010-01-01

    "Rehabilitation," as a term in and of itself, implies a goal of bringing something back to its original state of being. However, for many people living with traumatic brain injury (TBI), rehabilitation means learning to live all over again. Through means of education and employment, this article explores the quest for inclusive community…

  9. The roles of spirituality in the relationship between traumatic life events, mental health, and drug use among African American women from one southern state.

    PubMed

    Staton-Tindall, Michele; Duvall, Jamieson; Stevens-Watkins, Danelle; Oser, Carrie B

    2013-09-01

    This study examines the role of spirituality as a moderator of the relationship between traumatic life experiences, mental health, and drug use in a sample of African American women. It was hypothesized that there would be an inverse relationship overall between spirituality and mental health and drug use among this sample of African American women. Secondly, was expected that spirituality would moderate the relationship between traumatic life events and mental health and drug use. African American women (n = 206) were recruited from the community and from probation officers in three urban areas of a southern state, and face-to-face interviews were completed. Findings indicated that there was a main effect for spirituality (as measured by existential well-being on the Spiritual Well-Being Scale) and traumatic life events, mental health, and alcohol use. In addition, spirituality was a significant moderator of the relationship between traumatic life events and cocaine use. Discussion and implications for African American women are included. PMID:24041186

  10. Self-reported childhood maltreatment, lifelong traumatic events and mental disorders in fibromyalgia syndrome: a comparison of US and German outpatients

    PubMed Central

    Häuser, Winfried; Hoffmann, Eva-Maria; Wolfe, Frederick; Worthing, Angus B.; Stahl, Neil; Rothenberg, Russell; Walitt, Brian

    2016-01-01

    Objective The robustness of findings on retrospective self-reports of childhood maltreatment and lifetime traumatic experiences of adults with fibromyalgia syndrome (FMS) has not been demonstrated by transcultural studies. This is the first transcultural study to focus on the associations between FMS, childhood maltreatment, lifetime psychological traumas, and potential differences between countries adjusting for psychological distress. Methods 71 age-and sex-matched US and German FMS outpatients were compared. Childhood maltreatment were assessed by the Childhood Trauma Questionnaire and potential, traumatic experiences by the trauma list of the Munich Composite International Diagnostic Interview. Potential posttraumatic stress disorder (PTSD) was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders IV-TR symptom criteria by the Posttraumatic Diagnostic Scale. Potential depressive and anxiety disorder were assessed by the Patient Health Questionnaire PHQ 4. Results US and German patients did not significantly differ in the amount of self-reported childhood maltreatment (emotional, physical and sexual abuse or neglect) or in the frequency of lifetime traumatic experiences. No differences in the frequency of potential anxiety, depression, and PTSD were seen. Psychological distress fully accounted for group differences in emotional and sexual abuse and emotional and physical neglect. Conclusion The study demonstrated the transcultural robustness of findings on the association of adult FMS with self-reports of childhood maltreatment and lifelong traumatic experiences. These associations are mainly explained by current psychological distress. PMID:25786049

  11. PTSD symptoms and dominant emotional response to a traumatic event:an examination of DSM-IV Criterion A2.

    PubMed

    Hathaway, Lisa M; Boals, Adriel; Banks, Jonathan B

    2010-01-01

    To qualify for a diagnosis of posttraumatic stress disorder (PTSD), the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) requires that individuals report experiencing dominant emotions of fear, helplessness, and horror during the trauma (Criterion A2). Despite this stipulation, traumatic events can elicit a myriad of emotions other than fear, such as anger, guilt or shame, sadness, and numbing. The present study examined which emotional reactions to a stressful event in a college student sample are associated with the highest levels of PTSD symptoms. Our results suggest mixed support for the DSM-IV criteria. Although, participants who experienced a dominant emotion of fear reported relatively high PTSD symptomatology, participants who experience danger, disgust-related emotions, and sadness reported PTSD symptoms of equivalent severity. Additionally, participants reported dominant emotions of sadness and other emotions (including disgust, guilt, and shame) more frequently than they reported fear. These results question the specifics of diagnostic Criterion A2 and may have diagnostic and treatment implications. PMID:19337884

  12. The structure of post-traumatic stress symptoms in survivors of war: confirmatory factor analyses of the Impact of Event Scale--revised.

    PubMed

    Morina, Nexhmedin; Böhme, Hendryk F; Ajdukovic, Dean; Bogic, Marija; Franciskovic, Tanja; Galeazzi, Gian M; Kucukalic, Abdulah; Lecic-Tosevski, Dusica; Popovski, Mihajlo; Schützwohl, Matthias; Stangier, Ulrich; Priebe, Stefan

    2010-08-01

    The study aimed at establishing the factor structure of the Impact of Event Scale-Revised (IES-R) in survivors of war. A total sample of 4167 participants with potentially traumatic experiences during the war in Ex-Yugoslavia was split into three samples: two independent samples of people who stayed in the area of conflict and one sample of refugees to Western European countries. Alternative models with three, four, and five factors of post-traumatic symptoms were tested in one sample. The other samples were used for cross-validation. Results indicated that the model of best fit had five factors, i.e., intrusion, avoidance, hyperarousal, numbing, and sleep disturbance. Model superiority was cross-validated in the two other samples. These findings suggest a five-factor model of post-traumatic stress symptoms in war survivors with numbing and sleep disturbance as separate factors in addition to intrusion, avoidance and hyperarousal. PMID:20430572

  13. The Effects of Traumatizing Life Events on People with Intellectual Disabilities: A Systematic Review

    ERIC Educational Resources Information Center

    Wigham, Sarah; Hatton, Chris; Taylor, John L.

    2011-01-01

    This article systematically reviews the literature on the effects of adverse life events or trauma on people with intellectual disabilities. It is important to systematically examine empirical evidence of the effects of trauma in people with intellectual disabilities as to date the number of studies in this area is not substantial, and the effects…

  14. Helping Children and Teens Cope with Traumatic Events and Death: The Role of School Health Professionals.

    ERIC Educational Resources Information Center

    Spitalny, Kenneth; Gurian, Anita; Goodman, Robin F.

    2002-01-01

    Presents suggestions to help school nurses recognize and deal with the causes of children's physical problems in times of trauma and stress and coordinate their responsibilities with other professionals and parents (focusing on the events of September 11, 2001). The article also discusses how to recognize posttraumatic stress disorder in children…

  15. Tips for Talking to Children and Youth after Traumatic Events: A Guide for Parents and Educators

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2007

    2007-01-01

    Children respond to trauma in many different ways. Some may have reactions very soon after the event; others may do fine for weeks or months, and then begin to show troubling behavior. Knowing the signs that are common at different ages can help parents and teachers recognize problems and respond appropriately. This guide lists common symptoms of…

  16. Utilizing the PREPaRE Model When Multiple Classrooms Witness a Traumatic Event

    ERIC Educational Resources Information Center

    Bernard, Lisa J.; Rittle, Carrie; Roberts, Kathy

    2011-01-01

    This article presents an account of how the Charleston County School District responded to an event by utilizing the PREPaRE model (Brock, et al., 2009). The acronym, PREPaRE, refers to a range of crisis response activities: P (prevent and prepare for psychological trauma), R (reaffirm physical health and perceptions of security and safety), E…

  17. Potentially traumatic interpersonal events, psychological distress and recurrent headache in a population-based cohort of adolescents: the HUNT study

    PubMed Central

    Stensland, Synne Øien; Dyb, Grete; Thoresen, Siri; Wentzel-Larsen, Tore; Zwart, John-Anker

    2013-01-01

    Objectives Recurrent headache co-occurs commonly with psychological distress, such as anxiety or depression. Potentially traumatic interpersonal events (PTIEs) could represent important precursors of psychological distress and recurrent headache in adolescents. Our objective was to assess the hypothesised association between exposure to PTIEs and recurrent migraine and tension-type headache (TTH) in adolescents, and to further examine the potential impact of psychological distress on this relationship. Design Population-based, cross-sectional cohort study. The study includes self-reported data from youth on exposure to potentially traumatic events, psychological distress and a validated interview on headache. Setting The adolescent part of the Nord-Trøndelag Health Study 2006–2008 (HUNT), conducted in Norway. Participants A cohort of 10 464 adolescents were invited to the study. Age ranged from 12 to 20 years. The response rate was 73% (7620), of whom 50% (3832) were girls. Main outcome measures Data from the headache interview served as the outcome. Recurrent headache was defined as headache recurring at least monthly during the past year, and was subclassified into monthly, weekly and daily complaints. Subtypes were classified as TTH, migraine, migraine with TTH and/or non-classifiable headache, in accordance with the International Classification of Headache Disorders criteria, second edition. Results Multiple logistic regression analysis, adjusted for sociodemographics, showed consistently significant associations between exposure to PTIEs and recurrent headache, regardless of the frequency or subtype of headache. Increasing exposure to PTIEs was associated with higher prevalence of recurrent headache, indicating a dose–response relationship. The strength of associations between exposure to PTIEs and all recurrent headache disorders was significantly attenuated when psychological distress was entered into the regression equation. Conclusions The

  18. Potentially Traumatic Events at Different Points in the Life Span and Mental Health: Findings From SHARE-Israel

    PubMed Central

    Shrira, Amit; Shmotkin, Dov; Litwin, Howard

    2012-01-01

    This study addressed the association between adversity cumulated at different points in the life span and present mental health. Data of 1,130 participants aged 50+ were drawn from the Israeli component of the Survey of Health, Ageing and Retirement in Europe (SHARE). Measures included an inventory of potentially traumatic events, mental distress (depressive symptoms), and well-being (quality of life, life satisfaction). Adversity reported to have occurred early in life was positively related to mental health (i.e., to lower distress and higher well-being), whereas adversity reported to occur in late life was negatively related (i.e., to higher distress and lower well-being). Additional analyses showed that the positive association between early-life adversity and mental health was mainly restricted to adversity in which the primary harm was to another person (other-oriented adversity). In contrast, the negative association between late-life adversity and mental health was mainly restricted to adversity in which the primary harm was to the self (self-oriented adversity). This study suggests that the differential association between cumulative adversity and mental health is best captured when accounting for both time of occurrence and adversity type. PMID:22506527

  19. Near-Infrared Spectroscopy in the Monitoring of Adult Traumatic Brain Injury: A Review

    PubMed Central

    Su, Zhangjie; Clancy, Michael T.; Lucas, Samuel J. E.; Dehghani, Hamid; Logan, Ann; Belli, Antonio

    2015-01-01

    Abstract Cerebral near-infrared spectroscopy (NIRS) has long represented an exciting prospect for the noninvasive monitoring of cerebral tissue oxygenation and perfusion in the context of traumatic brain injury (TBI), although uncertainty still exists regarding the reliability of this technology specifically within this field. We have undertaken a review of the existing literature relating to the application of NIRS within TBI. We discuss current “state-of-the-art” NIRS monitoring, provide a brief background of the technology, and discuss the evidence regarding the ability of NIRS to substitute for established invasive monitoring in TBI. PMID:25603012

  20. Eye movement desensitization and reprocessing therapy in subsyndromal bipolar patients with a history of traumatic events: a randomized, controlled pilot-study.

    PubMed

    Novo, Patricia; Landin-Romero, Ramon; Radua, Joaquim; Vicens, Victor; Fernandez, Isabel; Garcia, Francisca; Pomarol-Clotet, Edith; McKenna, Peter J; Shapiro, Francine; Amann, Benedikt L

    2014-09-30

    Traumatic events are frequent in bipolar patients and can worsen the course of the disease. Psychotherapeutic interventions for these events have not been studied so far. Twenty DSM-IV bipolar I and II patients with subsyndromal mood symptoms and a history of traumatic events were randomly assigned to Eye Movement Desensitization and Reprocessing therapy (n=10) or treatment as usual (n=10). The treatment group received between 14 and 18 Eye Movement Desensitization and Reprocessing sessions during 12 weeks. Evaluations of affective symptoms, symptoms of trauma and trauma impact were carried out by a blind rater at baseline, 2 weeks, 5 weeks, 8 weeks, 12 weeks and at 24 weeks follow-up. Patients in the treatment group showed a statistically significant improvement in depressive and hypomanic symptoms, symptoms of trauma and trauma impact compared to the treatment as usual group after intervention. This effect was only partly maintained in trauma impact at the 24 weeks follow-up visit. One patient dropped from Eye Movement Desensitization and Reprocessing group whereas four from the treatment as usual group. This pilot study suggests that Eye Movement Desensitization and Reprocessing therapy may be an effective and safe intervention to treat subsyndromal mood and trauma symptoms in traumatized bipolar patients. PMID:24880581

  1. Unresolved legal and ethical issues in research of adults with severe traumatic brain injury: analysis of an ongoing protocol.

    PubMed

    Pape, Theresa Louise-Bender; Jaffe, Nancy Oddi; Savage, Teresa; Collins, Eileen; Warden, Deborah

    2004-03-01

    This paper synthesizes federal and state laws and bioethics literature with observations from an ongoing research protocol to identify, define, and clarify the unresolved legal and ethical issues regarding research involving adults with traumatic brain injury (TBI). Solutions that protect rights and minimize unnecessary impediments to valuable clinical and scientific inquiry are also illustrated using the same protocol. Research was performed at intensive care, inpatient rehabilitation, and long-term acute chronic hospitals. Our research protocol identified five areas of law impacting adults with TBI: advanced directives, healthcare surrogacy acts, probate acts, power of attorney acts, and the Health Insurance Portability and Accountability Act. The published bioethics literature and responses from local human subject institutional review boards (IRBs) suggest that some of the unresolved ethical issues in research include defining vulnerability, defining informed voluntary consent, determining competency and/or decision-making capacity, using caregivers as subjects, and conducting multisite cooperative studies. Collaboration with IRB members and administrators as well as legal and research ethic scholars developed procedures that protect rights while avoiding unnecessary impediments to research. Investigations of persons with TBI and other cognitive impairments are governed by complicated and inconsistent regulations within the Common Rule and federal and state statues. A need for clear and consistent regulatory guidance regarding multisite studies of TBI persists. In lieu of regulatory guidance, carefully researched solutions for critical peer review are needed to guide future multisite investigations of TBI. PMID:15558370

  2. Environmental Circadian Disruption Worsens Neurologic Impairment and Inhibits Hippocampal Neurogenesis in Adult Rats After Traumatic Brain Injury.

    PubMed

    Li, Dongpeng; Ma, Shanshan; Guo, Dewei; Cheng, Tian; Li, Hongwei; Tian, Yi; Li, Jianbin; Guan, Fangxia; Yang, Bo; Wang, Jian

    2016-10-01

    Circadian rhythms modulate many physiologic processes and behaviors. Therefore, their disruption causes a variety of potential adverse effects in humans and animals. Circadian disruption induced by constant light exposure has been discovered to produce pathophysiologic consequences after brain injury. However, the underlying mechanisms that lead to more severe impairment and disruption of neurophysiologic processes are not well understood. Here, we evaluated the effect of constant light exposure on the neurobehavioral impairment and survival of neurons in rats after traumatic brain injury (TBI). Sixty adult male Sprague-Dawley rats were subjected to a weight-drop model of TBI and then exposed to either a standard 12-/12-h light/dark cycle or a constant 24-h light/light cycle for 14 days. Our results showed that 14 days of constant light exposure after TBI significantly worsened the sensorimotor and cognitive deficits, which were associated with decreased body weight, impaired water and food intake, increased cortical lesion volume, and decreased neuronal survival. Furthermore, environmental circadian disruption inhibited cell proliferation and newborn cell survival and decreased immature cell production in rats subjected to the TBI model. We conclude that circadian disruption induced by constant light exposure worsens histologic and neurobehavioral impairment and inhibits neurogenesis in adult TBI rats. Our novel findings suggest that light exposure should be decreased and circadian rhythm reestablished in hospitalized TBI patients and that drugs and strategies that maintain circadian rhythm would offer a novel therapeutic option. PMID:26886755

  3. The Source of Adult Age Differences in Event-Based Prospective Memory: A Multinomial Modeling Approach

    ERIC Educational Resources Information Center

    Smith, Rebekah E.; Bayen, Ute J.

    2006-01-01

    Event-based prospective memory involves remembering to perform an action in response to a particular future event. Normal younger and older adults performed event-based prospective memory tasks in 2 experiments. The authors applied a formal multinomial processing tree model of prospective memory (Smith & Bayen, 2004) to disentangle age differences…

  4. Association between exposure to traumatic events and anxiety disorders in a post-conflict setting: a cross-sectional community study in South Sudan

    PubMed Central

    2014-01-01

    Background The negative effect of exposure to traumatic events on mental health is well known. Most studies of the effects of trauma on mental health in war-affected populations have focused on post-traumatic stress disorder (PTSD) and depression. Although some studies confirm the existence of anxiety symptoms in war-affected populations, the extent to which exposure to traumatic events is independently associated with anxiety diagnoses (other than PTSD) has received less attention. The study aimed to determine whether having an anxiety diagnosis, other than PTSD, was associated with experiencing traumatic events in a post-conflict setting, across genders and after controlling for demographic and socio-economic variables. Methods In this cross-sectional community study (n = 1200), we applied the Harvard Trauma Questionnaire (HTQ) to investigate the extent of trauma exposure and PTSD. The Mini-International Neuropsychiatric Interview (MINI) was used to investigate the prevalence of anxiety disorders: generalized anxiety disorder (GAD), panic disorder (PD), social phobia, obsessive-compulsive disorder (OCD), and agoraphobia. Multinomial logistic regression analyses were conducted to examine the association between these disorders, previous trauma exposure, and socio-economic factors. Results The participants were 56.4% male and 43.6% female. The age ranged between 18 and 73 years old (Mean 34.63, SD = 12.03). The estimated rates of GAD-only and PD-only (without comorbidity with PTSD) were 5.5% and 3.1%, respectively. Exposure to traumatic events and socio-economic disadvantage were significantly associated with having one or more anxiety diagnoses. After controlling for age, sex, rural/urban setting, and socio-economic disadvantage, exposure to trauma was independently associated with anxiety diagnosis. There were gender differences in the pattern of risk factors for having PTSD, GAD or PD. Conclusion In individuals with a history of war-related trauma

  5. Influence of mild traumatic brain injury during pediatric stage on short-term memory and hippocampal apoptosis in adult rats

    PubMed Central

    Park, Mi-Sook; Oh, Hyean-Ae; Ko, Il-Gyu; Kim, Sung-Eun; Kim, Sang-Hoon; Kim, Chang-Ju; Kim, Hyun-Bae; Kim, Hong

    2014-01-01

    Traumatic brain injury (TBI) is a leading cause of neurological deficit in the brain, which induces short- and long-term brain damage, cognitive impairment with/without structural alteration, motor deficits, emotional problems, and death both in children and adults. In the present study, we evaluated whether mild TBI in childhood causes persisting memory impairment until adulthood. Moreover, we investigated the influence of mild TBI on memory impairment in relation with hippocampal apoptosis. For this, step-down avoidance task, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay, and immunohistochemistry for caspase-3 were performed. Male Sprague-Dawley rats were used in the experiments. The animals were randomly divided into two groups: sham-operation group and TBI-induction group. The mild TBI model was created with an electromagnetic contusion device activated at a velocity of 3.0 m/sec. The results showed that mild TBI during the pediatric stage significantly decreased memory retention. The numbers of TUNEL-positive and caspase-3-positive cells were increased in the TBI-induction group compared to those in the sham-operation group. Defective memory retention and apoptosis sustained up to the adult stage. The present results shows that mild TBI induces long-lasting cognitive impairment from pediatric to adult stages in rats through the high level of apoptosis. The finding of this study suggests that children with mild TBI may need intensive treatments for the reduction of long-lasting cognitive impairment by secondary neuronal damage. PMID:25061593

  6. What becomes of infantile traumatic memories? An adult "wild child" is asked to remember.

    PubMed

    Terr, Lenore C

    2013-01-01

    A severely traumatized child, acting like a wild animal, was removed from her parents at thirteen months of age when her three-week-old sister was found, bitten and shaken to death. (Her father was later convicted of manslaughter and imprisoned.) The older child was also covered with bite marks. When she was twenty-nine months old, this child, whom I call "Cammie," was brought to me from miles away by herfoster parents for once-monthly psychotherapy. I have treated her, stressing abreaction, context, and correction, once a month ever since. When she was five years old Cammie's foster family adopted her. She is now twenty-two. I call her the "wild child" because of the growly voice, vomiting at will, grabbing at the genitalia of strangers, and cruelties to animals that she exhibited after her rescue. Presently she attends college and is training to be a preschool teacher or an aide to pediatricians. I have taken notes on what Cammie says and does during the twenty years she has come to me. In the spring of 2011, I was asked to speak later that year about infantile memories at the Margaret Mahler Symposium, Columbia University, New York. With the organizing committee's approval, I accompanied Cammie and her adoptive mother to the October 1, 2011, meeting and asked her in front of the psychoanalytic audience to recount her oldest remembrances. She, her mother, and I spoke about the nonverbal manifestations of her memory as well. I had briefly prepared Cammie and her mother for our presentation at the Mahler Symposium, but for the most part, it was spontaneous and unrehearsed. Their comments are quoted in this article. At twenty-two the "wild child" reports no verbal memory from her first year. On the other hand, her behaviors, attitudes, and perceptions over the years have reflected what occurred to her and indicate very active nonverbal memories of the traumatic experiences. Fragments of verbal memory that she recounted in therapy between ages two and three have

  7. Traumatic events and children

    MedlinePlus

    ... www.ncbi.nlm.nih.gov/pubmed/18692745 . Update Date 11/20/2014 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, ...

  8. Traumatic events and children

    MedlinePlus

    ... are: Natural disasters, such as a tornado, hurricane, fire, or flood Rape Witness shooting or stabbing of ... copes with the trauma by withdrawing from the world. They feel detached and see things happening around ...

  9. Two Decades Later: The Resilience and Post-Traumatic Responses of Indigenous Quechua Girls and Adolescents in the Aftermath of the Peruvian Armed Conflict

    ERIC Educational Resources Information Center

    Suarez, Eliana Barrios

    2013-01-01

    Objectives: In comparison to other traumatic events, the impact of a childhood during war on resilience later in life has been seldom examined. The aim of this study was therefore to examine the long term outcomes of post-traumatic responses and resilience of a sample of adult Indigenous Quechua women, who were girls or adolescents during the…

  10. Care of Adults With Intellectual and Developmental Disabilities: Traumatic Brain Injury.

    PubMed

    Jones, Kyle Bradford; Wilson, Benjamin; Weedon, Dean; Bilder, Deborah

    2015-12-01

    Traumatic brain injuries (TBIs) manifest in various forms and severities, and patients with TBIs can have multiple physical and psychological comorbidities. The physician should be prepared to assess effects of the injury and associated comorbidities, and provide needed social support. Common comorbidities include cognitive changes; epilepsy; chronic pain; headache; sleep disorders; neuroendocrine disorders; dizziness and balance issues; substance abuse; depression and anxiety; dementia; and behavioral disturbances, such as aggression. Early severity and cognitive assessment after TBI is key. For patients with mild TBIs, short-term management focuses on cognitive rest, symptom management, and gradual return to regular activities. Short-term management of patients with moderate to severe TBI often requires intensive care unit admission, early psychological consultation, and use of mannitol and probiotics. Long-term care includes monitoring and managing of the physical, behavioral, emotional, and psychological comorbidities that commonly occur in patients with TBIs. Assisting patients in accessing community and government resources can be crucial for improving their independence and quality of life. PMID:26669213

  11. Prognostically important EEG coma patterns in diffuse anoxic and traumatic encephalopathies in adults.

    PubMed

    Synek, V M

    1988-04-01

    Because of the paucity in the English literature of a detailed and universally accepted EEG grading scale relating to survival after diffuse traumatic and anoxic brain insults, prognostically oriented EEG patterns including recently described abnormalities are presented and discussed. The significance of these patterns may also apply in cases of coma of other etiologies, which can present morphologically similar features. EEG patterns have been classified into five major grades based on an internationally accepted scale. Individual patterns have been more clearly defined on the basis of the morphology of dominant activities, their distribution, persistence, and reactivity to external stimulation. Favorable outcome with survival seems to occur with both grade 1 and the "reactive type" of grade 2 abnormalities, with preservation of normal sleep features, and with frontal monorhythmic delta activity. Prognostically uncertain patterns are "nonreactive" grade 2 abnormalities, diffuse delta activity with grade 3 abnormality, and the "reactive type of alpha pattern coma." The following patterns are suggested to be prognostically malignant if persistent: grade 3 abnormality with small amplitude, diffuse, irregular delta activity; grade 4 ("burst suppression pattern"), in particular when epileptiform discharges are present and with "low-output EEG"; and grade 5 ("isoelectric EEG"). Fatal outcome is also common with the "nonreactive type of alpha pattern coma" and the recently reported "theta pattern coma." These patterns are presented in the illustrations. It is intended that this more detailed subdivision will promote understanding between electroencephalographers using visual EEG assessment in cases of coma. PMID:3074973

  12. The relationship between cognition and functional independence in adults with traumatic brain injury.

    PubMed

    Kaplan, C P; Corrigan, J D

    1994-06-01

    This study investigates the relationship between cognitive impairment, as measured by Orientation Group Monitoring System (OGMS) scores, and disability as measured by Functional Independence Measure (FIM) scores in a sample of 122 persons with traumatic brain injury admitted to an inpatient rehabilitation unit. The relationships between Aggregate OGMS and FIM Total, FIM Motor, and FIM Cognitive scores were significant (rho = .49, p < .001; .40, p < .001; and .64 p < .001 respectively). Lower cognition was related to greater disability; with this relationship stronger for FIM Cognitive versus FIM Motor scores. Consistent with prior research, time to rehabilitation was significantly related to FIM Total (rho = -.42 p < .001) at admission to rehabilitation, with shorter time to rehabilitation related to greater functional independence. Stepwise regression indicated that the Aggregate OGMS score contributed 24%, and time to rehabilitation 5% unique variance to FIM Total score. These results support previous findings of distinct cognitive and motor subscales of the FIM, and suggest the importance of cognitive impairment to both. PMID:8002762

  13. Chronic Histopathological and Behavioral Outcomes of Experimental Traumatic Brain Injury in Adult Male Animals.

    PubMed

    Osier, Nicole D; Carlson, Shaun W; DeSana, Anthony; Dixon, C Edward

    2015-12-01

    The purpose of this review is to survey the use of experimental animal models for studying the chronic histopathological and behavioral consequences of traumatic brain injury (TBI). The strategies employed to study the long-term consequences of TBI are described, along with a summary of the evidence available to date from common experimental TBI models: fluid percussion injury; controlled cortical impact; blast TBI; and closed-head injury. For each model, evidence is organized according to outcome. Histopathological outcomes included are gross changes in morphology/histology, ventricular enlargement, gray/white matter shrinkage, axonal injury, cerebrovascular histopathology, inflammation, and neurogenesis. Behavioral outcomes included are overall neurological function, motor function, cognitive function, frontal lobe function, and stress-related outcomes. A brief discussion is provided comparing the most common experimental models of TBI and highlighting the utility of each model in understanding specific aspects of TBI pathology. The majority of experimental TBI studies collect data in the acute postinjury period, but few continue into the chronic period. Available evidence from long-term studies suggests that many of the experimental TBI models can lead to progressive changes in histopathology and behavior. The studies described in this review contribute to our understanding of chronic TBI pathology. PMID:25490251

  14. Personality Compensates for Impaired Quality of Life and Social Functioning in Patients With Psychotic Disorders Who Experienced Traumatic Events

    PubMed Central

    Boyette, Lindy-Lou; van Dam, Daniëlla; Meijer, Carin; Velthorst, Eva; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René; de Haan, Lieuwe; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Cahn, Wiepke; Meijer, Carin; Myin-Germeys, Inez

    2014-01-01

    Background: Patients with psychotic disorders who experienced childhood trauma show more social dysfunction than patients without traumatic experiences. However, this may not hold for all patients with traumatic experiences. Little is known about the potential compensating role of Five-Factor Model personality traits within this group, despite their strong predictive value for social functioning and well-being in the general population. Methods: Our sample consisted of 195 patients with psychotic disorders (74% diagnosed with schizophrenia) and 132 controls. Cluster analyses were conducted to identify and validate distinct personality profiles. General linear model analyses were conducted to examine whether patients with different profiles differed in social functioning and quality of life (QoL), while controlling for possible confounders. Mediation models were tested to assess potential causal links. Results: In general, patients with higher levels of self-reported traumatic experiences (PT+) showed lower QoL and more social withdrawal compared with patients with lower traumatic experiences (PT−). Two clusters reflecting personality profiles were identified. PT+ with the first profile (lower neuroticism and higher extraversion, openness, agreeableness, and conscientiousness) presented higher levels of QoL and better social functioning in several areas, including less withdrawal, compared with both PT+ and PT− with the second profile. PT+ and PT− with the first personality profile did not differ in QoL and social functioning. Mediation analyses suggested that personality traits mediate the relation between traumatic experiences and QoL and social withdrawal. Conclusions: Our findings indicate that personality may “buffer” the impact of childhood traumatic experiences on functional outcome in patients with psychotic disorders. PMID:24771304

  15. Perpetrator Methodology as a Predictor of Traumatic Symptomatology in Adult Survivors of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Leahy, Trisha; Pretty, Grace; Tenenbaum, Gershon

    2004-01-01

    This retrospective study explores, through quantitative and qualitative methods, the relationship of two variables (perpetrator relationship and perpetrator methodology) to posttraumatic and dissociative symptomatology. The quantitative sample comprised a nonpsychiatric group (N = 39) of Australian adults reporting sexual abuse histories. A MANOVA…

  16. Experimental traumatic brain injury

    PubMed Central

    2010-01-01

    Traumatic brain injury, a leading cause of death and disability, is a result of an outside force causing mechanical disruption of brain tissue and delayed pathogenic events which collectively exacerbate the injury. These pathogenic injury processes are poorly understood and accordingly no effective neuroprotective treatment is available so far. Experimental models are essential for further clarification of the highly complex pathology of traumatic brain injury towards the development of novel treatments. Among the rodent models of traumatic brain injury the most commonly used are the weight-drop, the fluid percussion, and the cortical contusion injury models. As the entire spectrum of events that might occur in traumatic brain injury cannot be covered by one single rodent model, the design and choice of a specific model represents a major challenge for neuroscientists. This review summarizes and evaluates the strengths and weaknesses of the currently available rodent models for traumatic brain injury. PMID:20707892

  17. Clinical profile of non-traumatic acute abdominal pain presenting to an adult emergency department

    PubMed Central

    Chanana, Lakshay; Jegaraj, Moses A. K.; Kalyaniwala, Kimmin; Yadav, Bijesh; Abilash, Kundavaram

    2015-01-01

    Background: Abdominal pain is one of the most common reasons for presenting to the emergency depatment (ED) and the etiology is varied. Materials and Methods: This prospective observational study was conducted in a large ED of a tertiary care center in India. All patients older than 15 years and presenting with non-traumatic abdominal pain to the ED from May 2012 to October 2012 were recruited and the demographic characteristics, diagnosis and outcome were analyzed. Results: The study cohort included 264 patients over a 6 month period. More than half (55.6%) were aged between 15 and 40 years. There was a male predominance (56.8%). Majority of the patients (76.9%) presented with abdominal pain of less than 72 hour duration. The pain was sudden in onset in 54.9% of patients. Dull type was the most common character of pain (36%) followed by colicky type (22.3%). The most common site of pain was the lower abdomen (45.8%). Upper abdominal pain was seen in 26.9% and the pain was generalized in 27.3% of patients. The common causes were uretericcolic (16.3%), urinary tract infection (12.5%), acute pancreatitis (11%), acute appendicitis (10.6%) and acute gastritis (8%). More than half (51.9%) discharged from ED and 37% of cases were managed by the emergency physicians. Surgical intervention was required in 25.8% of patients. The mortality rate was 2.3%. Conclusions: Abdominal pain is a common ED symptom and clinicians must consider multiple diagnoses, especially those that require immediate intervention to limit morbidity and mortality. PMID:26288785

  18. A comparison of different models with motor dysfunction after traumatic brain injury in adult rats.

    PubMed

    Wang, Meng; Pu, Hongjian; Liu, Yingchao; Wang, Zengtao; Wang, Bomin; Xu, Wendong

    2014-12-01

    The aim of this study was to evaluate the validity of the model that could produce reproducible and persistent motor weakness and define the accurate tasks and testing parameters for longitudinal assessment of neurological deficits after traumatic brain injury (TBI). We compared the effects of two rat models that suffered different controlled cortical impact (CCI) injury, as well as extensive motor cortex resection model, on behavior recovery and brain morphology. Behavioral tests including the skilled reaching task, limb-use asymmetry test and the grasping test were employed to evaluate neurofunctional recovery from pre- to 12 weeks after the injury. The results demonstrated that all the rats in four groups showed spontaneous functional improvement with the past of time after surgery, especially in rats with mild and moderate CCI injury. At the end of the experiment, the animals' performance reached preoperative base lines on reaching task and limb-use asymmetry test in mild and moderate groups, while severe motor weakness could be observed in rats with severe CCI injury, as well as rats with extended motor cortex resection. Overall, the results of this study indicated that both models with severe CCI injury and extended resection of the motor cortex developed reproducible and long-lasting motor weakness, comparable in severity and duration and identified skilled reaching task, as well as limb-use asymmetry test, as sensitive assessments for slight neurological deficits after brain injury. This will help to provide the basis for further research of the processes after the TBI and development of novel therapies. PMID:25385190

  19. Cognitive function and brain structure after recurrent mild traumatic brain injuries in young-to-middle-aged adults

    PubMed Central

    List, Jonathan; Ott, Stefanie; Bukowski, Martin; Lindenberg, Robert; Flöel, Agnes

    2015-01-01

    Recurrent mild traumatic brain injuries (mTBIs) are regarded as an independent risk factor for developing dementia in later life. We here aimed to evaluate associations between recurrent mTBIs, cognition, and gray matter volume and microstructure as revealed by structural magnetic resonance imaging (MRI) in the chronic phase after mTBIs in young adulthood. We enrolled 20 young-to-middle-aged subjects, who reported two or more sports-related mTBIs, with the last mTBI > 6 months prior to study enrolment (mTBI group), and 21 age-, sex- and education matched controls with no history of mTBI (control group). All participants received comprehensive neuropsychological testing, and high resolution T1-weighted and diffusion tensor MRI in order to assess cortical thickness (CT) and microstructure, hippocampal volume, and ventricle size. Compared to the control group, subjects of the mTBI group presented with lower CT within the right temporal lobe and left insula using an a priori region of interest approach. Higher number of mTBIs was associated with lower CT in bilateral insula, right middle temporal gyrus and right entorhinal area. Our results suggest persistent detrimental effects of recurrent mTBIs on CT already in young-to-middle-aged adults. If additional structural deterioration occurs during aging, subtle neuropsychological decline may progress to clinically overt dementia earlier than in age-matched controls, a hypothesis to be assessed in future prospective trials. PMID:26052275

  20. A Clinical Decision Rule to Predict Adult Patients with Traumatic Intracranial Hemorrhage Who Do Not Require Intensive Care Unit Admission

    PubMed Central

    Nishijima, Daniel K.; Shahlaie, Kiarash; Echeverri, Angela; Holmes, James F.

    2016-01-01

    Objective To derive a clinical decision rule to identify adult emergency department (ED) patients with traumatic intracranial hemorrhage (tICH) who are at low risk for requiring critical care resources during hospitalization. Methods This is a retrospective cohort study of patients (≥18 years) with tICH presenting to the ED. The need for intensive care unit (ICU) admission was defined as the presence of a critical care intervention including: intubation, neurosurgical intervention, blood product transfusion, vasopressor or inotrope administration, invasive monitoring for hemodynamic instability, emergent treatment for arrhythmia, therapeutic angiography, and cardiopulmonary resuscitation. The decision rule was derived using binary recursive partitioning. Results A total of 432 patients were identified (median age 48 years) of which 174 patients (40%) had a critical care intervention. We performed binary recursive partitioning with Classification and Regression Trees (CART) software to develop the clinical decision rule. Patients with a normal mental status (Glasgow Coma Score=15), isolated head injury, and age < 65 were considered low risk for a critical care intervention. The derived rule had a sensitivity of 98% (95% confidence interval [CI] 94–99), a specificity of 50% (95% CI 44–56), a positive predictive value of 57% (95% CI 51–62), and a negative predictive value of 97% (95% CI 93–99). The area under the curve for the decision rule was 0.74 (95% CI 0.70–0.77). Conclusions This clinical decision rule identifies low risk adult ED patients with tICH who do not need ICU admission. Further validation and refinement of these findings would allow for more appropriate ICU resource utilization. PMID:21839444

  1. [Recall of traumatic life events at the time of national socialism in (former) Jewish emigrants and concentration camp prisoners].

    PubMed

    Kruse, A; Schmitt, E

    1998-04-01

    Semi-structured interviews with 248 (former) Jewish emigrants and extermination camp survivors in Germany and three destination countries of Jewish emigration (Argentina, Israel, United States) indicate that reminiscence of traumatic experiences suffered from National Socialist Germany occurs in numerous daily contexts. In later life, traumatic memories do not only occur spontaneously and unexpectedly; moreover, they are an essential part of the people's frame of reference for questions about personal identity, perceptions of social relationships, society and societal development, and coping with specific themes. Following a pilot study on subjective reconstruction of the life course in (former) Jewish emigrants and extermination camp survivors, different phases of post-holocaust development are distinguished. Self-ratings for intensity of traumatic reminiscence for these phases of personal development support the hypothesis that traumatic reminiscence increased in old age. People highly differ in coping with stressful reminiscence. Some study participants react with depression, anxiety, feelings of survivor guilt, and withdrawal from social relationships. Others, however, are highly engaged in social relationships, especially with the following generations. They want to give a contribution to the educational work of their society and to prevent discrimination, racism, and xenophobia. PMID:9610507

  2. [Treatment of complete traumatic avulsion of an incisor tooth in adults].

    PubMed

    Benmansour, A

    2013-05-01

    It is possible to replant an incisor tooth completely avulsed after trauma in adults. These cases are relatively frequent among athletes. It is essential to conserve the tooth in saline solution. The time before replantation must be as short as possible. The simple technique described here, which requires a minimum of material and no dental chair, makes it possible to replant an avulsed incisor with a good success rate. PMID:23803559

  3. Severe Traumatic Brain Injury, Frontal Lesions, and Social Aspects of Language Use: A Study of French-Speaking Adults

    ERIC Educational Resources Information Center

    Dardier, Virginie; Bernicot, Josie; Delanoe, Anaig; Vanberten, Melanie; Fayada, Catherine; Chevignard, Mathilde; Delaye, Corinne; Laurent-Vannier, Anne; Dubois, Bruno

    2011-01-01

    The purpose of this study was to gain insight into the social (pragmatic) aspects of language use by French-speaking individuals with frontal lesions following a severe traumatic brain injury. Eleven participants with traumatic brain injury performed tasks in three areas of communication: production (interview situation), comprehension (direct…

  4. Further Examination of Relationships Between Life Events and Psychiatric Symptoms in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Hamilton, D.; Sutherland, G.; Iacono, T.

    2005-01-01

    Background: It has been proposed that people with intellectual disability (ID) might be similar to the general population in the way they respond to significant life events. Some preliminary findings have demonstrated that adults with ID who have experienced recent life events have an increased probability of having psychiatric problems. The aims…

  5. Off-Time Events and Life Quality of Older Adults.

    ERIC Educational Resources Information Center

    Goodhart, Darlene; Zautra, Alex

    Many previous studies have found that daily life events influence community residents' perceived quality of life, which refers to the relative goodness of life as evaluated subjectively. A subsample population of 539 older residents, aged 55 and over, were interviewed in their homes. A 60-item scale was devised to measure the effects of "off-time"…

  6. Adult eyewitness memory and compliance: effects of post-event misinformation on memory for a negative event.

    PubMed

    Paz-Alonso, Pedro M; Goodman, Gail S; Ibabe, Izaskun

    2013-01-01

    This study investigated effects of misleading post-event information, delay, and centrality definition on eyewitness memory and suggestibility for a negative event (a vividly filmed murder). Either immediately or 2 weeks after viewing the film, 93 adults read a (misleading or control) narrative about the event and then completed a recognition memory test. Misinformation acceptance was operative, but strong evidence for memory malleability was lacking. Compliance predicted misinformation effects, especially on the delayed test. Although accuracy was generally higher for central than peripheral information, centrality criteria influenced the pattern of results. Self-report of greater distress was associated with better recognition accuracy. The results suggest that use of different centrality definitions may partly explain inconsistencies across studies of memory and suggestibility for central and peripheral information. Moreover, social factors appeared, at least in part, to influence misinformation effects for the highly negative event, especially as memory faded. Implications for eyewitness memory and suggestibility are discussed. PMID:24022799

  7. Adverse events in childhood and chronic widespread pain in adult life: Results from the 1958 British Birth Cohort Study.

    PubMed

    Jones, Gareth T; Power, Chris; Macfarlane, Gary J

    2009-05-01

    Chronic widespread pain (CWP) is a common and frequently disabling condition. Several studies have shown that early life adversity is associated with CWP in later life; however, the majority are retrospective and suffer from potential recall bias. Using data from the 1958 British Birth Cohort Study, the aim of the current study was to examine, prospectively, the relationship between childhood physical and psychological adversity and CWP in adulthood. At 7 yrs data were collected, by parental report, on physically traumatic events (hospitalisation following a road traffic accident, or for surgery); and factors indicating poor social and psychological environment (periods in local authority care, death of a parent; or parental divorce, alcoholism, or financial hardship). CWP was assessed at 45 yrs using self-completion questionnaires. The relationship between childhood events and CWP was examined using Poisson regression. 7571 individuals provided pain data at 45 yrs (71.5%). There was no association between childhood surgery and CWP in adulthood (relative risk: 1.0; 95%CI: 0.9-1.1). However, children who had been hospitalised following a road traffic accident experienced a significant increase in the risk of future CWP (1.5; 1.05-2.1). Children who had resided in institutional care also experienced an increase in the risk of CWP (1.7; 1.3-2.4) as did those who experienced maternal death (2.0; 1.08-3.7) and familial financial hardship (1.6; 1.3-1.9). Further these associations were not explained by adult psychological distress or social class. To prevent long-term consequences of adverse childhood events, future research should study the mechanisms, in particular the biological mechanisms, underlying these relationships. PMID:19304391

  8. Functional and electrophysiological changes after graded traumatic spinal cord injury in adult rat.

    PubMed

    Cao, Qilin; Zhang, Yi Ping; Iannotti, Christopher; DeVries, William H; Xu, Xiao-Ming; Shields, Christopher B; Whittemore, Scott R

    2005-02-01

    A graded contusion spinal cord injury (SCI) was created in the adult rat spinal cord using the Infinite Horizons (IH) impactor to study the correlation between injury severity and anatomical, behavioral, and electrophysiological outcomes. Adult Fisher rats were equally divided into five groups and received contusion injuries at the ninth thoracic level (T9) with 100, 125, 150, 175, or 200 kdyn impact forces, respectively. Transcranial magnetic motor-evoked potentials (tcMMEPs) and BBB open-field locomotor analyses were performed weekly for 4 weeks postinjury. Our results demonstrated that hindlimb locomotor function decreased in accordance with an increase in injury severity. The locomotor deficits were proportional to the amount of damage to the ventral and lateral white matter (WM). Locomotor function was strongly correlated to the amount of spared WM, which contains the reticulospinal and propriospinal tracts. Normal tcMMEP latencies were recorded in control, all of 100-kdyn-injured and half of 125-kdyn-injured animals. Delayed latency responses were recorded in some of 125-kdyn-injured and all of 150-kdyn-injured animals. No tcMMEP responses were recorded in 175- and 200-kdyn-injured animals. Comparison of tcMMEP responses with areas of WM loss or demyelination identified the medial ventrolateral funiculus (VLF) as the location of the tcMMEP pathway. Immunohistochemical and electromicroscopic (EM) analyses showed the presence of demyelinated axons in WM tracts surrounding the lesion cavities at 28 days postinjury. These data support the notion that widespread WM damage in the ventral and lateral funiculi may be a major cause for locomotor deficits and lack of tcMMEP responses after SCI. PMID:15629760

  9. Adverse Childhood Events and the Risk for New-Onset Depression and Post-Traumatic Stress Disorder Among U.S. National Guard Soldiers.

