BACKGROUND Traumatic fractures are mainly caused by various exogenous traumatic events,which not only damage patients’physical health but also affect their psychological state and aggravate stress responses.AIM To an...BACKGROUND Traumatic fractures are mainly caused by various exogenous traumatic events,which not only damage patients’physical health but also affect their psychological state and aggravate stress responses.AIM To analyze the influencing factors of psychological resilience of patients with traumatic fractures and the effect of psychological resilience on posttraumatic growth(PTG).METHODS This study included 188 patients with traumatic fractures admitted to the First People’s Hospital of Shangqiu from November 2022 to November 2023.The participants were categorized based on the patient’s psychological resilience assessed by the Connor-Davidson Resilience Scale(CD-RISC)into the better resilience group(CD-RISC score≥60 points,n=80)and the poor resilience group(CD-RISC score<60 points,n=108).Patients’sleep quality was assessed with the Pittsburgh Sleep Quality Index(PSQI).The identification of the influencing factors of psychological resilience in patients with traumatic fractures was realized by binary Logistic regression(with factors such as sex,age,injury cause,trauma severity,fracture site,personality,and PSQI included for analysis).The determination of the PTG status of all participants used the Chinese version of the Posttraumatic Growth Inventory(C-PTGI).Furthermore,a Spearman correlation analysis was conducted to analyze the association between psychological resilience and PTG.RESULTS The psychological resilience of patients with traumatic fractures was related to age,sex,trauma severity,and personality.The better resilience group demonstrated statistically lower PSQI scores than the poor resilience group(P<0.05).The Logistic regression analysis revealed sex,age,trauma severity,personality,and sleep quality as influencing factors of CD-RISC scores in patients with traumatic fractures(all P<0.05).The score of each C-PTGI dimension and the total score(relating to others,new possibilities,personal strength,spiritual change,and appreciation of life)were higher in the better resilience group than in the poor resilience group(all P<0.05).Spearman correlation analysis indicated a positive association of the CD-RISC score in patients with traumatic fractures with the scores of all dimensions of C-PTGI and the total C-PTGI score(all P<0.05).CONCLUSION The factors influencing the psychological resilience of patients with traumatic fractures include age,sex,trauma severity,personality,and sleep quality,and psychological resilience is closely associated with PTG.展开更多
Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,Ps...Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.展开更多
BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking beh...BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.展开更多
BACKGROUND Patients with multiple injuries endure not just physical trauma and suffering but are also at risk of psychological conditions such as posttraumatic stress disorder(PTSD),anxiety,and depression.The co-occur...BACKGROUND Patients with multiple injuries endure not just physical trauma and suffering but are also at risk of psychological conditions such as posttraumatic stress disorder(PTSD),anxiety,and depression.The co-occurrence of PTSD in these patients may cause prolonged physical and mental health complications,thereby further increasing their healthcare expenses.AIM To determine the association between the high-risk factors of PTSD and anxiety as well as depression among patients with multiple injuries.METHODS This study selected 110 patients with multiple injuries who were admitted to our hospital from November 2022 to November 2024.The number and percentage of patients developing PTSD were tallied.Univariate and multivariate analyses were conducted to investigate the high-risk factors of PTSD in these patients.Subse-quently,the associations between these factors and the anxiety and depression levels of patients were analyzed.RESULTS Of the 110 patients,33 suffered from PTSD,representing an incidence rate of 30.0%.The univariate analysis identified age,personality,Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),economic status,negative life events,and smoking history to be significantly associated with PTSD in patients with multiple injuries.Further,the multivariate analysis revealed age,HAMA,HAMD,monthly income,and negative life events as prominent high-risk factors for PTSD in such patients.Regarding the relationships between these factors and HAMA and HAMD,age exhibited a significant positive correlation(r=0.398,P<0.001;r=0.387,P<0.001),monthly income showed a significant negative correlation(r=-0.437,P<0.001;r=-0.319,P<0.001),and negative life events demonstrated a significant positive correlation(r=0.505,P<0.001;r=0.365,P<0.001).CONCLUSION These results indicate age,HAMA,HAMD,monthly income,negative life events,etc.as high-risk factors for PTSD in patients with multiple injuries,among which age,monthly income,and negative life events are closely associated with anxiety and depression.展开更多
Objective:To elucidate the specific mechanisms by which electroacupuncture(EA)alleviates anxiety and fear behaviors associated with posttraumatic stress disorder(PTSD),focusing on the role of lipocalin-2(Lcn2).Methods...Objective:To elucidate the specific mechanisms by which electroacupuncture(EA)alleviates anxiety and fear behaviors associated with posttraumatic stress disorder(PTSD),focusing on the role of lipocalin-2(Lcn2).Methods:The PTSD mouse model was subjected to single prolonged stress and shock(SPS&S),and the animals received 15 min sessions of EA at Shenmen acupoint(HT7).Behavioral tests were used to investigate the effects of EA at HT7 on anxiety and fear.Western blotting and enzyme-linked immunosorbent assay were used to quantify Lcn2 and inflammatory cytokine levels in the prefrontal cortex(PFC).Additionally,the activity of PFC neurons was evaluated by immunofluorescence and in vivo electrophysiology.Results:Mice subjected to SPS&S presented increased anxiety-and fear-like behaviors.Lcn2 expression in the PFC was significantly upregulated following SPS&S,leading to increased expression of the proinflammatory cytokines tumor necrosis factor-a and interleukin-6 and suppression of PFC neuronal activity.However,EA at HT7 inhibited Lcn2 release,reducing neuroinflammation and hypoexcitability in the PFC.Lcn2 overexpression mitigated the effects of EA at HT7,resulting in anxiety-and fear-like behaviors.Conclusion:EA at HT7 can ameliorate PTSD-associated anxiety and fear,and its mechanism of action appears to involve the inhibition of Lcn2-mediated neural activity and inflammation in the PFC.展开更多
BACKGROUND Studies have indicated that childhood exposure to domestic violence is a common factor in posttraumatic growth(PTG)and posttraumatic stress disorder(PTSD),but it is unclear whether PTG and PTSD share a comm...BACKGROUND Studies have indicated that childhood exposure to domestic violence is a common factor in posttraumatic growth(PTG)and posttraumatic stress disorder(PTSD),but it is unclear whether PTG and PTSD share a common/different underlying mechanism.AIM To explore the common/different underlying mechanism of PTG and PTSD.METHODS Between February 12 and 17,2020,a nationwide cross-sectional online survey was conducted in China among 2038 university students,and a self-administered questionnaire was used for the data collection.The data included demographic characteristics,such as age,gender,and subjective social economic status,and childhood exposure to domestic violence scale that was selected from the Chinese version of revised Adverse Childhood Experiences Question,Self-compassion Scale,Connor–Davidson Resilience Scale,Posttraumatic Growth Inventory,and the Abbreviated PTSD Checklist-Civilian version.A structural equation model was used to test the hypotheses.RESULTS Exposure to domestic violence was significantly associated with PTG and PTSD via a 1-step indirect path of self-compassion(PTG:β=-0.023,95%CI:-0.44 to-0.007;PTSD:β=0.008,95%CI:0.002,0.014)and via a 2-step indirect path from self-compassion to resilience(PTG:β=-0.008,95%CI:-0.018 to-0.002;PTSD:β=0.013,95%CI:0.004-0.024).However,resilience did not mediate the relationship between exposure to domestic violence and PTG and PTSD.CONCLUSION PTG and PTSD are common results of childhood exposure to domestic violence,which may be influenced by self-compassion and resilience.展开更多
Objectives:The present study compared the prevalence and psychosocial factors affecting posttraumatic growth(PTG),posttraumatic stress disorder(PTSD),and psychological distress in nurses,physicians,and medical student...Objectives:The present study compared the prevalence and psychosocial factors affecting posttraumatic growth(PTG),posttraumatic stress disorder(PTSD),and psychological distress in nurses,physicians,and medical students.Materials and Methods:In a cross‑sectional study,three groups of medical staff including nurses(n=57),physicians(n=40),and medical students(n=34)who were responsible for the care/treatment of COVID‑19 patients admitted to a general hospital for 4 months responded to Posttraumatic Growth