    PubMed

    Rudenstine, Sasha; Cohen, Greg; Prescott, Marta; Sampson, Laura; Liberzon, Israel; Tamburrino, Marijo; Calabrese, Joseph; Galea, Sandro

    2015-09-01

    This article examines the relationship between childhood adversity and postdeployment new-onset psychopathology among a sample of U.S. National Guard personnel deployed during Operation Iraqi Freedom and Operation Enduring Freedom with no history of post-traumatic stress disorder (PTSD) or depression. We recruited a sample of 991 Ohio Army National Guard soldiers and conducted structured interviews to assess traumatic event exposure, a history of childhood adversity, and postdeployment depression, and PTSD, consistent with the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition. We assessed childhood adversity by using questions from the Childhood Adverse Events Survey. In multivariable logistic models, a history of any childhood adversity was significantly associated with new-onset depression, but not PTSD, postdeployment. This finding suggests that a history of childhood adversity is predisposing for new-onset depression, among U.S. National Guard soldiers who were deployed with no prior history of PTSD or depression. This highlights the centrality of childhood experience for the production of mental health among soldiers. PMID:26327549

  10. Intravenous Multipotent Adult Progenitor Cell Therapy Attenuates Activated Microglial/Macrophage Response and Improves Spatial Learning After Traumatic Brain Injury

    PubMed Central

    Bedi, Supinder S.; Hetz, Robert; Thomas, Chelsea; Smith, Philippa; Olsen, Alex B.; Williams, Stephen; Xue, Hasen; Aroom, Kevin; Uray, Karen; Hamilton, Jason; Mays, Robert W.

    2013-01-01

    We previously demonstrated that the intravenous delivery of multipotent adult progenitor cells (MAPCs) after traumatic brain injury (TBI) in rodents provides neuroprotection by preserving the blood-brain barrier and systemically attenuating inflammation in the acute time frame following cell treatment; however, the long-term behavioral and anti-inflammatory effects of MAPC administration after TBI have yet to be explored. We hypothesized that the intravenous injection of MAPCs after TBI attenuates the inflammatory response (as measured by microglial morphology) and improves performance at motor tasks and spatial learning (Morris water maze [MWM]). MAPCs were administered intravenously 2 and 24 hours after a cortical contusion injury (CCI). We tested four groups at 120 days after TBI: sham (uninjured), injured but not treated (CCI), and injured and treated with one of two concentrations of MAPCs, either 2 million cells per kilogram (CCI-2) or 10 million cells per kilogram (CCI-10). CCI-10 rats showed significant improvement in left hind limb deficit on the balance beam. On the fifth day of MWM trials, CCI-10 animals showed a significant decrease in both latency to platform and distance traveled compared with CCI. Probe trials revealed a significant decrease in proximity measure in CCI-10 compared with CCI, suggesting improved memory retrieval. Neuroinflammation was quantified by enumerating activated microglia in the ipsilateral hippocampus. We observed a significant decrease in the number of activated microglia in the dentate gyrus in CCI-10 compared with CCI. Our results demonstrate that intravenous MAPC treatment after TBI in a rodent model offers long-term improvements in spatial learning as well as attenuation of neuroinflammation. PMID:24191266

  11. Memory for Traumatic Experiences in Early Childhood

    ERIC Educational Resources Information Center

    Cordon, Ingrid M.; Pipe, Margaret-Ellen; Sayfan, Liat; Melinder, Annika; Goodman, Gail S.

    2004-01-01

    Traumatic experiences in early childhood raise important questions about memory development in general and about the durability and accessibility of memories for traumatic events in particular. We discuss memory for early childhood traumatic events, from a developmental perspective, focusing on those factors that may equally influence memories for…

  12. P3 event-related evoked potential in young adults.

    PubMed

    Tandon, O P

    1990-07-01

    P3 component of event related potential reflects memory and decision making processes. It has been applied as an index of information processing in a wide variety of normal and cognitive impaired subjects. Scalp P3 was elicited in 24 male neurologically and audiologically normal young subjects of 17-20 years (Av. 17.7) of age. Standard auditory 'Oddball' paradigm involving simple discrimination task of concentrating on infrequent (target) stimulus and ignoring frequent (non target) stimulus was employed. Evoked response trials of discriminating 32 target stimuli out of 160 total presented (20% target and 80% non target randomly) were replicated and analysed by computer. Latency of P3 as 305 +/- 18.4 msec and amplitude 6.5 +/- 2.1 uv are being reported which are comparable with age and sex matched subjects of western world. PMID:2286422

  13. Post-traumatic stress disorder symptomatology and alcohol use among HIV-seropositive adults in Haiti.

    PubMed

    Dévieux, Jessy G; Malow, Robert M; Attonito, Jennifer M; Jean-Gilles, Michèle; Rosenberg, Rhonda; Gaston, Stéphanie; Saint-Jean, Gilbert; Deschamps, Marie-Marcelle

    2013-01-01

    Psychological trauma resulting from natural disasters can negatively affect the health of persons living with HIV/AIDS (PLWH). This study examined relationships of alcohol use and exposure to the 2010 Haiti earthquake on symptoms of posttraumatic stress disorder (PTSD) among HIV-positive adults enrolled in an intervention study. Baseline data were collected from male and female PLWH, 19-56 years old on: alcohol consumption and related harms; anxiety; and coping strategies used to deal with HIV. Two to three months postearthquake, data were collected from 104 of the study participants on PTSD and earthquake-related impacts. Most participants had less than a secondary education (66%) and very low income (92% ≤ H$10,000 or ≤ US$1250/year). Over two-thirds of participants felt at some point that they should cut down on drinking. Fifty-two (50.5%) met criteria for PTSD. More than 83% lost their belongings and 64% had someone close to them hurt or killed during the earthquake. Bivariate analysis showed that women, younger participants, those who lost all belongings, and those with greater overall alcohol impact were more likely to report PTSD symptoms. In the multivariate model, participants more likely to meet PTSD criteria (p<0.05) were those who reported feeling a need to cut down on drinking (OR = 3.14, [CI = 1.16, 8.49]) and participants who used behavioral disengagement as a coping mechanism (OR = 1.49, [CI = 1.15, 1.92]). Following a natural disaster, it is important to address trauma-related mental health needs of PLWH - particularly women and individuals who abuse alcohol. PMID:23373569

  14. Post-traumatic stress in Crohn's disease and its association with disease activity

    PubMed Central

    Cámara, Rafael J A; Gander, Marie-Louise; Begré, Stefan; von Känel, Roland

    2011-01-01

    Objective Violence, accidents and natural disasters are known to cause post-traumatic stress, which is typically accompanied by fear, suffering and impaired quality of life. Similar to chronic diseases, such events preoccupy the patient over longer periods. We hypothesised that post-traumatic stress could also be caused by Crohn's disease (CD), and that CD specific post-traumatic stress could be associated with an increased risk of disease exacerbation. Methods A cohort of CD patients was observed over 18 months in various types of locations providing gastroenterological treatment in Switzerland. The cohort included 597 consecutively recruited adults. At inclusion, CD specific post-traumatic stress was assessed using the Post-traumatic Diagnostic Scale (range 0–51 points). During follow-up, clinical aggravation was assessed by combining important outcome measures. Patients with post-traumatic stress levels suggestive of a post-traumatic stress disorder (≥ 15 points) were compared with patients with lower post-traumatic stress levels as well as with patients without post-traumatic stress. Also, the continuous relation between post-traumatic stress severity and risk of disease exacerbation was assessed. Results The 88 (19.1%) patients scoring ≥15 points had 4.3 times higher odds of exacerbation (95% CI 2.6 to 7.2) than the 372 (80.9%) patients scoring <15 points, and 13.0 times higher odds (95% CI 3.6 to 46.2) than the 45 (9.8%) patients scoring 0 points. The odds of exacerbation increased by 2.2 (95% CI 1.6 to 2.8) per standard deviation of post-traumatic stress. Conclusions CD specific post-traumatic stress is frequent and seems to be associated with exacerbation of CD. Thus gastroenterologists may want to ask about symptoms of post-traumatic stress and, where relevant, offer appropriate management according to current knowledge. PMID:24349679

  15. Post-Traumatic Stress Disorder

    MedlinePlus

    ... PTSD) is a real illness. You can get PTSD after living through or seeing a traumatic event, such ... at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people ...

  16. Labor market participation among young adults: an event history analysis.

    PubMed

    Johnson, R J; Herring, C

    1989-09-01

    This study models culture of poverty explanations, earlier experiences that tend to restrict opportunities, demographic effects representing differential rates of participation by social groups, and health and marijuana use variables indicating the influence of individual life- style differences as predictors of the rate of labor market entry, promotion, and dismissal among subjects from early adolescence to young adulthood. The data are drawn from the 1st and 4th waves of a 4-wave panel of half the 1971 Houston, Texas, Independent School District 7th grade born in 1958. The findings indicate that those who believe most in the efficacy of alternatives to conventional social and economic institutions and those who expect to benefit least are most likely to have higher rates of participation. This higher rate of participation is significantly greater for earlier years and contradicts predictions of a culture of poverty theory. 1 opportunity-structure variable, poor grades, significantly increases the rate of entry into the labor market primarily because it represents the inability of individuals to pursue advanced education prior to labor market entry. Education reduces overall rates of labor market entry for a young adult cohort by delaying labor market entry. The strong relationship between drug use and unemployment may be due to motivation, impaired ability, probability of failure, or increased time to use drugs. The findings also indicate that females are more capable overall of performing their jobs and getting along with co-workers but are less likely to be promoted. Finally, those who have been sanctioned or disadvantaged within the institutions that define and enforce the norms of the economic opportunity structure are significantly more likely to enter the labor market earlier and continue to have higher rates of negative experiences, such as dismissal, within those institutions. PMID:12316383

  17. Type and Intensity of Negative Life Events Are Associated With Depression in Adults With Intellectual Disabilities.

    PubMed

    Hove, Oddbjørn; Assmus, Jörg; Havik, Odd E

    2016-09-01

    This study investigated the associations between types and intensity of life events and symptoms of depression among adults with intellectual disabilities. A community sample (N = 593) was screened for current depression and exposure to life events (i.e., loss, illness, change, and bullying) during the previous 12 months. Symptoms of depression were measured using the Psychopathology Checklists for Adults With Intellectual Disabilities. Exposure to three of the four types of life events studied (loss, illness, and bullying) and the intensity of the events were associated with depression, particularly in the cases of loss of relatives and bullying. Quality of care moderated the association between bullying and depression and may buffer the adverse consequences of bullying. PMID:27611352

  18. Stressful Life Events, Sexual Orientation, and Cardiometabolic Risk Among Young Adults in the United States

    PubMed Central

    Hatzenbuehler, Mark L.; Slopen, Natalie; McLaughlin, Kate A.

    2015-01-01

    Objective The goal of the present study was to examine whether sexual minority young adults are more vulnerable to developing cardiometabolic risk following exposure to stressful life events than heterosexual young adults. Method Data came from the National Longitudinal Study for Adolescent Health (Shin, Edwards, & Heeren, 2009; Brummett et al., 2013), a prospective nationally representative study of U.S. adolescents followed into young adulthood. A total of 306 lesbian, gay, and bisexual (LGB) respondents and 6,667 heterosexual respondents met inclusion criteria for this analysis. Measures of cumulative stressful life events were drawn from all 4 waves of data collection; sexual orientation and cardiometabolic biomarkers were assessed at Wave 4 (2008–2009). Results Gay/bisexual men exposed to 1–2 (β = 0.71, p = .01) and 5 + (β = 0.87, p = .01) stressful life events had a statistically significant elevation in cardiometabolic risk, controlling for demographics, health behaviors, and socioeconomic status. Moreover, in models adjusted for all covariates, lesbian/bisexual (β = 0.52, p = .046) women with 5 + stressful life events had a statistically significant elevation in cardiometabolic risk. There was no relationship between stressful life events and cardiometabolic risk among heterosexual men or women. Conclusion Stressful life events during childhood, adolescence, and young adulthood place LGB young adults at heightened risk for elevated cardiometabolic risk as early as young adulthood. The mechanisms underlying this relationship require future study. PMID:25133830

  19. Associations between a History of Traumatic Brain Injuries and Current Cigarette Smoking, Substance Use, and Elevated Psychological Distress in a Population Sample of Canadian Adults.

    PubMed

    Ilie, Gabriela; Adlaf, Edward M; Mann, Robert E; Ialomiteanu, Anca; Hamilton, Hayley; Rehm, Jürgen; Asbridge, Mark; Cusimano, Michael D

    2015-07-15

    This study describes the prevalence of reported history of traumatic brain injury (TBI) and its association with reports of current substance use, cigarette smoking, and psychological distress among Canadian adults in a population sample. A cross-sectional sample of 1999 Ontario adults 18-93 years of age were surveyed by telephone in 2011 as part of the Center for Addiction and Mental Health's ongoing representative survey of adult mental health and substance use in Ontario, Canada. Loss of consciousness for at least 5 min or at least one overnight hospitalization resulting from symptoms associated with the TBI injury represented minimum criteria for TBI. An estimated 16.8% (95% confidence interval, 14.8, 19.0) of adults reported a TBI in their lifetime. Men had higher prevalence of TBI than women. Adults who reported a history of TBI had higher odds of reported past-year daily smoking (adjusted odds ratio [AOR] = 2.15), using cannabis (AOR = 2.80) and nonmedical opioids (AOR = 2.90), as well as screened significantly for recent elevated psychological distress (AOR = 1.97) in the past few weeks, compared to adults without a history of TBI. Co-occurrence of a history of TBI with current elevated psychological distress and substance use warrants vigilance among medical practitioners to assess the possibility of a history of TBI during reviews of the history leading to the occurrence of these conditions. PMID:25496189

  20. [S3 Guideline. Part 1: Diagnosis and Differential Diagnosis of Non-Traumatic Adult Femoral Head Necrosis].

    PubMed

    Bohndorf, K; Beckmann, J; Jäger, M; Kenn, W; Maus, U; Nöth, U; Peters, K M; Rader, C; Reppenhagen, S; Roth, A

    2015-08-01

    Non-traumatic femoral head necrosis (FHN) is primarily a disease of the middle-aged adult. Early diagnosis, at a time with lacking or minimal clinical symptoms, is mandatory to consider conservative therapy or joint preserving operations as a therapeutic option. The new German S3 guideline about diagnosis and therapy of FHN is a cooperative effort of five professional medical societies, overall headed by the Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC). This review (part I/III) cites and explains the statements of the S3 guideline as agreed on the use of imaging methods for diagnosis of FHN. A diagnostic algorithm is presented. FHN clinically has to be considered in case of equivocal pain of a hip joint with a minimum of 6 weeks duration, when risk factors can be revealed, groin pain at clinical investigation, limping, pain or limitation of movement in case of load, and no obvious differential diagnoses. Is an FHN clinically suspected, primarily radiographs of the pelvis ap and a Lauenstein projection of the hip involved should be carried out. When the radiographs are normal, an MRI of the hips should follow routinely. MRI allows the diagnosis of FNH with high accuracy. Furthermore, MRI reveals the site and the size of the necrotic area involved and evaluates the integrity of the joint surface and subchondral fractures. When ARCO stage II (ARCO: Association Research Circulation Osseous) is diagnosed and MRI does not allow one to determine the joint surface with certainty, a CT of the hip joints should be performed. The S3 guideline explains and recommends the use of the ARCO classification. Although, this classification of 1993 is still largely based on radiographs, the pragmatic use of an "extended" version seems reasonable. Today, classical radiographic criteria like impression of the joint surface and subchondral fractures ("crescent sign") are better to be evaluated by MRI, in cases of subtle findings MRI is even surpassed by CT

  1. Prevalence of exposure to potentially traumatic events in a healthy birth cohort of very young children in the northeastern United States.

    PubMed

    Briggs-Gowan, Margaret J; Ford, Julian D; Fraleigh, Lisa; McCarthy, Kimberly; Carter, Alice S

    2010-12-01

    Prevalence estimates of very young children's exposure to potentially traumatic events (PTEs) are limited. The study objective was to estimate the lifetime prevalence and correlates of noninterpersonal PTEs and violence exposure in a representative healthy birth cohort (ages 1-3 years) from an urban-suburban region of the United States (37.8% minority, 20.2% poverty). Parents completed 2 surveys approximately 1-year apart. By 24-48 months of age, the prevalence of exposure was 26.3% (14.5% noninterpersonal, 13.8% violence). Exposure was common among children living in poverty (49.0% overall, 19.7% noninterpersonal, 33.7% violence). The most consistent factors associated with exposure were poverty, parental depressive symptoms, and single parenting. Findings underscore the potential for prevention and intervention in early childhood to advance public health and reduce morbidity. PMID:21171133

  2. CIU and Main Event Analyses of the Structured Discourse of Older and Younger Adults

    ERIC Educational Resources Information Center

    Capilouto, Gilson; Wright, Heather Harris; Wagovich, Stacy A.

    2005-01-01

    Correct information unit (CIU) and main event analyses are quantitative measures for analyzing discourse of individuals with aphasia. Comparative data from healthy younger (YG) and older (OD) adults and an investigation of the influence of stimuli type would considerably extend the usefulness of such analyses. The objectives were (a) to compare…

  3. Potentially Stressful Life Events and Emotional Closeness between Grandparents and Adult Grandchildren

    ERIC Educational Resources Information Center

    Wood, Suzanne; Liossis, Poppy

    2007-01-01

    The purpose of this study is to explore the variation in emotional closeness in the adult grandchild and grandparent relationship in relation to the occurrence of potentially stressful life events in childhood. A sample of university students (N = 119) completed a questionnaire measuring elements of intergenerational solidarity. Comparisons were…

  4. Neural correlates of the modified Stroop effect in post-traumatic stress disorder: an event-related potential study.

    PubMed

    Chen, Xiaoyi; Wei, Dongtao; Dupuis-Roy, Nicolas; Du, Xue; Qiu, Jiang; Zhang, Qinglin

    2012-12-19

    Previous studies have provided electrophysiological evidence for attentional abnormalities in patients with post-traumatic stress disorder (PTSD). The present study examined the electrophysiological activity of trauma-exposed patients with or without a PTSD during a modified Stroop task. The PTSD group showed a reduced P2 and P3 amplitude relative to the non-PTSD group under both the earthquake-related and earthquake-unrelated words conditions. Importantly, the earthquake-related words elicited a greater P3 amplitude (350-450 ms after stimulus) than did unrelated words in the non-PTSD group, whereas no significant difference was found in the PTSD group. This indicates that PTSD patients had some attention deficits compared with non-PTSD individuals, and that these attention deficits were not just limited to earthquake-related words. PMID:23108040

  5. Superior Mesenteric Arterial Flow Pattern is Associated with Major Adverse Events in Adults with Fontan Circulation.

    PubMed

    Mori, Makoto; Shioda, Kayoko; Elder, Robert W; Pernetz, Maria A; Rodriguez, Fred H; Rangosch, Alicia; Kogon, Brian E; Book, Wendy M

    2016-08-01

    Factors contributing to the failure of Fontan circulation in adults are poorly understood. Reduced superior mesenteric arterial (SMA) flow has been identified in pediatric Fontan patients with protein-losing enteropathy. SMA flow has not been profiled in an adult Fontan population and its association with adverse events is unknown. We aimed to examine associations between SMA flow patterns and adverse events in adult Fontan patients. We performed a retrospective review of adult Fontan patients who underwent echocardiograms between 2008 and 2014. SMA Doppler data included peak systolic and end-diastolic velocity and velocity time integral (VTI). Systolic/diastolic (S/D) ratio and resistive index were calculated. The relationship between SMA flow parameters and major adverse events (death or transplantation) was examined using proportional hazard Cox regression analyses. Kaplan-Meyer analysis was conducted to construct survival curve of patients with and without adverse events. 91 post-Fontan adult patients (76 % systemic left ventricle, 20 % atriopulmonary Fontan, mean age 27.9 years) were analyzed. Adverse events occurred in nine patients (death = 4, transplant = 5). When compared with the non-event group, the event group had increased end-diastolic velocity [hazard ratio (HR) 1.5, 95 % confidence interval (CI) 1.1-1.8; p = 0.002], increased systolic VTI (HR 1.5, 95 % CI 1.1-2.2, p = 0.02), increased diastolic VTI (HR 1.7, 95 % CI 1.2-2.4, p = 0.004), decreased S/D velocity ratio (HR 0.32, 95 % CI 0.14-0.71, p = 0.006), decreased S/D VTI ratio (HR 0.76, 95 % CI 0.61-0.97, p = 0.02), and decreased resistive index (HR 0.29, 95 % CI 0.14-0.60, p = 0.0007). Increased end-diastolic velocity and VTI in mesenteric arterial flow, with lower systolic/diastolic ratio and resistive index, were associated with death and need for heart transplant in adult Fontan patients. The mesenteric hyperemic flow was also associated with clinical signs of portal

  6. Recent Literature on Medication Errors and Adverse Drug Events in Older Adults.

    PubMed

    Naples, Jennifer G; Hanlon, Joseph T; Schmader, Kenneth E; Semla, Todd P

    2016-02-01

    Medication errors and adverse drug events are common in older adults, but locating literature addressing these issues is often challenging. The objective of this article is to summarize recent studies addressing medication errors and adverse drug events in a single location to improve accessibility for individuals working with older adults. A comprehensive literature search for studies published in 2014 was conducted, and 51 potential articles were identified. After critical review, 17 studies were selected for inclusion based on innovation; rigorous observational or experimental study designs; and use of reliable, valid measures. Four articles characterizing potentially inappropriate prescribing and interventions to optimize medication regimens were annotated and critiqued in detail. The authors hope that health policy-makers and clinicians find this information helpful in improving the quality of care for older adults. PMID:26804210

  7. Adults' reports of their earliest memories: consistency in events, ages, and narrative characteristics over time.

    PubMed

    Bauer, Patricia J; Tasdemir-Ozdes, Aylin; Larkina, Marina

    2014-07-01

    Earliest memories have been of interest since the late 1800s, when it was first noted that most adults do not have memories from the first years of life (so-called childhood amnesia). Several characteristics of adults' earliest memories have been investigated, including emotional content, the perspective from which they are recalled, and vividness. The focus of the present research was a feature of early memories heretofore relatively neglected in the literature, namely, their consistency. Adults reported their earliest memories 2-4 times over a 4-year period. Reports of earliest memories were highly consistent in the events identified as the bases for earliest memories, the reported age at the time of the event, and in terms of qualities of the narrative descriptions. These findings imply stability in the boundary that marks the offset of childhood amnesia, as well as in the beginning of a continuous sense of self over time. PMID:24836979

  8. Recent Literature on Medication Errors and Adverse Drug Events in Older Adults

    PubMed Central

    Naples, Jennifer G.; Hanlon, Joseph T.; Schmader, Kenneth E.; Semla, Todd P.

    2015-01-01

    Medication errors and adverse drug events are common in older adults, but locating literature addressing these issues is often challenging. The objective of this article was to summarize recent studies addressing medication errors and adverse drug events in a single location to improve accessibility for individuals working with older adults. The authors conducted a comprehensive literature search for studies published in 2014 and identified 51 potential articles. After critical review, 17 studies were selected for inclusion based on innovation, rigorous observational or experimental study designs, and use of reliable, valid measures. Four articles characterizing potentially inappropriate prescribing and interventions to optimize medication regimens were annotated and critiqued in detail. We hope that health policy makers and clinicians find this information helpful in improving the quality of care for older adults. PMID:26804210

  9. Childhood maltreatment, stressful life events, and alcohol craving in adult drinkers

    PubMed Central

    Kim, June H.; Martins, Silvia S.; Shmulewitz, Dvora; Santaella, Julian; Wall, Melanie M.; Keyes, Katherine M.; Eaton, Nicholas R.; Krueger, Robert; Grant, Bridget F.; Hasin, Deborah S.

    2014-01-01

    Background Little is known about the relationship of stressful life events and alcohol craving in the general population, and whether a history of childhood maltreatment sensitizes individuals to crave alcohol after adult stressors. Methods Participants were 22,147 past-year drinkers from Wave 2 (2004-2006) of the National Epidemiologic Survey on Alcohol and Related Conditions. A structured, face-to-face interview assessed past-year stressful life events, alcohol craving, and history of childhood maltreatment. Logistic regression was used to generate adjusted odds ratios (aOR) to evaluate the relationship between stressful life events and craving, adjusting for demographic characteristics and parental history of alcoholism. Interaction between stressful life events and childhood maltreatment was also assessed. Results Compared to participants with no stressful life events, those with ≥3 events had increased odds of moderate alcohol craving (aOR=3.15 [95% CI=2.30-4.33]) and severe craving (aOR=8.47 [95% CI=4.78-15.01]). Stressful life events and childhood maltreatment interacted in predicting severe craving (p=0.017); those with ≥3 events were at higher risk for craving if they had been exposed to childhood maltreatment. Conclusion A direct relationship between stressful life events and risk for alcohol craving was observed. Further, history of childhood maltreatment increased the salience of stressful life events in adulthood. Future studies should examine the role of psychiatric comorbidity in more complex models of stress sensitization and alcohol craving. PMID:24961735

  10. Treatment of reactivated post-traumatic stress disorder. Imaginal exposure in an older adult with multiple traumas.

    PubMed

    Russo, S A; Hersen, M; Van Hasselt, V B

    2001-01-01

    A single-case analysis was used to assess the effects of imaginal exposure in a 57-year-old woman suffering from current and reactivated post-traumatic stress disorder (PTSD) following a transient ischemic attack. The client's responses to self-reported depression, anxiety, and PTSD symptoms were repeatedly recorded during four phases: (a) initial psychotherapy, (b) imaginal exposure, (c) skill generalization, and (d) fading of treatment. In addition to dramatic reduction in levels of depression and anxiety, results showed a significant improvement in PTSD symptoms relating to recent and remote traumatic experiences. Improvements were maintained approximately 16 months after imaginal exposure ended, despite ongoing external stressors. PMID:11151488

  11. The "Wall of Fear": The Bridge between the Traumatic Event and Trauma Resolution Therapy for Childhood Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    Oz, Sheri

    2005-01-01

    A multitude of published books and papers on child sexual abuse (CSA) describe symptoms, long-term effects, and therapy for survivors of abuse. However, the parallels between the nature of the sexual trauma event(s) as originally experienced by the victim and the therapeutic process into which the survivor later becomes engaged have not been…

  12. Correlation of a set of gene variants, life events and personality features on adult ADHD severity.

    PubMed

    Müller, Daniel J; Chiesa, Alberto; Mandelli, Laura; De Luca, Vincenzo; De Ronchi, Diana; Jain, Umesh; Serretti, Alessandro; Kennedy, James L

    2010-07-01

    Increasing evidence suggests that symptoms of attention deficit hyperactivity disorder (ADHD) could persist into adult life in a substantial proportion of cases. The aim of the present study was to investigate the impact of (1) adverse events, (2) personality traits and (3) genetic variants chosen on the basis of previous findings and (4) their possible interactions on adult ADHD severity. One hundred and ten individuals diagnosed with adult ADHD were evaluated for occurrence of adverse events in childhood and adulthood, and personality traits by the Temperament and Character Inventory (TCI). Common polymorphisms within a set of nine important candidate genes (SLC6A3, DBH, DRD4, DRD5, HTR2A, CHRNA7, BDNF, PRKG1 and TAAR9) were genotyped for each subject. Life events, personality traits and genetic variations were analyzed in relationship to severity of current symptoms, according to the Brown Attention Deficit Disorder Scale (BADDS). Genetic variations were not significantly associated with severity of ADHD symptoms. Life stressors displayed only a minor effect as compared to personality traits. Indeed, symptoms' severity was significantly correlated with the temperamental trait of Harm avoidance and the character trait of Self directedness. The results of the present work are in line with previous evidence of a significant correlation between some personality traits and adult ADHD. However, several limitations such as the small sample size and the exclusion of patients with other severe comorbid psychiatric disorders could have influenced the significance of present findings. PMID:20006992

  13. Older Adults' Coping with Negative Life Events: Common Processes of Managing Health, Interpersonal, and Financial/Work Stressors

    ERIC Educational Resources Information Center

    Moos, Rudolf H.; Brennan, Penny L.; Schutte, Kathleen K.; Moos, Bernice S.

    2006-01-01

    This study examined how older adults cope with negative life events in health, interpersonal, and financial/work domains and whether common stress and coping processes hold across these three domains. On three occasions, older adults identified the most severe negative event they faced in the last year and described how they appraised and coped…

  14. Interplay between neuroimmunoendocrine systems during post-traumatic stress disorder: a minireview.

    PubMed

    Bauer, Moisés E; Wieck, Andréa; Lopes, Rodrigo P; Teixeira, Antonio L; Grassi-Oliveira, Rodrigo

    2010-01-01

    Early life stress has been suggested to mediate vulnerability to affective disorders. Traumatic events experienced in childhood such as sexual abuse and/or physical neglect may lead to psychiatric diseases in adult life, including post-traumatic stress disorder (PTSD). Previous studies have focused on adult traumatic events and very little is known regarding the long-term physiological effects of early life stress. Here, we review the complex interplay between most important cognitive, neuroendocrine and immunological changes reported in PTSD, focusing on long-term implications of childhood maltreatment. PTSD has been associated with significant biological changes related to impaired cognitive functions, attenuated hypothalamic-pituitary-adrenal (HPA) axis function (hypocortisolism) and activation of innate immune responses (low-grade inflammation). PMID:20134200

  15. Self-reports of potentially traumatic experiences in an adult community sample: gender differences and test-retest stabilities of the items in a brief betrayal-trauma survey.

    PubMed

    Goldberg, Lewis R; Freyd, Jennifer J

    2006-01-01

    A new survey of potentially traumatic events was administered to a large community sample on two occasions, three years apart. In contrast to previous surveys, this one included separate items for events that involve mistreatment by someone close, mistreatment by someone not so close, and non-interpersonal events. For both kinds of interpersonal events, separate items focused on physical, sexual, and emotional types of potential abuse. For each event, respondents indicated the extent of their exposure both prior to and after age 18. This paper reports the prevalence of each of the various kinds of events in subsamples of women (N = 397) and men (N = 292) in both childhood and adulthood, and provides four alternative indices of test-retest stability for each of the event reports. Substantial differences between men and women were found for many of the reported events on both occasions. Specifically, far more women than men reported having experienced traumatic events perpetrated by someone close to them, whereas far more men than women reported having experienced traumatic events perpetrated by someone not close. Some of the implications of these gender interaction effects are discussed. PMID:16873229

  16. Community Destruction and Traumatic Stress in Post-Tsunami Indonesia

    PubMed Central

    Frankenberg, Elizabeth; Nobles, Jenna; Sumantri, Cecep

    2013-01-01

    How are individuals affected when the communities they live in change for the worse? This question is central to understanding neighborhood effects, but few study designs generate estimates that can be interpreted causally. We address issues of inference through a natural experiment, examining post-traumatic stress at multiple time points in a population differentially exposed to the 2004 Indian Ocean tsunami. The data, from the Study of the Tsunami Aftermath and Recovery, include interviews with over 16,000 Indonesian adults before and after the event. These data are combined with satellite imagery, direct observation, and informant interviews to examine the consequences of community destruction for post-traumatic stress. Using multilevel linear mixed models, we show that community destruction worsens post-traumatic stress, net of rigorous controls for individual experiences of trauma and loss. Furthermore, the effect of community destruction persists over time and extends across a wide range of community types. PMID:22940603

  17. Bringing Order to Life Events: Memory for the Temporal Order of Autobiographical Events over an Extended Period in School-Aged Children and Adults

    ERIC Educational Resources Information Center

    Pathman, Thanujeni; Doydum, Ayzit; Bauer, Patricia J.

    2013-01-01

    Remembering temporal information associated with personal past events is critical. Yet little is known about the development of temporal order memory for naturally occurring events. In the current research, 8- to 10-year-old children and adults took photographs daily for 4 weeks. Later, they participated in a primacy/recency task (were shown 2 of…

  18. Love and load--the lived experience of the mother-child relationship among young adult traumatic brain-injured survivors.

    PubMed

    Kao, Hsueh-Fen S; Stuifbergen, Alexa K

    2004-04-01

    This study aims to describe the meaning of the experience of the relationship between young adult traumatic brain injury (TBI) survivors and their mothers using a phenomenological approach. Informants included 9 males and 3 females who were at least 2 years post-TBI, and their mothers, who were their primary caregivers after the injury. TBI informants were 18 to 25 years of age, had motor vehicle accident-induced injury, experienced post-traumatic amnesia longer than 24 hours, and were able to participate in a verbal interview. In addition, all informants currently were living with their mothers, who also participated in this study. Survivors acquired the sense of being abnormal from various sources, including social pressures, dynamics within the family, and intrapersonal changes. Mothers adopted both positive and negative actions during the period of uncertainty and often struggled to balance protecting their children and letting them become independent. They also struggled to maintain harmonious relationships with people both inside and outside of the family. Sometimes, survivors' parents marital relationships were at risk. Health professionals should design more appropriate long-term community interventions to help TBI survivors and their families decrease the burden of injury and the resulting stress, increase survivors' self-esteem, and improve quality of life of both survivors and their families, serving as a foundation for further TBI care. PMID:15115361

  19. Men's and women's experiences of violence and traumatic events in rural Côte d'Ivoire before, during and after a period of armed conflict

    PubMed Central

    Hossain, Mazeda; Zimmerman, Cathy; Kiss, Ligia; Kone, Drissa; Bakayoko-Topolska, Monika; Manan K A, David; Lehmann, Heidi; Watts, Charlotte

    2014-01-01

    Objective We assessed men's and women's experiences of gender based violence and other traumatic events in Côte d'Ivoire, a West African conflict-affected setting, before, during and after a period of active armed conflict (2000–2007). Design Cross-sectional, household survey. Setting 12 rural communities directly impacted by the Crisis in Côte d'Ivoire, spanning regions controlled by government forces, rebels and UN peacekeepers in 2008. Participants 2678 men and women aged 15–49 years. Primary outcome measures Violence exposures measured since age 15. Questions included intimate partner physical and sexual violence; physical and sexual violence by others (including combatants) and exposure to traumatic events before, during and after the Crisis period (2000–2007). Results Physical and/or sexual violence since age 15 was reported by 57.1% women and 40.2% men (p=0.01); 29.9% women and 12.3% men reported exposure to any violence in the past year. Nearly 1 in 10 women (9.9%) and 5.9% men (p=0.03) were forced to have sex by a non-partner since age 15, and 14.8% women and 3.3% men (p=0.00) reported their first sexual experience was forced. Combatants were rarely reported as sexual violence perpetrators (0.3% women). After the Crisis, intimate partner physical violence was the most frequently reported form of violence and highest among women (20.9% women, 9.9% men, p=0.00). Fearing for their life was reported by men and women before, during and after the Crisis. Conclusions Sexual violence in conflict remains a critical international policy concern. However, men and women experience different types of violence before, during and after conflict. In many conflict settings, other forms of violence, including intimate partner violence, may be more widespread than conflict-related sexual violence. Alongside service provision for rape survivors, our findings underscore the need for postconflict reconstruction efforts to invest in programmes to prevent and respond to

  20. Post-traumatic stress disorder

    MedlinePlus

    Post-traumatic stress disorder (PTSD) is a type of anxiety disorder . It can occur after you have gone through an extreme ... Normally, after the event, the body recovers. The stress hormones and chemicals the body releases due to ...

  1. Post-traumatic stress disorder

    MedlinePlus

    ... some people, but not in others. Your genes, emotions, and family setting may all play roles. Past emotional trauma may increase your risk of PTSD after a recent traumatic event. With PTSD, the body's response to ...

  2. Post-traumatic Stress Disorder.

    PubMed

    Javidi, H; Yadollahie, M

    2012-01-01

    Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with

  3. Unitization improves source memory in older adults: An event-related potential study.

    PubMed

    Zheng, Zhiwei; Li, Juan; Xiao, Fengqiu; Ren, Weicong; He, Rongqiao

    2016-08-01

    Aging-related decline in episodic memory, particularly in associative memory, is attributed to an impaired recollection of the specific details of a study episode. Fortunately, familiarity is relatively preserved in older adults. Previous studies have indicated that unitization is a specialized form of learning that increases the contribution of familiarity to associative retrieval. Here we examined whether older adults' associative memory could be improved when employing an encoding strategy that encouraged unitization. Young and older adults encoded items and background colors either in a unitized condition (i.e., by imagining the color as an internal feature of the item) or in a non-unitized condition (i.e., by imagining the color as a contextual feature of the item). The participants then performed a source recognition test. The effects of unitization on the neural correlates of familiarity were measured by event-related potentials (ERPs). The age differences in source memory performance were lower in the unitized condition than in the non-unitized condition. The older adults only demonstrated neural correlates of familiarity-based source recognition in the unitized condition. These findings suggest that a unitized encoding strategy could improve source memory performance in older adults by enhancing the involvement of familiarity in source recognition. PMID:27343684

  4. Injection time-dependent effect of adult human bone marrow stromal cell transplantation in a rat model of severe traumatic brain injury.

    PubMed

    Han, Eun Young; Chun, Min Ho; Kim, Sang Tae; Lim, Dong-pyo

    2013-03-01

    The object of this study is to evaluate the effects of injecting adult human bone marrow stromal cells (hBMSCs) into rats with severe traumatic brain injury in acute phase and to determine more optimal injection timing between day 1 and day 2 postinjury. The lateral fluid percussion injury model was used. Adult hBMSCs were transplanted into hemisphere to injury sites in the corpus callosum ipsilateral on day 1 (n = 12) or day 7 (n = 8) after injury. A control group (n = 7) underwent only a sham operation without stem cell transplantation. Rats in all groups were analyzed by magnetic resonance spectroscopy (MRS), and by using behavioral, rotarod, and Barnes maze tests on day 1, 7, 14, and 42. Another nine randomly designated rats were sacrificed for immunohistochemical staining. Behavioral test scores increased significantly at all time-points after TBI in the day 7-injected group, compared to the others (p=0.008). GFAP staining was lower on day 42 in day 7-injected rats than in those injected on day 1. But no significant inter- or intra-group differences were observed for other tests. The injection of hBMSCs was found to have limited therapeutic potential with respect to neuroprotection after traumatic brain injury. However, because injection on day 7 after TBI produced greater functional improvements in neurobehavioral tests and more effectively suppressed astroglial activation than an injection on post-injury day 1, we cautiously recommend the injection time of day 7 post injury in hBMSCs transplantation in severe TBI, rather than day 1 post injury but further studies on developing hBMSC-based new therapeutic approaches should be warranted for improving neuroprotection in severe TBI. PMID:23363468

  5. Effect of Symptoms of Adult Attention Deficit Hyperactivity Disorder on Symptoms of Post Traumatic Stress Disorder in Korean Conscripts

    PubMed Central

    Lee, Dong-Yun; Park, Chul-Soo; Kim, Bong-Jo; Cha, Bo-Seok; Lee, So-Jin; Bhang, Soo Young

    2012-01-01

    Objective This study is conducted to investigate the effect of symptoms of Attention Deficit and Hyperactivity Disorder (ADHD) on symptoms of Posttraumatic Stress Disorder (PTSD) among 224 conscripts during 5 weeks of military basic training. Methods Total number of subject is 224 conscripts. We evaluated past and present symptoms of ADHD with Korean-Wender Utah rating scale (K-WURS) and Korean adult attention -deficit/hyperactivity disorder scale (K-AADHDS) and stress and symptoms of PTSD with Brief Encounter Psychosocial Instrument-K (BEPSI-K), the Korean version of the Impact of Event Scale-Revised (IES-R-K) on 1 week and 5 weeks later of basic military training. Pearson correlation analysis and multivariate logistic regression analysis were performed to evaluate risk factors of PTSD using SPSS program and Path analysis also was used to find relationship between past and present ADHD and PTSD simultaneously using AMOS program. Results Present symptoms of ADHD (OR=1.145, CI=1.054-1.245, p=0.001) and Past symptoms of ADHD (OR=1.049, CI=1.005-1.095, p=0.028) were significant risk factor of PTSD symptoms on 1st week of basic military training. The symptoms of PTSD on fist week was also significant risk factor of PTSD after 5weeks of basic military training (OR=1.073, CI=1.020-1.129, p=0.006). Using path analysis, we could found confirm these relations between past and present ADHD symptoms and symptoms of PTSD. Conclusion The result suggests that past and present symptoms of ADHD are the risk factor of symptoms of PTSD on first week. And the symptoms of PTSD on first week are also risk factor of PTSD symptoms on last weeks in Korean conscripts. The symptoms of ADHD might make an important role in vulnerability of the symptoms of PTSD in Korean conscripts. PMID:22707966

  6. Political Imprisonment and Adult Functioning: A Life Event History Analysis of Palestinians.

    PubMed

    McNeely, Clea; Barber, Brian K; Spellings, Carolyn; Belli, Robert; Giacaman, Rita; Arafat, Cairo; Daher, Mahmoud; El Sarraj, Eyad; Mallouh, Mohammed Abu

    2015-06-01

    Political imprisonment is a traumatic event, often accompanied by torture and deprivation. This study explores the association of political imprisonment between 1987 and 2011 with political, economic, community, psychological, physical, and family functioning in a population-based sample of Palestinian men ages 32-43 years (N = 884) derived from a dataset collected in 2011. Twenty-six percent (n = 233) had been politically imprisoned. Men imprisoned between 1987 and 2005 reported functioning as well as never-imprisoned men in most domains, suggesting that men imprisoned as youth have moved forward with their lives in ways similar to their nonimprisoned counterparts. In an exception to this pattern, men imprisoned during the Oslo Accords period (1994-1999) reported higher levels of trauma-related stress (B = 0.24, p = .027) compared to never-imprisoned men. Men imprisoned since 2006 reported lower functioning in multiple domains: human insecurity (B = 0.33, p = .023), freedom of public expression (B = -0.48, p = .017), perceived government stability (B = -0.38, p = .009), feeling broken or destroyed (B = 0.59, p = .001), physical limitations (B = 0.55, p = .002), and community belonging (B = -0.33, p = .048). Findings pointed to the value of examining the effects of imprisonment on functioning in multiple domains. PMID:26062134

  7. The UCLA Study of Children with Moderate-to-Severe Traumatic Brain Injury: Event-Related Potential Measure of Interhemispheric Transfer Time.