Inventory,Brief Symptom Inventory‑18,Resilience Questionnaire,PTSD Screen,and Social Capital‑Integrated Questionnaire.Results:After the exposure of medical staff to at least 4 months of treatment/care of COVID‑19 patients,PTG prevalence was higher than PTSD(38.2%vs.14.6%),but they experienced some degrees of psychological distress(65.5%).The nurses had 8.33(confidence interval[CI]:2.5–26.7)times higher PTG rate than medical students(P<0.001).Physicists also experienced 5.00(CI:1.4–26.7)times higher PTG than medical students(P<0.001).PTG was aided by age,married status,strong resilience,and high social capital,but gender had no influence.Resilience played an important protective role to prevent the incidence of psychological distress in nurses,medical students,and physicians.Conclusion:Despite the fact that the PTSD and psychological distress were same in the three groups of medical staff,the nurses had a greater rate of PTG than physicians and medical students.展开更多
Objective: To identify the moderating effects of cognitive reappraisal(CR) and expressive suppression(ES) on the relationship between posttraumatic stress(PTS) symptoms and posttraumatic growth(PTG) in university stud...Objective: To identify the moderating effects of cognitive reappraisal(CR) and expressive suppression(ES) on the relationship between posttraumatic stress(PTS) symptoms and posttraumatic growth(PTG) in university students. Methods: The survey included 1 987 Chinese university students who completed questionnaires on PTS symptoms in February 2020, with three follow-up surveys at two-month intervals until August 2020. We assessed CR and ES at February 2020 and PTG at August 2020. Growth mixture modeling was used to classify the PTS symptom trajectories. Multinomial logistic regression was used to recognize the predictors of class membership. The relationships among PTS symptoms, CR, ES, and PTG were examined using multi-group path analysis.Results: Sex, SARS-Co V-2 infection of a family member or friend, number of siblings, CR, and ES were significantly associated with PTS symptoms. Three latent classes were identified: ‘Increasing PTS’(n=205, 10.0%) who had rapid deterioration of PTS symptoms, ‘Moderate PTS’(n=149, 8.0%) who had a high level of PTS symptoms at the beginning and slightly increasing, and ‘Persistent Minimal PTS’(n=1 633, 82.0%), who had slow resolution of PTS symptoms over time. Male, SARS-Co V-2 infection of a family member or friend, and having a lower CR and a higher ES, were more likely to have ‘Increasing PTS’. PTS at February 2020 predicted PTG only in ‘Increasing PTS’ class, and both CR and ES had moderating effects on the conversion between them.Conclusions: Most students recovered from posttraumatic stress of COVID-19 pandemic, but a small proportion expeienced increasing PTS symptoms, and those with this condition may benefit from emotional regulation intervention.展开更多
Complex posttraumatic stress disorder(Complex PTSD)has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases,11^(th)version,due to be published,two decades after its ...Complex posttraumatic stress disorder(Complex PTSD)has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases,11^(th)version,due to be published,two decades after its first initiation.It is described as an enhanced version of the current definition of PTSD,with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation,negative self-cognitions and interpersonal hardship,thus resembling the clinical features commonly encountered in borderline personality disorder(BPD).Complex PTSD is related to complex trauma which is defined by its threatening and entrapping context,generally interpersonal in nature.In this manuscript,we review the current findings related to traumatic events predisposing the above-mentioned disorders as well as the biological correlates surrounding them,along with their clinical features.Furthermore,we suggest that besides the present distinct clinical diagnoses(PTSD;Complex PTSD;BPD),there is a cluster of these comorbid disorders,that follow a continuum of trauma and biological severity on a spectrum of common or similar clinical features and should be treated as such.More studies are needed to confirm or reject this hypothesis,particularly in clinical terms and how they correlate to clinical entities'biological background,endorsing a shift from the phenomenologically only classification of psychiatric disorders towards a more biologically validated classification.展开更多