    PubMed

    Ellis, Monica U; DeBoard Marion, Sarah; McArthur, David L; Babikian, Talin; Giza, Christopher; Kernan, Claudia L; Newman, Nina; Moran, Lisa; Akarakian, Roy; Houshiarnejad, Asal; Mink, Richard; Johnson, Jeffrey; Babbitt, Christopher J; Olsen, Alexander; Asarnow, Robert F

    2016-06-01

    Traumatic brain injury (TBI) frequently results in diffuse axonal injury and other white matter damage. The corpus callosum (CC) is particularly vulnerable to injury following TBI. Damage to this white matter tract has been associated with impaired neurocognitive functioning in children with TBI. Event-related potentials can identify stimulus-locked neural activity with high temporal resolution. They were used in this study to measure interhemispheric transfer time (IHTT) as an indicator of CC integrity in 44 children with moderate/severe TBI at 3-5 months post-injury, compared with 39 healthy control children. Neurocognitive performance also was examined in these groups. Nearly half of the children with TBI had IHTTs that were outside the range of the healthy control group children. This subgroup of TBI children with slow IHTT also had significantly poorer neurocognitive functioning than healthy controls-even after correction for premorbid intellectual functioning. We discuss alternative models for the relationship between IHTT and neurocognitive functioning following TBI. Slow IHTT may be a biomarker that identifies children at risk for poor cognitive functioning following moderate/severe TBI. PMID:26153851

  8. The prediction of intrusions following an analogue traumatic event: peritraumatic cognitive processes and anxiety-focused rumination versus rumination in response to intrusions.

    PubMed

    Laposa, Judith M; Rector, Neil A

    2012-09-01

    Intrusions are often considered the hallmark of posttraumatic stress disorder (PTSD). Despite this, relatively little is known about factors that give rise to intrusions. Cognitive models of PTSD highlight the importance of pre-existing cognitive vulnerabilities, cognitive processing and anxiety during a traumatic event, as well as negative responses to trauma sequelae. However, few studies have examined multiple forms of peritraumatic processes, and rumination in response to trauma intrusions using analogue trauma tasks, and none have examined whether broader anxious ruminative processes contribute to intrusion development. In addition, little work has investigated the role of post-state anxiety in intrusions, and anxiety may be related to both peritraumatic processing and rumination. The current study employed a distressing film paradigm to examine key tenets of cognitive models of PTSD. Ninety-one female university students completed measures of anxiety, rumination in response to anxious symptoms, peritraumatic dissociation, data driven processing, lack of self referent processing, intrusions, and rumination in response to intrusions of the distressing film. Results revealed that peritraumatic dissociation, data driven processing, and self referent processing were associated with intrusion development, with lack of self referent processing being a strong predictor of intrusion development. Post-state anxiety and rumination in response to intrusions also predicted intrusion development. Discussion focuses on implications of cognitive processes and anxiety in theories of intrusion development. PMID:22296743

  9. Post-traumatic growth, stressful life events, and relationships with substance use behaviors among alternative high school students: a prospective study.

    PubMed

    Arpawong, Thalida E; Sussman, Steve; Milam, Joel E; Unger, Jennifer B; Land, Helen; Sun, Ping; Rohrbach, Louise A

    2015-01-01

    A highly stressful life event (SLE) can elicit positive psychosocial growth, referred to as post-traumatic growth (PTG) among youth. We examined PTG and the number of SLEs for their influence on substance use behaviours among a sample of older, diverse alternative high school students participating in a drug prevention programme (n=564; mean age=16.8; 49% female; 65% Hispanic). Surveys assessed PTG, SLEs and substance use behaviours at the two-year follow-up. Multilevel regression models were run to examine the effect of PTG and the number of SLEs on frequency of substance use at the two-year follow-up, controlling for baseline substance use, sociodemographic variables, peer substance use, attrition propensity and treatment group. Greater PTG scores were associated with lower frequencies of alcohol use, getting drunk on alcohol, binge drinking, marijuana use and less substance abuse at the two-year follow-up, but not associated with cigarette or hard drug use. Also, PTG did not moderate the relationship between cumulative number of SLEs and substance use behaviours, rather PTG appears to be protective against negative effects of a single, life-altering SLE. Fostering PTG from a particularly poignant SLE may be useful for prevention programmes targeting alcohol, marijuana and substance abuse behaviours among high-risk youth. PMID:25346382

  10. The interaction between child maltreatment, adult stressful life events and the 5-HTTLPR in major depression.

    PubMed

    Power, Robert A; Lecky-Thompson, Lucy; Fisher, Helen L; Cohen-Woods, Sarah; Hosang, Georgina M; Uher, Rudolf; Powell-Smith, Georgia; Keers, Robert; Tropeano, Maria; Korszun, Ania; Jones, Lisa; Jones, Ian; Owen, Michael J; Craddock, Nick; Craig, Ian W; Farmer, Anne E; McGuffin, Peter

    2013-08-01

    Both childhood maltreatment and adult stressful life events are established risk factors for the onset of depression in adulthood. However, the interaction between them can be viewed through two conflicting frameworks. Under a mismatch hypothesis stressful childhoods allow 'adaptive programming' for a stressful adulthood and so can be protective. Only when childhood and adulthood do not match is there a risk of behavioural problems. Alternatively, under the cumulative stress hypothesis we expect increased risk with each additional stressor. It has also been suggested that an individual's genetic background may determine the extent they undergo adaptive programming, and so which of these two hypotheses is relevant. In this study we test for an interaction between exposure to childhood maltreatment and adult stressful life events in a retrospective sample of 455 individuals, using major depression as the outcome. We also test whether this interaction differs by genotype at the 5-HTTLPR, a candidate for an individual's plasticity to adaptive programming. Early maltreatment and stressful life events in adulthood interacted to produce increased risk for depression over each individually (p = 0.055). This supports the cumulative stress hypothesis over the mismatch hypothesis, at least with respect to severe environmental risk factors. This effect was not altered by 5-HTTLPR allele, suggesting there was no difference by genotype in adaptive programming to these events. We suggest that the apparent additional vulnerability to stressful events of those who have experienced maltreatment has clinical relevance, highlighting the importance of providing support beyond the immediate aftermath of maltreatment into adulthood. PMID:23618376

  11. The negative event scale: measuring frequency and intensity of adult hassles.

    PubMed

    Maybery, D J; Neale, Jason; Arentz, Alex; Jones-Ellis, Jenny

    2007-06-01

    This study examined the structure, concurrent validity, and reliability of a hassle measure for middle-aged adults in both event frequency and intensity recordings. The measure included a range of interpersonal day-to-day events and re-examined aspects of the primary appraisal confounding debate between Lazarus and colleagues (Lazarus, Delongis, Folkman, & Gruen, 1985) and Dohrenwend and Shrout (1985). Of the 373 participants, 73% were female, 72% were in paid work, 69% were in permanent relationships and 62% had children. Principal component analyses of separate hassle frequency and intensity scores highlighted components consistent with previous research. There were seven interpersonal and four non-interpersonal subscales associated with negative events with family and friends, work, health, money, and household. The subscales had very good reliability and concurrent validity and there were generally strong correlations (i.e. up .84) between frequency and intensity scores for each subscale. Given some important sampling limitations (e.g. female overrepresentation) the findings show a psychometrically sound hassle scale for adults. PMID:17999222

  12. An event-related potential study of selective auditory attention in children and adults.

    PubMed

    Coch, Donna; Sanders, Lisa D; Neville, Helen J

    2005-04-01

    In a dichotic listening paradigm, event-related potentials (ERPs) were recorded to linguistic and nonlinguistic probe stimuli embedded in 2 different narrative contexts as they were either attended or unattended. In adults, the typical N1 attention effect was observed for both types of probes: Probes superimposed on the attended narrative elicited an enhanced negativity compared to the same probes when unattended. Overall, this sustained attention effect was greater over medial and left lateral sites, but was more posteriorly distributed and of longer duration for linguistic as compared to nonlinguistic probes. In contrast, in 6- to 8-year-old children the ERPs were morphologically dissimilar to those elicited in adults and children displayed a greater positivity to both types of probe stimuli when embedded in the attended as compared to the unattended narrative. Although both adults and children showed attention effects beginning at about 100 msec, only adults displayed left-lateralized attention effects and a distinct, posterior distribution for linguistic probes. These results suggest that the attentional networks indexed by this task continue to develop beyond the age of 8 years. PMID:15829081

  13. Distinguishing shyness and sociability in adults: An event-related electrocortical-neuroendocrine study.

    PubMed

    Tang, Alva; Santesso, Diane L; Segalowitz, Sidney J; Schulkin, Jay; Schmidt, Louis A

    2016-09-01

    Shyness and sociability are orthogonal personality dimensions, but little is known about how the two traits are instantiated in the brain and body. Using a 3-stimulus auditory oddball task, we examined whether shyness and sociability were distinguishable on P300 event-related potentials (ERPs) in processing task-relevant, novel, and standard auditory tones in 48 young adults. ERP amplitudes were measured at four midline scalp sites (Fz, FCz, Cz, Pz). We found that shyness, but not sociability, was related to reduced frontal novelty P300 amplitudes and to high emotionality. We also found that low baseline salivary cortisol levels mediated the relation between: (a) high shyness and reduced frontal P300 amplitudes to novel tones, and (b) high shyness and high scores of emotionality. We speculate that low baseline cortisol may serve as a putative mechanism influencing central attentional states of avoidance to threat and novelty and emotional arousal in adults who are shy. PMID:27377789

  14. The Impact of Stressful Life Events and Social Support on Drinking among Older Adults: A General Population Survey.

    ERIC Educational Resources Information Center

    Jennison, Karen M.

    1992-01-01

    Analyzed stressful life events, buffering hypothesis, and alcohol use in 1,418 older adults. Results indicated that older adults who experienced stressful losses were significantly more likely to drink excessively than those who had not experienced such losses or who had experienced them to lesser extent. Supportive resources appeared to have…

  15. Using passive acoustic telemetry to infer mortality events in adult herbivorous coral reef fishes

    NASA Astrophysics Data System (ADS)

    Khan, J. A.; Welsh, J. Q.; Bellwood, D. R.

    2016-06-01

    Mortality is considered to be an important factor shaping the structure of coral reef fish communities, but data on the rate and nature of mortality of adult coral reef fishes are sparse. Mortality on coral reefs is intrinsically linked with predation, with most evidence suggesting that predation is highest during crepuscular periods. We tested this hypothesis using passive acoustic telemetry data to determine the time of day of potential mortality events (PMEs) of adult herbivorous reef fishes. A total of 94 fishes were tagged with acoustic transmitters, of which 43 exhibited a PME. Furthermore, we identified five categories of PMEs based on the nature of change in acoustic signal detections from tagged fishes. The majority of PMEs were characterised by an abrupt stop in detections, possibly as a result of a large, mobile predator. Overall, mortality rates were estimated to be approximately 59 % per year using passive acoustic telemetry. The time of day of PMEs suggests that predation was highest during the day and crepuscular periods and lowest at night, offering only partial support for the crepuscular predation hypothesis. Visually oriented, diurnal and crepuscular predators appear to be more important than their nocturnal counterparts in terms of predation on adult reef fishes. By timing PMEs, passive acoustic telemetry may offer an important new tool for investigating the nature of predation on coral reefs.

  16. Amputation - traumatic

    MedlinePlus

    ... accidents, or from motor vehicle accidents. Natural disasters, war, and terrorist attacks can also cause traumatic amputations. ... bag and place the bag in an ice water bath. Do NOT directly put the body part ...

  17. Mild Traumatic Brain Injury with Social Defeat Stress Alters Anxiety, Contextual Fear Extinction, and Limbic Monoamines in Adult Rats.

    PubMed

    Davies, Daniel R; Olson, Dawne; Meyer, Danielle L; Scholl, Jamie L; Watt, Michael J; Manzerra, Pasquale; Renner, Kenneth J; Forster, Gina L

    2016-01-01

    Mild traumatic brain injury (mTBI) produces symptoms similar to those typifying posttraumatic stress disorder (PTSD) in humans. We sought to determine whether a rodent model of stress concurrent with mTBI produces characteristics of PTSD such as impaired contextual fear extinction, while also examining concurrent alterations to limbic monoamine activity in brain regions relevant to fear and anxiety states. Male rats were exposed to social stress or control conditions immediately prior to mTBI induction, and 6 days later were tested either for anxiety-like behavior using the elevated plus maze (EPM), or for contextual fear conditioning and extinction. Brains were collected 24 h after EPM testing, and tissue from various limbic regions analyzed for content of monoamines, their precursors and metabolites using HPLC with electrochemical detection. Either social defeat or mTBI alone decreased time spent in open arms of the EPM, indicating greater anxiety-like behavior. However, this effect was enhanced by the combination of treatments. Further, rats exposed to both social defeat and mTBI exhibited greater freezing within extinction sessions compared to all other groups, suggesting impaired contextual fear extinction. Social defeat combined with mTBI also had greater effects on limbic monoamines than either insult alone, particularly with respect to serotonergic effects associated with anxiety and fear learning. The results suggest social stress concurrent with mTBI produces provides a relevant animal model for studying the prevention and treatment of post-concussive psychobiological outcomes. PMID:27147992

  18. Mild Traumatic Brain Injury with Social Defeat Stress Alters Anxiety, Contextual Fear Extinction, and Limbic Monoamines in Adult Rats

    PubMed Central

    Davies, Daniel R.; Olson, Dawne; Meyer, Danielle L.; Scholl, Jamie L.; Watt, Michael J.; Manzerra, Pasquale; Renner, Kenneth J.; Forster, Gina L.

    2016-01-01

    Mild traumatic brain injury (mTBI) produces symptoms similar to those typifying posttraumatic stress disorder (PTSD) in humans. We sought to determine whether a rodent model of stress concurrent with mTBI produces characteristics of PTSD such as impaired contextual fear extinction, while also examining concurrent alterations to limbic monoamine activity in brain regions relevant to fear and anxiety states. Male rats were exposed to social stress or control conditions immediately prior to mTBI induction, and 6 days later were tested either for anxiety-like behavior using the elevated plus maze (EPM), or for contextual fear conditioning and extinction. Brains were collected 24 h after EPM testing, and tissue from various limbic regions analyzed for content of monoamines, their precursors and metabolites using HPLC with electrochemical detection. Either social defeat or mTBI alone decreased time spent in open arms of the EPM, indicating greater anxiety-like behavior. However, this effect was enhanced by the combination of treatments. Further, rats exposed to both social defeat and mTBI exhibited greater freezing within extinction sessions compared to all other groups, suggesting impaired contextual fear extinction. Social defeat combined with mTBI also had greater effects on limbic monoamines than either insult alone, particularly with respect to serotonergic effects associated with anxiety and fear learning. The results suggest social stress concurrent with mTBI produces provides a relevant animal model for studying the prevention and treatment of post-concussive psychobiological outcomes. PMID:27147992

  19. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    ERIC Educational Resources Information Center

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  20. Effects of Social Cognitive Demand on Theory of Mind in Conversations of Adults with Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Byom, Lindsey J.; Turkstra, Lyn

    2012-01-01

    Background: A requisite skill for successful conversation is the ability to adjust one's language according to contextual factors. Aims: This study examined one aspect of language use in context--the use of mental-state terms, i.e. words that communicate thoughts, beliefs or feelings--in conversations between adult males with and without traumatic…

  1. Coping with a Traumatic Event

    MedlinePlus

    ... on meeting people’s immediate emergency needs after a disaster, such as shelter, food, and physical and mental ... handle inquiries from concerned family members outside the disaster area, provide blood and blood products to disaster ...

  2. Post traumatic stress disorder.

    PubMed

    Tiller, J; Kyrios, M; Bennett, P

    1996-10-01

    Post traumatic stress disorder (PTSD) occurs after a person has been exposed to a traumatic event involving actual or threatened death, and has responded with intense fear or helplessness. The event is then persistently re-experienced. The person avoids stimuli associated with the trauma and experiences a numbing of general responsiveness. Symptoms of increased arousal can occur as well as depression and anxiety. PTSD causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The general practitioner is uniquely placed to identify PTSD and can have a key role in treatment. Cognitive behavioural treatment is a central therapeutic approach and can be carried out in general practice. The issues are to counteract the physiological components, expose the patient to the feared situation and help the patient to relearn that the stimuli are not necessarily associated with danger or threat. Repeated brief consultations over time can facilitate this process. PMID:8936738

  3. Traumatic Bonding: Clinical Implications in Incest.

    ERIC Educational Resources Information Center

    deYoung, Mary; Lowry, Judith A.

    1992-01-01

    "Traumatic bonding" is defined as "the evolution of emotional dependency between...a child and an adult [in] a relationship characterized by periodic sexual abuse." Maintains that the concept holds promise for explaining confusing dynamics of incest. Demonstrates ways in which traumatic bonding can be applied to cases of incest and discusses…

  4. Understanding Traumatic Stress in Children

    ERIC Educational Resources Information Center

    Bassuk, Ellen L.; Konnath, Kristina; Volk, Katherine T.

    2006-01-01

    The unexpected loss of a loved one, a car accident, or exposure to a violent experience is familiar to many. Everyone reacts to such events, but the responses vary widely, ranging from numbness and withdrawal, to crying, nervousness, and agitation. Because traumatic events are prevalent, cause profound suffering, and may lead to life altering…

  5. Development, Implementation and Use of Electronic Surveillance for Ventilator-Associated Events (VAE) in Adults

    PubMed Central

    Resetar, Ervina; McMullen, Kathleen M.; Russo, Anthony J.; Doherty, Joshua A.; Gase, Kathleen A.; Woeltje, Keith F.

    2014-01-01

    Mechanical ventilation provides an important, life-saving therapy for severely ill patients, but ventilated patients are at an increased risk for complications, poor outcomes, and death during hospitalization.1 The timely measurement of negative outcomes is important in order to identify potential issues and to minimize the risk to patients. The Centers for Disease Control and Prevention (CDC) created an algorithm for identifying Ventilator-Associated Events (VAE) in adult patients for reporting to the National Healthcare Safety Network (NHSN). Currently, the primarily manual surveillance tools require a significant amount of time from hospital infection prevention (IP) staff to apply and interpret. This paper describes the implementation of an electronic VAE tool using an internal clinical data repository and an internally developed electronic surveillance system that resulted in a reduction of labor efforts involved in identifying VAE at Barnes Jewish Hospital (BJH). PMID:25954410

  6. Development, Implementation and Use of Electronic Surveillance for Ventilator-Associated Events (VAE) in Adults.

    PubMed

    Resetar, Ervina; McMullen, Kathleen M; Russo, Anthony J; Doherty, Joshua A; Gase, Kathleen A; Woeltje, Keith F

    2014-01-01

    Mechanical ventilation provides an important, life-saving therapy for severely ill patients, but ventilated patients are at an increased risk for complications, poor outcomes, and death during hospitalization.1 The timely measurement of negative outcomes is important in order to identify potential issues and to minimize the risk to patients. The Centers for Disease Control and Prevention (CDC) created an algorithm for identifying Ventilator-Associated Events (VAE) in adult patients for reporting to the National Healthcare Safety Network (NHSN). Currently, the primarily manual surveillance tools require a significant amount of time from hospital infection prevention (IP) staff to apply and interpret. This paper describes the implementation of an electronic VAE tool using an internal clinical data repository and an internally developed electronic surveillance system that resulted in a reduction of labor efforts involved in identifying VAE at Barnes Jewish Hospital (BJH). PMID:25954410

  7. Stressful events and coping responses among older adults in two sociocultural groups.

    PubMed

    Chovan, M J; Chovan, W

    1985-05-01

    In this study of the way 32 men and women between the ages of 60 to 90 coped with stressful situations, two instruments were used: the Life Experiences Survey and the Ways of Coping Checklist. Overall, health-related concerns were more frequently reported by older adults than any other stressful event. When coping responses were categorized according to four modes--intrapsychic, inaction, direct action, and information seeking--the Appalachian group was found to use the information-seeking mode; the Cherokee group, the intrapsychic mode. Significant differences were found between males and females in coping modes and life-stress categories. When groups were combined, significant correlations were noted between life stress, particularly health-related stress, and the coping modes of intrapsychic and information seeking. PMID:4078770

  8. Greater neurobehavioral deficits occur in adult mice after repeated, as compared to single, mild traumatic brain injury (mTBI).

    PubMed

    Nichols, Jessica N; Deshane, Alok S; Niedzielko, Tracy L; Smith, Cory D; Floyd, Candace L

    2016-02-01

    Mild traumatic brain injury (mTBI) accounts for the majority of all brain injuries and affected individuals typically experience some extent of cognitive and/or neuropsychiatric deficits. Given that repeated mTBIs often result in worsened prognosis, the cumulative effect of repeated mTBIs is an area of clinical concern and on-going pre-clinical research. Animal models are critical in elucidating the underlying mechanisms of single and repeated mTBI-associated deficits, but the neurobehavioral sequelae produced by these models have not been well characterized. Thus, we sought to evaluate the behavioral changes incurred after single and repeated mTBIs in mice utilizing a modified impact-acceleration model. Mice in the mTBI group received 1 impact while the repeated mTBI group received 3 impacts with an inter-injury interval of 24h. Classic behavior evaluations included the Morris water maze (MWM) to assess learning and memory, elevated plus maze (EPM) for anxiety, and forced swim test (FST) for depression/helplessness. Additionally, species-typical behaviors were evaluated with the marble-burying and nestlet shredding tests to determine motivation and apathy. Non-invasive vibration platforms were used to examine sleep patterns post-mTBI. We found that the repeated mTBI mice demonstrated deficits in MWM testing and poorer performance on species-typical behaviors. While neither single nor repeated mTBI affected behavior in the EPM or FST, sleep disturbances were observed after both single and repeated mTBI. Here, we conclude that behavioral alterations shown after repeated mTBI resemble several of the deficits or disturbances reported by patients, thus demonstrating the relevance of this murine model to study repeated mTBIs. PMID:26542813

  9. Effectiveness of executive functions training within a virtual supermarket for adults with traumatic brain injury: a pilot study.

    PubMed

    Jacoby, Michele; Averbuch, Sara; Sacher, Yaron; Katz, Noomi; Weiss, Patrice L; Kizony, Rachel

    2013-03-01

    Impairments of executive functions (EF) significantly affect the ability to lead an independent lifestyle. Virtual environments offer a way to rehabilitate EF due to their ecological validity. The purpose of this pilot study was to examine the effectiveness of a virtual reality (VR) supermarket (VMall) for treatment of EF in patients with Traumatic Brain Injury (TBI), compared to conventional occupational therapy (OT), in order to provide initial data regarding the effect sizes for calculation of sample size as well as to establish an intervention protocol for future Randomized Control Trials (RCTs). Twelve men and women, aged 19-55 years, who had TBI resulting in EF impairments participated in this study. Outcome measures were the Multiple Errands Test-Simplified Version (MET-SV) and the Executive Function Performance Test (EFPT). Cognitive treatment provided to both groups was based on the same principles; the participants in the experimental group received 10 45-min VR-based treatment sessions and the control group participants received 10 sessions of occupational therapy cognitive retraining without VR. Baseline performance prior to intervention showed no statistically significant differences between groups. Most participants improved their performance after therapy. Following a Bonferroni correction for multiple comparisons, no significant between or within group differences were found, Nevertheless, large effect sizes (0.51) for the percent (%) relative change of the MET-SV total score and EFPT total score after intervention were high in favor of the experimental group indicating a larger improvement in EF. Based on this pilot study, results show a trend towards an advantage to VR therapy compared to cognitive retraining OT without VR, as it leads to greater improvement in complex everyday activities. PMID:23292820

  10. Effects of a rapid-resisted elliptical training program on motor, cognitive and neurobehavioral functioning in adults with chronic traumatic brain injury

    PubMed Central

    Zampieri, Cris; Ge, Jie; Acevedo, Ana; Dsurney, John

    2016-01-01

    This small clinical trial utilized a novel rehabilitation strategy, rapid-resisted elliptical training, in an effort to increase motor, and thereby cognitive, processing speed in ambulatory individuals with traumatic brain injury (TBI). As an initial step, multimodal functional abilities were quantified and compared in 12 ambulatory adults with and 12 without TBI. After the baseline assessment, the group with TBI participated in an intensive 8-week daily exercise program using an elliptical trainer and was reassessed after completion and at an 8-week follow-up. The focus of training was on achieving a fast movement speed, and once the target was reached, resistance to motion was increased in small increments to increase intensity of muscle activation. Primary outcomes were: High-Level Mobility Assessment Tool (HiMAT), instrumented balance tests, dual-task (DT) performance and neurobehavioral questionnaires. The group with TBI had poorer movement excursion during balance tests and poorer dual-task (DT) performance. After training, balance reaction times improved and were correlated with gains in the HiMAT and DT. Sleep quality also improved and was correlated with improved depression and learning. This study illustrates how brain injury can affect multiple linked aspects of functioning and provides preliminary evidence that intensive rapid-resisted training has specific positive effects on dynamic balance and more generalized effects on sleep quality in TBI. PMID:27025506

  11. Effects of a rapid-resisted elliptical training program on motor, cognitive and neurobehavioral functioning in adults with chronic traumatic brain injury.

    PubMed

    Damiano, Diane L; Zampieri, Cristiane; Ge, Jie; Acevedo, Ana; Dsurney, John

    2016-08-01

    This small clinical trial utilized a novel rehabilitation strategy, rapid-resisted elliptical training, in an effort to increase motor, and thereby cognitive, processing speed in ambulatory individuals with traumatic brain injury (TBI). As an initial step, multimodal functional abilities were quantified and compared in 12 ambulatory adults with and 12 without TBI. After the baseline assessment, the group with TBI participated in an intensive 8-week daily exercise program using an elliptical trainer and was reassessed after completion and at an 8-week follow-up. The focus of training was on achieving a fast movement speed, and once the target was reached, resistance to motion was increased in small increments to increase intensity of muscle activation. Primary outcomes were: High-Level Mobility Assessment Tool (HiMAT), instrumented balance tests, dual-task (DT) performance and neurobehavioral questionnaires. The group with TBI had poorer movement excursion during balance tests and poorer dual-task (DT) performance. After training, balance reaction times improved and were correlated with gains in the HiMAT and DT. Sleep quality also improved and was correlated with improved depression and learning. This study illustrates how brain injury can affect multiple linked aspects of functioning and provides preliminary evidence that intensive rapid-resisted training has specific positive effects on dynamic balance and more generalized effects on sleep quality in TBI. PMID:27025506

  12. Long-Term Upregulation of Inflammation and Suppression of Cell Proliferation in the Brain of Adult Rats Exposed to Traumatic Brain Injury Using the Controlled Cortical Impact Model

    PubMed Central

    Acosta, Sandra A.; Tajiri, Naoki; Shinozuka, Kazutaka; Ishikawa, Hiroto; Grimmig, Bethany; Diamond, David; Sanberg, Paul R.; Bickford, Paula C.; Kaneko, Yuji; Borlongan, Cesar V.

    2013-01-01

    The long-term consequences of traumatic brain injury (TBI), specifically the detrimental effects of inflammation on the neurogenic niches, are not very well understood. In the present in vivo study, we examined the prolonged pathological outcomes of experimental TBI in different parts of the rat brain with special emphasis on inflammation and neurogenesis. Sixty days after moderate controlled cortical impact injury, adult Sprague-Dawley male rats were euthanized and brain tissues harvested. Antibodies against the activated microglial marker, OX6, the cell cycle-regulating protein marker, Ki67, and the immature neuronal marker, doublecortin, DCX, were used to estimate microglial activation, cell proliferation, and neuronal differentiation, respectively, in the subventricular zone (SVZ), subgranular zone (SGZ), striatum, thalamus, and cerebral peduncle. Stereology-based analyses revealed significant exacerbation of OX6-positive activated microglial cells in the striatum, thalamus, and cerebral peduncle. In parallel, significant decrements in Ki67-positive proliferating cells in SVZ and SGZ, but only trends of reduced DCX-positive immature neuronal cells in SVZ and SGZ were detected relative to sham control group. These results indicate a progressive deterioration of the TBI brain over time characterized by elevated inflammation and suppressed neurogenesis. Therapeutic intervention at the chronic stage of TBI may confer abrogation of these deleterious cell death processes. PMID:23301065

  13. Lifetime mood symptoms and adult separation anxiety in patients with complicated grief and/or post-traumatic stress disorder: a preliminary report.

    PubMed

    Dell'Osso, Liliana; Carmassi, Claudia; Musetti, Laura; Socci, Chiara; Shear, M Katherine; Conversano, Ciro; Maremmani, Icro; Perugi, Giulio

    2012-08-15

    A minority of bereaved individuals experiences symptoms of complicated grief (CG) that are associated with significant distress and impairment. CG is currently under consideration for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) and a major issue is whether or not it can be differentiated from major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). The purpose of this study is to compare the clinical features of CG with those of PTSD and CG+PTSD. A total sample of 116 patients (66 PTSD, 22 CG and 28 CG+PTSD) was recruited. Assessments included: Structured Clinical Interview for DSM-IV Axis-I disorders (SCID-I/P), Inventory of Complicated Grief (ICG), Adult Separation Anxiety Questionnaire (ASA-27), Work and Social Adjustment Scale (WSAS), and Mood Spectrum-Self Report (MOODS-SR) lifetime version. CG was strongly associated with female gender. MDD comorbidity was more common among patients with CG while bipolar disorder was highest among those with PTSD+CG. Patients with CG+PTSD reported significantly higher ASA-27 scores compared to patients with either CG or PTSD alone. Patients with CG+PTSD or PTSD alone reported significantly higher scores on the manic component of the MOODS-SR. No significant differences were reported in the WSAS scores. Our results support differences between CG and PTSD that are important for the consideration of including CG as a new disorder in the DSM-V. PMID:22436352

  14. Exploring the experience of sleep and fatigue in male and female adults over the 2 years following traumatic brain injury: a qualitative descriptive study

    PubMed Central

    Theadom, Alice; Rowland, Vickie; Levack, William; Starkey, Nicola; Wilkinson-Meyers, Laura; McPherson, Kathryn

    2016-01-01

    Objectives To explore the experience of fatigue and sleep difficulties over the first 2 years after traumatic brain injury (TBI). Design Longitudinal qualitative descriptive analysis of interviews completed as part of a larger longitudinal study of recovery following TBI. Data relating to the experience of fatigue and/or sleep were extracted and coded by two independent researchers. Setting Community-based study in the Hamilton and Auckland regions of New Zealand. Participants 30 adult participants who had experienced mild, moderate or severe brain injury within the past 6 months (>16 years of age). 15 participants also nominated significant others to take part. Interviews were completed at 6, 12 and 24 months postinjury. Results Participants described feeling unprepared for the intensity, impact and persistent nature of fatigue and sleep difficulties after injury. They struggled to learn how to manage their difficulties by themselves and to adapt strategies in response to changing circumstances over time. Four themes were identified: (1) Making sense of fatigue and sleep after TBI; (2) accepting the need for rest; (3) learning how to rest and; (4) need for rest impacts on ability to engage in life. Conclusions Targeted support to understand, accept and manage the sleep and fatigue difficulties experienced may be crucial to improve recovery and facilitate engagement in everyday life. Advice needs to be timely and revised for relevance over the course of recovery. PMID:27059468

  15. Gender modulates the development of theta event related oscillations in adolescents and young adults.

    PubMed

    Chorlian, David B; Rangaswamy, Madhavi; Manz, Niklas; Kamarajan, Chella; Pandey, Ashwini K; Edenberg, Howard; Kuperman, Samuel; Porjesz, Bernice

    2015-10-01

    The developmental trajectories of theta band (4-7 Hz) event-related oscillations (EROs), a key neurophysiological constituent of the P3 response, were assessed in 2170 adolescents and young adults ages 12 to 25. The theta EROs occurring in the P3 response, important indicators of neurocognitive function, were elicited during the evaluation of task-relevant target stimuli in visual and auditory oddball tasks. These tasks call upon attentional and working memory resources. Large differences in developmental rates between males and females were found; scalp location and task modality (visual or auditory) differences within males and females were small compared to gender differences. Trajectories of interregional and intermodal correlations between ERO power values exhibited increases with age in both genders, but showed a divergence in development between auditory and visual systems during ages 16 to 21. These results are consistent with previous electrophysiological and imaging studies and provide additional temporal detail about the development of neurophysiological indices of cognitive activity. Since measures of the P3 response has been found to be a useful endophenotypes for the study of a number of clinical and behavioral disorders, studies of its development in adolescents and young adults may illuminate neurophysiological factors contributing to the onset of these conditions. PMID:26102560

  16. An event-related potential investigation of sentence processing in adults who stutter.

    PubMed

    Murase, Shinobu; Kawashima, Takashi; Satake, Hirotaka; Era, Seiichi

    2016-05-01

    The purpose of this study was to investigate characteristics of the semantic processing of sentences' final verbs in stutterers using event-related potential (ERP). ERPs elicited from semantically violating and non-violating verbs in Japanese sentences were compared between 13 adults who stutter (AWS) and 13 adults who do not stutter (AWNS). The stimulus sentences elicited the N400 and the late positive component (LPC) in both groups. The amplitude of the N400, however, was attenuated in AWS. Regarding the LPC, the LPC in the 450-700ms time window (the early LPC) was evident in both groups, but the LPC in the 700-850 time window (the late LPC) was only apparent in AWS. Because AWS judged sentence congruency as accurately as AWNS did, it is assumed that AWS depended more on the LPC for semantic processing, resulting in the enhancement of the late LPC. We speculate that semantic processing of sentences for AWS is more time consuming than that for AWNS. PMID:26477716

  17. Preserved face inversion effects in adults with autism spectrum disorder: an event-related potential study.

    PubMed

    Tavares, Paula P; Mouga, Susana S; Oliveira, Guiomar G; Castelo-Branco, Miguel

    2016-05-25

    Individuals with autism spectrum disorder (ASD) are impaired in face recognition and emotional expression identification. According to current models, there are at least three levels of face processing: first order (two eyes, above a nose, which is above a mouth), second order (the relative distance between features), and holistic (ability to recognize as faces images that lack distinctive facial features). Some studies have reported deficits in configural and holistic processing in individuals with ASD. We investigated the neural correlates of these phenomena by measuring event-related potentials in high-functioning adults with ASD and healthy controls, during a face decision task, using a comprehensive set of photographic, schematic and Mooney upright and inverted faces, and scrambled images. Behaviorally, ASD and healthy controls were performance matched. At the electrophysiological level, individuals with ASD showed a bilateral N170 inversion effect in latency and left lateralized in amplitude for photographic faces, with bilaterally longer latencies and left higher amplitudes (more negative) N170 for inverted than upright photographic faces, and a right lateralized N170 inversion effect in latency for schematic faces. We conclude that under performance-matched conditions, adults with ASD show preserved N170 inversion effects and associated sparing of facial configural processing. An oral presentation of this work can be consulted using the following link, Supplemental digital content 1, http://links.lww.com/WNR/A382. PMID:27092469

  18. Rejection in Bargaining Situations: An Event-Related Potential Study in Adolescents and Adults

    PubMed Central

    Zanolie, Kiki; de Cremer, David; Güroğlu, Berna; Crone, Eveline A.

    2015-01-01

    The neural correlates of rejection in bargaining situations when proposing a fair or unfair offer are not yet well understood. We measured neural responses to rejection and acceptance of monetary offers with event-related potentials (ERPs) in mid-adolescents (14–17 years) and early adults (19–24 years). Participants played multiple rounds of the Ultimatum Game as proposers, dividing coins between themselves and a second player (responder) by making a choice between an unfair distribution (7 coins for proposer and 3 for responder; 7/3) and one of two alternatives: a fair distribution (5/5) or a hyperfair distribution (3/7). Participants mostly made fair offers (5/5) when the alternative was unfair (7/3), but made mostly unfair offers (7/3) when the alternative was hyperfair (3/7). When participants’ fair offers (5/5; alternative was 7/3) were rejected this was associated with a larger Medial Frontal Negativity (MFN) compared to acceptance of fair offers and rejection of unfair offers (7/3; alternative was 3/7). Also, the MFN was smaller after acceptance of unfair offers (7/3) compared to rejection. These neural responses did not differ between adults and mid-adolescents, suggesting that the MFN reacts as a neural alarm system to social prediction errors which is already prevalent during adolescence. PMID:26445134

  19. Common carotid intima-media thickness relates to cardiovascular events in adults aged <45 years.

    PubMed

    Eikendal, Anouk L M; Groenewegen, Karlijn A; Anderson, Todd J; Britton, Annie R; Engström, Gunnar; Evans, Greg W; de Graaf, Jacqueline; Grobbee, Diederick E; Hedblad, Bo; Holewijn, Suzanne; Ikeda, Ai; Kitagawa, Kazuo; Kitamura, Akihiko; Lonn, Eva M; Lorenz, Matthias W; Mathiesen, Ellisiv B; Nijpels, Giel; Dekker, Jacqueline M; Okazaki, Shuhei; O'Leary, Daniel H; Polak, Joseph F; Price, Jacqueline F; Robertson, Christine; Rembold, Christopher M; Rosvall, Maria; Rundek, Tatjana; Salonen, Jukka T; Sitzer, Matthias; Stehouwer, Coen D A; Hoefer, Imo E; Peters, Sanne A E; Bots, Michiel L; den Ruijter, Hester M

    2015-04-01

    Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden. PMID:25624341

  20. EMERGENCY BRAKING IN ADULTS VERSUS NOVICE TEEN DRIVERS: RESPONSE TO SIMULATED SUDDEN DRIVING EVENTS

    PubMed Central

    Kandadai, Venk; McDonald, Catherine C.; Winston, Flaura K.

    2015-01-01

    Motor vehicle crashes remain the leading cause of death in teens in the United States. Newly licensed drivers are the group most at risk for crashes. Their driving skills are very new, still very often untested, so that their ability to properly react in an emergency situation remains a research question. Since it is impossible to expose human subjects to critical life threatening driving scenarios, researchers have been increasingly using driving simulators to assess driving skills. This paper summarizes the results of a driving scenario in a study comparing the driving performance of novice teen drivers (n=21) 16–17 year olds with 90 days of provisional licensure with that of experienced adult drivers (n=17) 25–50 year olds with at least 5 years of PA licensure, at least 100 miles driven per week and no self-reported collisions in the previous 3 years. As part of a 30 to 35 simulated drive that encompassed the most common scenarios that result in serious crashes, participants were exposed to a sudden car event. As the participant drove on a suburban road, a car surged from a driveway hidden by a fence on the right side of the road. To avoid the crash, participants must hard brake, exhibiting dynamic control over both attentional and motor resources. The results showed strong differences between the experienced adult and novice teen drivers in the brake pressure applied. When placed in the same situation, the novice teens decelerated on average 50% less than the experienced adults (p<0.01). PMID:26709330

  1. Daily oral intake of theanine prevents the decline of 5-bromo-2'-deoxyuridine incorporation in hippocampal dentate gyrus with concomitant alleviation of behavioral abnormalities in adult mice with severe traumatic stress.

    PubMed

    Takarada, Takeshi; Nakamichi, Noritaka; Kakuda, Takami; Nakazato, Ryota; Kokubo, Hiroshi; Ikeno, Shinsuke; Nakamura, Saki; Hinoi, Eiichi; Yoneda, Yukio

    2015-03-01

    Posttraumatic stress disorder is a long-lasting psychiatric disease with the consequence of hippocampal atrophy in humans exposed to severe fatal stress. We demonstrated a positive correlation between the transient decline of 5-bromo-2'-deoxyuridine (BrdU) incorporation in the hippocampal dentate gyrus (DG) and long-lasting behavioral abnormalities in mice with traumatic stress. Here, we investigated pharmacological properties of theanine on the declined BrdU incorporation and abnormal behaviors in mice with traumatic stress. Prior daily oral administration of theanine at 50-500 mg/kg for 5 days significantly prevented the decline of BrdU incorporation, while theanine significantly prevented the decline in the DG even when administered for 5 days after stress. Consecutive daily administration of theanine significantly inhibited the prolonged immobility in mice with stress in forced swimming test seen 14 days later. Although traumatic stress significantly increased spontaneous locomotor activity over 30 min even when determined 14 days later, the increased total locomotion was significantly ameliorated following the administration of theanine at 50 mg/kg for 14 days after stress. These results suggest that theanine alleviates behavioral abnormalities together with prevention of the transient decline of BrdU incorporation in the hippocampal DG in adult mice with severe traumatic stress. PMID:25837925

  2. Traumatic grief and traumatic stress in survivors 12 years after the genocide in Rwanda.

    PubMed

    Mutabaruka, Jean; Séjourné, Nathalène; Bui, Eric; Birmes, Philippe; Chabrol, Henri

    2012-10-01

    The relationship between exposure to traumatic events and traumatic grief and the role of mediating and moderating variables [peritraumatic distress, post traumatic stress disorder (PTSD) symptoms and symptoms of depression] were studied in survivors of the genocide of Batutsi in Rwanda in 1994. One hundred and two survivors (70 women, mean age 45 ± 7.53 years) participated in this retrospective study. All of them had lost a member of their family. The severity of traumatic exposure (Comprehensive Trauma Inventory), peritraumatic distress (Peritraumatic Distress Inventory), current PTSD symptoms (PTSD Checklist), depressive symptoms (Beck Depression Inventory) and traumatic grief symptoms (Inventory of Traumatic Grief) was evaluated. A hierarchical multiple regression analysis was then conducted to examine the relative contribution of each variable to the symptoms of traumatic grief. The severity of traumatic exposure was related to traumatic grief symptoms (B=0.06, R=0.6, R(2) =0.36 and ß=0.6, t=7.54, p=0.00). The Baron and Kenny procedure (1986) (including three separate regressions), along with the Sobel test, was used to test mediation effects. Peritraumatic distress and PTSD symptoms may be mediating variables between traumatic exposure and traumatic grief. Traumatic grief is a complex but assessable entity, where previous distress and suffering result from both psychological trauma and the loss of a loved one. PMID:22282057

  3. MedlinePlus: Post-Traumatic Stress Disorder

    MedlinePlus

    ... traumatic stress disorder Traumatic events and children Related Health Topics Stress Veterans and Military Health National Institutes of Health ... Stress Disorder is the National Institute of Mental Health NIH MedlinePlus Magazine Post Traumatic Stress Disorder (PTSD): NIH Research to Results PTSD: A ...

  4. When the world collapses: changed worldview and social reconstruction in a traumatized community

    PubMed Central

    Biruski, Dinka Corkalo; Ajdukovic, Dean; Stanic, Ajana Löw

    2014-01-01

    Background Traumatic experience can affect the individual's basic beliefs about the world as a predictable and safe place. One of the cornerstones in recovery from trauma is reestablishment of safety, connectedness, and the shattered schema of a worldview. Objective This study explored the role of negatively changed worldview in the relationship between war-related traumatization and readiness for social reconstruction of intergroup relations in a post-conflict community measured by three processes: intergroup rapprochement, rebuilding trust, and need for apology. It was hypothesized that more traumatized people are less supportive of social reconstruction and that this relationship is mediated by the changed worldview. Method The study included a community random sample of 333 adults in the city of Vukovar, Croatia, that was most devastated during the 1991–1995 war. Six instruments were administered: Stressful Events Scale, Impact of Event Scale-Revised, Changed Worldview Scale, and three scales measuring the post-conflict social reconstruction processes: Intergroup Rapprochement, Intergroup Trust and Need for Apology. Results Mediation analyses showed that the worldview change fully mediated between traumatization and all three aspects of social reconstruction. Conclusions In a population exposed to war traumatization the worldview change mediates post-conflict social recovery of community relations. PMID:25279101

  5. Does Silent Reading Speed in Normal Adult Readers Depend on Early Visual Processes? Evidence from Event-Related Brain Potentials

    ERIC Educational Resources Information Center

    Korinth, Sebastian Peter; Sommer, Werner; Breznitz, Zvia

    2012-01-01

    Little is known about the relationship of reading speed and early visual processes in normal readers. Here we examined the association of the early P1, N170 and late N1 component in visual event-related potentials (ERPs) with silent reading speed and a number of additional cognitive skills in a sample of 52 adult German readers utilizing a Lexical…

  6. Long-Term Safety and Adverse Events of Risperidone in Children, Adolescents, and Adults with Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Hellings, Jessica A.; Cardona, Alicia M.; Schroeder, Stephen R.