Objective:To evaluate serum IL-2,IL-4,IL-6.IL-8,TL-10 and TNF-αlevels in posttraumatic stress disorder(PTSD) patients.Methods:We utilized ELISA technology to examine cytokines such as IL-2,IL-4.IL-6.IL-8,IL-10 and T...Objective:To evaluate serum IL-2,IL-4,IL-6.IL-8,TL-10 and TNF-αlevels in posttraumatic stress disorder(PTSD) patients.Methods:We utilized ELISA technology to examine cytokines such as IL-2,IL-4.IL-6.IL-8,IL-10 and TNF-αin serum from 50 well-characterized individuals with a primary DSM-1V PTSD diagnosis,and 50 age- and gender-matched healthy controls.We conservatively employed a Mann-Whitney U testing.Results:Individuals with primary PTSD had significantly elevated peripheral cytokine levels for all 6 different cytokines compared to age- and gender-matched healthy controls(allP【0.01).Conclusions:These findings suggest that a generalized inflammatory state may be present in individuals with PTSD.展开更多
Alcohol use disorder （AUD）, mild traumatic brain injury （mTBI）, and posttraumatic stress disorder （PTSD） commonly co-occur （AUD ＋ mTBI ＋ PTSD）. These conditions have overlapping symptoms which are, in part, ...Alcohol use disorder （AUD）, mild traumatic brain injury （mTBI）, and posttraumatic stress disorder （PTSD） commonly co-occur （AUD ＋ mTBI ＋ PTSD）. These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation （rTMS） is non-invasive and may be an ideal treatment for co-occurring AUD ＋ mTBI ＋ PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD ＋ mTBI ＋ PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.展开更多
BACKGROUND: Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liv...BACKGROUND: Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010. METHODS: Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires. RESULTS: The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD. CONCLUSIONS: PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.展开更多
Objective: Equine-assisted activities and therapies(EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self...Objective: Equine-assisted activities and therapies(EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder(PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury(TBI).Methods: A family member or support person could accompany veterans and participate in the program.One hundred and six participants(veteran n = 62, family n = 44) left the urban environment in an intensive outpatient program(IOP) to attend a two-day, weekend EAAT in rural New Hampshire. Satisfaction surveys were conducted on the last day of the program and examined using thematic analysis.Results: The following themes were reported in the surveys: ability of horses to catalyze emotional rehabilitation, effectiveness of immersion in equine-assisted activities, program’s ability to foster interpersonal relationships and necessity of education about PTSD for staff. Participants also reported enjoying the program as highlighted by qualitative feedback, a mean score of 9.76(standard deviation[SD] = 0.61) as reported by veterans and a mean score of 9.91(SD = 0.29) as reported by family members on a 10-point visual analog scale with higher scores indicating a greater overall experience.Conclusion: These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.展开更多
Gap junction blocking agents can inhibit spontaneous discharge frequency in cells. We established a rat model of posttraumatic epilepsy induced using ferric ions. Rats were intraperitoneally injected with carbenoxolon...Gap junction blocking agents can inhibit spontaneous discharge frequency in cells. We established a rat model of posttraumatic epilepsy induced using ferric ions. Rats were intraperitoneally injected with carbenoxolone, 20 mg/kg, prior to and 30 minutes after model establishment, once a day for 14 consecutive days. Immunohistochemistry showed glial cell proliferation around a cortical focus and significantly increased connexin expression in posttraumatic epilepsy. However, carbenoxolone pretreatment or treatment significantly reduced connexin expression in the cortex, inhibited glial fibdllary acidic protein expression and ameliorated seizure degree in rats. These findings indicate that large amounts of glial cell proliferation and abnormal gap junction generation play a role in posttraumatic epilepsy, and that carbenoxolone may prevent and treat this disease.展开更多