    2010-01-01

    The objective of this study was to examine long-term adverse events of risperidone in 19 children, adolescents, and adults with Pervasive Developmental Disorders and intellectual disability, continuing risperidone for a mean of 186.5 weeks, following a 46-week risperidone study. Nineteen individuals continued long-term follow-up after our…

  7. An Event-Related Potential Study of Adolescents' and Young Adults' Judgments of Moral and Social Conventional Violations

    ERIC Educational Resources Information Center

    Lahat, Ayelet; Helwig, Charles C.; Zelazo, Philip David

    2013-01-01

    The neurocognitive development of moral and conventional judgments was examined. Event-related potentials were recorded while 24 adolescents (13 years) and 30 young adults (20 years) read scenarios with 1 of 3 endings: moral violations, conventional violations, or neutral acts. Participants judged whether the act was acceptable or unacceptable…

  8. Stressful Life Event Experiences of Homeless Adults: A Comparison of Single Men, Single Women, and Women with Children

    ERIC Educational Resources Information Center

    Zugazaga, Carole

    2004-01-01

    This article describes stressful life events experienced by a multi-shelter sample of 162 homeless adults in the Central Florida area. Participants included homeless single men (n = 54), homeless single women (n = 54), and homeless women with children (n = 54). Subjects were interviewed with a modified version of the List of Threatening…

  9. Neural correlates of conceptual object priming in young and older adults: An event-related fMRI study

    PubMed Central

    Ballesteros, Soledad; Bischof, Gérard N.; Goh, Joshua O.; Park, Denise C.

    2012-01-01

    In this event-related fMRI study, we investigated age-related differences in brain activity associated with conceptual repetition priming in young and older adults. Participants performed a speeded “living/non-living” classification task with three repetitions of familiar objects. Both young and older adults showed a similar magnitude of behavioral priming to repeated objects and evidencing repetition-related activation reductions in fusiform gyrus, superior occipital, middle and inferior temporal cortex, as well as inferior frontal and insula regions. The neural priming effect in young adults was extensive and continued through both the second and third stimulus repetitions, whereas neural priming in older adults was markedly attenuated and reached floor at the second repetition. In young adults, greater neural priming in multiple brain regions correlated with greater behavioral facilitation whereas in older adults, only activation reduction in the left inferior frontal correlated with faster behavioral responses. These findings provide evidence for altered neural priming in older adults despite preserved behavioral priming, and suggest the possibility that age-invariant behavioral priming is observed as a result of more sustained neural processing of stimuli in older adults which may be a form of compensatory neural activity. PMID:23102512

  10. Neural correlates of conceptual object priming in young and older adults: an event-related functional magnetic resonance imaging study.

    PubMed

    Ballesteros, Soledad; Bischof, Gérard N; Goh, Joshua O; Park, Denise C

    2013-04-01

    In this event-related functional magnetic resonance imaging study, we investigated age-related differences in brain activity associated with conceptual repetition priming in young and older adults. Participants performed a speeded "living/nonliving" classification task with 3 repetitions of familiar objects. Both young and older adults showed a similar magnitude of behavioral priming to repeated objects and evidenced repetition-related activation reductions in fusiform gyrus, superior occipital, middle, and inferior temporal cortex, and inferior frontal and insula regions. The neural priming effect in young adults was extensive and continued through both the second and third stimulus repetitions, and neural priming in older adults was markedly attenuated and reached floor at the second repetition. In young adults, greater neural priming in multiple brain regions correlated with greater behavioral facilitation and in older adults, only activation reduction in the left inferior frontal correlated with faster behavioral responses. These findings provide evidence for altered neural priming in older adults despite preserved behavioral priming, and suggest the possibility that age-invariant behavioral priming is observed as a result of more sustained neural processing of stimuli in older adults which might be a form of compensatory neural activity. PMID:23102512

  11. Attenuation of microglial activation with minocycline is not associated with changes in neurogenesis after focal traumatic brain injury in adult mice.

    PubMed

    Ng, Si Yun; Semple, Bridgette D; Morganti-Kossmann, M Cristina; Bye, Nicole

    2012-05-01

    Neurogenesis is stimulated following injury to the adult brain and could potentially contribute to tissue repair. However, evidence suggests that microglia activated in response to injury are detrimental to the survival of new neurons, thus limiting the neurogenic response. The aim of this study was to determine the effect of the anti-inflammatory drug minocycline on neurogenesis and functional recovery after a closed head injury model of focal traumatic brain injury (TBI). Beginning 30 min after trauma, minocycline was administered for up to 2 weeks and bromodeoxyuridine was given on days 1-4 to label proliferating cells. Neurological outcome and motor function were evaluated over 6 weeks using the Neurological Severity Score (NSS) and ledged beam task. Microglial activation was assessed in the pericontusional cortex and hippocampus at 1 week post-trauma, using immunohistochemistry to detect F4/80. Following immunolabeling of bromodeoxyuridine, double-cortin, and NeuN, cells undergoing distinct stages of neurogenesis, including proliferation, neuronal differentiation, neuroblast migration, and long-term survival, were quantified at 1 and 6 weeks in the hippocampal dentate gyrus, as well as in the subventricular zone of the lateral ventricles and the pericontusional cortex. Our results show that minocycline successfully reduced microglial activation and promoted early neurological recovery that was sustained over 6 weeks. We also show for the first time in the closed head injury model, that early stages of neurogenesis were stimulated in the hippocampus and subventricular zone; however, no increase in new mature neurons occurred. Contrary to our hypothesis, despite the attenuation of activated microglia, minocycline did not support neurogenesis in the hippocampus, lateral ventricles, or pericontusional cortex, with none of the neurogenic stages being affected by treatment. These data provide evidence that a general suppression of microglial activation is

  12. A Single Hot Event Stimulates Adult Performance but Reduces Egg Survival in the Oriental Fruit Moth, Grapholitha molesta

    PubMed Central

    Ma, Gang; Hoffmann, Ary A.; Ma, Chun-Sen

    2014-01-01

    Climate warming is expected to increase the exposure of insects to hot events (involving a few hours at extreme high temperatures). These events are unlikely to cause widespread mortality but may modify population dynamics via impacting life history traits such as adult fecundity and egg hatching. These effects and their potential impact on population predictions are still largely unknown. In this study, we simulated a single hot event (maximum of 38°C lasting for 4 h) of a magnitude increasingly found under field conditions and examined its effect in the oriental fruit moth, Grapholitha molesta. This hot event had no impact on the survival of G. molesta adults, copulation periods or male longevity. However, the event increased female lifespan and the length of the oviposition period, leading to a potential increase in lifetime fecundity and suggesting hormesis. In contrast, exposure of males to this event markedly reduced the net reproductive value. Male heat treatment delayed the onset of oviposition in the females they mated with, as well as causing a decrease in the duration of oviposition period and lifetime fecundity. Both male and female stress also reduced egg hatch. Our findings of hormetic effects on female performance but concurrent detrimental effects on egg hatch suggest that hot events have unpredictable consequences on the population dynamics of this pest species with implications for likely effects associated with climate warming. PMID:25551751

  13. Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study.

    PubMed

    Yen, Shirley; Shea, M Tracie; Battle, Cynthia L; Johnson, Dawn M; Zlotnick, Caron; Dolan-Sewell, Regina; Skodol, Andrew E; Grilo, Carlos M; Gunderson, John G; Sanislow, Charles A; Zanarini, Mary C; Bender, Donna S; Rettew, Jennifer Bame; McGlashan, Thomas H

    2002-08-01

    The association between trauma and personality disorders (PDs), while receiving much attention and debate, has not been comprehensively examined for multiple types of trauma and PDs. The authors examined data from a multisite study of four PD groups: schizotypal, borderline (BPD), avoidant, and obsessive-compulsive, and a major depression comparison group. Rates of traumatic exposure to specific types of trauma, age of first trauma onset, and rates of posttraumatic stress disorder are compared. Results indicate that BPD participants reported the highest rate of traumatic exposure (particularly to sexual traumas, including childhood sexual abuse), the highest rate of posttraumatic stress disorder, and youngest age of first traumatic event. Those with the more severe PDs (schizotypal, BPD) reported more types of traumatic exposure and higher rates of being physically attacked (childhood and adult) when compared to other groups. These results suggest a specific relationship between BPD and sexual trauma (childhood and adult) that does not exist among other PDs. In addition, they support an association between severity of PD and severity of traumatic exposure, as indicated by earlier trauma onset, trauma of an assaultive and personal nature, and more types of traumatic events. PMID:12193835

  14. Event-related fields evoked by vocal response inhibition: a comparison of younger and older adults.

    PubMed

    Castro-Meneses, Leidy J; Johnson, Blake W; Sowman, Paul F

    2016-06-01

    The current study examined event-related fields (ERFs) evoked by vocal response inhibition in a stimulus-selective stop-signal task. We compared inhibition-related ERFs across a younger and an older group of adults. Behavioural results revealed that stop-signal reaction times (RTs), go-RTs, ignore-stop RTs and failed stop RTs were longer in the older, relative to the younger group by 38, 123, 149 and 116 ms, respectively. The amplitude of the ERF M2 peak (approximately 200 ms after the stop signal) evoked on successful stop trials was larger compared to that evoked on both failed stop and ignore-stop trials. The M4 peak (approximately 450 ms after stop signal) was of larger amplitude in both successful and failed stops compared to ignore-stop trials. In the older group, the M2, M3 and M4 peaks were smaller in amplitude and peaked later in time (by 24, 50 and 76 ms, respectively). We demonstrate that vocal response inhibition-related ERFs exhibit a similar temporal evolution to those previously described for manual response inhibition: an early peak at 200 ms (i.e. M2) that differentiates successful from failed stopping, and a later peak (i.e. M4) that is consistent with a neural marker of response checking and error processing. Across groups, our data support a more general decline of stimulus processing speed with age. PMID:26821315

  15. Derivation of a Clinical Decision Instrument to Identify Adult Patients with Mild Traumatic Intracranial Hemorrhage at Low Risk for Requiring ICU Admission

    PubMed Central

    Nishijima, Daniel K.; Sena, Matthew J.; Galante, Joseph M.; Shahlaie, Kiarash; London, Jason A.; Melnikow, Joy; Holmes, James F.

    2013-01-01

    Study Objective The objective of this study was to derive a clinical decision instrument with a sensitivity of at least 95% (with upper and lower bounds of the 95% CIs within a 5% range) to identify adult emergency department patients with mild traumatic intracranial hemorrhage (tICH) who are at low risk for requiring critical care resources during hospitalization and thus may not need admission to the ICU. Methods This was a prospective, observational study of adult patients with mild tICH (initial Glasgow Coma Scale [GCS] score 13 to 15 with tICH) presenting to a Level 1 trauma center from July 2009 to February 2013. The need for ICU admission was defined as the presence of an acute critical care intervention (intubation, neurosurgical intervention, blood product transfusion, vasopressor or inotrope administration, invasive monitoring for hemodynamic instability, emergent treatment for arrhythmia or cardiopulmonary resuscitation, therapeutic angiography). We derived the clinical decision instrument using binary recursive partitioning (with a misclassification cost of 20 to 1). The accuracy of the decision instrument was compared to the treating physician’s (emergency medicine faculty) clinical impression. Results A total of 600 patients with mild tICH were enrolled; 116 patients (19%) had a critical care intervention. The derived instrument consisted of four predictor variables: admission GCS score less than 15, non-isolated head injury, age 65 years or older, and evidence of swelling or shift on initial cranial computed tomography scan. The decision instrument identified 114 of 116 patients requiring an acute critical care intervention (sensitivity 98.3%; 95% CI 93.9–99.5%) if at least one variable was present, and 192 of 484 patients that did not have an acute critical care intervention (specificity 39.7%; 95% CI 35.4–44.1%) if no variables were present. Physician clinical impression was slightly less sensitive (90.1%; 95% CI 83.1–94.4%) but overall

  16. Young Adult Exposure to Cardiovascular Risk Factors and Risk of Events Later in Life: The Framingham Offspring Study

    PubMed Central

    Pletcher, Mark J.; Vittinghoff, Eric; Thanataveerat, Anusorn; Bibbins-Domingo, Kirsten

    2016-01-01

    Background It is unclear whether coronary heart disease (CHD) risk factor exposure during early adulthood contributes to CHD risk later in life. Our objective was to analyze whether extent of early adult exposures to systolic and diastolic blood pressure (SBP, DBP) and low-and high-density lipoprotein cholesterol (LDL, HDL) are independent predictors of CHD events later in life. Methods and Findings We used all available measurements of SBP, DBP, LDL, and HDL collected over 40 years in the Framingham Offspring Study to estimate risk factor trajectories, starting at age 20 years, for all participants. Average early adult (age 20–39) exposure to each risk factor was then estimated, and used to predict CHD events (myocardial infarction or CHD death) after age 40, with adjustment for risk factor exposures later in life (age 40+). 4860 participants contributed an average of 6.3 risk factor measurements from in-person examinations and 24.5 years of follow-up after age 40, and 510 had a first CHD event. Early adult exposures to high SBP, DBP, LDL or low HDL were associated with 8- to 30-fold increases in later life CHD event rates, but were also strongly correlated with risk factor levels later in life. After adjustment for later life levels and other risk factors, early adult DBP and LDL remained strongly associated with later life risk. Compared with DBP≤70 mmHg, adjusted hazard ratios (HRs) were 2.1 (95% confidence interval: 0.8–5.7) for DBP = 71–80, 2.6 (0.9–7.2) for DBP = 81–90, and 3.6 (1.2–11) for DBP>90 (p-trend = 0.019). Compared with LDL≤100 mg/dl, adjusted HRs were 1.5 (0.9–2.6) for LDL = 101–130, 2.2 (1.2–4.0) for LDL = 131–160, and 2.4 (1.2–4.7) for LDL>160 (p-trend = 0.009). While current levels of SBP and HDL were also associated with CHD events, we did not detect an independent association with early adult exposure to either of these risk factors. Conclusions Using a mixed modeling approach to estimation of young adult exposures

  17. Female receptivity and secondary traumatization in the family.

    PubMed

    Baum, Nehami

    2014-06-01

    This paper addresses the question of gendered receptivity to Secondary Traumatic Syndrome (STS) in the family. Unlike other manifestations of distress in the family, where gender comparisons are a matter of course, very few such comparisons are made in studies of STS. Review of the findings of 12 studies, the only studies, to date, that provide data enabling the comparison of STS in males and females, shows that females in the family, whether daughters, wives, or mothers, are consistently more likely than the males, whether sons, husbands, or fathers, to experience the Posttraumatic Stress Disorder (PTSD) symptoms of a traumatized family member without having experienced the traumatic event itself. This pattern pertains to whether the event that precipitated the primary trauma was a collective or individual trauma and whether the STS sufferer was a child or adult or living or not living with the PTSD casualty. The Discussion points out that gender is an important factor in the development of STS, whether in interaction with role, beyond role, or both. PMID:24224512

  18. Traumatic Brain Injury

    MedlinePlus

    ... Center PTACs Workspaces Log-in Search for: Traumatic Brain Injury A legacy resource from NICHCY Disability Fact ... in her. Back to top What is Traumatic Brain Injury? A traumatic brain injury (TBI) is an ...

  19. Post-traumatic Stress Disorder (PTSD) in Children of Conflict Region of Kashmir (India): A Review

    PubMed Central

    Shah, Tabindah; Mushtaq, Sahil

    2016-01-01

    Post-traumatic stress disorder (PTSD) occurs due to traumatic events. The last two decades have seen various traumatic events in Kashmiri population, which has led to psychological impact on all population, especially children. PTSD is one of the psychiatric disorders occurring after witnessing of traumatic events. A review of literature regarding PTSD in children of Kashmir (India) has been done to assess the prevalence, causes, neurobiology, risk factors and psychiatric co morbidity associated with it. PMID:26894159

  20. Psychological aspects of traumatic injury in children and adolescents.

    PubMed

    Caffo, Ernesto; Belaise, Carlotta

    2003-07-01

    Each year millions of children are exposed to some form of extreme traumatic stressor. These traumatic events include natural disasters (e.g., tornadoes, floods, hurricanes), motor vehicle accidents, life-threatening illnesses and associated painful medical procedures (e.g., severe burns, cancer, limb amputations), physical abuse, sexual assault, witnessing domestic or community violence, kidnapping, and sudden death of a parent. During times of war, violent and nonviolent trauma (e.g., lack of fuel and food) may have terrible effects on children's adjustment. The events of September 11, 2001 and the unceasing suicidal attacks in the Middle East underscore the importance of understanding how children and adolescents react to disasters and terrorism. The body of literature related to children and their responses to disasters and trauma is growing. Mental health professionals are increasing their understanding about what factors are associated with increased risk (vulnerability) and affect how children cope with traumatic events. Researchers recognize that children's responses to major stress are similar to adults' (reexperiencing the event, avoidance, and arousal) and that these responses are not transient. A review of the literature indicates that PTSD is the most common psychiatric disorder after traumatic experiences, including physical injuries. There is also evidence for other comorbid conditions, including mood, anxiety, sleep, conduct, learning, and attention problems. In terms of providing treatment, CBT emerges as the best validated therapeutic approach for children and adolescents who experienced trauma-related symptoms, particularly symptoms associated with anxiety or mood disorders. The best approach to the injured child requires injury and pain assessment followed by specific interventions, such as pain management, brief consultation, and crisis intervention immediately after the specific traumatic event. Family support also may be necessary to help the

  1. Traumatic amputations

    PubMed Central

    Ramasamy, Arul

    2013-01-01

    Traumatic amputations remain one of the most emotionally disturbing wounds of conflict, as demonstrated by their frequent use in films to illustrate the horrors of war. Unfortunately, they remain common injuries, particularly following explosions, and, in addition, many survivors require primary amputation for unsalvageable injuries or to save their life. A third group, late amputations, is being increasingly recognised, often as a result of the sequelae of complex foot injuries. This article will look at the epidemiology of these injuries and their acute management, complications and outcome. PMID:26516502

  2. Changes and events over life course: a comparative study between groups of older adults

    PubMed Central

    Silva, Luípa Michele; Silva, Antônia Oliveira; Tura, Luiz Fernando Rangel; Moreira, Maria Adelaide Silva Paredes; Nogueira, Jordana Almeida; Cavalli, Stefano

    2015-01-01

    OBJECTIVE: to identify the changes which had occurred over the last year in the life of older adults, as well as the values attributed to these changes. METHOD: this is a multicentric, cross-sectional study, of the inquiry type, undertaken in three cities of the Brazilian Northeast, investigating two distinct groups of older adults. RESULTS: among the 236 older adults interviewed, it was observed that 30.0% reported health as the main change in their life course in the last year, this category being the most significant response among the older adults aged between 80 and 84 years old (37.7%). Changes in the family were mentioned by 11.5% of the older adults; death (9.6%) and alterations in routine activities (9.6%). In relation to the value attributed to these changes, it was ascertained that for 64.7% of the older adults aged between 65 and 69 years old, these changes were positive. In the older group, 49.4% of the older adults believe that their changes were related to losses. CONCLUSION: the knowledge of the changes mentioned, the value attributed to these changes, and the self-evaluation of health provide information which assists in formulating actions which are more specific to the real needs of these age groups. They also provide the health professionals with a better understanding of how some experiences are experienced in the life trajectories of these older adults. PMID:25806625

  3. Socioeconomic Determinants of Adult Mortality in Namibia Using an Event History Analysis.

    PubMed

    Kandjimbi, Alina; Nickanor, Ndeyapo; Kazembe, Lawrence N

    2014-01-01

    Adult mortality remains a neglected public health issue in sub-Saharan Africa, with most policy instruments concentrated on child and maternal health. In developed countries, adult mortality is negatively associated with socioeconomic factors. A similar pattern is expected in developing countries, but has not been extensively demonstrated, because of dearth of data. Understanding the hazard and factors associated with adult mortality is crucial for informing policies and for implementation of interventions aimed at improving adult survival. This paper applied a geo-additive survival model to elucidate effects of socioeconomic factors on adult mortality in Namibia, controlling for spatial frailties. Results show a clear disadvantage for adults in rural areas, for those not married and from poor households or in female-headed households. The hazard of adult mortality was highly variable with a 1.5-fold difference between areas, with highest hazard recorded in north eastern, central west and southern west parts of the country. The analysis emphasizes that, for Namibia to achieve its national development goals, targeted interventions should be aimed at poor-resourced adults, particularly in high-risk areas. PMID:26208512

  4. Relationships of Childhood Adverse Experiences With Mental Health and Quality of Life at Treatment Start for Adult Refugees Traumatized by Pre-Flight Experiences of War and Human Rights Violations

    PubMed Central

    Opaas, Marianne; Varvin, Sverre

    2015-01-01

    Abstract Adverse and potentially traumatic experiences (PTEs) in childhood were examined among 54 adult refugee patients with pre-flight PTEs of war and human rights violations (HRVs) and related to mental health and quality of life at treatment start. Extent of childhood PTEs was more strongly related to mental health and quality of life than the extent of war and HRV experiences. Childhood PTEs were significantly related to arousal and avoidance symptoms of posttraumatic stress disorder (PTSD) and to quality of life, whereas pre-flight war and HRV experiences were significantly related to reexperiencing symptoms of PTSD only. Within childhood adversities, experiences of family violence and external violence, but not of loss and illness, were significantly related to increased mental health symptoms and reduced quality of life. These results point to the importance of taking childhood adverse experiences into account in research and treatment planning for adult refugees with war and HRVs trauma. PMID:26103604

  5. Relationships of Childhood Adverse Experiences With Mental Health and Quality of Life at Treatment Start for Adult Refugees Traumatized by Pre-Flight Experiences of War and Human Rights Violations.

    PubMed

    Opaas, Marianne; Varvin, Sverre

    2015-09-01

    Adverse and potentially traumatic experiences (PTEs) in childhood were examined among 54 adult refugee patients with pre-flight PTEs of war and human rights violations (HRVs) and related to mental health and quality of life at treatment start. Extent of childhood PTEs was more strongly related to mental health and quality of life than the extent of war and HRV experiences. Childhood PTEs were significantly related to arousal and avoidance symptoms of posttraumatic stress disorder (PTSD) and to quality of life, whereas pre-flight war and HRV experiences were significantly related to reexperiencing symptoms of PTSD only. Within childhood adversities, experiences of family violence and external violence, but not of loss and illness, were significantly related to increased mental health symptoms and reduced quality of life. These results point to the importance of taking childhood adverse experiences into account in research and treatment planning for adult refugees with war and HRVs trauma. PMID:26103604

  6. Early and late event-related potentials are modulated by infant and adult faces of high and low attractiveness.

    PubMed

    Hahn, Amanda C; Symons, Lawrence A; Kredel, Taylor; Hanson, Kevin; Hodgson, Lianne; Schiavone, Lori; Jantzen, K J

    2016-04-01

    The processing of infant faces may be somewhat distinct from that of adult faces. Indeed, recent neuroimaging studies have provided evidence of an early, "baby-specific" neural response whereby infant faces are perceived more rapidly than adult faces. Using event-related potentials, the present study aimed to determine whether the preferential response to infant faces is present at both early and late stages of face processing, and to investigate the effects of esthetic appearance on the processing of adult and infant faces by directly manipulating the perceived attractiveness or cuteness within a given face identity. Here, we find evidence for enhanced processing of infant faces, relative to adult faces, at both early (N170, P2) and late (LPC) stages of face processing. We also find that the esthetic appearance of both infant and adult faces modulates early neural responses, with enhanced responses to less attractive/cute faces as compared to more attractive/cute faces. Overall, our results provide additional evidence for a preferential response to infant faces at early stages of processing, and provide new evidence that this preferential response occurs at later stages of face processing as well, independent of the esthetic quality of the face or observer sex. PMID:26160142

  7. Diffuse traumatic brain injury induces prolonged immune dysregulation and potentiates hyperalgesia following a peripheral immune challenge

    PubMed Central

    Rowe, Rachel K; Ellis, Gavin I; Harrison, Jordan L; Bachstetter, Adam D; Corder, Gregory F; Van Eldik, Linda J; Taylor, Bradley K; Marti, Francesc

    2016-01-01

    Background Nociceptive and neuropathic pain occurs as part of the disease process after traumatic brain injury (TBI) in humans. Central and peripheral inflammation, a major secondary injury process initiated by the traumatic brain injury event, has been implicated in the potentiation of peripheral nociceptive pain. We hypothesized that the inflammatory response to diffuse traumatic brain injury potentiates persistent pain through prolonged immune dysregulation. Results To test this, adult, male C57BL/6 mice were subjected to midline fluid percussion brain injury or to sham procedure. One cohort of mice was analyzed for inflammation-related cytokine levels in cortical biopsies and serum along an acute time course. In a second cohort, peripheral inflammation was induced seven days after surgery/injury with an intraplantar injection of carrageenan. This was followed by measurement of mechanical hyperalgesia, glial fibrillary acidic protein and Iba1 immunohistochemical analysis of neuroinflammation in the brain, and flow cytometric analysis of T-cell differentiation in mucosal lymph. Traumatic brain injury increased interleukin-6 and chemokine ligand 1 levels in the cortex and serum that peaked within 1–9 h and then resolved. Intraplantar carrageenan produced mechanical hyperalgesia that was potentiated by traumatic brain injury. Further, mucosal T cells from brain-injured mice showed a distinct deficiency in the ability to differentiate into inflammation-suppressing regulatory T cells (Tregs). Conclusions We conclude that traumatic brain injury increased the inflammatory pain associated with cutaneous inflammation by contributing to systemic immune dysregulation. Regulatory T cells are immune suppressors and failure of T cells to differentiate into regulatory T cells leads to unregulated cytokine production which may contribute to the potentiation of peripheral pain through the excitation of peripheral sensory neurons. In addition, regulatory T cells are

  8. Systemic inflammation and multiple organ injury in traumatic hemorrhagic shock.

    PubMed

    Liu, Huaizheng; Xiao, Xuefei; Sun, Chuanzheng; Sun, Dao; Li, Yayong; Yang, Mingshi

    2015-01-01

    Traumatic hemorrhagic shock (HS) is a severe outcome of traumatic injury that accounts for numerous traumatic deaths. In the process of traumatic HS, both hemorrhage and trauma can trigger a complex cascade of posttraumatic events that are related to inflammatory and immune responses, which may lead to multiple organ injury or even death. From a mechanistic perspective, systemic inflammation and organ injury are involved coagulation, the complement system, impaired microcirculation and inflammatory signaling pathways. In this review, we discuss the systemic inflammation and multiple organ injury in post-traumatic HS. PMID:25961533

  9. Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

    2015-01-01

    We analyzed 2010 US National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million…

  10. Using Basic Reading Skills Instruction and Formative Assessments to Teach an Adult with Traumatic Brain Injury to Read: A Case Study

    ERIC Educational Resources Information Center

    Goddard, Yvonne; Rinderknecht, Laura

    2009-01-01

    Literacy expectations for persons with cognitive impairments, including impairments caused by traumatic brain injury (TBI), have remained quite low. Some researchers have suggested that educators move from a focus on teaching functional skills to teaching basic reading skills in a manner similar to instruction for nondisabled learners. The purpose…

  11. The influence of childhood abuse, adult life events, and affective temperaments on the well-being of the general, nonclinical adult population

    PubMed Central

    Kanai, Yoshiaki; Takaesu, Yoshikazu; Nakai, Yukiei; Ichiki, Masahiko; Sato, Mitsuhiko; Matsumoto, Yasunori; Ishikawa, Jun; Ono, Yasuyuki; Murakoshi, Akiko; Tanabe, Hajime; Kusumi, Ichiro; Inoue, Takeshi

    2016-01-01

    Background Previous studies have shown the effects of childhood abuse, life events, and temperaments on well-being (positive affect) and ill-being (negative affect). We hypothesized that childhood abuse, affective temperaments, and adult life events interact with one another and influence positive and negative affects in the general adult population and tested this hypothesis using structural equation modeling. Methods A total of 415 participants from the general, nonclinical adult population were studied using the following self-administered questionnaires: the Subjective Well-Being Inventory (SUBI); Life Experiences Survey (LES); Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A); and the Child Abuse and Trauma Scale (CATS). The data were analyzed with single and multiple regression analyses and structural equation modeling (Mplus). Results Childhood abuse indirectly predicted the worsening of positive and negative affects through cyclothymic, anxious, and irritable temperaments as measured by the TEMPS-A in the structural equation model. The cyclothymic, anxious, and irritable temperaments directly worsened the positive and negative affects and the negative appraisal of life events that occurred during the past year, while the hyperthymic temperament had the opposite effects. Limitations The subjects of this study were nonclinical volunteers. The findings might not be generalizable to psychiatric patients. Conclusion This study demonstrated that childhood abuse, particularly neglect, indirectly worsened the well-being of individuals through cyclothymic, anxious, and irritable affective temperaments. An important “mediator” role of affective temperaments in the effect of childhood abuse on well-being was suggested. PMID:27110116

  12. Episodic memory in adults with autistic spectrum disorders: recall for self- versus other-experienced events.

    PubMed

    Hare, Dougal Julian; Mellor, Christine; Azmi, Sabiha

    2007-01-01

    People with autistic spectrum disorders (ASD) have difficulties in recalling recently experienced events, which is dependent upon intact functioning of several aspects of 'self awareness'. The current study examined impaired episodic recall in ASD and its relationship to specific impairments in aspects of 'self awareness'. Between-group (participants with learning disabilities with and without autistic spectrum disorder) experimental design examining free and cued recall of table-top activities that were either self-experienced by participants or observed being performed by the experimenter. Participants with ASD did not show superiority of free recall for self-experienced events over observed events, nor for recall of other-experienced events over self-experienced events, but did demonstrate a superiority for cued recall of self-experienced events. The implications for theory and practice are discussed. PMID:16839739

  13. Characteristics of the traumatic stressors experienced by rural first responders.

    PubMed

    Regambal, Marci J; Alden, Lynn E; Wagner, Shannon L; Harder, Henry G; Koch, William J; Fung, Klint; Parsons, Carly

    2015-08-01

    First responders routinely experience work-related events that meet the definition of a traumatic stressor. Despite the high exposure to traumatic events, prevalence rates of posttraumatic stress disorder (PTSD) are relatively low. This discrepancy points to the potential value of identifying factors that distinguish those traumatic stressors that produce ongoing traumatic stress symptoms from those that do not. The present study surveyed 181 first responders from rural settings. A repeated-measures design was used to compare characteristics of traumatic stressors that were or were not associated with ongoing PTSD symptoms. A factor analysis revealed that distressing events were characterized by chaos and resource limitations. Consistent with contemporary models, two mediational analyses revealed that each event characteristic predicted peritraumatic dissociation and posttraumatic cognitions, which in turn predicted PTSD symptoms. Moreover, the effect of each event characteristic on PTSD symptoms was partially mediated by these cognitive processes. PMID:26188614

  14. A Prospective Analysis of Life Events, Problem Behaviours and Depression in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Esbensen, A. J.; Benson, B. A.

    2006-01-01

    Background: Life events have consistently been found to be associated with behaviour problems and depression among individuals with intellectual disability (ID). However, prior findings have typically been based on correlational or retrospective analyses of case files. The current study attempted to replicate prior findings from life events with…

  15. Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive after Extremely Aversive Events?

    ERIC Educational Resources Information Center

    Bonanno, George A.

    2004-01-01

    Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology's knowledge about how adults cope with loss or trauma has come from…

  16. The influence of monetary incentives on context processing in younger and older adults: an event-related potential study.

    PubMed

    Schmitt, Hannah; Ferdinand, Nicola K; Kray, Jutta

    2015-06-01

    Recent evidence has indicated that neuronal activity related to reward anticipation benefits subsequent stimulus processing, but the effect of penalties remains largely unknown. Since the dual-mechanisms-of-control theory (DMC; Braver & Barch, Neuroscience and Biobehavioral Reviews, 26, 809-81, 2002) assumes that temporal differences in context updating underlie age differences in cognitive control, in this study we investigated whether motivational cues (signaling the chance to win or the risk to lose money, relative to neutral cues) preceding context information in a modified AX-CPT paradigm influence the temporal stages of context processing in younger and older adults. In the behavioral data, younger adults benefited from gain cues, evident in their enhanced context updating, whereas older adults exhibited slowed responding after motivational cues, irrespective of valence. Event-related potentials (ERPs) revealed that the enhanced processing of motivational cues in the P2 and P3b was mainly age-invariant, whereas age-differential effects were found for the ERP correlates of context processing. Younger adults showed improved context maintenance (i.e., a larger negative-going CNV), as well as increased conflict detection (larger N450) and resolution (indicated by a sustained positivity), whenever incorrect responding would lead to a monetary loss. In contrast, motivationally salient cues benefited context representations (in cue-locked P3b amplitudes), but increased working memory demands during response preparation (via a temporally prolonged P3b) in older adults. In sum, motivational valence and salience effects differentially modulated the temporal stages of context processing in younger and older adults. These results are discussed in terms of the DMC theory, recent findings of emotion regulation in old age, and the relationship between cognitive and affective processing. PMID:25665666

  17. Stopping and Starting: Experiences of Adults Returning to Formal Literacy Learning.

    ERIC Educational Resources Information Center

    Boyd, Vivienne; Cates, Julie; Hellyer, Jan; Leverton, Marianne; Robinson, Helen; Tobias, Robert

    2002-01-01

    Case studies of six adult literacy students revealed factors that had influenced them to stop and restart formal education: family conditions, traumatic events, initial schooling experiences, social networks, personal motivations, and informal learning experiences. The influence of contextual factors on literacy learning and characteristics of…

  18. Task Importance Affects Event-based Prospective Memory Performance in Adults with HIV-Associated Neurocognitive Disorders and HIV-infected Young Adults with Problematic Substance Use

    PubMed Central

    Woods, Steven Paul; Doyle, Katie L.; Morgan, Erin E.; Naar-King, Sylvie; Outlaw, Angulique Y.; Nichols, Sharon L.; Loft, Shayne

    2014-01-01

    Objective Two experiments were conducted to examine the effects of task importance on event-based prospective memory (PM) in separate samples of adults with HIV-associated Neurocognitive Disorders (HAND) and HIV-infected young adults with Substance Use Disorders (SUD). Method All participants completed three conditions of an ongoing lexical decision task: 1) without PM task requirements; 2) with PM task requirements that emphasized the importance of the ongoing task; and 3) with PM task requirements that emphasized the importance of the PM task. Results In both experiments, all HIV+ groups showed the expected increase in response costs to the ongoing task when the PM task’s importance was emphasized. In Experiment 1, individuals with HAND showed significantly lower PM accuracy as compared to HIV+ subjects without HAND when the importance of the ongoing task was emphasized, but improved significantly and no longer differed from HIV+ subjects without HAND when the PM task was emphasized. A similar pattern of findings emerged in Experiment 2, whereby HIV+ young adults with SUD (especially cannabis) showed significant improvements in PM accuracy when the PM task was emphasized. Conclusions Findings suggest that both HAND and SUD may increase the amount of cognitive attentional resources that need to be allocated to support PM performance in persons living with HIV infection. PMID:24834469

  19. Inhibition in adults with attention deficit/hyperactivity disorder: event-related potentials in the stop task.

    PubMed

    MacLaren, Vance V; Taukulis, Harald K; Best, Lisa A

    2007-12-01

    The core deficit in Attention Deficit/Hyperactivity Disorder (ADHD) may be a deficiency in executive functions, particularly the processes that are associated with the inhibition of predominant responses. To test this notion in the adult population, healthy undergraduate volunteers and students with ADHD symptoms performed a visual Stop Signal Task (Logan et al. J Exp Psychol: Hum Percept Perform 10:276-291, 1984) while Event-Related brain Potentials were recorded. The two groups did not differ on behavioral measures of performance, but there was a significant difference in the N2-P3 component. These results underline the robustness of an N2-P3 difference between healthy adults and people with ADHD symptoms that have persisted into young adulthood. PMID:17922184

  20. Traumatic fat embolism syndrome.

    PubMed

    Al-Khuwaitir, Tarig S; Al-Moghairi, Abdurahman M; Sherbeeni, Suphia M; Subh, Hamed M

    2002-12-01

    Traumatic fat embolism syndrome occurs most often following fractures of long bones sustained in road traffic accidents and is a common cause of medical consultation from the orthopedic surgery department. The sub-clinical presentation is subtle and expresses itself by the presence of hypoxemia, while the full clinical syndrome compromises respiratory insufficiency, an altered consciousness and a characteristic petechial rash. Recognition is simple once the patient is viewed in the context of his or her clinical setting. Diagnosis is aided further by the presence of hematological and biochemical abnormalities including anemia, thrombocytopenia, an elevated erythrocyte sedimentation rate and fat macroglobulinemia. Imaging by chest radiograph, computed tomography or magnetic resonance of the brain is used to confirm the extent of the respective organ involvement and to exclude alternative pathologies. The release of free fatty acids into the circulation and their subsequent effects is the key pathological event. Treatment is based on supportive care and high-dose corticosteroid therapy. We report a patient with traumatic fat embolism syndrome who developed the syndromes classical symptoms and signs following fracture of the long bones of his left lower leg. Admission to an intensive care unit, mechanical ventilatory support with positive end-expiratory pressure and corticosteroid therapy lead to his improvement and allowed eventual open reduction and internal fixation and discharge of our patient. Modern therapy offers a relatively good prognosis for patients with traumatic fat embolism syndrome; the optimal dose and timing of corticosteroid therapy in prophylaxis and treatment however, remain the subject of intense debate. PMID:12518208

  1. Event-Related Brain Potentials Elicited during Word Recognition by Adult Good and Poor Phonological Decoders

    ERIC Educational Resources Information Center

    Martin, Frances Heritage; Kaine, Alison; Kirby, Miriam

    2006-01-01

    Cognitive processing of lexical and sub-lexical stimuli was compared for good and poor adult phonological decoders. Sixteen good decoders and 16 poor decoders, average age 19 years, silently read 150 randomly computer presented sentences ending in incongruous regular, irregular, or nonwords and 100 congruent filler sentences.…

  2. The Ticking of the Social Clock: Adults' Beliefs about the Timing of Transition Events.

    ERIC Educational Resources Information Center

    Peterson, Candida C.

    1996-01-01

    Two studies regarding beliefs about descriptive and prescriptive age norms for adults in developmental transitions were examined in a sample of 214 Australian university students ages 17 to 50. Discusses research methodology. The probable consequences for self-esteem, mental health, and life planning are discussed in the context of the research…

  3. Coexisting Psychiatric Problems and Stressful Life Events in Adults with Symptoms of ADHD--A Large Swedish Population-Based Study of Twins

    ERIC Educational Resources Information Center

    Friedrichs, Bettina; Igl, Wilmar; Larsson, Henrik; Larsson, Jan-Olov

    2012-01-01

    Objective: To explore the associations of subtypes of adult ADHD with other psychiatric problems, stressful life events, and sex differences. Method: Odds ratios were calculated using information from 17,899 participants from a population-based survey of adult twins born in Sweden between 1959 and 1985. Results: Symptoms of attention deficit…

  4. The Cognitive Processes Underlying Event-Based Prospective Memory in School-Age Children and Young Adults: A Formal Model-Based Study

    ERIC Educational Resources Information Center

    Smith, Rebekah E.; Bayen, Ute J.; Martin, Claudia

    2010-01-01

    Fifty children 7 years of age (29 girls, 21 boys), 53 children 10 years of age (29 girls, 24 boys), and 36 young adults (19 women, 17 men) performed a computerized event-based prospective memory task. All 3 groups differed significantly in prospective memory performance, with adults showing the best performance and with 7-year-olds showing the…

  5. Coronary artery calcium and exercise electrocardiogram as predictors of coronary events in asymptomatic adults.

    PubMed

    Grossman, Chagai; Ehrlich, Shay; Shemesh, Joseph; Koren-Morag, Nira; Grossman, Ehud

    2015-03-15

    Early identification of patients at risk for coronary heart disease is crucial to formulate effective preventive strategies. The elevated risk of coronary artery calcium (CAC) for coronary heart disease is well established. Our aim was to estimate the relative risk of abnormal exercise electrocardiography (Ex ECG) in the presence of CAC. During the year 2001, 566 asymptomatic subjects performed a treadmill exercise test and consented to perform an unenhanced computed tomography to assess CAC. Patients were followed until December 2012. The relative risk for coronary events (acute myocardial infarction, hospitalization for unstable angina or coronary catheterization that resulted in angioplasty or coronary artery bypass surgery), of abnormal Ex ECG and presence of CAC were analyzed. An abnormal Ex ECG was found in 71 subjects (12.5%), and CAC was found in 286 subjects (50.5%). During a mean follow-up of 6.5 ± 3.3 years, 35 subjects experienced a first coronary event. In those without CAC, the rate of coronary events was low (4 of 280; 1.4%) regardless of the Ex ECG results. Subjects with both CAC and abnormal Ex ECG had the highest rate of coronary events (13 of 39; 33%). The adjusted hazard ratio for coronary events, in subjects with CAC, was 5.16 (95% confidence interval 2.52 to 10.60) in those with abnormal Ex ECG compared with those with normal Ex ECG. In conclusion, in subjects with CAC, further risk stratification can be achieved by an Ex ECG, whereas in those without CAC, an Ex ECG has less additional value in predicting coronary events. PMID:25616536

  6. Dysfunctional cortical inhibition in adult ADHD: neural correlates in auditory event-related potentials.

    PubMed

    Schubert, J K; Gonzalez-Trejo, E; Retz, W; Rösler, M; Corona-Strauss, F I; Steidl, G; Teuber, T; Strauss, D J

    2014-09-30

    In recent times, the relevance of an accurate diagnosis of attention-deficit/hyperactivity disorder (ADHD) in adults has been the focus of several studies. No longer considered a pathology exclusive to children and adolescents, and taking into account its social implications, developing enhanced support tools for the current diagnostic procedure becomes a priority. Here we present a method for the objective assessment of ADHD in adults using chirp-evoked, paired auditory late responses (ALRs) combined with a two-dimensional ALR denoising scheme to extract correlates of intracortical inhibition. Our method allows for an effective single-sweep denoising, thus requiring less trials to obtain recognizable physiological features, useful as pointers of cortical impairment. Results allow an optimized diagnosis, reduction of data loss and acquisition time; moreover, they do not account exclusively for critical elements within clinical evaluations, but also allow studying the pathophysiology of the condition by providing objective information regarding impaired cortical functions. PMID:25033725

  7. Glucocorticoid-induced fetal origins of adult hypertension: Association with epigenetic events.

    PubMed

    Anwar, M Akhtar; Saleh, Alaaeldin I; Al Olabi, Reem; Al Shehabi, Tuqa S; Eid, Ali H

    2016-07-01

    Hypertension is a predominant risk factor for cardiovascular diseases and a major health care burden. Accumulating epidemiological and experimental evidence suggest that adult-onset hypertension may have its origins during early development. Upon exposure to glucocorticoids, the fetus develops hypertension, and the offspring may be programmed to continue the hypertensive trajectory into adulthood. Elevated oxidative stress and deranged nitric oxide system are not only hallmarks of adult hypertension but are also observed earlier in life. Endothelial dysfunction and remodeling of the vasculature, which are robustly associated with increased incidence of hypertension, are likely to have been pre-programmed during fetal life. Apparently, genomic, non-genomic, and epigenomic factors play a significant role in the development of hypertension, including glucocorticoid-driven effects on blood pressure. In this review, we discuss the involvement of the aforementioned participants in the pathophysiology of hypertension and suggest therapeutic opportunities for targeting epigenome modifiers, potentially for personalized medicine. PMID:26903240

  8. The Moderating Effect of the Negative Impact of Recent Life Events on the Relation between Intrinsic Religiosity and Death Ideation in Older Adults

    ERIC Educational Resources Information Center

    Jahn, Danielle R.; Poindexter, Erin K.; Graham, Ryan D.; Cukrowicz, Kelly C.