Background: Posttraumatic stress disorder(PTSD) is a common and debilitating disorder among war veterans. Although complementary and alternative therapies are gaining acceptance in the treatment of PTSD, the efficacy ...Background: Posttraumatic stress disorder(PTSD) is a common and debilitating disorder among war veterans. Although complementary and alternative therapies are gaining acceptance in the treatment of PTSD, the efficacy of animal-based therapies in this disorder is unknown. The goal of equine-assisted psychotherapy(EAP) is to improve the social, emotional, and/or cognitive functions of individuals with PTSD.Objective: This study aims to explore the effects of EAP on PTSD symptoms. We hypothesized that veterans with PTSD who participate in a standardized EAP program for 1 h per week for 6 weeks would experience decreased PTSD symptoms and would demonstrate increased resilience as compared with individuals who do not receive EAP intervention.Design, setting, participants and interventions: We conducted a sequentially assigned, two-arm parallel group trial comparing 6 weeks of EAP with standard, previously established, ongoing PTSD therapy.Therapy was conducted at a community EAP facility in conjunction with an academic University Hospital. Twenty adult veterans with symptomatic PTSD completed the study. Ten adult veterans with previously diagnosed PTSD were assigned to EAP and received directed interaction with trained horses for one hour a week in groups of 3 or 4 individuals, while also continuing their previously established therapies. A certified therapist supervised the sessions, and a professional horse handler was also present.Results were compared with those from 10 adult veterans who only received their standard previously established PTSD care as prescribed by their provider.Main outcome measures: Changes in salivary cortisol, scores for the PTSD Check List-Military Version(PCL-M) and the Connor-Davidson Resilience Scale(CD-RISC) after 6 weeks of study were measured.Results: Of the 20 enrolled patients, 10 served in Afghanistan, 5 served in Iraq, and 3 served in Vietnam. Subjects were(47 ± 14) years old, were predominantly male, and had a body mass index of(29 ± 7) kg/m2. They had(9.2 ± 6.1) years of military service and carried 66% ± 37% service-connected disability. PCL-M scores declined significantly in both groups and CD-RISC scores increased significantly in the EAP group. There was no difference between the groups with respect to the magnitude of change.Conclusion: As compared to the control group, a 6-week EAP program did not produce a statistically significant difference with respect to PCL-M and CD-RISC scores, or salivary cortisol. However, our results suggest that EAP may work as well as standard therapy with respect to these parameters. This study supports further inquiry into EAP as a potentially efficacious alternative for veterans suffering from PTSD.Trial registration: ClinicalTrials.gov NCT #03039361.展开更多
Objectives: To examine a conceptual model of posttraumatic growth (PTG) with the inclusion of family resilience as a mediator,and social support,individual resilience,maternal care,and family members' intimacy aft...Objectives: To examine a conceptual model of posttraumatic growth (PTG) with the inclusion of family resilience as a mediator,and social support,individual resilience,maternal care,and family members' intimacy after trauma as protective factors.Methods: A cross-sectional questionnaire survey was carried out in a sample of 134 college nursing students who had a parent with a non-congenital disability.The Socio-demographic Information Questionnaire,the Chinese version of Perceived Social Support Scale (PSSS),10-item Connor-Davidson Resilience Scale (CD-RISC10),Parental Bonding Instrument (PBI),Family Resilience Assessment Scale (FRAS) and the Posttraumatic Growth Inventory (PTGI) were used to collect data.Results: Results showed that social support,individual resilience,maternal care,and family members' intimacy after trauma positively predicted family resilience (β=0.41,0.20,0.20,0.22,all P<0.01),respectively,and indirectly predicted PTG through family resilience.Family resilience positively predicted PTG (β =0.25,P < 0.01).Moreover,individual resilience directly positively predicted PTG (β =0.25,P < 0.001).Conclusions: Family resilience could facilitate PTG in nursing students in the face of parental disability.Interventions to promote PTG among college nursing students who have experienced parental disability should consider individual or family resilience-based intervention.展开更多
Posttraumatic stress disorder(PTSD) has been associated with significantly greater incidence of heart disease.Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than i...Posttraumatic stress disorder(PTSD) has been associated with significantly greater incidence of heart disease.Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese(CVD)risk in PTSD,including neurochemical,behavioral,and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First,we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last,we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD.展开更多