    2012-01-01

    Researchers tested the hypothesis that the negative impact of recent life events would moderate the relationship between intrinsic religiosity and death ideation in older adults. Participants (n = 272) completed assessments of death ideation, intrinsic religiosity, and negative impact of recent life events. We confirmed the presence of concurrent…

  9. Training-related changes in early visual processing of functionally illiterate adults: evidence from event-related brain potentials

    PubMed Central

    2013-01-01

    Background Event-related brain potentials (ERPs) were used to investigate training-related changes in fast visual word recognition of functionally illiterate adults. Analyses focused on the left-lateralized occipito-temporal N170, which represents the earliest processing of visual word forms. Event-related brain potentials were recorded from 20 functional illiterates receiving intensive literacy training for adults, 10 functional illiterates not participating in the training and 14 regular readers while they read words, pseudowords or viewed symbol strings. Subjects were required to press a button whenever a stimulus was immediately repeated. Results Attending intensive literacy training was associated with improvements in reading and writing skills and with an increase of the word-related N170 amplitude. For untrained functional illiterates and regular readers no changes in literacy skills or N170 amplitude were observed. Conclusions Results of the present study suggest that the word-related N170 can still be modulated in adulthood as a result of the improvements in literacy skills. PMID:24330622

  10. Self-Reported Life Events, Social Support and Psychological Problems in Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Hulbert-Williams, Lee; Hastings, Richard P.; Crowe, Rachel; Pemberton, Jemma

    2011-01-01

    Background: Several studies have reported relationships between life events and psychological problems in people with intellectual disabilities. In contrast to the general literature, data have consistently been collected via proxy informants and putative moderator variables such as social support have not been examined. Materials and Methods:…

  11. Impaired Phonological and Orthographic Word Representations among Adult Dyslexic Readers: Evidence from Event-Related Potentials

    ERIC Educational Resources Information Center

    Meyler, Ann; Breznitz, Zvia

    2005-01-01

    The authors examined the processing of phonological and orthographic word representations among 17 dyslexic and 16 normal college-level readers using Event-Related Potential measures. They focused on 2 early components--the P200 and the P300. The results revealed P200 and P300 components of lower amplitude and later latency among dyslexic readers…

  12. Episodic Memory in Adults with Autistic Spectrum Disorders: Recall for Self- versus Other-Experienced Events

    ERIC Educational Resources Information Center

    Hare, Dougal Julian; Mellor, Christine; Azmi, Sabiha

    2007-01-01

    People with autistic spectrum disorders (ASD) have difficulties in recalling recently experienced events, which is dependent upon intact functioning of several aspects of "self awareness". The current study examined impaired episodic recall in ASD and its relationship to specific impairments in aspects of "self awareness". Between-group…

  13. Recall of a Live and Personally Experienced Eyewitness Event by Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Maras, Katie L.; Memon, Amina; Lambrechts, Anna; Bowler, Dermot M.

    2013-01-01

    The aim of the present study was to (a) extend previous eyewitness research in autism spectrum disorder (ASD) using a live and personally experienced event; (b) examine whether witnesses with ASD demonstrate a facilitative effect in memory for self- over other-performed actions; (c) explore source monitoring abilities by witnesses with ASD in…

  14. Young Adults' Fertility Expectations and Events: Associations with College Enrollment and Persistence

    ERIC Educational Resources Information Center

    Raley, R. Kelly; Kim, Yujin; Daniels, Kimberly

    2012-01-01

    The analyses described in this article investigated the association between adolescent fertility expectations and college enrollment (N = 7,838). They also explored the potential impact of fertility expectations and events on college persistence among 4-year (n = 2,605) and 2-year (n = 1,962) college students. The analysis, which used data from…

  15. Allowing Brief Delays in Responding Improves Event-Based Prospective Memory for Young Adults Living with HIV Disease

    PubMed Central

    Loft, Shayne; Doyle, Katie L.; Naar-King, Sylvie; Outlaw, Angulique Y.; Nichols, Sharon L.; Weber, Erica; Blackstone, Kaitlin; Woods, Steven Paul

    2014-01-01

    Event-based prospective memory (PM) tasks require individuals to remember to perform an action when they encounter a specific cue in the environment, and have clear relevance for daily functioning for individuals with HIV. In many everyday tasks, the individual must not only maintain the intent to perform the PM task, but the PM task response also competes with the alternative and more habitual task response. The current study examined whether event-based PM can be improved by slowing down the pace of the task environment. Fifty-seven young adults living with HIV performed an ongoing lexical decision task while simultaneously performing a PM task of monitoring for a specific word (which was focal to the ongoing task of making lexical decisions) or syllable contained in a word (which was nonfocal). Participants were instructed to refrain from making task responses until after a tone was presented, which occurred at varying onsets (0–1600ms) after each stimulus appeared. Improvements in focal and non-focal PM accuracy were observed with response delays of 600ms. Furthermore, the difference in PM accuracy between the low demand focal PM task and the resource demanding non-focal PM task was reduced by half across increasingly longer delays, falling from 31% at 0ms delay to only 14% at 1600ms delay. The degree of ongoing task response slowing for the PM conditions, relative to a control condition that did not have a PM task and made lexical decisions only, also decreased with increased delay. Overall, the evidence indicates that delaying the task responses of younger HIV-infected adults increased the probability that the PM relevant features of task stimuli were adequately assessed prior to the ongoing task response, and by implication that younger HIV infected adults can more adequately achieve PM goals when the pace of the task environment is slowed down. PMID:25116075

  16. Painful Traumatic Trigeminal Neuropathy.

    PubMed

    Rafael, Benoliel; Sorin, Teich; Eli, Eliav

    2016-08-01

    This article discusses neuropathic pain of traumatic origin affecting the trigeminal nerve. This syndrome has been termed painful traumatic trigeminal neuropathy by the International Headache Society and replaces atypical odontalgia, deafferentation pain, traumatic neuropathy, and phantom toothache. The discussion emphasizes the diagnosis and the early and late management of injuries to the trigeminal nerve and subsequent painful conditions. PMID:27475512

  17. Neuroprotective Effects of the Glutamate Transporter Activator (R)-(-)-5-methyl-1-nicotinoyl-2-pyrazoline (MS-153) following Traumatic Brain Injury in the Adult Rat.

    PubMed

    Karklin Fontana, Andréia Cristina; Fox, Douglas P; Zoubroulis, Argie; Valente Mortensen, Ole; Raghupathi, Ramesh

    2016-06-01

    Traumatic brain injury (TBI) in humans and in animals leads to an acute and sustained increase in tissue glutamate concentrations within the brain, triggering glutamate-mediated excitotoxicity. Excitatory amino acid transporters (EAATs) are responsible for maintaining extracellular central nervous system glutamate concentrations below neurotoxic levels. Our results demonstrate that as early as 5 min and up to 2 h following brain trauma in brain-injured rats, the activity (Vmax) of EAAT2 in the cortex and the hippocampus was significantly decreased, compared with sham-injured animals. The affinity for glutamate (KM) and the expression of glutamate transporter 1 (GLT-1) and glutamate aspartate transporter (GLAST) were not altered by the injury. Administration of (R)-(-)-5-methyl-1-nicotinoyl-2-pyrazoline (MS-153), a GLT-1 activator, beginning immediately after injury and continuing for 24 h, significantly decreased neurodegeneration, loss of microtubule-associated protein 2 and NeuN (+) immunoreactivities, and attenuated calpain activation in both the cortex and the hippocampus at 24 h after the injury; the reduction in neurodegeneration remained evident up to 14 days post-injury. In synaptosomal uptake assays, MS-153 up-regulated GLT-1 activity in the naïve rat brain but did not reverse the reduced activity of GLT-1 in traumatically-injured brains. This study demonstrates that administration of MS-153 in the acute post-traumatic period provides acute and long-term neuroprotection for TBI and suggests that the neuroprotective effects of MS-153 are related to mechanisms other than GLT-1 activation, such as the inhibition of voltage-gated calcium channels. PMID:26200170

  18. [Early childhood violent and sexual traumatization].

    PubMed

    Heigl-Evers, A; Kruse, J

    1991-04-01

    Violent and sexual child abuse represents an extreme traumatization that can continue to influence the lives of affected children into adulthood. Freud (1917) provided a concept of the influence of this extreme form of traumatization in his model of the traumatic neurosis. It is described as an after-the-fact attempt to master the flood of sensations that characterizes the trauma. More recent theoretical models identify a collapse of the ego during trauma as well as the effects of this collapse on the formation of self and object representants at the heart of the traumatic event. As a result of the collapse of the ego during trauma, the traumatized individual does not succeed in forming mature memories of the experience. Immature memories of trauma are marked by, among other things, very diffuse, near physical feelings that cannot be integrated into the ego (Cohen 1980). From the perspective of object relation theories, the lack of integration of "bad" and "good" self of the traumatized individual is emphasized by the abuser. Drawing on case studies, the authors illuminate the importance of the principle of the answer (Heigl-Evers/Heigl 1979, 1983) to the efforts to differentiate and integrate in the treatment of extremely traumatized patients. PMID:1857676

  19. Major adverse cardiovascular events in adult congenital heart disease: a population-based follow-up study from Taiwan

    PubMed Central

    2014-01-01

    Background The aim of the present study was to identify the long-term major adverse cardiovascular events (MACE) in adult congenital heart disease (ConHD) patients in Taiwan. Methods From the National Health Insurance Research Database (1997-2010), adult patients (≥18 years) with ConHD were identified and compared to non-ConHD control patients. The primary end point was the incidence of MACE. Cox proportional hazards models were used to compute hazard ratios as estimates for multivariate adjusted relative risks with or without adjusting for age and sex. Results A total of 3,267 adult patients with ConHD were identified between 2000 and 2003 with a median follow-up of 11 years till December 31, 2010. The five most common types of ConHD were atrial septal defects, ventricular septal defects, patent ductus arteriosus, tetralogy of Fallot, and pulmonary stenosis. Overall, the incidence of MACE was 4.0-fold higher in the ConHD group compared with the controls. After adjustment for age and gender, the patients with ConHD had an increased risk of heart failure, malignant dysrhythmia, acute coronary syndrome, and stroke. The adult ConHD patients had a decreased life-long risk of MACE if they received surgical correction, especially in the patients with atrial septal defects. Conclusions After a median of 11 years of follow-up, the Taiwanese patients with ConHD were at an increased risk of life-long cardiovascular MACE, including heart failure, stroke, acute coronary syndrome, and malignant dysrhythmia. Surgical correction may help to decrease long-term MACE in ConHD patients, especially those with ASD. PMID:24655794

  20. The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning among Older Adults

    ERIC Educational Resources Information Center

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2013-01-01

    The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas…

  1. Life after Adolescent and Adult Moderate and Severe Traumatic Brain Injury: Self-Reported Executive, Emotional, and Behavioural Function 2-5 Years after Injury.

    PubMed

    Finnanger, Torun Gangaune; Olsen, Alexander; Skandsen, Toril; Lydersen, Stian; Vik, Anne; Evensen, Kari Anne I; Catroppa, Cathy; Håberg, Asta K; Andersson, Stein; Indredavik, Marit S

    2015-01-01

    Survivors of moderate-severe Traumatic Brain Injury (TBI) are at risk for long-term cognitive, emotional, and behavioural problems. This prospective cohort study investigated self-reported executive, emotional, and behavioural problems in the late chronic phase of moderate and severe TBI, if demographic characteristics (i.e., age, years of education), injury characteristics (Glasgow Coma Scale score, MRI findings such as traumatic axonal injury (TAI), or duration of posttraumatic amnesia), symptoms of depression, or neuropsychological variables in the first year after injury predicted long-term self-reported function. Self-reported executive, emotional, and behavioural functioning were assessed among individuals with moderate and severe TBI (N = 67, age range 15-65 years at time of injury) 2-5 years after TBI, compared to a healthy matched control group (N = 72). Results revealed significantly more attentional, emotional regulation, and psychological difficulties in the TBI group than controls. Demographic and early clinical variables were associated with poorer cognitive and emotional outcome. Fewer years of education and depressive symptoms predicted greater executive dysfunction. Younger age at injury predicted more aggressive and rule-breaking behaviour. TAI and depressive symptoms predicted Internalizing problems and greater executive dysfunction. In conclusion, age, education, TAI, and depression appear to elevate risk for poor long-term outcome, emphasising the need for long-term follow-up of patients presenting with risk factors. PMID:26549936

  2. Life after Adolescent and Adult Moderate and Severe Traumatic Brain Injury: Self-Reported Executive, Emotional, and Behavioural Function 2–5 Years after Injury

    PubMed Central

    Finnanger, Torun Gangaune; Olsen, Alexander; Skandsen, Toril; Lydersen, Stian; Vik, Anne; Evensen, Kari Anne I.; Catroppa, Cathy; Håberg, Asta K.; Andersson, Stein; Indredavik, Marit S.

    2015-01-01

    Survivors of moderate-severe Traumatic Brain Injury (TBI) are at risk for long-term cognitive, emotional, and behavioural problems. This prospective cohort study investigated self-reported executive, emotional, and behavioural problems in the late chronic phase of moderate and severe TBI, if demographic characteristics (i.e., age, years of education), injury characteristics (Glasgow Coma Scale score, MRI findings such as traumatic axonal injury (TAI), or duration of posttraumatic amnesia), symptoms of depression, or neuropsychological variables in the first year after injury predicted long-term self-reported function. Self-reported executive, emotional, and behavioural functioning were assessed among individuals with moderate and severe TBI (N = 67, age range 15–65 years at time of injury) 2–5 years after TBI, compared to a healthy matched control group (N = 72). Results revealed significantly more attentional, emotional regulation, and psychological difficulties in the TBI group than controls. Demographic and early clinical variables were associated with poorer cognitive and emotional outcome. Fewer years of education and depressive symptoms predicted greater executive dysfunction. Younger age at injury predicted more aggressive and rule-breaking behaviour. TAI and depressive symptoms predicted Internalizing problems and greater executive dysfunction. In conclusion, age, education, TAI, and depression appear to elevate risk for poor long-term outcome, emphasising the need for long-term follow-up of patients presenting with risk factors. PMID:26549936

  3. Pushed to the margins and pushing back: a case study of one adult's reflections on social interactions after a traumatic brain injury sustained as an adolescent.

    PubMed

    Roscigno, Cecelia I; Van Liew, Kevin

    2008-08-01

    Traumatic brain injury (TBI) is a worldwide chronic health problem. Current empirical approaches to defining factors that contribute to a meaningful life after TBI have been limited to the biomedical perspective. Such a limited paradigm fails to address how people with TBI find meaning and act on and are acted on by the world in which they live. Between 2005 and 2007 an in-depth qualitative case study was conducted. The primary data source was a man's retrospective journal writings about his life after sustaining a severe TBI. The qualitative perspective of symbolic interactionism framed this case study analysis. Meaning is strongly influenced by the ways in which the social world interacts with the injured person. Despite an accumulation of negative social experiences, a traumatically brain-injured person can also assign positive meanings to the quality of his or her life. This has been ignored or explained away as a defense mechanism in previous investigations. More studies that include unbiased methods able to capture subjective experiences and what they mean to individuals with TBI are needed. This information will lead to more relevant interventions and better outcome instruments for use with this population. PMID:18727337

  4. Bicycle injury events among older adults in Northern Sweden: a 10-year population based study.

    PubMed

    Scheiman, Simeon; Moghaddas, Hossein S; Björnstig, Ulf; Bylund, Per-Olof; Saveman, Britt-Inger

    2010-03-01

    Bicycles are a common mode of transportation and injured bicyclists cause a substantial burden on the medical sector. In Sweden, about half of fatally injured bicyclists are 65 years or older. This study analyzes the injury mechanisms, injuries, and consequences among bicyclists 65 years or older and compare with younger bicyclists (< or =64) and older adults as passenger car drivers, to give a basis for an injury preventive discussion for this age group. Umeå University Hospital's primary catchments area had 142,000 inhabitants in 2006. Nearly all injured road users in the well-defined geographic area are treated at this hospital and a 10-year data set (N=456) of injured bicyclists aged 65+ from the hospital's continuous injury registration (1997-2006) was analyzed. The results show that the annual injury incidence was 2.4 and 2.2 per 1000 men and women, respectively, aged 65 or older. For men the incidence rate was constant in the three age groups 65-74, 75-84 and 85+, while it decreased strongly for women. The incidence rate for old adults as passenger car drivers and younger bicyclists was 1.0 and 4.6, respectively. Most frequent injury mechanisms were falls when getting on or off a bicycle (20%) and by potholes or irregularities on the ground, edge of a sidewalk, or similar (13%). Only 6% were hit by cars, trucks, or buses. Half of the injured suffered fractures or dislocations, and 10% suffered concussion or more serious intracranial injuries. Getting on or off the bicycle caused most fractures (especially a high fraction of the hip and femur fractures) and resulted in 27% of all inpatient days in hospital. Three individuals died. One-third of the injured were treated as inpatients for a total of 1413 days (on average 9 days), with 69% of the days being caused by fractures. The cost for out- and inpatient acute treatment was approximately USD 4700 (SEK 33,000) per injured. The results merit an interest for this target group; bicycle injuries among older

  5. Cav1.1 controls frequency-dependent events regulating adult skeletal muscle plasticity.

    PubMed

    Jorquera, Gonzalo; Altamirano, Francisco; Contreras-Ferrat, Ariel; Almarza, Gonzalo; Buvinic, Sonja; Jacquemond, Vincent; Jaimovich, Enrique; Casas, Mariana

    2013-03-01

    An important pending question in neuromuscular biology is how skeletal muscle cells decipher the stimulation pattern coming from motoneurons to define their phenotype as slow or fast twitch muscle fibers. We have previously shown that voltage-gated L-type calcium channel (Cav1.1) acts as a voltage sensor for activation of inositol (1,4,5)-trisphosphate [Ins(1,4,5)P₃]-dependent Ca(2+) signals that regulates gene expression. ATP released by muscle cells after electrical stimulation through pannexin-1 channels plays a key role in this process. We show now that stimulation frequency determines both ATP release and Ins(1,4,5)P₃ production in adult skeletal muscle and that Cav1.1 and pannexin-1 colocalize in the transverse tubules. Both ATP release and increased Ins(1,4,5)P₃ was seen in flexor digitorum brevis fibers stimulated with 270 pulses at 20 Hz, but not at 90 Hz. 20 Hz stimulation induced transcriptional changes related to fast-to-slow muscle fiber phenotype transition that required ATP release. Addition of 30 µM ATP to fibers induced the same transcriptional changes observed after 20 Hz stimulation. Myotubes lacking the Cav1.1-α1 subunit released almost no ATP after electrical stimulation, showing that Cav1.1 has a central role in this process. In adult muscle fibers, ATP release and the transcriptional changes produced by 20 Hz stimulation were blocked by both the Cav1.1 antagonist nifedipine (25 µM) and by the Cav1.1 agonist (-)S-BayK 8644 (10 µM). We propose a new role for Cav1.1, independent of its calcium channel activity, in the activation of signaling pathways allowing muscle fibers to decipher the frequency of electrical stimulation and to activate specific transcriptional programs that define their phenotype. PMID:23321639

  6. Epidemiology of Restricting Fatigue in Older Adults: The Precipitating Events Project

    PubMed Central

    de Rekeneire, Nathalie; Leo-Summers, Linda; Han, Ling; Gill, Thomas M.

    2014-01-01

    OBJECTIVES To estimate the rate of restricting fatigue among community-living older adults and to determine whether the rates differ according to age, sex, race, physical frailty and depression. DESIGN Prospective cohort study. SETTING Greater New Haven, Connecticut. PARTICIPANTS 754 nondisabled community-living older men and women aged ≥70. MEASUREMENTS Restricting fatigue was defined as staying in bed for at least ½ the day and/or cutting down on one’s usual activities because of fatigue for ≥3 consecutive months. Physical frailty was defined on the basis of slow gait speed, and depression was assessed using the CES-D. RESULTS During a median follow-up of 111 months, the cumulative incidence of restricting fatigue was 31.1% for men and 42.1% for women. The overall incidence rate of restricting fatigue was 6.7 per 1000 person-months - 7.8 for women and 4.4 for men (p< .001), but did not differ by race. Rates were higher in persons who were physically frail than those who were not frail (p< .001), in those who were depressed than those who were not depressed (p<.001), and in persons aged 75–79 and 80–84, respectively, than those 70–74 (both p< .01), but not in those aged ≥ 85. Of the 459 episodes of restricting fatigue, the median duration was 3 months and did not differ according to age, sex, race, physical frailty or depression. CONCLUSION Restricting fatigue is common among community-living older adults. Women, those aged 75–84, and those with physical frailty or depression had higher rates of restricting fatigue than their respective counterparts. PMID:24512073

  7. Imagery Rescripting of Early Traumatic Memories in Social Phobia

    ERIC Educational Resources Information Center

    Wild, Jennifer; Clark, David M.

    2011-01-01

    Negative self-images appear to play a role in the maintenance of social phobia and research suggests they are often linked to earlier memories of socially traumatic events. Imagery rescripting is a clinical intervention that aims to update such unpleasant or traumatic memories, and is increasingly being incorporated in cognitive behavioral therapy…

  8. Prevalence of Secondary Traumatic Stress among Social Workers

    ERIC Educational Resources Information Center

    Bride, Brian E.

    2007-01-01

    Social workers are increasingly being called on to assist survivors of childhood abuse, domestic violence, violent crime, disasters, and war and terrorism. It has become increasingly apparent that the psychological effects of traumatic events extend beyond those directly affected. Secondary traumatic stress (STS) is becoming viewed as an…

  9. A Prospective Study of Stressful Events, Coping Motives for Drinking, and Alcohol Use Among Middle-Aged Adults

    PubMed Central

    Windle, Michael; Windle, Rebecca C.

    2015-01-01

    Objective: This prospective study investigated moderator variable models of the interrelationships among stressful events, coping motives for drinking, and current alcohol use on subsequent alcohol use across a 5-year window with middle-aged adults. Method: Data from women (n = 716; Mage = 55.29 years at baseline) and men (n = 505; Mage = 57.57 years at baseline) were used to examine theory-guided hypotheses that current levels of alcohol use would interact with stressful events and coping motives for drinking to predict higher levels of alcohol use across time. Analyses were conducted separately for men and women. Results: After we controlled for several potentially important covariates (i.e., age, educational level, family income, and marital status), prospective regression analyses supported moderator effects for current alcohol use and stressful events as predictors of changes in alcohol use, and a somewhat weaker consistency of moderator effects for current alcohol use and coping motives for drinking as predictors of changes in alcohol use. For example, higher levels of baseline alcohol involvement in conjunction with higher levels of stress predicted higher levels of alcohol use and alcohol problems 5 years later. Similarly, higher levels of coping motives and higher levels of heavy episodic drinking predicted higher levels of heavy episodic drinking among women 5 years later. Conclusions: The findings were discussed from an alcohol–stress vulnerability model of affect regulation and a positive regulatory feedback loop perspective wherein conditional relationships among baseline alcohol use indicators, stressful events, and coping drinking motives predicted greater alcohol involvement, especially problematic use, across time. PMID:25978834

  10. Narrative Language in Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Marini, Andrea; Galetto, Valentina; Zampieri, Elisa; Vorano, Lorenza; Zettin, Marina; Carlomagno, Sergio

    2011-01-01

    Persons with traumatic brain injury (TBI) often show impaired linguistic and/or narrative abilities. The present study aimed to document the features of narrative discourse impairment in a group of adults with TBI. 14 severe TBI non-aphasic speakers (GCS less than 8) in the phase of neurological stability and 14 neurologically intact participants…

  11. Incidence and predictors of adverse drug events in an African cohort of HIV-infected adults treated with efavirenz

    PubMed Central

    Abah, Isaac Okoh; Akanbi, Maxwell; Abah, Mercy Enuwa; Finangwai, Amos Istifanus; Dady, Christy W; Falang, Kakjing Dadul; Ebonyi, Augustine Odoh; Okopi, Joseph Anejo; Agbaji, Oche Ochai; Sagay, Altiene Solomon; Okonkwo, Prosper; Idoko, John A; Kanki, Phyllis J

    2015-01-01

    Introduction Adverse drug reactions associated with efavirenz (EFV) therapy are poorly described beyond the first year of treatment. We aimed to describe the incidence and predictors of EFV-related adverse drug reactions (ADRs) in a cohort of adult Nigerian HIV-infected patients on antiretroviral therapy (ART). Methods This retrospective cohort study utilized clinical data of HIV-1 infected adults (aged ≥15 years), commenced on efavirenz containing-regimen between January 2004 and December 2011. The time-dependent occurrence of clinical adverse events as defined by the World Health Organization was analyzed by Cox regression analysis. Results A total of 2920 patients with baseline median (IQR) age of 39 (33-46) years, largely made up of men (78%) were included in the study. During 8834 person-years of follow up, 358 adverse drug events were reported; the incidence rate was 40.3 ADRs per 1000 person-years of treatment. Lipodystrophy and neuropsychiatric disorders were the most common ADRs with incidences of 63 and 30 per 1000 patients respectively. About one-third of the neuropsychiatric adverse events were within 12 months of commencement of ART. The risk of neuropsychiatric ADRs was independently predicted for women [adjusted hazard ratio (aHR) 9.05; 95% CI: 5.18-15.82], those aged <40 years (aHR 2.59; 95% CI: 1.50-4.45), advanced HIV disease (WHO stage 3 or 4) [aHR 2.26; 95% CI: 1.37-3.72], and zidovudine [aHR 2.21; 95% CI: 1.27-3.83] or stavudine [aHR 4.22; 95% CI: 1.99-8.92] containing regimen compared to tenofovir. Conclusion Neuropsychiatric adverse drug events associated with efavirenz-based ART had both early and late onset in our clinical cohort of patients on chronic EFV therapy. Continuous neuropsychiatric assessment for improved detection and management of neuropsychiatric ADRs is recommended in resource-limited settings where the use of efavirenz-based regimens has been scaled up. PMID:26405676

  12. Young Adults' Fertility Expectations and Events: Associations With College Enrollment and Persistence.

    PubMed

    Raley, R Kelly; Kim, Yujin; Daniels, Kimberly

    2012-08-01

    The analyses described in this article investigated the association between adolescent fertility expectations and college enrollment (N = 7,838). They also explored the potential impact of fertility expectations and events on college persistence among 4-year (n = 2,605) and 2-year (n = 1,962) college students. The analysis, which used data from the National Longitudinal Survey of Youth 1997 cohort, showed a significant association between expectations for early parenthood and the likelihood of going to a 4-year college or 2-year college for both men and women. In addition, the authors found that pregnancies were associated with an increased risk of college dropout for women; however, if all of the estimated effect of pregnancies on the risk of dropout were causal, they would still not be a major factor contributing to educational attainment because fertile pregnancies among college women are so rare. PMID:23729862

  13. Differences and similarities in event recall and suggestibility between children and adults in Germany and the United States.

    PubMed

    Roebers, Claudia M; Bjorklund, David F; Schneider, Wolfgang; Cassel, William S

    2002-01-01

    Children (5-6 year olds, 7-8 year olds, 9-10 year olds) and adults from Germany and the United States were shown a brief video of a theft. One week later, participants were asked to give a free narrative of an observed event (free recall), followed either by sets of misleading or unbiased questions, and finally they were given a three-choice recognition question for each queried item. German participants of all ages had higher levels of correct free recall than did American participants. American adults and 9-10 year olds gave more correct responses to the open-ended unbiased questions than did their German counterparts. Germans of all ages made more correct responses to the misleading questions, whereas national differences, favoring the Germans, for incorrect response to misleading questions were restricted to the 5-6 year olds. National differences were interpreted as reflecting possible differences in strategic abilities, exposure to formal instruction, and the degree to which children experience self-directed, autonomous learning opportunities. PMID:12053531

  14. Ipsilateral Traumatic Posterior Hip Dislocation, Posterior Wall and Transverse Acetabular Fracture with Trochanteric Fracture in an adult: Report of First Case

    PubMed Central

    Sinha, Skand; Naik, Ananta k; Arya, Rajendra K; Jain, Vijay K

    2013-01-01

    Introduction: Posterior dislocation of the hip joint with associated acetabular and intertrochanteric fracture is a complex injury. Early recognition, prompt and stable reduction is needed of successful outcome. Case Report: 45 year old male patient presented with posterior dislocation of the hip with transverse fracture with posterior wall fracture of acetabulam and intertrochanteric fracture on the ipsilateral side. The complex fracture geometry was confirmed by CT scan. The patient was successfully managed by open reduction and internal fixation of intertrochanteric fracture was achieved with dynamic hip screw (DHS) plate fixation followed by fixation of acetabular fracture with reconstruction plate. Conclusion: Hip dislocation combined with acetabular fracture is an uncommon injury; this article presents a unique case of posterior wall and transverse fractures of ipsilateral acetabulum with intertrochanteric fracture in a patient who sustained traumatic posterior hip dislocation. Early surgical intervention is important for satisfactory outcomes of such complex fracture-dislocation injuries. PMID:27298928

  15. Does recall of a past music event invoke a reminiscence bump in young adults?

    PubMed

    Schubert, Emery

    2016-08-01

    Many studies of the reminiscence bump (RB) in music invoke memories from different autobiographical times by using stimulus specific prompts (SSPs). This study investigated the utility of a non-SSP paradigm to determine whether the RB would emerge when participants were asked to recall a single memorable musical event from "a time long ago". The presence of a RB in response to music has not been obtained in such a manner for younger participants. Eighty-eight 20-22 year olds reported music episodes that peaked when their autobiographical age was 13-14 years. Self-selected stimuli included a range of musical styles, including classical and non-Western pop forms, such as J-pop and K-pop, as well as generational pop music, such as the Beatles. However, most participants reported pop/rock music that was contemporaneous with encoding age, providing support for the utility of published SSP paradigms using pop music. Implications for and limitations of SSP paradigms are discussed. Participants were also asked to relate the selected musical piece to current musical tastes. Most participants liked the music that they selected, with many continuing to like the music, but most also reported a general broadening of their taste, consistent with developmental literature on open-earedness. PMID:26275069

  16. Prevalence of secondary traumatic stress among social workers.

    PubMed

    Bride, Brian E

    2007-01-01

    Social workers are increasingly being called on to assist survivors of childhood abuse, domestic violence, violent crime, disasters, and war and terrorism. It has become increasingly apparent that the psychological effects of traumatic events extend beyond those directly affected. Secondary traumatic stress (STS) is becoming viewed as an occupational hazard of providing direct services to traumatized populations. The purpose of the present study was to investigate the prevalence of STS in a sample of social workers by examining the frequency of individual symptoms; the frequency with which diagnostic criteria for posttraumatic stress disorder (PTSD) are met; and the severity of STS levels. Results indicate that social workers engaged in direct practice are highly likely to be secondarily exposed to traumatic events through their work with traumatized populations, many social workers are likely to experience at least some symptoms of STS, and a significant minority may meet the diagnostic criteria for PTSD. PMID:17388084

  17. Understanding Traumatic Stress in Children

    MedlinePlus

    ... American Institutes for Research About Us Our Topics Client Services News & Events You are here Home 22 Apr ... and Wellness Adult Learning and the Workforce International Client Services Student Assessment Research and Evaluation Policy, Practice, and ...

  18. Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG): toward integrated treatment of symptoms related to traumatic loss

    PubMed Central

    Smid, Geert E.; Kleber, Rolf J.; de la Rie, Simone M.; Bos, Jannetta B. A.; Gersons, Berthold P. R.; Boelen, Paul A.

    2015-01-01

    Background Traumatic events such as disasters, accidents, war, or criminal violence are often accompanied by the loss of loved ones, and may then give rise to traumatic grief. Traumatic grief refers to a clinical diagnosis of persistent complex bereavement disorder (PCBD) with comorbid (symptoms of) posttraumatic stress disorder (PTSD) and/or major depressive disorder (MDD) following confrontation with a traumatic loss. Trauma survivors, who are frequently from different cultural backgrounds, have often experienced multiple losses and ambiguous loss (missing family members or friends). Current evidence-based treatments for PTSD do not focus on traumatic grief. Objective To develop a treatment for traumatic grief combining treatment interventions for PTSD and PCBD that may accommodate cultural aspects of grief. Method To provide a rationale for treatment, we propose a cognitive stress model of traumatic grief. Based on this model and on existing evidence-based treatments for PTSD and complicated grief, we developed Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) for the treatment of patients with traumatic grief. The treatment is presented along with a case vignette. Results Processes contributing to traumatic grief include inadequately integrating the memory of the traumatic loss, negative appraisal of the traumatic loss, sensitivity to matching triggers and new stressors, and attempting to avoid distress. BEP-TG targets these processes. The BEP-TG protocol consists of five parts with proven effectiveness in the treatment of PCBD, PTSD, and MDD: information and motivation, grief-focused exposure, memorabilia and writing assignments, finding meaning and activation, and a farewell ritual. Conclusion Tailored to fit the needs of trauma survivors, BEP-TG can be used to address traumatic grief symptoms related to multiple losses and ambiguous loss, as well as cultural aspects of bereavement through its different components. PMID:26154434

  19. Proximal coracobrachialis tendon rupture, subscapularis tendon rupture, and medial dislocation of the long head of the biceps tendon in an adult after traumatic anterior shoulder dislocation.

    PubMed

    Saltzman, Bryan M; Harris, Joshua D; Forsythe, Brian

    2015-01-01

    Rupture of the coracobrachialis is a rare entity, in isolation or in combination with other muscular or tendinous structures. When described, it is often a result of direct trauma to the anatomic area resulting in rupture of the muscle belly. The authors present a case of a 57-year-old female who suffered a proximal coracobrachialis tendon rupture from its origin at the coracoid process, with concomitant subscapularis tear and medial dislocation of the long head of biceps tendon after first time traumatic anterior shoulder dislocation. Two weeks after injury, magnetic resonance imaging suggested the diagnosis, which was confirmed during combined arthroscopic and open technique. Soft-tissue tenodesis of coracobrachialis to the intact short head of the biceps, tenodesis of the long head of biceps to the intertubercular groove, and double-row anatomic repair of the subscapularis were performed. The patient did well postoperatively, and ultimately at 6 months follow-up, she was without pain, and obtained 160° of active forward elevation, 45° of external rotation, internal rotation to T8, 5/5 subscapularis and biceps strength. Scoring scales had improved from the following preoperative to final follow-up: American Shoulder and Elbow Surgeons, 53.33-98.33; constant, 10-100; visual analogue scale-pain, 4-0. DASH score was 5. PMID:25937715

  20. Proximal coracobrachialis tendon rupture, subscapularis tendon rupture, and medial dislocation of the long head of the biceps tendon in an adult after traumatic anterior shoulder dislocation

    PubMed Central

    Saltzman, Bryan M.; Harris, Joshua D.; Forsythe, Brian

    2015-01-01

    Rupture of the coracobrachialis is a rare entity, in isolation or in combination with other muscular or tendinous structures. When described, it is often a result of direct trauma to the anatomic area resulting in rupture of the muscle belly. The authors present a case of a 57-year-old female who suffered a proximal coracobrachialis tendon rupture from its origin at the coracoid process, with concomitant subscapularis tear and medial dislocation of the long head of biceps tendon after first time traumatic anterior shoulder dislocation. Two weeks after injury, magnetic resonance imaging suggested the diagnosis, which was confirmed during combined arthroscopic and open technique. Soft-tissue tenodesis of coracobrachialis to the intact short head of the biceps, tenodesis of the long head of biceps to the intertubercular groove, and double-row anatomic repair of the subscapularis were performed. The patient did well postoperatively, and ultimately at 6 months follow-up, she was without pain, and obtained 160° of active forward elevation, 45° of external rotation, internal rotation to T8, 5/5 subscapularis and biceps strength. Scoring scales had improved from the following preoperative to final follow-up: American Shoulder and Elbow Surgeons, 53.33-98.33; constant, 10-100; visual analogue scale-pain, 4-0. DASH score was 5. PMID:25937715

  1. Fluency affects source memory for familiar names in younger and older adults: evidence from event-related brain potentials.

    PubMed

    Komes, Jessica; Schweinberger, Stefan R; Wiese, Holger

    2014-05-15

    A current debate in memory research is whether and how the access to source information depends not only on recollection, but on fluency-based processes as well. In three experiments, we used event-related brain potentials (ERPs) to examine influences of fluency on source memory for famous names. At test, names were presented visually throughout, whereas visual or auditory presentation was used at learning. In Experiment 1, source decisions following old/new judgments were more accurate for repeated relative to non-repeated visually and auditorily learned names. ERPs were more positive between 300 and 600 ms for visually learned as compared to both auditorily learned and new names, resembling an N400 priming effect. In Experiment 2, we omitted the old/new decision to more directly test fast-acting fluency effects on source memory. We observed more accurate source judgments for repeated versus non-repeated visually learned names, but no such effect for repeated versus non-repeated auditorily learned names. Again, an N400 effect (300-600 ms) differentiated between visually and auditorily learned names. Importantly, this effect occurred for correct source decisions only. We interpret it as indexing fluency arising from within-modality priming of visually learned names at test. This idea was further supported in Experiment 3, which revealed an analogous pattern of results in older adults, consistent with the assumption of spared fluency processes in older age. In sum, our findings suggest that fluency affects person-related source memory via within-modality repetition priming in both younger and older adults. PMID:24531047

  2. Prevalence, nature and potential preventability of adverse drug events – a population-based medical record study of 4970 adults

    PubMed Central

    Hakkarainen, Katja M; Gyllensten, Hanna; Jönsson, Anna K; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan

    2014-01-01

    Aims To estimate the 3 month prevalence of adverse drug events (ADEs), categories of ADEs and preventable ADEs, and the preventability of ADEs among adults in Sweden. Further, to identify drug classes and organ systems associated with ADEs and estimate their seriousness. Methods A random sample of 5025 adults in a Swedish county council in 2008 was drawn from the Total Population Register. All their medical records in 29 inpatient care departments in three hospitals, 110 specialized outpatient clinics and 51 primary care units were reviewed retrospectively in a stepwise manner, and complemented with register data on dispensed drugs. ADEs, including adverse drug reactions (ADRs), sub-therapeutic effects of drug therapy (STEs), drug dependence and abuse, drug intoxications from overdose, and morbidities due to drug-related untreated indication, were detected during a 3 month study period, and assessed for preventability. Results Among 4970 included individuals, the prevalence of ADEs was 12.0% (95% confidence interval (CI) 11.1, 12.9%), and preventable ADEs 5.6% (95% CI 5.0, 6.2%). ADRs (6.9%; 95% CI 6.2, 7.6%) and STEs (6.4%; 95% CI 5.8, 7.1%) were more prevalent than the other ADEs. Of the ADEs, 38.8% (95% CI 35.8–41.9%) was preventable, varying by ADE category and seriousness. ADEs were frequently associated with nervous system and cardiovascular drugs, but the associated drugs and affected organs varied by ADE category. Conclusions The considerable burden of ADEs and preventable ADEs from commonly used drugs across care settings warrants large-scale efforts to redesign safer, higher quality healthcare systems. The heterogeneous nature of the ADE categories should be considered in research and clinical practice for preventing, detecting and mitigating ADEs. PMID:24372506

  3. Psychoanalytic perspectives on early trauma: interviews with thirty analysts who treated an adult victim of a circumscribed trauma in early childhood.