Because posttraumatic stress disorder(PTSD) is a highly debilitating condition, prevention is an important research topic. This article reviews possible prevention approaches that involve the administration of drugs b...Because posttraumatic stress disorder(PTSD) is a highly debilitating condition, prevention is an important research topic. This article reviews possible prevention approaches that involve the administration of drugs before the traumatic event takes place. The considered approaches include drugs that address the sympathetic nervous system, drugs interfere with the hypothalamic-pituitary-adrenal(HPA) axis, narcotics and other psychoactive drugs, as well as modulators of protein synthesis. Furthermore, some thoughts on potential ethical implications of the use of drugs for the primary prevention of PTDS are presented. While there are many barriers to overcome in this field of study, this paper concludes with a call for additional research, as there are currently no approaches that are well-suited for regular daily use.展开更多
The present study observed the dynamic expression of CD133, nuclear factor-κB and glial fibrUlary acidic protein in the hippocampal CA3 area of the experimental posttraumatic epilepsy rats to investigate whether glio...The present study observed the dynamic expression of CD133, nuclear factor-κB and glial fibrUlary acidic protein in the hippocampal CA3 area of the experimental posttraumatic epilepsy rats to investigate whether gliosis occurs after posttraumatic epilepsy. CD133 and nuclear factor-κB expression was increased at 1 day after posttraumatic epilepsy, peaked at 7 days, and gradually decreased up to 14 days, as seen by double-irnmunohistochemical staining. Glial fibrillary acidic protein/nuclear factor-EB double-labeled cells increased with time and peaked at 14 days after posttraumatic epilepsy. Results show that activation of hippocampal neural stem cells and glial proliferation after posttraumatic epilepsy-induced oxidative stress increases hippocampal glial cell density.展开更多
BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive...BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.展开更多
文摘BACKGROUND Traumatic fractures are mainly caused by various exogenous traumatic events,which not only damage patients’physical health but also affect their psychological state and aggravate stress responses.AIM To analyze the influencing factors of psychological resilience of patients with traumatic fractures and the effect of psychological resilience on posttraumatic growth(PTG).METHODS This study included 188 patients with traumatic fractures admitted to the First People’s Hospital of Shangqiu from November 2022 to November 2023.The participants were categorized based on the patient’s psychological resilience assessed by the Connor-Davidson Resilience Scale(CD-RISC)into the better resilience group(CD-RISC score≥60 points,n=80)and the poor resilience group(CD-RISC score<60 points,n=108).Patients’sleep quality was assessed with the Pittsburgh Sleep Quality Index(PSQI).The identification of the influencing factors of psychological resilience in patients with traumatic fractures was realized by binary Logistic regression(with factors such as sex,age,injury cause,trauma severity,fracture site,personality,and PSQI included for analysis).The determination of the PTG status of all participants used the Chinese version of the Posttraumatic Growth Inventory(C-PTGI).Furthermore,a Spearman correlation analysis was conducted to analyze the association between psychological resilience and PTG.RESULTS The psychological resilience of patients with traumatic fractures was related to age,sex,trauma severity,and personality.The better resilience group demonstrated statistically lower PSQI scores than the poor resilience group(P<0.05).The Logistic regression analysis revealed sex,age,trauma severity,personality,and sleep quality as influencing factors of CD-RISC scores in patients with traumatic fractures(all P<0.05).The score of each C-PTGI dimension and the total score(relating to others,new possibilities,personal strength,spiritual change,and appreciation of life)were higher in the better resilience group than in the poor resilience group(all P<0.05).Spearman correlation analysis indicated a positive association of the CD-RISC score in patients with traumatic fractures with the scores of all dimensions of C-PTGI and the total C-PTGI score(all P<0.05).CONCLUSION The factors influencing the psychological resilience of patients with traumatic fractures include age,sex,trauma severity,personality,and sleep quality,and psychological resilience is closely associated with PTG.