    PubMed

    Gaensbauer, Theodore J; Jordan, Leslie

    2009-08-01

    Information on the long-term effects of early trauma and how such effects are manifested in treatment was obtained through interviews with thirty analysts who had treated an adult patient with a circumscribed trauma in the first four years of life. Childhood traumas fell into four categories: medical/accidental; separation/loss; witnessing a traumatic event; and physical/sexual abuse. Traumatic carryover was recorded in terms of explicit memories, implicit memories (somatic reliving, traumatic dreams, affective memories, behavioral reenactments, and transference phenomena), and global carryover effects (generalized traumatic affective states, defensive styles, patterns of object relating, and developmental disruptions). Linkages between the early trauma and adult symptomatology could be posited in almost every case, yet the clinical data supporting such linkages was often fragmented and ambiguous. Elements of patients' traumas appeared to be dispersed along variable avenues of expression and did not appear amenable to holistic, regressive reworking in treatment. The data did not support linear models of traumatic carryover or the idea that early traumatic experiences will be directly accessible in the course of an analysis. Factors that we believe help explain why traumatic aftereffects in our sample were so heterogeneous and difficult to track over the long term are discussed. PMID:19625455

  4. Prevalence and Perceived Preventability of Self-Reported Adverse Drug Events – A Population-Based Survey of 7099 Adults

    PubMed Central

    Hakkarainen, Katja Marja; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan

    2013-01-01

    Purpose Adverse drug events (ADEs) are common and often preventable among inpatients, but self-reported ADEs have not been investigated in a representative sample of the general public. The objectives of this study were to estimate the 1-month prevalence of self-reported ADEs among the adult general public, and the perceived preventability of 2 ADE categories: adverse drug reactions (ADRs) and sub-therapeutic effects (STEs). Methods In this cross-sectional study, a postal survey was sent in October 2010 to a random sample of 13 931 Swedish residents aged ≥18 years. Self-reported ADEs experienced during the past month included ADRs, STEs, drug dependence, drug intoxications and morbidity due to drug-related untreated indication. ADEs could be associated with prescription, non-prescription or herbal drugs. The respondents estimated whether ADRs and STEs could have been prevented. ADE prevalences in age groups (18–44, 45–64, or ≥65 years) were compared. Results Of 7099 respondents (response rate 51.0%), ADEs were reported by 19.4% (95% confidence interval, 18.5–20.3%), and the prevalence did not differ by age group (p>0.05). The prevalences of self-reported ADRs, STEs, and morbidities due to drug-related untreated indications were 7.8% (7.2–8.4%), 7.6% (7.0–8.2%) and 8.1% (7.5–8.7%), respectively. The prevalence of self-reported drug dependence was 2.2% (1.9–2.6%), and drug intoxications 0.2% (0.1–0.3%). The respondents considered 19.2% (14.8–23.6%) of ADRs and STEs preventable. Although reported drugs varied between ADE categories, most ADEs were attributable to commonly dispensed drugs. Drugs reported for all and preventable events were similar. Conclusions One-fifth of the adult general public across age groups reported ADEs during the past month, indicating a need for prevention strategies beyond hospitalised patients. For this, the underlying causes of ADEs should increasingly be investigated. The high burden of ADEs and preventable ADEs

  5. Suicidal behavior in adolescents with post-traumatic stress disorder.

    PubMed

    Ganz, D; Sher, L

    2010-08-01

    Recently, the prevalence of post-traumatic stress disorder (PTSD) in adolescence is higher than the prevalence of PTSD in adult populations. PTSD and suicidality are often found in populations of adolescents presenting with other emotional disorders (particularly mood disorders), traumatic grief, childhood abuse, and/or a family or peer history of suicide. The reasons and developments of the association between PTSD and suicidality in adolescence, however, remain unclear. Core psychobiological changes contributing to PTSD affect emotion, arousal, perception of the self and the world, irritability, impulsivity, anger, aggression and depression. There is evidence that the aforementioned factors, as well as alcohol and other drug use may act to moderate the influence of stressful life events and lead to eventual suicidality. Both PTSD and suicidality in adolescents have also been hypothesized to be a result of exposure to violence and negative coping styles. There are many treatment challenges for these populations, yet the most promising prevention and treatments include suicide risk screenings, suicide education, Dialectical Behavioral Therapy, addressing associated coping mechanisms and prescribing anti-depressant and anti-anxiety medications. However, when prescribing medications, physicians do need to be careful to consider the weaknesses and strengths of each of the pharmacological options as they apply to adolescents presenting with PTSD and suicidality. PMID:20940670

  6. Hypothalamic-Pituitary Autoimmunity and Traumatic Brain Injury

    PubMed Central

    Guaraldi, Federica; Grottoli, Silvia; Arvat, Emanuela; Ghigo, Ezio

    2015-01-01

    Background: Traumatic brain injury (TBI) is a leading cause of secondary hypopituitarism in children and adults, and is responsible for impaired quality of life, disabilities and compromised development. Alterations of pituitary function can occur at any time after the traumatic event, presenting in various ways and evolving during time, so they require appropriate screening for early detection and treatment. Although the exact pathophysiology is unknown, several mechanisms have been hypothesized, including hypothalamic-pituitary autoimmunity (HP-A). The aim of this study was to systematically review literature on the association between HP-A and TBI-induced hypopituitarism. Major pitfalls related to the HP-A investigation were also discussed. Methods: The PubMed database was searched with a string developed for this purpose, without temporal or language limits, for original articles assessing the association of HP-A and TBI-induced hypopituitarism. Results: Three articles from the same group met the inclusion criteria. Anti-pituitary and anti-hypothalamic antibodies were detected using indirect immunofluorescence in a significant number of patients with acute and chronic TBI. Elevated antibody titer was associated with an increased risk of persistent hypopituitarism, especially somatotroph and gonadotroph deficiency, while no correlations were found with clinical parameters. Conclusion: HPA seems to contribute to TBI-induced pituitary damage, although major methodological issues need to be overcome and larger studies are warranted to confirm these preliminary data. PMID:26239463

  7. Clinical and Socio-Demographic Characteristics of College Students Exposed to Traumatic Experiences: A Census of Seven College Institutions in Northeastern Brazil

    PubMed Central

    Netto, Liana R.; Cavalcanti-Ribeiro, Patrícia; Pereira, Juliana L.; Nogueira, José F.; Santos, Lene L.; Lira, Sidnei B.; Guedes, Gisela M.; Teles, Carlos A.; UFBA, The Trauma, Anxiety Disorders Study Group (TADSG) -.; Koenen, Karestan C.; Quarantini, Lucas C.

    2013-01-01

    Background Epidemiological studies show that most of the adult population will be exposed to at least one potentially traumatic event in the course of his/her life; adolescence and early adulthood are the most vulnerable periods of life for exposure to traumatic experiences (70% of their deaths are due to external causes). Posttraumatic Stress Disorder is characterized by the development of dysfunctional symptoms that cause distress or social, academic, or occupational impairment, as result of exposure to a traumatic event. The aim of this multicentric study is to establish the proportion of college students, within seven institutions in Northeastern Brazil, who were exposed to traumatic experience and met PTSD criteria. Methods/Design A one-phase census protocol of seven college institutions in three metropolitan regions in Northeastern Brazil was performed (April to July 2011). All students aged 18 years or older, matriculated and attending their first or final semester were eligible. The self-applied protocol consisted of a socio-demographic questionnaire and the following scales adjusted to Brazilian Portuguese standards Trauma History Questionnaire (THQ), PTSD Checklist-Civilian (PCL-C), Impulsivity Scale (BIS-11). Data were entered into SPSS 17.0. Results 2213 (85.5%) students consented to participate, and completely filled in the protocols. Of these, 66.1% were woman, mean age 23.9 (SD 6.3), 82.7% were single, and 57.3% attended university outside their native cities. The total PTSD prevalence was 14%, and the median for frequency of trauma exposure was 5 events. Conclusion A high frequency of exposure to violence, as well as a high rate of PTSD, suicide attempts, and high-risk sexual behavior was found in Brazilian college students. This highlights the importance of effective public health actions in relation to the prevention and treatment of PTSD and other dysfunctional behaviors resulting from traumatic exposure in young individuals, usually an at risk

  8. Age, Cumulative Trauma and Stressful Life Events, and Post-Traumatic Stress Symptoms among Older Adults in Prison: Do Subjective Impressions Matter?

    ERIC Educational Resources Information Center

    Maschi, Tina; Morgen, Keith; Zgoba, Kristen; Courtney, Deborah; Ristow, Jennifer

    2011-01-01

    Background: The aging prison population in the United States presents a significant public health challenge with high rates of trauma and mental health issues that the correctional system alone is ill-prepared to address. The purpose of this study was to examine the relationship of age, objective, and subjective measures of trauma and stressful…

  9. Cardiorespiratory Fitness Is Associated with Executive Control in Late-Middle-Aged Adults: An Event-Related (De) Synchronization (ERD/ERS) Study

    PubMed Central

    Chu, Chien-Heng; Yang, Kao-Teng; Song, Tai-Fen; Liu, Jen-Hao; Hung, Tsung-Min; Chang, Yu-Kai

    2016-01-01

    The present study sought to determine whether cardiorespiratory fitness is associated with cognitive function in late-middle-aged adults from event-related desynchronization (ERD) and event-related synchronization (ERS) perspectives. Late-middle-aged adults were categorized into either the high-fitness group or the low-fitness group based on their estimated cardiorespiratory fitness values. The participants completed the Stroop Test, which is comprised of incongruent and neutral conditions, while the brain activities were recoded. The alpha ERD and ERS values based on the equation proposed by Pfurtscheller (1977) were further calculated. The results revealed that the adults with higher levels of cardiorespiratory fitness demonstrated superior Stroop performance, regardless of Stroop congruency. While these high-fitness adults had less positive upper alpha ERD values in the later epoch window compared to their lower-fitness counterparts, they had greater lower alpha ERD values in the early epoch window. Additionally, in the late epoch window, the high-fitness adults showed less positive lower alpha ERD values on neutral, but not incongruent condition, relative to their low-fitness counterparts. These findings suggest that cardiorespiratory fitness of the late-middle-aged adults is positively associated with cognitive functioning, especially the cognitive processes related to the inhibition of task-irrelevant information and those processes required the devotion of greater amounts of attentional resources to a given task. PMID:27536259

  10. Childhood Physical and Sexual Abuse in Caribbean Young Adults and Its Association with Depression, Post-Traumatic Stress, and Skin Bleaching

    PubMed Central

    James, Caryl; Seixas, Azizi A; Harrison, Abigail; Jean-Louis, Girardin; Butler, Mark; Zizi, Ferdinand; Samuels, Alafia

    2016-01-01

    Background The global prevalence of skin depigmentation/skin bleaching among blacks, estimated at 35%, is on the rise and is associated with a host of negative health and medical consequences. Current etiological approaches do not fully capture the emotional and psychological underpinnings of skin bleaching. The current study investigated the potential mediating role of depression, or post-traumatic stress symptoms (avoidance and hyperarousal) on the relationship between childhood physical and sexual abuse (CPSA) and skin bleaching. Methods A total of 1226 university participants (ages 18–30 years and 63.4% female) from three Caribbean countries (Jamaica, Barbados, and Grenada) provided data for the current analysis. They all completed self-reported measures of general demographic information along with the short screening scale for posttraumatic stress disorder (DSM-IV), childhood trauma, and skin bleaching questions. Results The prevalence of skin bleaching in our study was 25.4%. Our findings showed that individuals who bleached their skin were more likely to have been abused as children (21.6% versus 13.5%, p<0.001), were more likely to have significant symptoms of trauma (34.1% versus 24.0%, p=0.005), and were more likely to have significant depression (43.7% versus 35.1%, p=0.032). We found that trauma-related hyperarousal symptoms positively mediated the relationship between childhood physical and sexual abuse and skin bleaching (Indirect Effect=0.03, p<0.05), while avoidance (Indirect Effect=0.000, p>0.05) and depressive (Indirect Effect=0.005, p>0.05) symptoms did not. Conclusion The presence of trauma symptoms and childhood physical and sexual abuse (CPSA) may increase the likelihood of skin bleaching. Findings suggest that further exploration is needed to ascertain if the presence of skin bleaching warrants being also screened for trauma. PMID:27019771

  11. Aqueous Date Fruit Efficiency as Preventing Traumatic Brain Deterioration and Improving Pathological Parameters after Traumatic Brain Injury in Male Rats

    PubMed Central

    Badeli, Hamze; Shahrokhi, Nader; KhoshNazar, Mahdieosadat; Asadi-Shekaari, Majid; Shabani, Mohammad; Eftekhar Vaghefi, Hassan; Khaksari, Mohammad; Basiri, Mohsen

    2016-01-01

    Objective Following traumatic brain injury, disruption of blood-brain-barrier and consequent brain edema are critical events which might lead to increasing intracranial pressure (ICP), and nerve damage. The current study assessed the effects of aqueous date fruit extract (ADFE) on the aforementioned parameters. Materials and Methods In this experimental study, diffused traumatic brain injury (TBI) was generated in adult male rats using Marmarou’s method. Experimental groups include two pre-treatment (oral ADFE, 4 and 8 mL/kg for 14 days), vehicle (distilled water, for 14 days) and sham groups. Brain edema and neuronal injury were measured 72 hours after TBI. Veterinary coma scale (VCS) and ICP were determined at -1, 4, 24, 48 and 72 hours after TBI. Differences among multiple groups were assessed using ANOVA. Turkey’s test was employed for the ANOVA post-hoc analysis. The criterion of statistical significance was sign at P<0.05. Results Brain water content in ADFE-treated groups was decreased in comparison with the TBI+vehicle group. VCS at 24, 48 and 72 hours after TBI showed a significant increase in ADFE groups in comparison with the TBI+vehicle group. ICP at 24, 48 and 72 hours after TBI, was decreased in ADFE groups, compared to the TBI+vehicle. Brain edema, ICP and neuronal injury were also decreased in ADFE group, but VCS was increased following on TBI. Conclusion ADFE pre-treatment demonstrated an efficient method for preventing traumatic brain deterioration and improving pathological parameters after TBI. PMID:27602324

  12. Life-long music practice and executive control in older adults: An event-related potential study.

    PubMed

    Moussard, Aline; Bermudez, Patrick; Alain, Claude; Tays, William; Moreno, Sylvain

    2016-07-01

    Recent research has indicated that music practice can influence cognitive processing across the lifespan. Although extensive musical experience may have a mitigating effect on cognitive decline in older adults, the nature of changes to brain functions underlying performance benefits remains underexplored. The present study was designed to investigate the underlying neural mechanisms that may support apparent beneficial effects of life-long musical practice on cognition. We recorded event-related potentials (ERPs) in older musicians (N=17; average age=69.2) and non-musicians (N=17; average age=69.9), matched for age and education, while they completed an executive control task (visual go/no-go). Whereas both groups showed similar response speed and accuracy on go trials, older musicians showed fewer no-go errors. ERP recordings revealed the typical N2/P3 complex, but the nature of these responses differed between groups in that (1) older musicians showed larger N2 and P3 effects ('no-go minus go' amplitude), with the N2 amplitude being correlated with behavioral accuracy for no-go trials and (2) the topography of the P3 response was more anterior in musicians. Moreover, P3 amplitude was correlated with measures of musical experience in musicians. In our discussion of these results, we propose that music practice may have conferred an executive control advantage for musicians in later life. PMID:27021953

  13. Management of Major Traumatic Upper Extremity Amputations.

    PubMed

    Solarz, Mark K; Thoder, Joseph J; Rehman, Saqib

    2016-01-01

    Traumatic upper extremity amputation is a life-altering event, and recovery of function depends on proper surgical management and postoperative rehabilitation. Many injuries require revision amputation and postoperative prosthesis fitting. Care should be taken to preserve maximal length of the limb and motion of the remaining joints. Skin grafting or free tissue transfer may be necessary for coverage to allow preservation of length. Early prosthetic fitting within 30 days of surgery should be performed so the amputee can start rehabilitation while the wound is healing and the stump is maturing. Multidisciplinary care is essential for the overall care of the patient following a traumatic amputation of the upper limb. PMID:26614927

  14. Appraisals of discriminatory events among adult offspring of Indian residential school survivors: the influences of identity centrality and past perceptions of discrimination.

    PubMed

    Bombay, Amy; Matheson, Kimberly; Anisman, Hymie

    2014-01-01

    As part of a government policy of assimilation beginning in the mid-1800s, a large proportion of Aboriginal children in Canada were forcibly removed from their homes to attend Indian Residential Schools (IRSs), a practice which continued into the 1990s. This traumatic experience had lasting negative effects not only on those who attended but also on their offspring, who were previously found to report higher levels of perceived discrimination and depressive symptoms compared with Aboriginal adults whose families were not directly affected by IRSs. In attempt to elucidate the processes involved in these previous findings, the current study (N = 399) revealed that greater levels of past perceptions of discrimination among IRS offspring, together with their greater likelihood of considering their Aboriginal heritage to be a central component of their self-concept (i.e., high identity centrality), were associated with an increased likelihood of appraising subsequent negative intergroup scenarios to be a result of discrimination and as threatening to their well-being. In turn, these altered appraisals of threat in response to the scenarios were associated with higher levels of depressive symptoms relative to non-IRS adults. The apparent reinforcing relationships between past discrimination, identity centrality, and appraisals of discrimination and threat in intergroup interactions highlight the need for interventions targeting this cycle that appears to contribute to heightened psychological distress among offspring of those who were directly victimized by collective race-based traumas. PMID:23834257

  15. Attenuated traumatic axonal injury and improved functional outcome after traumatic brain injury in mice lacking Sarm1.

    PubMed

    Henninger, Nils; Bouley, James; Sikoglu, Elif M; An, Jiyan; Moore, Constance M; King, Jean A; Bowser, Robert; Freeman, Marc R; Brown, Robert H

    2016-04-01

    Axonal degeneration is a critical, early event in many acute and chronic neurological disorders. It has been consistently observed after traumatic brain injury, but whether axon degeneration is a driver of traumatic brain injury remains unclear. Molecular pathways underlying the pathology of traumatic brain injury have not been defined, and there is no efficacious treatment for traumatic brain injury. Here we show that mice lacking the mouse Toll receptor adaptorSarm1(sterile α/Armadillo/Toll-Interleukin receptor homology domain protein) gene, a key mediator of Wallerian degeneration, demonstrate multiple improved traumatic brain injury-associated phenotypes after injury in a closed-head mild traumatic brain injury model.Sarm1(-/-)mice developed fewer β-amyloid precursor protein aggregates in axons of the corpus callosum after traumatic brain injury as compared toSarm1(+/+)mice. Furthermore, mice lackingSarm1had reduced plasma concentrations of the phophorylated axonal neurofilament subunit H, indicating that axonal integrity is maintained after traumatic brain injury. Strikingly, whereas wild-type mice exibited a number of behavioural deficits after traumatic brain injury, we observed a strong, early preservation of neurological function inSarm1(-/-)animals. Finally, usingin vivoproton magnetic resonance spectroscopy we found tissue signatures consistent with substantially preserved neuronal energy metabolism inSarm1(-/-)mice compared to controls immediately following traumatic brain injury. Our results indicate that the SARM1-mediated prodegenerative pathway promotes pathogenesis in traumatic brain injury and suggest that anti-SARM1 therapeutics are a viable approach for preserving neurological function after traumatic brain injury. PMID:26912636

  16. FREQUENCY OF TRAUMA EXPOSURE AND POST-TRAUMATIC STRESS DISORDERS IN ITALY: ANALYSIS FROM THE WORLD MENTAL HEALTH SURVEY INITIATIVE

    PubMed Central

    Carmassi, Claudia; Dell’Osso, Liliana; Manni, Corrado; Candini, Valentina; Dagani, Jessica; Iozzino, Laura; Koenen, Karestan C.; de Girolamo, Giovanni

    2015-01-01

    Epidemiological studies have examined the relative importance of Traumatic Events (TEs) in accounting for the societal burden of post-traumatic stress disorder (PTSD). However, most studies used the worst trauma experienced, which can lead to an overestimation of the conditional risk of PTSD. Although a number of epidemiological surveys on PTSD have been carried out in the United States, only a few studies in limited sample have been conducted in Italy. This study, carried out in the framework of the World Mental Health Survey Initiative, is a cross-sectional household survey of a representative sample of the Italian adult population. Lifetime prevalence of traumatic events (TEs) and 12-month prevalence of PTSD were evaluated using the Composite International Diagnostic Interview (CIDI). Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Network events was the most commonly reported TE (29.4%). War events had the highest conditional risk of PTSD (12.2%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (24.1%) and having seen atrocities (18.2%). Being female was related to high risk of PTSD after experiencing a TE. Exposure to network events is commonly reported among Italian adults, but two TE are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden. PMID:25266475

  17. Self versus family ratings of the frontal systems behaviour scale and measured executive functions: adult outcomes following childhood traumatic brain injury.

    PubMed

    Barrett, Robert D; McLellan, Tracey L; McKinlay, Audrey

    2013-01-01

    Traumatic brain injury (TBI) frequently occurs during childhood and adolescence with long-term neuropsychological and behavioral effects. Greater personal awareness of injury is associated with better outcomes. However, personal awareness is often assessed using ratings obtained from family members or significant others. Surprisingly, the accuracy of family-ratings compared with self-ratings has not been well studied in the TBI population. Thus, the purpose of this study was to examine self versus family-ratings of frontal dysfunction and secondly, the association between self/family reported frontal dysfunction and measured executive function outcomes. A total of 60 participants, approximately 10 years post-TBI, comprised 3 groups including; moderate/severe TBI (N=26; mean age 22.9, SD=3.0), mild TBI (N=20; mean age, 21.7, SD=2.7), and control (N=14: mean age, 21.6, SD=3.7). Neuropsychological testing was used to obtain domain scores for executive function and working memory/attention for each participant, and nominated family members and participants with TBI were asked to complete the Frontal Systems Behaviour Scale (FrSBe), consisting of three sub-scales; apathy, disinhibition, and executive dysfunction. Using the FrSBe there was no significant difference between the groups in executive function score, but the moderate/severe and mild groups had significantly lower working memory/attention scores compared with the control group (p<0.05). Repeated measures analysis of variance showed higher self-ratings on all sub-scales compared with family in each group (p<0.05). Scores on executive function and working memory/attention domains correlated with self, but not family reported executive dysfunction. Self-rated executive dysfunction explained 36% of the variance in executive function (p<0.001). While agreement between self-rated and family-rated total FrSBe scores was significant in all groups (p<0.001), our results showed that self-ratings were of higher

  18. Self versus Family Ratings of the Frontal Systems Behaviour Scale and Measured Executive Functions: Adult Outcomes following Childhood Traumatic Brain Injury

    PubMed Central

    Barrett, Robert D.; McLellan, Tracey L.; McKinlay, Audrey

    2013-01-01

    Traumatic brain injury (TBI) frequently occurs during childhood and adolescence with long-term neuropsychological and behavioral effects. Greater personal awareness of injury is associated with better outcomes. However, personal awareness is often assessed using ratings obtained from family members or significant others. Surprisingly, the accuracy of family-ratings compared with self-ratings has not been well studied in the TBI population. Thus, the purpose of this study was to examine self versus family-ratings of frontal dysfunction and secondly, the association between self/family reported frontal dysfunction and measured executive function outcomes. A total of 60 participants, approximately 10 years post-TBI, comprised 3 groups including; moderate/severe TBI (N=26; mean age 22.9, SD=3.0), mild TBI (N=20; mean age, 21.7, SD=2.7), and control (N=14: mean age, 21.6, SD=3.7). Neuropsychological testing was used to obtain domain scores for executive function and working memory/attention for each participant, and nominated family members and participants with TBI were asked to complete the Frontal Systems Behaviour Scale (FrSBe), consisting of three sub-scales; apathy, disinhibition, and executive dysfunction. Using the FrSBe there was no significant difference between the groups in executive function score, but the moderate/severe and mild groups had significantly lower working memory/attention scores compared with the control group (p<0.05). Repeated measures analysis of variance showed higher self-ratings on all sub-scales compared with family in each group (p<0.05). Scores on executive function and working memory/attention domains correlated with self, but not family reported executive dysfunction. Self-rated executive dysfunction explained 36% of the variance in executive function (p<0.001). While agreement between self-rated and family-rated total FrSBe scores was significant in all groups (p<0.001), our results showed that self-ratings were of higher

  19. EMDR for post-traumatic stress and other psychological trauma.

    PubMed

    Norgate, Kath

    Eye movement desensitisation and reprocessing (EMDR) is a powerful psychotherapy with well-researched benefits for adults and children who are experiencing post-traumatic stress and post-traumatic stress disorder. There is a wealth of research and practice-based evidence demonstrating the effectiveness of EMDR in many differing clinical presentations but the true potential of this extraordinarily beneficial therapeutic approach has not been fully embraced by the mental health nursing profession. PMID:23243806

  20. Secondary Traumatic Stress and Adjustment in Therapists Who Work with Sexual Violence Survivors: The Moderating Role of Posttraumatic Growth

    ERIC Educational Resources Information Center

    Samios, Christina; Rodzik, Amber K.; Abel, Lisa M.

    2012-01-01

    Due to their secondary exposure to the traumatic events disclosed by clients, therapists who work with sexual violence survivors are at risk of experiencing secondary traumatic stress. We examined whether the negative effects of secondary traumatic stress on therapist adjustment would be buffered by posttraumatic growth. Sixty-one therapists who…

  1. Traumatic Glaucoma in Children

    PubMed Central

    Kaur, Savleen; Singh Pandav, Surinder

    2014-01-01

    ABSTRACT Young patients are more prone to ocular trauma but most of the published studies describe complicated cataract as a result of trauma with its treatment modality. As a result, little is known about the different causes, common presenting signs and symptoms, visual outcomes, and most frequent management modalities of traumatic glaucoma in children. This review aims to study the demographical profile, presentation, management and outcome of traumatic glaucoma in children as well as the various factors associated with advanced glaucomatous changes. How to cite this article: Kaur S, Kaushik S, Pandav SS. Traumatic Glaucoma in Children. J Curr Glaucoma Pract 2014; 8(2):58-62. PMID:26997810

  2. Traumatic Brain Injury Due to Bull Assault in a Girl: a Case Report

    PubMed Central

    ALVIS-MIRANDA, Hernando Raphael; CASTELLAR-LEONES, Sandra Milena; VELÁSQUEZ-LOPERENA, Dufays Danith; VILLA-DELGADO, Rosmery; ALCALA-CERRA, Gabriel; MOSCOTE-SALAZAR, Luis Rafael

    2013-01-01

    ABSTRACT Traumatic brain injury is a common condition in the emergency services, affecting the pediatric and adult population significantly. Patterns of head injury as well as management principles in children are important differences compared to adults. Traumatic brain injury by bull rush is usually seen in adults but has not been described in children-report a pediatric cranial trauma present bull rush, which to our knowledge is the first report in the literature of this nature. PMID:24790672

  3. Rumination as a Mechanism Linking Stressful Life Events to Symptoms of Depression and Anxiety: Longitudinal Evidence in Early Adolescents and Adults

    PubMed Central

    Michl, Louisa C.; McLaughlin, Katie A.; Shepherd, Kathrine; Nolen-Hoeksema, Susan

    2014-01-01

    Rumination is a well-established risk factor for the onset of major depression and anxiety symptomatology in both adolescents and adults. Despite the robust associations between rumination and internalizing psychopathology, there is a dearth of research examining factors that might lead to a ruminative response style. In the current study, we examined whether social environmental experiences were associated with rumination. Specifically, we evaluated whether self-reported exposure to stressful life events predicted subsequent increases in rumination. We also investigated whether rumination served as a mechanism underlying the longitudinal association between self-reported stressful life events and internalizing symptoms. Self-reported stressful life events, rumination, and symptoms of depression and anxiety were assessed in 2 separate longitudinal samples. A sample of early adolescents (N = 1,065) was assessed at 3 time points spanning 7 months. A sample of adults (N = 1,132) was assessed at 2 time points spanning 12 months. In both samples, self-reported exposure to stressful life events was associated longitudinally with increased engagement in rumination. In addition, rumination mediated the longitudinal relationship between self-reported stressors and symptoms of anxiety in both samples and the relationship between self-reported life events and symptoms of depression in the adult sample. Identifying the psychological and neurobiological mechanisms that explain a greater propensity for rumination following stressors remains an important goal for future research. This study provides novel evidence for the role of stressful life events in shaping characteristic responses to distress, specifically engagement in rumination, highlighting potentially useful targets for interventions aimed at preventing the onset of depression and anxiety. PMID:23713497

  4. Rumination as a mechanism linking stressful life events to symptoms of depression and anxiety: longitudinal evidence in early adolescents and adults.

    PubMed

    Michl, Louisa C; McLaughlin, Katie A; Shepherd, Kathrine; Nolen-Hoeksema, Susan

    2013-05-01

    Rumination is a well-established risk factor for the onset of major depression and anxiety symptomatology in both adolescents and adults. Despite the robust associations between rumination and internalizing psychopathology, there is a dearth of research examining factors that might lead to a ruminative response style. In the current study, we examined whether social environmental experiences were associated with rumination. Specifically, we evaluated whether self-reported exposure to stressful life events predicted subsequent increases in rumination. We also investigated whether rumination served as a mechanism underlying the longitudinal association between self-reported stressful life events and internalizing symptoms. Self-reported stressful life events, rumination, and symptoms of depression and anxiety were assessed in 2 separate longitudinal samples. A sample of early adolescents (N = 1,065) was assessed at 3 time points spanning 7 months. A sample of adults (N = 1,132) was assessed at 2 time points spanning 12 months. In both samples, self-reported exposure to stressful life events was associated longitudinally with increased engagement in rumination. In addition, rumination mediated the longitudinal relationship between self-reported stressors and symptoms of anxiety in both samples and the relationship between self-reported life events and symptoms of depression in the adult sample. Identifying the psychological and neurobiological mechanisms that explain a greater propensity for rumination following stressors remains an important goal for future research. This study provides novel evidence for the role of stressful life events in shaping characteristic responses to distress, specifically engagement in rumination, highlighting potentially useful targets for interventions aimed at preventing the onset of depression and anxiety. PMID:23713497

  5. Parent and Child Agreement for Acute Stress Disorder, Post-Traumatic Stress Disorder and Other Psychopathology in a Prospective Study of Children and Adolescents Exposed to Single-Event Trauma

    ERIC Educational Resources Information Center

    Meiser-Stedman, Richard; Smith, Patrick; Glucksman, Edward; Yule, William; Dalgleish, Tim

    2007-01-01

    Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined…

  6. Traumatic Brain Injury

    MedlinePlus

    ... disabilities include problems with cognition (thinking, memory, and reasoning), sensory processing (sight, hearing, touch, taste, and smell), ... barrier. NIH Patient Recruitment for Traumatic Brain Injury Clinical Trials At NIH Clinical Center Throughout the U.S. ...

  7. Traumatic Brain Injury

    MedlinePlus

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  8. Traumatic Brain Injury

    MedlinePlus

    ... a wide range of changes affecting thinking, sensation, language, or emotions. TBI can be associated with post-traumatic stress disorder. People with severe injuries usually need rehabilitation. NIH: National Institute of Neurological Disorders and Stroke

  9. Therapeutic Hypothermia as a Neuroprotective Strategy in Neonatal Hypoxic-Ischemic Brain Injury and Traumatic Brain Injury

    PubMed Central

    Ma, H.; Sinha, B.; Pandya, R.S.; Lin, N.; Popp, A.J.; Li, J.; Yao, J.; Wang, X.

    2014-01-01

    Evidence shows that artificially lowering body and brain temperature can significantly reduce the deleterious effects of brain injury in both newborns and adults. Although the benefits of therapeutic hypothermia have long been known and applied clinically, the underlying molecular mechanisms have yet to be elucidated. Hypoxic-ischemic brain injury and traumatic brain injury both trigger a series of biochemical and molecular events that cause additional brain insult. Induction of therapeutic hypothermia seems to ameliorate the molecular cascade that culminates in neuronal damage. Hypothermia attenuates the toxicity produced by the initial injury that would normally produce reactive oxygen species, neurotransmitters, inflammatory mediators, and apoptosis. Experiments have been performed on various depths and levels of hypothermia to explore neuroprotection. This review summarizes what is currently known about the beneficial effects of therapeutic hypothermia in experimental models of neonatal hypoxic-ischemic brain injury and traumatic brain injury, and explores the molecular mechanisms that could become the targets of novel therapies. In addition, this review summarizes the clinical implications of therapeutic hypothermia in newborn hypoxic-ischemic encephalopathy and adult traumatic brain injury. PMID:22834830

  10. [Post-traumatic stress disorder: a problem for occupational medicine].

    PubMed

    Koniarek, J

    2000-01-01

    The impact of the mental stress on the human functioning and health has been evidenced in numerous studies. The majority of these studies focus on adverse effects of a long-term stress. Recently, a growing attention has been paid to the relationship between health and acute stress induced by sudden and short-lasting events or experiences characterised by particular intensity. A traumatic stress is one of the forms of the acute stress. It is some kind of reaction to an event in which life of an individual is directly threatened (serious injury, endangered physical integrity, etc.) or he/she witnesses sudden death, serious injury or life-threatening situation of other people. Traumatic experiences may lead among others to post-traumatic stress disorder (PTSD). The review of the studies, presented in this paper, indicates that the proportion of people with traumatic experiences ranges between 40 and 90% depending on the population. There are professions (rescue services, the police, etc.) with inherent traumatic experiences. About 10% of people with traumatic experiences develop PTSD. The author indicates factors responsible for the development of PTSD. The society, particularly people whose professions involve traumatic experiences, and those employed in various institutions responsible for health care should be aware of health problems related to this kind of experiences. PMID:11002473

  11. Traumatic Optic Neuropathy: A Review

    PubMed Central

    Kumaran, Arjunan Muthu; Sundar, Gangadhara; Chye, Lim Thiam

    2014-01-01

    The aim of this article is to evaluate current literature on investigation and management of traumatic optic neuropathy (TON), propose recommendations for diagnosis and management, and explore novel future treatments. TON, though uncommon, causes substantial visual loss. Without clear guidelines, there is much ambiguity regarding its diagnosis and management. Investigation and treatment (conservative, medical, surgical, and combined) vary widely between centers. Electronic databases PubMed, MEDLINE, PROSPERO, CENTRAL, and EMBASE were searched for content that matched “Traumatic optic neuropathy.” Articles with abstracts and full text available, published in the past 10 years, written English and limited to human adults, were selected. All study designs were acceptable except case reports and case series with fewer 10 patients. All abstracts were then evaluated for relevance. References of these studies were evaluated and if also relevant, included. A total of 2,686 articles were retrieved and 43 examined for relevance. Of these, 23 articles were included. TON is a clinical diagnosis. Visual-evoked potential is useful in diagnosis and prognosis. Computed tomography demonstrates canal fractures and concomitant injuries. Magnetic resonance images should be reserved for select and stable patients. Conservative treatment is appropriate in mild TON. Steroids are of questionable benefit and may be harmful. Surgery should be reserved for patients with radiological evidence of compression and individualized. PMID:25709751

  12. Mucocele accompanied by a traumatic neuroma: a case report.

    PubMed

    Jaafari Ashkavandi, Z; Dehghani Nazhvani, A; Hamzavi, M

    2013-03-01

    Mucocele and traumatic neuroma are two lesions related to the traumatic events; however there is only one reported case in which these two entities were perceived simultaneously. The current study reported a 21-year-old man who complained of painless recurrent swelling, accompanied by paresthesia on his left lower labial mucosa. He had a previous history of similar lesion and had been treated with surgery and cauterization last year. The primary clinical impression was a recurrent mucocele. Microscopic surveys displayed a traumatic neuroma in the vicinity of a mucocele which seems to be arising from the previous surgical treatment. PMID:24724117

  13. Pathophysiological links between traumatic brain injury and post-traumatic headaches

    PubMed Central

    Ruff, Robert L.; Blake, Kayla

    2016-01-01

    This article reviews possible ways that traumatic brain injury (TBI) can induce migraine-type post-traumatic headaches (PTHs) in children, adults, civilians, and military personnel. Several cerebral alterations resulting from TBI can foster the development of PTH, including neuroinflammation that can activate neural systems associated with migraine. TBI can also compromise the intrinsic pain modulation system and this would increase the level of perceived pain associated with PTH. Depression and anxiety disorders, especially post-traumatic stress disorder (PTSD), are associated with TBI and these psychological conditions can directly intensify PTH. Additionally, depression and PTSD alter sleep and this will increase headache severity and foster the genesis of PTH. This article also reviews the anatomic loci of injury associated with TBI and notes the overlap between areas of injury associated with TBI and PTSD.

  14. Aggregating validity indicators embedded in Conners' CPT-II outperforms individual cutoffs at separating valid from invalid performance in adults with traumatic brain injury.

    PubMed

    Erdodi, Laszlo A; Roth, Robert M; Kirsch, Ned L; Lajiness-O'neill, Renee; Medoff, Brent

    2014-08-01

    Continuous performance tests (CPT) provide a useful paradigm to assess vigilance and sustained attention. However, few established methods exist to assess the validity of a given response set. The present study examined embedded validity indicators (EVIs) previously found effective at dissociating valid from invalid performance in relation to well-established performance validity tests in 104 adults with TBI referred for neuropsychological testing. Findings suggest that aggregating EVIs increases their signal detection performance. While individual EVIs performed well at their optimal cutoffs, two specific combinations of these five indicators generally produced the best classification accuracy. A CVI-5A ≥3 had a specificity of .92-.95 and a sensitivity of .45-.54. At ≥4 the CVI-5B had a specificity of .94-.97 and sensitivity of .40-.50. The CVI-5s provide a single numerical summary of the cumulative evidence of invalid performance within the CPT-II. Results support the use of a flexible, multivariate approach to performance validity assessment. PMID:24957927

  15. Traumatic Alterations in Consciousness: Traumatic Brain Injury

    PubMed Central

    Blyth, Brian J.; Bazarian, Jeffrey J.

    2010-01-01

    Mild traumatic brain injury (mTBI) refers to the clinical condition of transient alteration of consciousness as a result of traumatic injury to the brain. The priority of emergency care is to identify and facilitate the treatment of rare but potentially life threatening intra-cranial injuries associated with mTBI through the judicious application of appropriate imaging studies and neurosurgical consultation. Although post-mTBI symptoms quickly and completely resolve in the vast majority of cases, a significant number of patients will complain of lasting problems that may cause significant disability. Simple and early interventions such as patient education and appropriate referral can reduce the likelihood of chronic symptoms. Although definitive evidence is lacking, mTBI is likely to be related to significant long-term sequelae such as Alzheimer's disease and other neurodegenerative processes. PMID:20709244

  16. Be vigilant for post-traumatic stress reactions.

    PubMed

    Hull, Alastair M; Curran, Stephen A

    2016-05-01

    Most people experience at least one potentially traumatic event (PTE) during their life. Many will develop only transient distress and not a psychological illness. Even the most inherently horrific event does not invariably lead to the development of a psychological disorder while an individual with sufficient vulnerabilit may develop post-traumatic stress disorder (PTSD) after what appears be an event of low magnitude. The diagnosis of PTSD differs fro most psychiatric disorders as it includes an aetiological factor, the traumatic event, as a core criterion. The DSM 5 core symptoms of PTSD are grouped into four key symptom clusters: re-experiencing, avoidance, negative cognitions and mood, and arousal. Symptoms must be present for at least one month and cause functional impairment. PTSD patients can avoid engaging in treatment and assertive follow-up may be necessary. PMID:27382915

  17. Subacute to chronic mild traumatic brain injury.

    PubMed

    Mott, Timothy F; McConnon, Michael L; Rieger, Brian P

    2012-12-01

    Although a universally accepted definition is lacking, mild traumatic brain injury and concussion are classified by transient loss of consciousness, amnesia, altered mental status, a Glasgow Coma Score of 13 to 15, and focal neurologic deficits following an acute closed head injury. Most patients recover quickly, with a predictable clinical course of recovery within the first one to two weeks following traumatic brain injury. Persistent physical, cognitive, or behavioral postconcussive symptoms may be noted in 5 to 20 percent of persons who have mild traumatic brain injury. Physical symptoms include headaches, dizziness, and nausea, and changes in coordination, balance, appetite, sleep, vision, and hearing. Cognitive and behavioral symptoms include fatigue, anxiety, depression, and irritability, and problems with memory, concentration and decision making. Women, older adults, less educated persons, and those with a previous mental health diagnosis are more likely to have persistent symptoms. The diagnostic workup for subacute to chronic mild traumatic brain injury focuses on the history and physical examination, with continuing observation for the development of red flags such as the progression of physical, cognitive, and behavioral symptoms, seizure, progressive vomiting, and altered mental status. Early patient and family education should include information on diagnosis and prognosis, symptoms, and further injury prevention. Symptom-specific treatment, gradual return to activity, and multidisciplinary coordination of care lead to the best outcomes. Psychiatric and medical comorbidities, psychosocial issues, and legal or compensatory incentives should be explored in patients resistant to treatment. PMID:23198672

  18. Using patients’ experiences of adverse events to improve health service delivery and practice: protocol of a data linkage study of Australian adults age 45 and above

    PubMed Central

    Walton, Merrilyn; Smith-Merry, Jennifer; Harrison, Reema; Manias, Elizabeth; Iedema, Rick; Kelly, Patrick

    2014-01-01

    Introduction Evidence of patients’ experiences is fundamental to creating effective health policy and service responses, yet is missing from our knowledge of adverse events. This protocol describes explorative research redressing this significant deficit; investigating the experiences of a large cohort of recently hospitalised patients aged 45 years and above in hospitals in New South Wales (NSW), Australia. Methods and analysis The 45 and Up Study is a cohort of 265 000 adults aged 45 years and above in NSW. Patients who were hospitalised between 1 January and 30 June 2014 will be identified from this cohort using data linkage and a random sample of 20 000 invited to participate. A cross-sectional survey (including qualitative and quantitative components) will capture patients’ experiences in hospital and specifically of adverse events. Approximately 25% of respondents are likely to report experiencing an adverse event. Quantitative components will capture the nature and type of events as well as common features of patients’ experiences. Qualitative data provide contextual knowledge of their condition and care and the impact of the event on individuals. Respondents who do not report an adverse event will report their experience in hospital and be the control group. Statistical and thematic analysis will be used to present a patient perspective of their experiences in hospital; the characteristics of patients experiencing an adverse event; experiences of information sharing after an event (open disclosure) and the other avenues of redress pursued. Interviews with key policymakers and a document analysis will be used to create a map of the current practice. Ethics and dissemination Dissemination via a one-day workshop, peer-reviewed publications and conference presentations will enable effective clinical responses and service provision and policy responses to adverse events to be developed. PMID:25311039

  19. Art Therapy for Individuals with Traumatic Brain Injury: A Comprehensive Neurorehabilitation-Informed Approach to Treatment

    ERIC Educational Resources Information Center

    Kline, Tori

    2016-01-01

    I describe an approach to art therapy treatment for survivors of traumatic brain injury developed at a rehabilitation facility for adults that serves inpatient, outpatient, and long-term residential clients. This approach is based on a review of the literature on traumatic brain injury, comprehensive neurorehabilitation, brain plasticity, and art…

  20. Is Disclosure Therapeutic for Children following Exposure to Traumatic Violence?

    ERIC Educational Resources Information Center

    Graham-Bermann, Sandra A.; Kulkarni, Madhur R.; Kanukollu, Shanta

    2011-01-01

    Trauma theory suggests that to recover from exposure to traumatic events, such as exposure to violence, therapeutic interventions should include opportunities to disclose and to process the fearful and stressful events. Yet little is known about the circumstances that foster disclosure of such information in therapeutic environments by children…

  1. Use of brain electrical activity for the identification of hematomas in mild traumatic brain injury.

    PubMed

    Hanley, Daniel F; Chabot, Robert; Mould, W Andrew; Morgan, Timothy; Naunheim, Rosanne; Sheth, Kevin N; Chiang, William; Prichep, Leslie S

    2013-12-15

    This study investigates the potential clinical utility in the emergency department (ED) of an index of brain electrical activity to identify intracranial hematomas. The relationship between this index and depth, size, and type of hematoma was explored. Ten minutes of brain electrical activity was recorded from a limited montage in 38 adult patients with traumatic hematomas (CT scan positive) and 38 mild head injured controls (CT scan negative) in the ED. The volume of blood and distance from recording electrodes were measured by blinded independent experts. Brain electrical activity data were submitted to a classification algorithm independently developed traumatic brain injury (TBI) index to identify the probability of a CT+traumatic event. There was no significant relationship between the TBI-Index and type of hematoma, or distance of the bleed from recording sites. A significant correlation was found between TBI-Index and blood volume. The sensitivity to hematomas was 100%, positive predictive value was 74.5%, and positive likelihood ratio was 2.92. The TBI-Index, derived from brain electrical activity, demonstrates high accuracy for identification of traumatic hematomas. Further, this was not influenced by distance of the bleed from the recording electrodes, blood volume, or type of hematoma. Distance and volume limitations noted with other methods, (such as that based on near-infrared spectroscopy) were not found, thus suggesting the TBI-Index to be a potentially important adjunct to acute assessment of head injury. Because of the life-threatening risk of undetected hematomas (false negatives), specificity was permitted to be lower, 66%, in exchange for extremely high sensitivity. PMID:24040943

  2. Traumatic Wound Dehiscence following Corneal Transplantation

    PubMed Central

    Jafarinasab, Mohammad-Reza; Feizi, Sepehr; Esfandiari, Hamed; Kheiri, Bahareh; Feizi, Mohadesse

    2012-01-01

    Purpose To investigate the incidence, mechanisms, characteristics, and visual outcomes of traumatic wound dehiscence following keratoplasty. Methods Medical records of 32 consecutive patients with traumatic globe rupture following keratoplasty who had been treated at our center from 2001 to 2009 were retrospectively reviewed. Results The study population consisted of 32 eyes of 32 patients including 25 men and 7 women with history of corneal transplantation who had sustained eye trauma leading to globe rupture. Mean patient age was 38.1 (range, 8 to 87) years and median interval between keratoplasty and the traumatic event was 9 months (range, 30 days to 20 years). Associated anterior segment findings included iris prolapse in 71.9%, lens extrusion in 34.4%, and hyphema in 40.6% of eyes. Posterior segment complications included vitreous prolapse (56%), vitreous hemorrhage (28%) and retinal detachment (18%). Eyes which had undergone deep anterior lamellar keratoplasty (DALK; 5 cases, 15.6%) tended to have less severe presentation and better final visual acuity. There was no correlation between the time interval from keratoplasty to the traumatic event, and final visual outcomes. Conclusion The host-graft interface demonstrates decreased stability long after surgery and the visual prognosis of traumatic wound dehiscence is poor in many cases. An intact Descemet’s membrane in DALK may mitigate the severity of ocular injuries, but even in these cases, the visual outcome of globe rupture is not good and prevention of ocular trauma should be emphasized to all patients undergoing any kind of keratoplasty. PMID:23264863

  3. Pediatric Traumatic Brain Injury.

    PubMed

    Schaller, Alexandra L; Lakhani, Saquib A; Hsu, Benson S

    2015-10-01

    The purpose of this article is to provide a better understanding of pediatric traumatic brain injury and its management. Within the pediatric age group, ages 1 to 19, injuries are the number one cause of death with traumatic brain injury being involved in almost 50 percent of these cases. This, along with the fact that the medical system spends over $1 billion annually on pediatric traumatic brain injury, makes this issue both timely and relevant to health care providers. Over the course of this article the epidemiology, physiology, pathophysiology, and treatment of pediatric traumatic brain injury will be explored. Emphasis will be placed on the role of the early responder and the immediate interventions that should be considered and/or performed. The management discussed in this article follows the most recent recommendations from the 2012 edition of the Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury in Infants, Children, and Adolescents. Despite the focus of this article, it is important not to lose sight of the fact that an ounce of prevention is worth a pound--or, to be more precise and use the average human's brain measurements, just above three pounds--of cure. PMID:26630835

  4. Facilitating post traumatic growth

    PubMed Central

    Turner, de Sales; Cox, Helen

    2004-01-01

    Background Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal care. All participants were injured through involvement in a motor vehicle accident, with the exception of one, who was injured through falling off the roof of a house. Methods In this qualitative study, we used an audio-taped in-depth interview with each participant as the means of data collection. Interviews were transcribed verbatim and analysed thematically to determine the participants' unique perspectives on the experience of recovery from traumatic injury. In reporting the findings, all participants' were given a pseudonym to assure their anonymity. Results Most participants indicated that their involvement in a traumatic occurrence was a springboard for growth that enabled them to develop new perspectives on life and living. Conclusion There are a number of contributions that health providers may make to the recovery of individuals who have been traumatically injured to assist them to develop new views of vulnerability and strength, make changes in relationships, and facilitate philosophical, physical and spiritual growth. PMID:15248894

  5. TRAUMATIC BRAIN INJURY (TBI) DATABASE

    EPA Science Inventory

    The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Instit...

  6. Vicarious traumatization: concept analysis.

    PubMed

    Tabor, Pamela Diane

    2011-12-01

    There is growing knowledge of the effects of stress on professionals, including various negative symptoms that may mirror the biopsychosocial effects exhibited by the victims of trauma. Multiple concepts including burn out, compassion fatigue, post-traumatic stress disorder (PTSD), and secondary traumatic stress, are terms that have been incorrectly interchanged with the term vicarious traumatization (VT). Clarity of vicarious victimization and understanding contributing factors is imperative in order to facilitate future research and implement timely and effective interventions, as well as sculpt evidence based practice. This concept anaylsis, complete with a concept map, discusses VT; related terminology; symptomology; prevention and relevant interventions; and discusses opportunities for personal/professional growth for nurses and especially forensic nurses working with victims of violence. PMID:22123041

  7. Severe Traumatic Injury

    PubMed Central

    Minei, Joseph P.; Schmicker, Robert H.; Kerby, Jeffrey D.; Stiell, Ian G.; Schreiber, Martin A.; Bulger, Eileen; Tisherman, Samuel; Hoyt, David B.; Nichol, Graham

    2014-01-01

    Objectives The public health implications of regional variation in incidence and outcome of severe traumatic injury remain to be analyzed. The objective of this study was to determine whether the incidence and outcome associated with severe traumatic injury differs across geographic regions of North America. Methods A prospective, observational study was conducted of the Resuscitation Outcomes Consortium of all patients in 9 North American sites (6 US and 3 Canadian) sustaining severe traumatic injury from April 1, 2006 to March 31, 2007 followed to hospital discharge. Eligible patients were assessed by organized emergency medical services, and had field-based physiologic criteria including systolic blood pressure ≤90 mm Hg, Glasgow Coma Scale score ≤12, respiratory rate <10 or >29 per minute, advanced airway procedure, or traumatic death in the field. Census data were used to determine rates adjusted for age and sex. The main outcome measures were incidence rate, mortality rate, case fatality rate, and survival to discharge for patients sustaining severe traumatic injury assessed by EMS. Results The total catchment population of 20.5 million yielded 7080 cases of severe traumatic injury. Median age was 36 years and 67% were male. The median incidence of EMS-assessed severe traumatic injury per 100,000 population across sites was 37.4 (interquartile range [IQR] = 24.6 – 69.6); survival ranged from 39.8% to 80.8%, with a median of 64.5% (IQR = 55.5–78.4). About 942 cases were pronounced dead at the scene and 5857 patients were transported to hospital; 4477 (63.2%) were discharged alive. The median incidence of severe trauma due to a blunt mechanism, transported to hospital, was 25.8 (IQR = 13.1–44.3); survival ranged from 52.6% to 87.3%, with a median of 78.0% (IQR = 68.4–83.5). The median incidence of severe penetrating trauma, transported to hospital, was 2.6 (IQR = 1.5–10.4); survival ranged from 37.5% to 84.7%, with a median of 67.5% (IQR = 54.1

  8. Medical interventions for traumatic hyphema

    PubMed Central

    Gharaibeh, Almutez; Savage, Howard I; Scherer, Roberta W; Goldberg, Morton F; Lindsley, Kristina

    2014-01-01

    events compared with placebo. We found no difference in the number of adverse events with the use of systemic versus topical aminocaproic acid or with standard versus lower drug dose. The available evidence on usage of corticosteroids, cycloplegics, or aspirin in traumatic hyphema was limited due to the small numbers of participants and events in the trials. We found no difference in effect between a single versus binocular patch or ambulation versus complete bed rest on the risk of secondary hemorrhage or time to rebleed. Authors’ conclusions Traumatic hyphema in the absence of other intraocular injuries uncommonly leads to permanent loss of vision. Complications resulting from secondary hemorrhage could lead to permanent impairment of vision, especially in patients with sickle cell trait/disease. We found no evidence to show an effect on visual acuity by any of the interventions evaluated in this review. Although evidence was limited, it appears that patients with traumatic hyphema who receive aminocaproic acid or tranexamic acid are less likely to experience secondary hemorrhaging. However, hyphema in patients treated with aminocaproic acid take longer to clear. Other than the possible benefits of antifibrinolytic usage to reduce the rate of secondary hemorrhage, the decision to use corticosteroids, cycloplegics, or nondrug interventions (such as binocular patching, bed rest, or head elevation) should remain individualized because no solid scientific evidence supports a benefit. As these multiple interventions are rarely used in isolation, further research to assess the additive effect of these interventions might be of value. PMID:24302299

  9. Medical interventions for traumatic hyphema

    PubMed Central

    Gharaibeh, Almutez; Savage, Howard I; Scherer, Roberta W; Goldberg, Morton F; Lindsley, Kristina

    2012-01-01

    acid was associated with increased nausea, vomiting, and other adverse events compares with placebo. We found no difference in the number of adverse events with the use of systemic versus topical aminocaproic acid or with standard versus lower drug dose. The available evidence on usage of corticosteroids, cycloplegics or aspirin in traumatic hyphema was limited due to the small numbers of participants and events in the trials. We found no difference in effect between a single versus binocular patch nor ambulation versus complete bed rest on the risk of secondary hemorrhage or time to rebleed. Authors’ conclusions Traumatic hyphema in the absence of other intraocular injuries, uncommonly leads to permanent loss of vision. Complications resulting from secondary hemorrhage could lead to permanent impairment of vision, especially in patients with sickle cell trait/disease. We found no evidence to show an effect on visual acuity by any of the interventions evaluated in this review. Although evidence is limited, it appears that patients with traumatic hyphema who receive aminocaproic acid or tranexamic acid are less likely to experience secondary hemorrhaging. However, hyphema in patients on aminocaproic acid take longer to clear. Other than the possible benefits of antifibrinolytic usage to reduce the rate of secondary hemorrhage, the decision to use corticosteroids, cycloplegics, or non-drug interventions (such as binocular patching, bed rest, or head elevation) should remain individualized because no solid scientific evidence supports a benefit. As these multiple interventions are rarely used in isolation, further research to assess the additive effect of these interventions might be of value. PMID:21249670

  10. The hidden price of repeated traumatic exposure.

    PubMed

    Levy-Gigi, Einat; Richter-Levin, Gal

    2014-07-01

    Neuroimaging studies have demonstrated reduced hippocampal volume in trauma-exposed individuals without posttraumatic stress disorder (PTSD). However, the implications of such a deficit in this non-clinical population are still unclear. Animal and human models of PTSD suggest that hippocampal deficit may result in impaired learning and use of associations between contextual information and aversive events. Previous study has shown that individuals with PTSD have a selective impairment in reversing the negative outcome of context-related information. The aim of this study was to test whether non-PTSD individuals who are repeatedly exposed to traumatic events display similar impairment. To that end, we compared the performance of active-duty firefighters who are frequently exposed to traumatic events as part of their occupational routine and civilian matched-controls with no history of trauma-exposure. We used a novel cue-context reversal paradigm, which separately evaluates reversal of negative and positive outcomes of cue and context-related information. As predicted, we found that while both trauma-exposed firefighters and unexposed matched-controls were able to acquire and retain stimulus-outcome associations, firefighters struggled to learn that a previously negative context is later associated with a positive outcome. This impairment did not correlate with levels of PTSD, anxiety or depressive symptoms. The results suggest that similar to individuals with PTSD, highly exposed individuals fail to associate traumatic outcomes with their appropriate context. This impairment may reflect a possible hidden price of repeated traumatic exposure, which is not necessarily associated with PTSD diagnosis, and may affect the way highly exposed individuals interpret and react to their environment. PMID:24810272

  11. Urinary heavy metals, phthalates and polyaromatic hydrocarbons independent of health events are associated with adult depression: USA NHANES, 2011-2012.

    PubMed

    Shiue, Ivy

    2015-11-01

    Links between environmental chemicals and human health have emerged, but the effects on mental health such as depression were less studied. Therefore, it was aimed to study the relationships between different sets of urinary environmental chemical concentrations and adult depression in a national and population-based setting in recent years. Data was retrieved from the US National Health and Nutrition Examination Survey in 2011-2012 including demographics, serum measurements, lifestyle factors, self-reported health conditions and urinary chemical concentrations. Depression was determined by using the Patient Health Questionnaire with a cutoff point at 9/10. Chi-square test, t test and survey-weighted logistic regression modeling were performed. Among 5560 American adults aged 20-80 years, 363 (7.8%) people were classified as having depression (Patient Health Questionnaire score ≥ 10). They tended to have history of health events. After full adjustment including urinary creatinine; demographic characteristics; lifestyle factors; health conditions (such as cardiovascular, neurological, respiratory, digestive and bone diseases, and injury); and subsample weighing; and higher levels of manganese, tin, and phthalates including mono-2-ethyl-5-carboxypentyl, mono-n-butyl, mono-isobutyl, and mono-benzyl were associated with adult depression. Similarly, urinary polyaromatic hydrocarbons including 2-hydroxyfluorene, 3-hydroxyfluorene, 9-hydroxyfluorene, 1-hydroxyphenanthrene, 2-hydroxyphenanthrene, 3-hydroxyphenanthrene, 1-hydroxypyrene, 1-hydroxynaphthalene (1-naphthol), 2-hydroxynaphthalene (2-naphthol) and 4-hydroxyphenanthrene were associated with depression. There were no associations observed in urinary arsenic, phenols, parabens, pesticides, perchlorate, nitrate, thiocyanate and polyfluorinated compounds. Urinary heavy metal, phthalates and polyaromatic hydrocarbons were associated with adult depression, being independent of health events. Further elimination

  12. Traumatic Brain Injury (TBI)

    MedlinePlus

    ... A. (2008). Mild traumatic brain injury in U.S. soldiers returning from Iraq. New England Journal of Medicine, 358, 453–463. ... and Spotlights U.S. hospitals miss followup for suspected child abuse Q&A with NICHD Acting Director Catherine ...

  13. Traumatic Brain Injury

    MedlinePlus

    ... a concussion may feel dazed and may lose vision or balance for a while after the injury A brain contusion is a bruise of the brain. This ... consciousness Headache Confusion Feeling dizzy or lightheaded Blurry vision ... or severe traumatic brain injury include all of the symptoms listed above ...

  14. Post-Traumatic Stress Disorder and Group Leadership Instruction for Rehabilitation Counselors-in-Training

    ERIC Educational Resources Information Center

    Moore, Nykeisha; Wadsworth, John; Cory, James

    2009-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety syndrome that can develop after exposure to a traumatic event in which harm occurred or was threatened. PTSD is often treated with group therapy. Rehabilitation counselors need to be aware of the group treatments for PTSD because counselors may be leaders of group therapy, may work with consumers…

  15. 38 CFR 4.129 - Mental disorders due to traumatic stress.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Mental disorders due to traumatic stress. 4.129 Section 4.129 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event...

  16. 38 CFR 4.129 - Mental disorders due to traumatic stress.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Mental disorders due to traumatic stress. 4.129 Section 4.129 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event...

  17. 38 CFR 4.129 - Mental disorders due to traumatic stress.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Mental disorders due to traumatic stress. 4.129 Section 4.129 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event...

  18. 38 CFR 4.129 - Mental disorders due to traumatic stress.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Mental disorders due to traumatic stress. 4.129 Section 4.129 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event...

  19. 38 CFR 4.129 - Mental disorders due to traumatic stress.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental disorders due to traumatic stress. 4.129 Section 4.129 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS... traumatic stress. When a mental disorder that develops in service as a result of a highly stressful event...

  20. Functional neuroimaging studies of post-traumatic stress disorder

    PubMed Central

    Hughes, Katherine C; Shin, Lisa M

    2011-01-01

    Post-traumatic stress disorder (PTSD) is a significant problem that can affect individuals who have been exposed to a traumatic event or events, such as combat, violent crime or childhood abuse. Over the past several years, neuroimaging studies of PTSD have focused on elucidating the brain circuits that mediate this disorder. In this article, we will briefly introduce some of the methods used in functional neuroimaging studies of PTSD. We will then review functional neuroimaging studies that have reported significant findings in the amygdala, medial prefrontal cortex, hippocampus and insula. Finally, we will suggest future directions for research. PMID:21306214

  1. Symptoms of borderline personality disorder predict interpersonal (but not independent) stressful life events in a community sample of older adults.

    PubMed

    Powers, Abigail D; Gleason, Marci E J; Oltmanns, Thomas F

    2013-05-01

    Individuals with borderline personality disorder (BPD) often experience stressful life events at a higher frequency than those without BPD. It is less clear what specific types of events are involved in this effect, and it has not been determined whether some features of BPD are more important than others in accounting for this effect. The latter issue is important in light of the heterogeneous nature of this diagnostic construct. These issues were examined in a large, representative community sample of men and women, ages 55-64. Ten Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, Washington, DC, American Psychiatric Association, 2000) personality disorders were assessed at baseline using the Structured Interview for DSM-IV Personality: SIDP-IV (B. Pfohl, N. Blum, & M. Zimmerman, 1997, Washington, DC, American Psychiatric Press). Life events were measured at three sequential assessments following baseline at 6-month (N = 1,294), 12-month (N = 1,070), and 18-month (N = 837) follow-ups. Stressful life events were identified using a self-report questionnaire (LTE-Q; List of Threatening Experiences Questionnaire: A subset of prescribed life events with considerable long-term contextual threat by T. Brugha, C. Bebbington, P. Tennant, and J. Hurry, 1985, Psychological Medicine, Vol. 15, pp. 189-194.) followed by a telephone interview. Only borderline personality pathology was related to an increase in the frequency of interpersonal stressful life events. Three specific symptoms of BPD were largely responsible for this connection: unstable interpersonal relationships, impulsivity, and chronic feelings of emptiness (negative association). Symptoms of avoidant and schizoid personality disorders were associated with a reduced number of stressful life events that are considered to be outside a person's control (e.g., serious illness, injury, or death of a loved one). None of the personality disorders predicted an increase in the number of

  2. Symptoms of Borderline Personality Disorder Predict Interpersonal (but not Independent) Stressful Life Events in a Community Sample of Older Adults

    PubMed Central

    Powers, Abigail D.; Gleason, Marci E. J.; Oltmanns, Thomas F.

    2013-01-01

    Individuals with borderline personality disorder (BPD) often experience stressful life events at a higher frequency than those without BPD. It is less clear what specific types of events are involved in this effect, and it has not been determined whether some features of BPD are more important than others in accounting for this effect. The latter issue is important in light of the heterogeneous nature of this diagnostic construct. These issues were examined in a large, representative community sample of men and women, ages 55–64. Ten Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM–IV–TR, Washington, DC, American Psychiatric Association, 2000) personality disorders were assessed at baseline using the Structured Interview for DSM-IV Personality: SIDP-IV (B. Pfohl, N. Blum, & M. Zimmerman, 1997, Washington, DC, American Psychiatric Press). Life events were measured at three sequential assessments following baseline at 6-month (N = 1,294), 12-month (N = 1,070), and 18-month (N = 837) follow-ups. Stressful life events were identified using a self-report questionnaire (LTE-Q; List of Threatening Experiences Questionnaire: A subset of prescribed life events with considerable long-term contextual threat by T. Brugha, C. Bebbington, P. Tennant, and J. Hurry, 1985, Psychological Medicine, Vol. 15, pp. 189–194.) followed by a telephone interview. Only borderline personality pathology was related to an increase in the frequency of interpersonal stressful life events. Three specific symptoms of BPD were largely responsible for this connection: unstable interpersonal relationships, impulsivity, and chronic feelings of emptiness (negative association). Symptoms of avoidant and schizoid personality disorders were associated with a reduced number of stressful life events that are considered to be outside a person’s control (e.g., serious illness, injury, or death of a loved one). None of the personality disorders predicted an increase in the

  3. Forensic Pathology of Traumatic Brain Injury.

    PubMed

    Finnie, J W

    2016-09-01

    Traumatic brain injury constitutes a significant proportion of cases requiring forensic examination, and it encompasses (1) blunt, nonmissile head injury, especially involving motor vehicle accidents, and (2) penetrating, missile injury produced by a range of high- and lower-velocity projectiles. This review examines the complex pathophysiology and biomechanics of both types of neurotrauma and assesses the macroscopic and histologic features of component lesions, which may be used to determine the cause and manner of death resulting from an intentional assault or accident. Estimation of the survival time postinjury by pathologic examination is also important where malicious head injury is suspected, in an attempt to ascertain a time at which the traumatic event might have been committed, thereby evaluating the authenticity of statements made by the alleged perpetrator. PMID:26578643

  4. Measuring secondary traumatic stress symptoms in military spouses with the posttraumatic stress disorder checklist military version.

    PubMed

    Bjornestad, Andrea G; Schweinle, Amy; Elhai, Jon D

    2014-12-01

    Little research to date has examined secondary traumatic stress symptoms in spouses of military veterans. This study investigated the presence and severity of posttraumatic stress symptoms in a sample of 227 Army National Guard veterans and secondary traumatic stress symptoms among their spouses. The veterans completed the posttraumatic stress disorder (PTSD) Checklist Military Version (PCL-M) (Weathers et al., 1993) to determine the probable prevalence rate of posttraumatic stress symptoms. A modified version of the PCL-M was used to assess secondary traumatic stress symptoms in the spouses. A confirmatory factor analysis showed that the modified version of the PCL-M used to assess secondary traumatic stress symptoms in spouses fits using the same four-factor PTSD structure as the PCL-M for veterans. This study provides initial evidence on the underlying symptom structure of secondary traumatic stress symptoms among spouses of traumatic event victims. PMID:25386765

  5. Post-traumatic stress disorder among survivors two years after the 2010 Mount Merapi volcano eruption: A survey study.

    PubMed

    Warsini, Sri; Buettner, Petra; Mills, Jane; West, Caryn; Usher, Kim

    2015-06-01

    The Mount Merapi volcanic eruption in October 2010 was one of Indonesia's largest and most recent natural disasters. A cross-sectional study was undertaken to measure the psychosocial impact of the eruption on survivors in two locations in Yogyakarta, Java, Indonesia. The Impact of Event Scale Revised was used to assess participants' symptoms of post-traumatic stress disorder. Post-Traumatic Stress Disorder responses and demographic characteristics were compared in both locations by conducting bivariate analysis using Mann-Whitney and t tests. The relative contributions of demographic variables and psychosocial impact were examined using multiple linear regression analyses. Two years after the eruption, survivors from the area closest to the eruption had significantly higher Impact of Event Scale Revised scores than those in the comparison area. In particular, females, adults between the ages of 18 and 59, and people who owned their own home experienced the highest levels of psychosocial impact. Nurses and other health professionals need to be aware of the impact of natural disasters on survivors and develop interventions to help people adjust to the psychosocial impact of these events. PMID:24845603

  6. Information Processing Bias in Post-traumatic Stress Disorder.

    PubMed

    Weber, Darren L

    2008-01-01

    This review considers theory and evidence for abnormal information processing in post-traumatic stress disorder (PTSD). Cognitive studies have indicated sensitivity in PTSD for traumatic information, more so than general emotional information. These findings were supported by neuroimaging studies that identify increased brain activity during traumatic cognition, especially in affective networks (including the amygdala, orbitofrontal and anterior cingulate cortex). In theory, it is proposed that traumatic cognition may interfere with neutral cognition and there is evidence of abnormal neutral stimulus processing in PTSD. Firstly, PTSD patients perform poorly on a variety of neuropsychology tasks that involve attention and memory for neutral information. The evidence from event-related potentials and functional neuroimaging also indicates abnormal results in PTSD during neutral stimulus processing. The research evidence generally provides support for theories of trauma sensitivity and abnormal neutral stimulus processing in PTSD. However, there is only tentative evidence that trauma cognition concurrently interferes with neutral cognition. There is even some evidence that traumatic or novelty arousal processes can increase the capacity for attentive processing, thereby enhancing cognition for neutral stimulus information. Research on this topic has not yet fully explored the mechanisms of interaction between traumatic and neutral content in the cognitive dynamics of PTSD. PMID:19639038

  7. Information Processing Bias in Post-traumatic Stress Disorder

    PubMed Central

    Weber, Darren L

    2008-01-01

    This review considers theory and evidence for abnormal information processing in post-traumatic stress disorder (PTSD). Cognitive studies have indicated sensitivity in PTSD for traumatic information, more so than general emotional information. These findings were supported by neuroimaging studies that identify increased brain activity during traumatic cognition, especially in affective networks (including the amygdala, orbitofrontal and anterior cingulate cortex). In theory, it is proposed that traumatic cognition may interfere with neutral cognition and there is evidence of abnormal neutral stimulus processing in PTSD. Firstly, PTSD patients perform poorly on a variety of neuropsychology tasks that involve attention and memory for neutral information. The evidence from event-related potentials and functional neuroimaging also indicates abnormal results in PTSD during neutral stimulus processing. The research evidence generally provides support for theories of trauma sensitivity and abnormal neutral stimulus processing in PTSD. However, there is only tentative evidence that trauma cognition concurrently interferes with neutral cognition. There is even some evidence that traumatic or novelty arousal processes can increase the capacity for attentive processing, thereby enhancing cognition for neutral stimulus information. Research on this topic has not yet fully explored the mechanisms of interaction between traumatic and neutral content in the cognitive dynamics of PTSD. PMID:19639038

  8. Traumatic insemination in terrestrial arthropods.

    PubMed

    Tatarnic, Nikolai J; Cassis, Gerasimos; Siva-Jothy, Michael T

    2014-01-01

    Traumatic insemination is a bizarre form of mating practiced by some invertebrates in which males use hypodermic genitalia to penetrate their partner's body wall during copulation, frequently bypassing the female genital tract and ejaculating into their blood system. The requirements for traumatic insemination to evolve are stringent, yet surprisingly it has arisen multiple times within invertebrates. In terrestrial arthropods traumatic insemination is most prevalent in the true bug infraorder Cimicomorpha, where it has evolved independently at least three times. Traumatic insemination is thought to occur in the Strepsiptera and has recently been recorded in fruit fly and spider lineages. We review the putative selective pressures that may have led to the evolution of traumatic insemination across these lineages, as well as the pressures that continue to drive divergence in male and female reproductive morphology and behavior. Traumatic insemination mechanisms and attributes are compared across independent lineages. PMID:24160423

  9. [Clinical and psychometric study of post-traumatic stress disorders following acts of violence].

    PubMed

    De Mol, J

    1994-01-01

    Fifty victims of assaults and hold-ups underwent a medical and psychological examination in order to assess the semiological and psychometric features of post-traumatic stress disorder: 27 males and 23 females with a mean age of 41 years were examined 18 months after the traumatic event. The following semiology was observed: excitability, phobic avoidance, distrust, recurrent traumatic nightmares, difficulties in concentration, impaired memory, dysphoric mood, hyperfatigability, recurrent recollection of the traumatic event, headache, middle and terminal sleep disturbances and neurovegetative hyperreactivity. Testing demonstrated anxious and depressive troubles and moderate cognitive disturbances. Statistical study showed no correlation between type of aggression (psychological trauma with or without concomitant physical component) and cognitive and psycho-affective variables. Most of the cognitive disturbances were correlated with the severity of anxiety and depression. Post-traumatic stress disorder also perturbed the work capacity: only 8 patients resumed previous activities after a lapse of time of 1-54 months. PMID:8066356

  10. [Effects of traumatic stress].

    PubMed

    Herbst, Gesa; Jaeger, Ulrich; Leichsenring, Falk; Streeck-Fischer, Annette

    2009-01-01

    The diagnosis PTSD does not adequately describe the impact of exposure to childhood trauma of the developing child. The objective of the study was to examine the prevalence of different interpersonal trauma types and to describe the long-term effects of maltreatment and neglect in a clinical sample of 34 adolescents. The majority (62%) of the sample was exposed to two different types of trauma during childhood. Emotional abuse and emotional neglect have been the most common trauma types (59%; 53%). 71% of the traumatized adolescents did not meet the criteria for PTSD. The most common diagnosis in the sample was Borderline Personality Disorder. All average scores at SCL-90-Symptom-Scale were clinical significant. Half of the sample reported suicide attempts and self destructive behavior. One third reported substance abuse and aggressive behavior against others respectively. None of the traumatized adolescents had a positive Self-concept. Altogether the results show that abused children and adolescents have a range of psychological sequelae that are not captured in the PTSD diagnostic criteria. Therefore the results support the necessity for a new and more precise diagnosis for chronically traumatized children and adolescents. PMID:19961125

  11. Traumatic brain injury

    PubMed Central

    Risdall, Jane E.; Menon, David K.

    2011-01-01

    There is an increasing incidence of military traumatic brain injury (TBI), and similar injuries are seen in civilians in war zones or terrorist incidents. Indeed, blast-induced mild TBI has been referred to as the signature injury of the conflicts in Iraq and Afghanistan. Assessment involves schemes that are common in civilcian practice but, in common with civilian TBI, takes little account of information available from modern imaging (particularly diffusion tensor magnetic resonance imaging) and emerging biomarkers. The efficient logistics of clinical care delivery in the field may have a role in optimizing outcome. Clinical care has much in common with civilian TBI, but intracranial pressure monitoring is not always available, and protocols need to be modified to take account of this. In addition, severe early oedema has led to increasing use of decompressive craniectomy, and blast TBI may be associated with a higher incidence of vasospasm and pseudoaneurysm formation. Visual and/or auditory deficits are common, and there is a significant risk of post-traumatic epilepsy. TBI is rarely an isolated finding in this setting, and persistent post-concussive symptoms are commonly associated with post-traumatic stress disorder and chronic pain, a constellation of findings that has been called the polytrauma clinical triad. PMID:21149359

  12. Delayed traumatic diaphragmatic hernia

    PubMed Central

    Lu, Jing; Wang, Bo; Che, Xiangming; Li, Xuqi; Qiu, Guanglin; He, Shicai; Fan, Lin

    2016-01-01

    Abstract Background: Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. Methods: Clinical data of patients who received treatment for delayed traumatic diaphragmatic hernias in registers of the First Affiliated Hospital of Xi’an Jiaotong University from 1998 to 2014 were analyzed retrospectively. Results: Six patients were included in this study. Left hemidiaphragm was affected in all of them. Most of the patients had a history of traffic accident and 1 a stab-penetrating injury. The interval from injury to developing symptoms ranged from 2 to 11 years (median 5 years). The hernial contents included the stomach, omentum, small intestine, and colon. Diaphragmatic injury was missed in all of them during the initial managements. All patients received operations once the diagnosis of delayed TDH was confirmed, and no postoperative mortality was detected. Conclusions: Delayed TDHs are not common, but can lead to serious consequences once occurred. Early detection of diaphragmatic injuries is crucial. Surgeons should maintain a high suspicion for injuries of the diaphragm in cases with abdominal or lower chest traumas, especially in the initial surgical explorations. We emphasize the need for radiographical follow-up to detect diaphragmatic injuries at an earlier stage. PMID:27512848

  13. Dermatitis artefacta in a vulnerable adult with a dissociative state.

    PubMed

    Ahmed, A; Bewley, A; Taylor, R

    2013-12-01

    Dermatitis artefacta (DA), a factitious skin disorder, often occurs as a response to traumatic life events or as a factitious behaviour, which may result in secondary gain. It can be difficult to get patients to engage with health services, and they seldom admit to causing the lesions themselves. The possibility of DA lesions occurring in dissociative states is less well known. We present a case of DA diagnosed in a vulnerable adult, who we believe caused the lesions during periods of dissociation. We discuss the way in which the concept of dissociation can provide an acceptable way of discussing the behaviour with patients and initiating psychological therapy. PMID:23758341

  14. The Effects of Traumatic Stressors and HIV-Related Trauma Symptoms on Health and Health Related Quality of Life

    PubMed Central

    Sher, Tamara G.; Mattson, Melissa; Thilges, Sarah; Hansen, Nathan B.

    2012-01-01

    The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment. PMID:21667297

  15. Dietary Sodium Content, Mortality, and Risk for Cardiovascular Events in Older Adults: The Health, Aging, and Body Composition Study

    PubMed Central

    Kalogeropoulos, Andreas P.; Georgiopoulou, Vasiliki V.; Murphy, Rachel A.; Newman, Anne B.; Bauer, Douglas C.; Harris, Tamara B.; Yang, Zhou; Applegate, William B.; Kritchevsky, Stephen B.

    2016-01-01

    Importance Additional information is needed on the role of dietary sodium on health outcomes in older adults. Objective To examine the association between dietary sodium intake and mortality, incident cardiovascular disease (CVD), and incident heart failure (HF) in older adults. Design, Setting, and Participants We analyzed 10-year follow-up data from 2,642 older adults (age 71-80) participating in a community-based, prospective cohort study (inception 1997-98). Exposure Dietary sodium intake at baseline was assessed by a food frequency questionnaire (FFQ). We examined sodium intake both as a continuous and as a categorical variable (<1500mg/d [N=291; 11.0%]; 1500–2300mg/d [N=779; 29.5%]; and >2300mg/d [N=1572; 59.5%]. Main Outcomes Adjudicated death, incident CVD, and incident HF over 10-years of follow-up. Analysis of incident CVD was restricted to those without prevalent CVD (N=1981) at baseline. Results Average age of participants was 73.6±2.9 years; 51.2% were women; 61.7% white; and 38.3% black. After 10 years, 881 participants had died, 572 developed CVD and 398 developed HF. In adjusted Cox proportional hazards models, sodium intake was not associated with mortality (HR per 1g, 1.03; 95%CI 0.98–1.09; P=0.27). Ten-year mortality was nonsignificantly lower in the 1500–2300-mg group (30.7%) compared to the <1500-mg (33.8%) and >2300-mg (35.2%) groups; P=0.074. Sodium intake >2300mg/d was associated with nonsignificantly higher mortality in adjusted models (HR vs. 1500–2300 mg/d, 1.15; 95%CI 0.99–1.35; P=0.072). Indexing sodium intake for caloric intake and body mass index did not materially affect the results. Adjusted HR for mortality was 1.20 (95%CI 0.93–1.54; P=0.16) per mg/kcal sodium and 1.11 (95%CI 0.96–1.28; P=0.17) per 100mg/kg/m2 sodium. In adjusted models accounting for the competing risk of death, sodium intake was not associated with risk for CVD (HR per 1g, 1.03; 95%CI 0.95–1.11; P=0.47) or HF (HR per 1g, 1.00; 95%CI 0.92–1

  16. Survivors of a Silent Epidemic: The Learning Experience of College Students with a History of Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Schlessman, Heather A.

    2010-01-01

    A significant proportion of young adults experience a traumatic brain injury (TBI) every year, and students with this history are becoming a growing presence on college campuses. A review of the literature revealed very little research exploring the learning experiences of college students with a history of traumatic brain injury. The purpose of…

  17. School-Based Support Groups for Traumatized Students

    ERIC Educational Resources Information Center

    Openshaw, Linda Leek

    2011-01-01

    After students experience a traumatic event, group counseling is an effective tool to offset the effects of grief and distress. Following a school crisis, successful school-based intervention requires interdisciplinary coordination between school psychologists, counselors, school social workers, teachers, and administrative staff. Within a short…

  18. Antifibrinolytic drugs for acute traumatic injury.

    PubMed

    McCaul, Michael; Kredo, Tamara

    2016-08-01

    In South Africa, trauma is a major concern, with violence and road traffic accidents being the fifth and seventh leading causes of death, respectively. Antifibrinolytic agents have been used in trauma and major surgery to prevent fibrinolysis and reduce blood loss. We highlight an updated Cochrane review investigating the effect of antifibrinolytic drugs in patients with acute traumatic injury. The review authorsconducted comprehensive literature searches in January 2015 with regard to all randomised controlled trials comparing antifibrinolytic agents after acute traumatic injury. Three randomised controlled trials, of which two (n=20 451) assessed the effect of tranexamic acid (TXA), were included. The authors concluded that TXA safely reduces mortality in trauma with bleeding without increasing the risk ofadverse events. TXA should be administered as early as possible, and within 3 hours of injury. There is still uncertainty with regard to the effect of TXA on patients with traumatic brain injury; however, ongoing randomised controlled trials should shed more light on this. PMID:27499400

  19. Frequency of trauma exposure and Post-Traumatic Stress Disorder in Italy: analysis from the World Mental Health Survey Initiative.

    PubMed

    Carmassi, Claudia; Dell'Osso, Liliana; Manni, Corrado; Candini, Valentina; Dagani, Jessica; Iozzino, Laura; Koenen, Karestan C; de Girolamo, Giovanni

    2014-12-01

    Epidemiological studies have examined the relative importance of Traumatic Events (TEs) in accounting for the societal burden of post-traumatic stress disorder (PTSD). However, most studies used the worst trauma experienced, which can lead to an overestimation of the conditional risk of PTSD. Although a number of epidemiological surveys on PTSD have been carried out in the United States, only a few studies in limited sample have been conducted in Italy. This study, carried out in the framework of the World Mental Health Survey Initiative, is a cross-sectional household survey of a representative sample of the Italian adult population. Lifetime prevalence of TEs and 12-month prevalence of PTSD were evaluated using the Composite International Diagnostic Interview (CIDI). Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Network events was the most commonly reported class of TEs (29.4%). War events had the highest conditional risk of PTSD (12.2%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (24.1%) and having seen atrocities (18.2%). Being female was related to high risk of PTSD after experiencing a TE. Exposure to network events is commonly reported among Italian adults, but two TEs are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden. PMID:25266475

  20. Post-Traumatic Stress Disorder and Urban Violence: An Anthropological Study

    PubMed Central

    Da Silva-Mannel, Juliana; Andreoli, Sérgio Baxter; Martin, Denise

    2013-01-01

    The study aimed to understand how “distress” is experienced by patients with Post-Traumatic Stress Disorder (PTSD) in the social-cultural context of São Paulo, Brazil, an urban environment marked by social inequality and high levels of violence. A qualitative study was conducted between 2008 and 2010 with PTSD patients (F43.1, ICD-10, 1997) who had been victims of robberies and kidnappings in São Paulo. Dense ethnographic observations were carried out, as well as in-depth semi-structured interviews with ten adult patients. The analysis method used was based on anthropology. The results show that it is particularly important to distinguish between perceptions of different forms of the experience of social suffering and perceptions of health and illness held by victims and biomedical experts. The cause of PTSD is more often associated with the personal problems of the victim than with the specific traumatic event. The distress described in terms of what is considered a “normal” reaction to violence and what is considered a symptom of PTSD. The findings indicate that the diagnostic of PTSD can be understood in relation to the different contexts within a culture. The ethnographic approach serves not only to illuminate individual suffering but also the social suffering experienced by the residents of São Paulo. PMID:24284352

  1. Low recognition of post-traumatic stress disorder in primary care.

    PubMed

    Ehlers, Anke; Gene-Cos, Nuri; Perrin, Sean

    2009-01-01

    Post-traumatic stress disorder (PTSD) is a common and disabling disorder that develops as a consequence of traumatic events and is characterised by distressing re-experiencing of parts of the trauma, avoidance of reminders, emotional numbing and hyperarousal. The NICE guidelines for PTSD (2005) recommend trauma-focused psychological therapy as the first-line treatment. A survey of 129 GPs in south London investigated the recognition and treatment of PTSD in primary care. The majority of GPs underestimated the prevalence of PTSD. Most PTSD patients seen in GP surgeries currently do not receive or are not referred for NICE recommended psychological treatments. Medications, especially SSRIs, appear to be more commonly prescribed than recommended by NICE. Efforts to disseminate information about PTSD and effective treatments to both patients and GPs are needed to increase recognition rates and prompter access to treatment. The Improving Access to Psychological Therapies (IAPT) programme will make the NICE recommended treatments more widely available and will allow self-referral by adults with PTSD to trauma-focused psychological therapy. PMID:26042164

  2. Children of traumatized and exiled refugee families: resilience and vulnerability. A case study report.

    PubMed

    Hosin, A A

    2001-01-01

    This paper focuses on the main problems and outcomes of two children of a traumatized refugee family who have been in Britain since 1993. Their parents witnessed near death experiences and physical assaults, and suffered losses and a wide range of physical problems; the father manifests post traumatic stress disorder (PTSD) symptoms. The children have been exposed regularly to episodic rage and violent behaviour by their father, and have developed separation problems and psychosomatic complaints. Their mother has coped better and is very resilient in her care and approach to problems. This report acknowledges the negative experience of trauma, but also the sources of resilience of parents, children's adjustment and cultural differences in coping styles. Refugee experiences devastate individual well-being and coping mechanisms if there is no hope, support and faith in one's own potential. Protective and risk factors that may affect the manifestation of trauma symptoms are highlighted. A variety of treatment approaches are required for both adult and child victims of multiple trauma. A wide range of techniques, such as group therapy, behaviour and cognitive therapy, and desensitization and relaxation training, can help sufferers to enhance their coping skills and deal effectively with devastating life events. PMID:11471915

  3. Adult Attachment and Motivated Attention to Social Images: Attachment-Based Differences in Event-Related Brain Potentials to Emotional Images

    PubMed Central

    Chavis, J. M.; Kisley, Michael A.

    2012-01-01

    Differences in adult attachment may concord with differences in social perception. The present study aimed to measure neural activity associated with the presentation of visual social stimuli. In an affective oddball paradigm, event-related brain potentials were recorded while participants viewed negative, positive, and neutral images of people and categorized them according to valence. Brain response amplitudes were examined across valence categories and across attachment groups. Results revealed differences between anxious and avoidant groups in “emotion bias.” The avoidant group displayed a bias towards more neural activation in response to negative compared to positive images. The anxious group trended in the opposite direction. Results are discussed in terms of possible attachment-based differences in motivated attention to social stimuli. PMID:22639475

  4. Neurobiological consequences of traumatic brain injury

    PubMed Central

    McAllister, Thomas W.

    2011-01-01

    Traumatic brain injury (TBI) is a worldwide public health problem typically caused by contact and inertial forces acting on the brain. Recent attention has also focused on the mechanisms of injury associated with exposure to blast events or explosions. Advances in the understanding of the neuropathophysiology of TBI suggest that these forces initiate an elaborate and complex array of cellular and subcellular events related to alterations in Ca++ homeostasis and signaling. Furthermore, there is a fairly predictable profile of brain regions that are impacted by neurotrauma and the related events. This profile of brain damage accurately predicts the acute and chronic sequelae that TBI survivors suffer from, although there is enough variation to suggest that individual differences such as genetic polymorphisms and factors governing resiliency play a role in modulating outcome. This paper reviews our current understanding of the neuropathophysiology of TBI and how this relates to the common clinical presentation of neurobehavioral difficulties seen after an injury. PMID:22033563

  5. Economic Impact of Adverse Drug Events – A Retrospective Population-Based Cohort Study of 4970 Adults

    PubMed Central

    Gyllensten, Hanna; Hakkarainen, Katja M.; Hägg, Staffan; Carlsten, Anders; Petzold, Max; Rehnberg, Clas; Jönsson, Anna K.