基金supported by the‘Double First-Class’Construction Specialized Discipline Project at Zhejiang University(No HL2024012).
文摘Objectives:This systematic review and meta-analysis aimed to identify and synthesize the factors correlated with posttraumatic growth(PTG)in patients with colorectal cancer(CRC).Methods:PubMed,Web of Science,Embase,PsycINFO,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang database,China Science and Technology Journal Database(VIP)and SinoMed were searched for studies that reported data on the correlated factors associated with PTG in patients with CRC from inception to September 3,2024.The methodological quality of the included studies was assessed via the Agency for Healthcare Research and Quality(AHRQ)methodology checklist and the Newcastle-Ottawa Scale(NOS).Pearson correlation coefficient(r)was utilized to indicate effect size.Meta-analysis was conducted in R Studio.Results:Thirty-one eligible studies encompassing 6,400 participants were included in this review.Correlated factors were identified to be significantly associated with PTG in patients with CRC including demographic factors:residential area(r=0.13),marital status(r=0.10),employment status(r=0.18),education level(r=0.19),income level(r=0.16);disease-related factors:time since surgery(r=0.17),stoma-related complications(r=0.14),health-promoting behavior(r=0.46),and sexual function(r=0.17);psychosocial factors:confrontation coping(r=0.68),avoidance coping(r=-0.65),deliberate rumination(r=0.56),social support(r=0.47),family function(r=0.50),resilience(r=0.53),selfefficacy(r=0.91),self-compassion(r=-0.32),psychosocial adjustment(r=0.39),gratitude(r=0.45),stigma(r=-0.65),self-perceived burden(r=-0.31),fear of cancer recurrence(r=-0.45);and quality of life(r=0.32).Conclusions:This meta-analysis identified 23 factors associated with PTG in CRC patients.Medical workers can combine those relevant factors from the perspective of positive psychology,further explore the occurrence and development mechanism of PTG,and establish targeted interventions to promote PTG.
文摘BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.
基金Supported by Nanjing Municipal Special Fund for Health Science and Technology Development Support Project,No.GBX21333.
文摘BACKGROUND Patients with multiple injuries endure not just physical trauma and suffering but are also at risk of psychological conditions such as posttraumatic stress disorder(PTSD),anxiety,and depression.The co-occurrence of PTSD in these patients may cause prolonged physical and mental health complications,thereby further increasing their healthcare expenses.AIM To determine the association between the high-risk factors of PTSD and anxiety as well as depression among patients with multiple injuries.METHODS This study selected 110 patients with multiple injuries who were admitted to our hospital from November 2022 to November 2024.The number and percentage of patients developing PTSD were tallied.Univariate and multivariate analyses were conducted to investigate the high-risk factors of PTSD in these patients.Subse-quently,the associations between these factors and the anxiety and depression levels of patients were analyzed.RESULTS Of the 110 patients,33 suffered from PTSD,representing an incidence rate of 30.0%.The univariate analysis identified age,personality,Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),economic status,negative life events,and smoking history to be significantly associated with PTSD in patients with multiple injuries.Further,the multivariate analysis revealed age,HAMA,HAMD,monthly income,and negative life events as prominent high-risk factors for PTSD in such patients.Regarding the relationships between these factors and HAMA and HAMD,age exhibited a significant positive correlation(r=0.398,P<0.001;r=0.387,P<0.001),monthly income showed a significant negative correlation(r=-0.437,P<0.001;r=-0.319,P<0.001),and negative life events demonstrated a significant positive correlation(r=0.505,P<0.001;r=0.365,P<0.001).CONCLUSION These results indicate age,HAMA,HAMD,monthly income,negative life events,etc.as high-risk factors for PTSD in patients with multiple injuries,among which age,monthly income,and negative life events are closely associated with anxiety and depression.