    2014-01-01

    Background The aim was to estimate the direct costs caused by ADEs, including costs for dispensed drugs, primary care, other outpatient care, and inpatient care, and to relate the direct costs caused by ADEs to the societal COI (direct and indirect costs), for patients with ADEs and for the entire study population. Methods We conducted a population-based observational retrospective cohort study of ADEs identified from medical records. From a random sample of 5025 adults in a Swedish county council, 4970 were included in the analyses. During a three-month study period in 2008, direct and indirect costs were estimated from resource use identified in the medical records and from register data on costs for resource use. Results Among 596 patients with ADEs, the average direct costs per patient caused by ADEs were USD 444.9 [95% CI: 264.4 to 625.3], corresponding to USD 21 million per 100 000 adult inhabitants per year. Inpatient care accounted for 53.9% of all direct costs caused by ADEs. For patients with ADEs, the average societal cost of illness was USD 6235.0 [5442.8 to 7027.2], of which direct costs were USD 2830.1 [2260.7 to 3399.4] (45%), and indirect costs USD 3404.9 [2899.3 to 3910.4] (55%). The societal cost of illness was higher for patients with ADEs compared to other patients. ADEs caused 9.5% of all direct healthcare costs in the study population. Conclusions Healthcare costs for patients with ADEs are substantial across different settings; in primary care, other outpatient care and inpatient care. Hence the economic impact of ADEs will be underestimated in studies focusing on inpatient ADEs alone. Moreover, the high proportion of indirect costs in the societal COI for patients with ADEs suggests that the observed costs caused by ADEs would be even higher if including indirect costs. Additional studies are needed to identify interventions to prevent and manage ADEs. PMID:24637879

  6. Chronic Traumatic Encephalopathy: The Neuropathological Legacy of Traumatic Brain Injury.

    PubMed

    Hay, Jennifer; Johnson, Victoria E; Smith, Douglas H; Stewart, William

    2016-05-23

    Almost a century ago, the first clinical account of the punch-drunk syndrome emerged, describing chronic neurological and neuropsychiatric sequelae occurring in former boxers. Thereafter, throughout the twentieth century, further reports added to our understanding of the neuropathological consequences of a career in boxing, leading to descriptions of a distinct neurodegenerative pathology, termed dementia pugilistica. During the past decade, growing recognition of this pathology in autopsy studies of nonboxers who were exposed to repetitive, mild traumatic brain injury, or to a single, moderate or severe traumatic brain injury, has led to an awareness that it is exposure to traumatic brain injury that carries with it a risk of this neurodegenerative disease, not the sport or the circumstance in which the injury is sustained. Furthermore, the neuropathology of the neurodegeneration that occurs after traumatic brain injury, now termed chronic traumatic encephalopathy, is acknowledged as being a complex, mixed, but distinctive pathology, the detail of which is reviewed in this article. PMID:26772317

  7. Event centrality of positive and negative autobiographical memories to identity and life story across cultures.

    PubMed

    Zaragoza Scherman, Alejandra; Salgado, Sinué; Shao, Zhifang; Berntsen, Dorthe

    2015-01-01

    The aim of this study was to investigate whether cultural differences exist in event centrality, emotional distress and well-being in a total of 565 adults above age 40 from Mexico, Greenland, China and Denmark. Participants completed questionnaires to determine their level of post-traumatic stress disorder and depression symptoms, and of life satisfaction. They also completed event centrality scales for their most positive and most negative life events. Across cultures, participants rated positive events as more central to their identity and life stories, compared with negative events. Furthermore, participants with higher levels of emotional distress rated negative events as more central to their identity and life story, compared with participants with lower scores. However, a converse pattern was not found for positive events. Finally, participants with higher scores of life satisfaction tended to rate positive events as more central and negative events as less central to their identity and life story, compared with participants with lower scores. It is concluded that across cultures, positive events are considered more central to identity and life story than negative events and that event centrality ratings tend to be affected in similar ways by higher versus lower levels of emotional distress or well-being. PMID:25337771

  8. Non-AIDS-defining events among HIV-1-infected adults receiving combination antiretroviral therapy in resource-replete versus resource-limited urban setting

    PubMed Central

    Wester, C. William; Koethe, John R.; Shepherd, Bryan E.; Stinnette, Samuel E.; Rebeiro, Peter F.; Kipp, Aaron M.; Hong, Hwanhee; Bussmann, Hermann; Gaolathe, Tendani; McGowan, Catherine C.; Sterling, Timothy R.; Marlink, Richard G.

    2011-01-01

    Objective To compare incidence and distribution of non-AIDS-defining events (NADEs) among HIV-1-infected adults receiving combination antiretroviral therapy (cART) in urban sub-Saharan African versus United States settings. Design Retrospective cohort analysis of clinical trial and observational data. Methods Compared crude and standardized (to US cohort by age and sex) NADE rates from two urban adult HIV-infected cART-initiating populations: a clinical trial cohort in Gaborone, Botswana (Botswana) and an observational cohort in Nashville, Tennessee (USA). Results Crude NADE incidence rates were similar: 10.0 [95% confidence interval 6.3–15.9] per 1000 person-years in Botswana versus 12.4 [8.4–18.4] per 1000 person-years in the United States. However, after standardizing to an older, predominantly male US population, the overall NADE incidence rates were higher in Botswana [18.7 (8.3–33.1) per 1000 person-years]. Standardized rates differed most for cardiovascular events (8.4 versus 5.0 per 1000 person-years) and non-AIDS-defining malignancies (8.0 versus 0.5 per 1000 person-years) – both higher in Botswana. Conversely, hepatic NADE rates were higher in the United States (4.0 versus 0.0 per 1000 person-years), whereas renal NADE rates [3.0 per 1000 person-years (United States) versus 2.4 per 1000 person-years (Botswana)] were comparable. Conclusion Crude NADE incidence rates were similar between cART-treated patients in a US observational cohort and a sub-Saharan African clinical trial. However, when standardized to the US cohort, overall NADE rates were higher in Botswana. NADEs appear to be a significant problem in our sub-Saharan African setting, and the monitoring, prevention, and treatment of NADEs should be a critical component of care in resource-limited settings. PMID:21572309

  9. Depression, Stressful Life Events, and the Impact of Variation in the Serotonin Transporter: Findings from the National Longitudinal Study of Adolescent to Adult Health (Add Health)

    PubMed Central

    Haberstick, Brett C.; Boardman, Jason D.; Wagner, Brandon; Smolen, Andrew; Hewitt, John K.; Killeya-Jones, Ley A.; Tabor, Joyce; Halpern, Carolyn T.; Brummett, Beverly H.; Williams, Redford B.; Siegler, Ilene C.; Hopfer, Christian J.; Mullan Harris, Kathleen

    2016-01-01

    Background The low transcriptionally efficient short-allele of the 5HTTLPR serotonin transporter polymorphism has been implicated to moderate the relationship between the experience of stressful life events (SLEs) and depression. Despite numerous attempts at replicating this observation, results remain inconclusive. Methods We examined this relationship in young-adult Non-Hispanic white males and females between the ages of 22 and 26 (n = 4724) participating in the National Longitudinal Study of Adolescent to Adult Health (Add Health) with follow-up information every six years since 1995. Results Linear and logistic regression models, corrected for multiple testing, indicated that carriers of one or more of the S-alleles were more sensitive to stress than those with two L-alleles and at a higher risk for depression. This relationship behaved in a dose-response manner such that the risk for depression was greatest among those who reported experiencing higher numbers of SLEs. In post-hoc analyses we were not able to replicate an interaction effect for suicide ideation but did find suggestive evidence that the effects of SLEs and 5HTTLPR on suicide ideation differed for males and females. There were no effects of childhood maltreatment. Discussion Our results provide partial support for the original hypothesis that 5-HTTLPR genotype interacts with the experience of stressful life events in the etiology of depression during young adulthood. However, even with this large sample, and a carefully constructed a priori analysis plan, the results were still not definitive. For the purposes of replication, characterizing the 5HTTLPR in other large data sets with extensive environmental and depression measures is needed. PMID:26938215

  10. Nutrient- and non-nutrient-based natural health product (NHP) use in adults with mood disorders: prevalence, characteristics and potential for exposure to adverse events

    PubMed Central

    2013-01-01

    Background To address knowledge gaps regarding natural health product (NHP) usage in mental health populations, we examined their use in adults with mood disorders, and explored the potential for adverse events. Methods Food and NHP intake was obtained from 97 adults with mood disorders. NHP data was used to compare prevalence with population norms (British Columbia Nutrition Survey; BCNS). Bivariate and regression analyses examined factors associated with NHP use. Assessment of potential adverse effects of NHP use was based on comparing nutrient intakes from food plus supplements with the Dietary Reference Intakes and by reviewing databases for reported adverse health effects. Results Two-thirds (66%; 95% CI 56 to 75) were taking at least one NHP; 58% (95% CI 47 to 68) were taking NHPs in combination with psychiatric medications. The proportion of each type of NHP used was generally higher than the BCNS (range of p’s < 0.05 to 0.0001). When intakes from food and NHP sources were combined, a small proportion exceeded any Lowest-Observed-Adverse-Effect-Levels: only for niacin (n = 17) and magnesium (n = 6), two nutrients for which the potential for adverse effects is minimal. Conversely, about 38% (95% CI 28 to 49) of the sample were taking a non-nutrient based NHP for which previous adverse events had been documented. Conclusions The prevalent use of NHPs in this population suggests that health care providers need to be knowledgeable about their characteristics. The efficacy and safety of NHPs in relation to mental health warrants further investigation. PMID:23570306

  11. Left atrial dimension and traditional cardiovascular risk factors predict 20-year clinical cardiovascular events in young healthy adults: the CARDIA study

    PubMed Central

    Armstrong, Anderson C.; Liu, Kiang; Lewis, Cora E.; Sidney, Stephen; Colangelo, Laura A.; Kishi, Satoru; Ambale-Venkatesh, Bharath; Arynchyn, Alex; Jacobs, David R.; Correia, Luís C.L.; Gidding, Samuel S.; Lima, João A.C.

    2014-01-01

    Aims We investigated whether the addition of left atrial (LA) size determined by echocardiography improves cardiovascular risk prediction in young adults over and above the clinically established Framingham 10-year global CV risk score (FRS). Methods and results We included white and black CARDIA participants who had echocardiograms in Year-5 examination (1990–91). The combined endpoint after 20 years was incident fatal or non-fatal cardiovascular disease: myocardial infarction, heart failure, cerebrovascular disease, peripheral artery disease, and atrial fibrillation/flutter. Echocardiography-derived M-mode LA diameter (LAD; n = 4082; 149 events) and 2D four-chamber LA area (LAA; n = 2412; 77 events) were then indexed by height or body surface area (BSA). We used Cox regression, areas under the receiver operating characteristic curves (AUC), and net reclassification improvement (NRI) to assess the prediction power of LA size when added to calculated FRS or FRS covariates. The LAD and LAA cohorts had similar characteristics; mean LAD/height was 2.1 ± 0.3 mm/m and LAA/height 9.3 ± 2.0 mm2/m. After indexing by height and adjusting for FRS covariates, hazard ratios were 1.31 (95% CI 1.12, 1.60) and 1.43 (95% CI 1.13, 1.80) for LAD and LAA, respectively; AUC was 0.77 for LAD and 0.78 for LAA. When LAD and LAA were indexed to BSA, the results were similar but slightly inferior. Both LAD and LAA showed modest reclassification ability, with non-significant NRIs. Conclusion LA size measurements independently predict clinical outcomes. However, it only improves discrimination over clinical parameters modestly without altering risk classification. Indexing LA size by height is at least as robust as by BSA. Further research is needed to assess subgroups of young adults who may benefit from LA size information in risk stratification. PMID:24534011

  12. Post-Traumatic Stress Symptoms and Post-Traumatic Growth: Evidence from a Longitudinal Study following an Earthquake Disaster

    PubMed Central

    Chen, Jieling; Zhou, Xiao; Zeng, Min; Wu, Xinchun

    2015-01-01

    Objective The current longitudinal study aims to examine the bidirectional relationship between post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG). Method One hundred twenty-two adults in the most severely affected area were investigated by self-report questionnaires at 12 months and 18 months after the Wenchuan Earthquake occurred in China. Results The autoregressive cross-lagged structure equation analysis revealed that PTG at 12 months post-earthquake could negatively predict PTSS at 18 months post-earthquake above and beyond PTSS stability, whereas PTSS at 12 months post-earthquake could not significantly predict subsequent PTG. Moreover, PTG at 12 months post-earthquake could predict fewer subsequent intrusions, numbing and hyper-arousal symptoms but not avoidance symptoms. Conclusion Growth can play a role in reducing long-term post-traumatic stress symptoms, and the implication of a positive perspective in post-trauma circumstance is discussed. PMID:26046912

  13. [Traumatic neurogenic shock].

    PubMed

    Maurin, O; de Régloix, S; Caballé, D; Arvis, A-M; Perrochon, J-C; Tourtier, J-P

    2013-05-01

    Traumatic neurogenic shock is a rare but serious complication of spinal cord injury. It associates bradycardia and hypotension caused by a medullary trauma. It is life-threatening for the patient and it aggravates the neurological deficit. Strict immobilization and a quick assessment of the gravity of cord injury are necessary as soon as prehospital care has begun. Initial treatment requires vasopressors associated with fluid resuscitation. Steroids are not recommended. Early decompression is recommended for incomplete deficit seen in the first 6 hours. We relate the case of secondary spinal shock to a luxation C6/C7 treated in prehospital care. PMID:23566590

  14. [Traumatic disease and metabolism].

    PubMed

    Deriabin, I I; Nasonkin, O S; Nemchenko, N S; Gol'm, N P; Zimina, Z P

    1984-06-01

    The authors have established that the traumatic disease is accompanied by phasic nonspecific changes of metabolism correlating with the trauma severity as well as with its specific features and outcomes. Within the first 3-7 days catabolic processes are found to prevail and metabolic acidosis develop. Later, anabolic processes become activated in the non-complicated course of the disease. Normalization of most biochemical processes is accomplished within 15-21 days. More pronounced and prolonged disturbances of metabolism are observed in complications and lethal outcomes. PMID:6474706

  15. Animal models of post-traumatic stress disorder: face validity

    PubMed Central

    Goswami, Sonal; Rodríguez-Sierra, Olga; Cascardi, Michele; Paré, Denis

    2013-01-01

    Post-traumatic stress disorder (PTSD) is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic) are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma. PMID:23754973

  16. Animal models of post-traumatic stress disorder: face validity.

    PubMed

    Goswami, Sonal; Rodríguez-Sierra, Olga; Cascardi, Michele; Paré, Denis

    2013-01-01

    Post-traumatic stress disorder (PTSD) is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic) are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma. PMID:23754973

  17. Shame amplifies the association between stressful life events and paranoia amongst young adults using mental health services: Implications for understanding risk and psychological resilience.

    PubMed

    Johnson, Judith; Jones, Christopher; Lin, Ashleigh; Wood, Stephen; Heinze, Kareen; Jackson, Christopher

    2014-12-15

    Shame is associated with a range of psychological disorders, and is a trans-diagnostic moderator of the association between stressors and symptoms of disorder. However, research has yet to investigate shame in relation to specific psychotic symptoms in clinical groups. In order to address this, the present study investigated shame in young adults with mental health problems, to test whether shame was i) directly associated with paranoia, a prevalent psychotic symptom, and ii) a moderator of the association between stress and paranoia. Sixty participants completed measures of stressful events, paranoia, shame, depression and anxiety. Results from a cross-sectional regression analysis suggested that shame was associated with paranoia after the stressful life event measure was entered into the model, and shame moderated the association between stress and paranoia. For individuals scoring high on shame, shame amplified the association between stress and paranoia, but for low-shame individuals, the association between stress and paranoia was non-significant. These findings suggest that high levels of shame could confer vulnerability for paranoia amongst clinical groups, and that resistance to experiencing shame could be a marker of resilience. PMID:25086764

  18. Sterile post-traumatic immunosuppression.

    PubMed

    Islam, Md Nahidul; Bradley, Benjamin A; Ceredig, Rhodri

    2016-04-01

    After major trauma, the human immune system initiates a series of inflammatory events at the injury site that is later followed by suppression of local inflammation favoring the repair and remodeling of the damaged tissues. This local immune response involves complex interactions between resident cells such as macrophages and dendritic cells, soluble mediators such as cytokines and chemokines, and recruited cells such as neutrophils, monocytes and mesenchymal stromal cells. If of sufficient magnitude, these initial immune responses nevertheless have systemic consequences resulting in a state called post-traumatic immunosuppression (PTI). However, controversy exists regarding the exact immunological changes occurring in systemic compartments triggered by these local immune responses. PTI is one of the leading causes of post-surgical mortality and makes patients vulnerable to hospital-acquired infections, multiple organ failure and many other complications. In addition, hemorrhage, blood transfusion, immunesenescence and immunosuppressant drugs aggravate PTI. PTI has been intensively studied, but published results are frequently cloudy. The purpose of this review is to focus on the contributions made by different responsive modalities to immunosuppression following sterile trauma and to try to integrate these into an overall scheme of PTI. PMID:27195120

  19. Sterile post-traumatic immunosuppression

    PubMed Central

    Islam, Md Nahidul; Bradley, Benjamin A; Ceredig, Rhodri

    2016-01-01

    After major trauma, the human immune system initiates a series of inflammatory events at the injury site that is later followed by suppression of local inflammation favoring the repair and remodeling of the damaged tissues. This local immune response involves complex interactions between resident cells such as macrophages and dendritic cells, soluble mediators such as cytokines and chemokines, and recruited cells such as neutrophils, monocytes and mesenchymal stromal cells. If of sufficient magnitude, these initial immune responses nevertheless have systemic consequences resulting in a state called post-traumatic immunosuppression (PTI). However, controversy exists regarding the exact immunological changes occurring in systemic compartments triggered by these local immune responses. PTI is one of the leading causes of post-surgical mortality and makes patients vulnerable to hospital-acquired infections, multiple organ failure and many other complications. In addition, hemorrhage, blood transfusion, immunesenescence and immunosuppressant drugs aggravate PTI. PTI has been intensively studied, but published results are frequently cloudy. The purpose of this review is to focus on the contributions made by different responsive modalities to immunosuppression following sterile trauma and to try to integrate these into an overall scheme of PTI. PMID:27195120

  20. The validity of assessing temporal events, sub-phases and trunk kinematics of the sit-to-walk movement in older adults using a single inertial sensor.

    PubMed

    Walgaard, Stefan; Faber, Gert S; van Lummel, Rob C; van Dieën, Jaap H; Kingma, Idsart

    2016-06-14

    The aim of this study was to develop a method to identify temporal events, sub-phases and trunk kinematics of the sit-to-walk (STW) using a single inertial sensor (IS) worn at the lower back and to determine the validity of this method. Twenty-seven healthy older adults performed a STW movement, which started from sitting in a chair and included walking 3m. Participants׳ movements were recorded with the IS, a reference measurement system consisting of an optical motion capture system (3 markers on the IS and one on each foot) and on-off switches located in the seat of the chair. Using the data from the IS and the reference measurement systems, the following signals and variables were calculated and compared: 3D IS motion (accelerations, velocities, displacements and angles), temporal events (start of trunk movement, seat-off, end of trunk flexion phase, end of trunk rising phase and gait initiation) and trunk kinematics (flexion range, maximum flexion velocity, maximum forward velocity and forward velocity during seat-off and at first heel-strike and maximum vertical velocity and vertical velocity at first heel-strike). For most variables acceptable differences (RMSE<10%) were found between IS and reference measurement systems, except for sideways displacements and non-sagittal plane rotations. Furthermore, good results were found for temporal event detection, with ICC values for all variables being 0.988 or higher. With exception of the vertical velocity at heel-strike agreement for trunk kinematics was high, with ICC values being 0.867 or higher. PMID:27017301

  1. Prediabetes is not an independent risk factor for incident heart failure, other cardiovascular events or mortality in older adults: Findings from a population-based cohort study

    PubMed Central

    Deedwania, Prakash; Patel, Kanan; Fonarow, Gregg C.; Desai, Ravi V.; Zhang, Yan; Feller, Margaret A.; Ovalle, Fernando; Love, Thomas E.; Aban, Inmaculada B.; Mujib, Marjan; Ahmed, Mustafa I.; Anker, Stefan D.; Ahmed, Ali

    2013-01-01

    Background Whether prediabetes is an independent risk factor for incident heart failure (HF) in non-diabetic older adults remains unclear. Methods Of the 4602 Cardiovascular Health Study participants, age ≥ 65 years, without baseline HF and diabetes, 2157 had prediabetes, defined as fasting plasma glucose (FPG) 100–125 mg/dL. Propensity scores for prediabetes, estimated for each of the 4602 participants, were used to assemble a cohort of 1421 pairs of individuals with and without prediabetes, balanced on 44 baseline characteristics. Results Participants had a mean age of 73 years, 57% were women, and 13% African American. Incident HF occurred in 18% and 20% of matched participants with and without prediabetes, respectively (hazard ratio {HR} associated with prediabetes, 0.90; 95% confidence interval {CI}, 0.76–1.07; p = 0.239). Unadjusted and multivariable-adjusted HRs (95% CIs) for incident HF associated with prediabetes among 4602 pre-match participants were 1.22 (95% CI, 1.07–1.40; p = 0.003) and 0.98 (95% CI, 0.85–1.14; p = 0.826), respectively. Among matched individuals, prediabetes had no independent association with incident acute myocardial infarction (HR, 1.02; 95% CI, 0.81–1.28; p = 0.875), angina pectoris (HR, 0.93; 95% CI, 0.77–1.12; p = 0.451), stroke (HR, 0.86; 95% CI, 0.70–1.06; p = 0.151) or all-cause mortality (HR, 0.99; 95% CI, 0.88–1.11; p = 0.840). Conclusions We found no evidence that prediabetes is an independent risk factor for incident HF, other cardiovascular events or mortality in community-dwelling older adults. These findings question the wisdom of routine screening for prediabetes in older adults and targeted interventions to prevent adverse outcomes in older adults with prediabetes. PMID:23731526

  2. Neutropenia as an Adverse Event following Vaccination: Results from Randomized Clinical Trials in Healthy Adults and Systematic Review

    PubMed Central

    Muturi-Kioi, Vincent; Lewis, David; Launay, Odile; Leroux-Roels, Geert; Anemona, Alessandra; Loulergue, Pierre; Bodinham, Caroline L.; Aerssens, Annelies; Groth, Nicola; Saul, Allan; Podda, Audino

    2016-01-01

    Background In the context of early vaccine trials aimed at evaluating the safety profile of novel vaccines, abnormal haematological values, such as neutropenia, are often reported. It is therefore important to evaluate how these trials should be planned not to miss potentially important safety signals, but also to understand the implications and the clinical relevance. Methodology We report and discuss the results from five clinical trials (two with a new Shigella vaccine in the early stage of clinical development and three with licensed vaccines) where the absolute neutrophil counts (ANC) were evaluated before and after vaccination. Additionally, we have performed a systematic review of the literature on cases of neutropenia reported during vaccine trials to discuss our results in a more general context. Principal Findings Both in our clinical trials and in the literature review, several cases of neutropenia have been reported, in the first two weeks after vaccination. However, neutropenia was generally transient and had a benign clinical outcome, after vaccination with either multiple novel candidates or well-known licensed vaccines. Additionally, the vaccine recipients with neutropenia frequently had lower baseline ANC than non-neutropenic vaccinees. In many instances neutropenia occurred in subjects of African descent, known to have lower ANC compared to western populations. Conclusions It is important to include ANC and other haematological tests in early vaccine trials to identify potential safety signals. Post-vaccination neutropenia is not uncommon, generally transient and clinically benign, but many vaccine trials do not have a sampling schedule that allows its detection. Given ethnic variability in the level of circulating neutrophils, normal ranges taking into account ethnicity should be used for determination of trial inclusion/exclusion criteria and classification of neutropenia related adverse events. Trial registration ClinicalTrials.gov NCT02017899

  3. Prospective Surveillance for Cardiac Adverse Events in Healthy Adults Receiving Modified Vaccinia Ankara Vaccines: A Systematic Review

    PubMed Central

    Elizaga, Marnie L.; Vasan, Sandhya; Marovich, Mary A.; Sato, Alicia H.; Lawrence, Dale N.; Chaitman, Bernard R.; Frey, Sharon E.; Keefer, Michael C.

    2013-01-01

    Background Vaccinia-associated myo/pericarditis was observed during the US smallpox vaccination (DryVax) campaign initiated in 2002. A highly-attenuated vaccinia strain, modified vaccinia Ankara (MVA) has been evaluated in clinical trials as a safer alternative to DryVax and as a vector for recombinant vaccines. Due to the lack of prospectively collected cardiac safety data, the US Food and Drug Administration required cardiac screening and surveillance in all clinical trials of MVA since 2004. Here, we report cardiac safety surveillance from 6 phase I trials of MVA vaccines. Methods Four clinical research organizations contributed cardiac safety data using common surveillance methods in trials administering MVA or recombinant MVA vaccines to healthy participants. ‘Routine cardiac investigations’ (ECGs and cardiac enzymes obtained 2 weeks after injections of MVA or MVA-HIV recombinants, or placebo-controls), and ‘Symptom-driven cardiac investigations’ are reported. The outcome measure is the number of participants who met the CDC-case definition for vaccinia-related myo/pericarditis or who experienced cardiac adverse events from an MVA vaccine. Results Four hundred twenty-five study participants had post-vaccination safety data analyzed, 382 received at least one MVA-containing vaccine and 43 received placebo; 717 routine ECGs and 930 cardiac troponin assays were performed. Forty-five MVA recipients (12%) had additional cardiac testing performed; 22 for cardiac symptoms, 19 for ECG/laboratory changes, and 4 for cardiac symptoms with an ECG/laboratory change. No participant had evidence of symptomatic or asymptomatic myo/pericarditis meeting the CDC-case definition and judged to be related to an MVA vaccine. Conclusions Prospective surveillance of MVA recipients for myo/pericarditis did not detect cardiac adverse reactions in 382 study participants. Trial Registration ClinicalTrials.gov NCT00082446 NCT003766090 NCT00252148 NCT00083603 NCT00301184

  4. Return to Work and Social Communication Ability Following Severe Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Douglas, Jacinta M.; Bracy, Christine A.; Snow, Pamela C.

    2016-01-01

    Purpose: Return to competitive employment presents a major challenge to adults who survive traumatic brain injury (TBI). This study was undertaken to better understand factors that shape employment outcome by comparing the communication profiles and self-awareness of communication deficits of adults who return to and maintain employment with those…

  5. [Emergence of early childhood trauma in adult psychiatric symptomatology].

    PubMed

    Bouras, G; Lazaratou, E

    2012-06-01

    Trauma comes as a result of the subject's exposure to extremely negative and stressful events, such as natural or human-provoked catastrophes, wars, serious injuries, violent deaths, tortures, terrorist attacks, rapes and other sexual crimes. A child's exposure to traumatic circumstances of this level during the crucial period of self-structuring creates rather difficult conditions for its development. Moreover, if the child does not have the opportunity to elaborate and analyze all these stressful conditions and put them into words, serious consequences, both psychological and somatic, may occur in adult life. Specific factors and child characteristics, namely, the age, the developmental stage within which the trauma occurs, its type (physical or sexual abuse, neglect or traumatic social events), frequency, duration and intensity, have been proved to seriously affect the trauma's consequences. The immediate emotional impact of trauma may include isolation, fear, feeling of weakness or loss of the sense of confidence. Moreover, mood disorders such as depression and withdrawal, negative effects on cognitive ability, language development and academic performance, difficulties in creating a secure link and post-traumatic stress disorder (PTSD) are also observed. The long-term consequences for the individual's mental health can be expressed through the following: post-traumatic stress disorder (PTSD) combined or not with depression and anxiety disorder, mood disorders, personality disorders, poor control of impulsions, dissociation disorder, psychotic disorder. Finally, apart from the dramatic impact of trauma on the person itself, there is also a high social cost to be paid as a result of the individual's poor adjustment and dysfunction in the community. Early support and intervention in the child's environment may significantly minimize the negative effects of trauma. Beyond the expression of genes, good maternal care as well as psychological support, lead to normal

  6. Traumatization and chronic pain: a further model of interaction

    PubMed Central

    Egloff, Niklaus; Hirschi, Anna; von Känel, Roland

    2013-01-01

    Up to 80% of patients with severe posttraumatic stress disorder are suffering from “unexplained” chronic pain. Theories about the links between traumatization and chronic pain have become the subject of increased interest over the last several years. We will give a short summary about the existing interaction models that emphasize particularly psychological and behavioral aspects of this interaction. After a synopsis of the most important psychoneurobiological mechanisms of pain in the context of traumatization, we introduce the hypermnesia–hyperarousal model, which focuses on two psychoneurobiological aspects of the physiology of learning. This hypothesis provides an answer to the hitherto open question about the origin of pain persistence and pain sensitization following a traumatic event and also provides a straightforward explanatory model for educational purposes. PMID:24231792

  7. Traumatization and chronic pain: a further model of interaction.

    PubMed

    Egloff, Niklaus; Hirschi, Anna; von Känel, Roland

    2013-01-01

    Up to 80% of patients with severe posttraumatic stress disorder are suffering from "unexplained" chronic pain. Theories about the links between traumatization and chronic pain have become the subject of increased interest over the last several years. We will give a short summary about the existing interaction models that emphasize particularly psychological and behavioral aspects of this interaction. After a synopsis of the most important psychoneurobiological mechanisms of pain in the context of traumatization, we introduce the hypermnesia-hyperarousal model, which focuses on two psychoneurobiological aspects of the physiology of learning. This hypothesis provides an answer to the hitherto open question about the origin of pain persistence and pain sensitization following a traumatic event and also provides a straightforward explanatory model for educational purposes. PMID:24231792

  8. Trauma, post-traumatic stress disorder and psychiatric disorders in a middle-income setting: prevalence and comorbidity

    PubMed Central

    Dorrington, Sarah; Zavos, Helena; Ball, Harriet; McGuffin, Peter; Rijsdijk, Fruhling; Siribaddana, Sisira; Sumathipala, Athula; Hotopf, Matthew

    2014-01-01

    Background Most studies of post-traumatic stress disorder (PTSD) in low- and middle-income countries (LMICs) have focused on ‘high-risk’ populations defined by exposure to trauma. Aims To estimate the prevalence of post-traumatic stress disorder (PTSD) in a LMIC, the conditional probability of PTSD given a traumatic event and the strength of associations between traumatic events and other psychiatric disorders. Method Our sample contained a mix of 3995 twins and 2019 non-twins. We asked participants about nine different traumatic exposures, including the category ‘other’, but excluding sexual trauma. Results Traumatic events were reported by 36.3% of participants and lifetime PTSD was present in 2.0%. Prevalence of non-PTSD lifetime diagnosis was 19.1%. Of people who had experienced three or more traumatic events, 13.3% had lifetime PTSD and 40.4% had a non-PTSD psychiatric diagnosis. Conclusions Despite high rates of exposure to trauma, this population had lower rates of PTSD than high-income populations, although the prevalence might have been slightly affected by the exclusion of sexual trauma. There are high rates of non-PTSD diagnoses associated with trauma exposure that could be considered in interventions for trauma-exposed populations. Our findings suggest that there is no unique relationship between traumatic experiences and the specific symptomatology of PTSD. PMID:25257062

  9. [Traumatic dissection of the internal carotid artery by a safety belt: a report of two cases].

    PubMed

    López-Sánchez, M; Ballesteros-Sanz, M A; Pérez-Ceballos, A; González-Fernández, C; López-Espadas, F

    2009-10-01

    Traumatic internal carotid artery dissection secondary to blunt trauma is a rare event accounting for 0.08 to 0.4% of all traumatic lesions. The spectrum of traumatic lesions that can affect the internal carotid artery includes minor lesions like spasm, intimal tears, or mural contusions and serious lesions like pseudoaneurysms and complete occlusion. Delayed clinical presentation is typical and can include headache, hemiparesis, partial Horner's syndrome, and cranial nerve palsy. Embolization secondary to the dissection can have devastating effects because it may cause ischemic stroke. Traumatic internal carotid artery dissection after safety belt trauma is very rare; it is usually due to direct cervical trauma on the side of the shoulder fixation point, which causes external bruising along the pathway of the safety belt. We present two cases of traumatic internal carotid artery dissection with concomitant cerebral infarcts caused by safety belts; we discuss the clinical, diagnostic, and therapeutic aspects of this lesion. PMID:19828398

  10. Elder mistreatment and physical health among older adults: the South Carolina Elder Mistreatment Study.

    PubMed

    Cisler, Josh M; Amstadter, Ananda B; Begle, Angela M; Hernandez, Melba; Acierno, Ron

    2010-08-01

    Exposure to potentially traumatic events (PTEs), including interpersonal violence, is associated with poorer physical health in young adults. This relation has not been well-investigated among older adults in specific populations. The present study was designed to investigate whether exposure to PTEs and elder mistreatment are associated with physical health status among older adults residing in South Carolina. Older adults aged 60 and above (N = 902) participated in a structured interview assessing elder mistreatment history, PTEs, demographics, and social dependency variables. Results demonstrated that PTEs were associated with poor self-rated health independently and when controlling for other significant predictors. A recent history of emotional mistreatment was associated with poor self-rated health independently, but not when controlling for other significant predictors. PMID:20690195

  11. Crisis-induced depression, physical activity and dietary intake among young adults: evidence from the 9/11 terrorist attacks.

    PubMed

    Wang, Yang; Yang, Muzhe

    2013-03-01

    Using data from the National Longitudinal Study of Adolescent Health, we provide evidence that young adults respond to crisis-induced depression by exercising less and having breakfast less often. Exogenous variation in the crisis-induced depression is obtained through a unique event in our sample period - the 9/11 terrorist attacks. We compare those who were interviewed just before and just after 9/11 and find a significant and sharp increase in the symptoms of depression. We also provide evidence that this increase is not a September effect, but an effect of the external traumatic event. PMID:22959863

  12. Study of the Clinical Outcome between Traumatic and Degenerative (non-traumatic) Meniscal Tears after Arthroscopic Surgery: A 4-Years Follow-up Study

    PubMed Central

    Ghislain, Nietiayurk Aminake; Wei, Ji-Nan

    2016-01-01

    Introduction The meniscus is a biconcave fibrocartilage in the knee joint interpose between the femoral condyles and tibial plateau; the meniscus has functions in load bearing, load transmission, shock absorption joint stability, joint lubrication, and joint congruity. Aim The aim of this study is to provide orthopeadic surgeon a base of reference in the choice of the optimal course of management for meniscal tears. Materials and Methods One hundred and seventeen patients met the criteria of inclusion for the present study. Patients were divided in two groups T and NT according to the presence of distinct previous traumatic events to the knees. Two subgroups were formed in each groups T and NT respectively at a mean follow up of 1 and 4 years. Postoperative clinical outcome were assessed using Lysholm scores and Rand SF-36 survey. Results One hundred and seventeen patients were included in the present study with 60(51.28%) patients in the traumatic group and 57(48.71%) in the degenerative group. 95(81.19%) patients in total were satisfied with their health status at end of follow up. The mean value of Lysholm scores at 1 year were respectively 85.25±8.78 for traumatic group and 86.38±12.14 for non-traumatic group and at 4 years were respectively 92.63±7.31 for traumatic group and 72.90±20.77 for non-traumatic group. According to Rand SF-36 health, traumatic group showed better improvements compare to non-traumatic group between 1 and 4 years after arthroscopic meniscus surgery. Conclusion A total of 95(81.19%) patients in total were satisfied with their health status at follow up, however, we found that arthroscopy as a treatment for meniscal tear have a relatively better mid-term clinical outcome for traumatic meniscal tears compare to non-traumatic/degenerative meniscal tears. PMID:27190905

  13. Traumatic pulmonary pseudocysts: CT findings.

    PubMed

    Tsitouridis, Ioannis; Tsinoglou, Konstantinos; Tsandiridis, Christos; Papastergiou, Christos; Bintoudi, Antonia

    2007-08-01

    Traumatic pulmonary pseudocyst constitutes an uncommon, though well recognized, manifestation of closed chest trauma. It is usually encountered in young patients, whose compliant chest wall permits the transmission of great compressive forces to the lung parenchyma and the laceration of the latter. Traumatic pulmonary pseudocyst is usually detected during the imaging evaluation of multi-injured patients with the use of computed tomography, as it is often not apparent in the initial supine anteroposterior chest radiographs. We present 5 cases of trauma patients, in whom we detected the presence of multiple traumatic pulmonary pseudocysts during the imaging evaluation of blunt chest trauma with the use of computed tomography. PMID:17721334

  14. Adverse Events Profile of PrePex a Non-Surgical Device for Adult Male Circumcision in a Ugandan Urban Setting

    PubMed Central

    Galukande, Moses; Duffy, Kevin; Bitega, Jean Paul; Rackara, Sam; Bbaale, Denis Sekavuga; Nakaggwa, Florence; Nagaddya, Teddy; Wooding, Nick; Dea, Monica; Coutinho, Alex

    2014-01-01

    Background Safe Male Circumcision is a proven approach for partial HIV prevention. Several sub Saharan African countries have plans to reach a prevalence of 80% of their adult males circumcised by 2015. These targets require out of ordinary organization, demand creation, timely execution and perhaps the use of SMC devices. Objective To profile Adverse Events rate and acceptance of PrePex, a non surgical device for adult male circumcision. Methods A prospective study, conducted at International Hospital Kampala, Uganda, between August and October 2012. Ethical approval was obtained from Uganda National Council of Science and Technology. Results Of 1,040 men received to undergo SMC, 678 opted for PrePex, 36 were excluded at an initial physical examination screening. 642 were enrolled and consented, and another 17 were excluded before device placement. 625 underwent the procedure. Average age was 24 years (±7). Twelve moderate AEs occurred among 10 participants 12/625, (1.9%). These were all reversible. Five had device displacement, one had an everted foreskin; five had bleeding after the device was removed and one had voiding difficulties. The majority (279 out of 300) of men interviewed complained of some pain within the week of placement. Mean pain score at device placement (using visual analogue scale) was 0.5, at device removal 4.5 and within 2 min of removal the pain score was 1.4. Over 70% of the devices were placed and removed by non-physician clinicians. Presented with a choice, 60% of men chose PrePex over surgical SMC. Close to 90% would recommend the device to their friends. Odour from the necrotic skin was a concern. Removals done 1–2 days earlier than day 7 were beneficial and conferred no extra risk. Conclusion AEs of a moderate or severe nature associated with PrePex were low and reversible. PrePex is feasible for mass safe male circumcision scaling up. PMID:24489754

  15. Maturation processes in automatic change detection as revealed by event-related brain potentials and dipole source localization: significance for adult AD/HD.

    PubMed

    Wild-Wall, Nele; Oades, Robert D; Juran, Stephanie A

    2005-10-01

    Mismatch negativity (MMN) is an event-related potential reflecting automatic attention-related information processing marking the detection of auditory change. The bilateral scalp distribution develops by 14 years of age, and is elicited with adult latencies by 17 years. But consistent with reports of continued brain maturation after adolescence, we show here that features of the temporal and frontal lobe dipole sources also continue to develop in the third decade of life. This has consequences for studies of the developmental course of MMN anomalies, from childhood into adulthood, in attention-deficit/hyperactivity disorder. Two groups of healthy subjects with mean ages of 17 and 30 years were presented with a 3-tone auditory oddball. The duration-deviant MMN was recorded during attention to a visual discrimination (auditory-passive condition) and an active auditory discrimination. MMN amplitudes were smaller in the older subjects and the MMN lasted longer over the right hemisphere. Latencies and moments of the four dipoles in the temporal and frontal lobes did not distinguish the two subject-groups. But both temporal lobe sources were located significantly more ventrally and further left in the young adult than in the adolescent subjects. The left cingular source moved posteriorly and the right inferior frontal source moved antero-medially in the older subjects. Brain development in the third decade may cause the two frontal sources to move apart on the rostro-caudal axis but the temporal lobe sources to move left on the lateral and down on the dorsoventral axes. Thus special care is necessary in interpreting putative dysfunctional neurobiological changes in developmental attention-deficit disorders where as-yet-unspecified sub-groups may show a late developmental lag, partial lag, or no lag at all, associated with other impairments. PMID:15922470

  16. [First stage in identifying traumatic profil inpatients hospitalised in psychiatry in Martinique].

    PubMed

    Evans, M; Vacher, E; Lamy, S; Seridi, H; Jan, M; Debien, C; Sigward, J-M; Jehel, L

    2014-01-01

    The population hospitalised in psychiatry seems more exposed to traumatic events than the French general population, with particularly more sexual aggressions. The aim of this study is to describe the population hospitalised in psychiatry and more precisely the traumatic history of these patients, their comorbidities (mental diseases and addictions), and socio economical level. This descriptive, cross sectional and retrospective study took place in the Crisis Center in the University Hospital in Martinique (French West Indies), from February to July 2013. A socio-demographic information, the Mini International Neuropsychiatric Interview 5.0, the Trauma History Questionnaire and the Impact Events Scale-Revised were realised with 49 of the 143 patients admitted during this period (34.3%). In this population, we found a mean of 6.5 (standart-deviation=4.2) different types of traumatic event, with 38.8% patients reporting a natural disaster, and 38.8% declaring at least one sexual aggression. In the 25 patients suffering from post-traumatic stress disorder, 66.7% underwent a sexual aggression, significatively during childhood (before 10 years old, P=0.01), and during adolescence (between 10 to 18 years old, P=0.01). These results underline the importance of a systematic screening of the traumatic profile: the characteristics of the traumatic events and its clinical impact. PMID:25590554

  17. A diagnostic dilemma between psychosis and post-traumatic stress disorder: a case report and review of the literature

    PubMed Central

    2011-01-01

    Introduction Post-traumatic stress disorder is defined as a mental disorder that arises from the experience of traumatic life events. Research has shown a high incidence of co-morbidity between post-traumatic stress disorder and psychosis. Case presentation We report the case of a 32-year-old black African woman with a history of both post-traumatic stress disorder and psychosis. Two years ago she presented to mental health services with auditory and visual hallucinations, persecutory delusions, suicidal ideation, recurring nightmares, hyper-arousal, and initial and middle insomnia. She was prescribed trifluoperazine (5 mg/day) and began cognitive-behavioral therapy for psychosis. Her psychotic symptoms gradually resolved over a period of three weeks; however, she continues to experience ongoing symptoms of post-traumatic stress disorder. In our case report, we review both the diagnostic and treatment issues regarding post-traumatic stress disorder with psychotic symptoms. Conclusions There are many factors responsible for the symptoms that occur in response to a traumatic event, including cognitive, affective and environmental factors. These factors may predispose both to the development of post-traumatic stress disorder and/or psychotic disorders. The independent diagnosis of post-traumatic stress disorder with psychotic features remains an open issue. A psychological formulation is essential regarding the appropriate treatment in a clinical setting. PMID:21392392

  18. Guilt, shame and need for a container: a study of post-traumatic stress among ambulance personnel.

    PubMed

    Jonsson, Anders; Segesten, Kerstin

    2004-10-01

    Post-traumatic stress symptoms among ambulance personnel are regarded as a natural behaviour and reaction to working with the severely injured, suicides, injured children and dead people. The findings show that post-traumatic stress symptoms, guilt, shame and self-reproach are common after duty-related traumatic events. To handle these overwhelming feelings it is necessary to talk about them with fellow workers, friends or family members. By using another person as a container it is possible to internalise the traumatic experience. Poor and un-emphatic behaviour towards a patient and their relatives can have its origin in untreated traumatic experiences. Personnel in ambulance organisations who perform defusing, debriefing and counselling have to be informed of the importance that the roll of guilt and shame may play in the developing of post-traumatic stress symptoms. PMID:15474346

  19. Secondary traumatic stress among emergency nurses: a cross-sectional study.

    PubMed

    Duffy, Emer; Avalos, Gloria; Dowling, Maura

    2015-04-01

    Emergency department nurses are required to deal with emotional trauma issues on a daily basis, which may result in them experiencing symptoms of secondary traumatic stress, a consequence of stress experienced when helping or wanting to help a person traumatised or suffering. This study measured emergency department nurses' self-reported levels of secondary traumatic stress. Registered nurses (n = 117) working at three emergency departments in the Western geographical region of Ireland were invited to complete the secondary traumatic stress scale (STSS). A response rate of 90% (n = 105) was achieved. Most participants (n = 67/64%) met the criteria for secondary traumatic stress. A statistically significant finding was that the highest proportion (82%) of secondary traumatic stress existed in the staff nurse group (p = 0.042). Moreover, for those nurses reporting secondary traumatic stress, statistical significance was found for the variables 'change of career considered' (p = 0.017) and 'finds alcohol helpful in alleviating work-related stress' (p = 0.004), when compared with nurses not reporting secondary traumatic stress. The findings suggest the need to examine current crisis management interventions and to introduce new systems to support nurses in Irish emergency departments. Moreover, because different types of traumatic events in the ED require different types of interventions, the prevention and management of STS among emergency department nurses must be tackled using a variety of approaches. PMID:24927978

  20. Post-Traumatic Stress Disorder

    MedlinePlus

    ... PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. For Consumers General Information Post-Traumatic Stress Disorder ( NIMH ) Anxiety Information Stress Information Depression Information St. John's Wort Information See more Research ...