基金supported by the Anhui Provincial Department of Education Outstanding Young Teachers Cultivation Key Project(No.YQZD2023046)the Anhui University of Traditional Chinese Medicine School Talent Support Program Project(Nos.DT2400000222 and DT2100000545)。
文摘Objective:To elucidate the specific mechanisms by which electroacupuncture(EA)alleviates anxiety and fear behaviors associated with posttraumatic stress disorder(PTSD),focusing on the role of lipocalin-2(Lcn2).Methods:The PTSD mouse model was subjected to single prolonged stress and shock(SPS&S),and the animals received 15 min sessions of EA at Shenmen acupoint(HT7).Behavioral tests were used to investigate the effects of EA at HT7 on anxiety and fear.Western blotting and enzyme-linked immunosorbent assay were used to quantify Lcn2 and inflammatory cytokine levels in the prefrontal cortex(PFC).Additionally,the activity of PFC neurons was evaluated by immunofluorescence and in vivo electrophysiology.Results:Mice subjected to SPS&S presented increased anxiety-and fear-like behaviors.Lcn2 expression in the PFC was significantly upregulated following SPS&S,leading to increased expression of the proinflammatory cytokines tumor necrosis factor-a and interleukin-6 and suppression of PFC neuronal activity.However,EA at HT7 inhibited Lcn2 release,reducing neuroinflammation and hypoexcitability in the PFC.Lcn2 overexpression mitigated the effects of EA at HT7,resulting in anxiety-and fear-like behaviors.Conclusion:EA at HT7 can ameliorate PTSD-associated anxiety and fear,and its mechanism of action appears to involve the inhibition of Lcn2-mediated neural activity and inflammation in the PFC.
文摘BACKGROUND Studies have indicated that childhood exposure to domestic violence is a common factor in posttraumatic growth(PTG)and posttraumatic stress disorder(PTSD),but it is unclear whether PTG and PTSD share a common/different underlying mechanism.AIM To explore the common/different underlying mechanism of PTG and PTSD.METHODS Between February 12 and 17,2020,a nationwide cross-sectional online survey was conducted in China among 2038 university students,and a self-administered questionnaire was used for the data collection.The data included demographic characteristics,such as age,gender,and subjective social economic status,and childhood exposure to domestic violence scale that was selected from the Chinese version of revised Adverse Childhood Experiences Question,Self-compassion Scale,Connor–Davidson Resilience Scale,Posttraumatic Growth Inventory,and the Abbreviated PTSD Checklist-Civilian version.A structural equation model was used to test the hypotheses.RESULTS Exposure to domestic violence was significantly associated with PTG and PTSD via a 1-step indirect path of self-compassion(PTG:β=-0.023,95%CI:-0.44 to-0.007;PTSD:β=0.008,95%CI:0.002,0.014)and via a 2-step indirect path from self-compassion to resilience(PTG:β=-0.008,95%CI:-0.018 to-0.002;PTSD:β=0.013,95%CI:0.004-0.024).However,resilience did not mediate the relationship between exposure to domestic violence and PTG and PTSD.CONCLUSION PTG and PTSD are common results of childhood exposure to domestic violence,which may be influenced by self-compassion and resilience.
基金The Deputy Research of Babol University of Medical Sciences approved and supported the study(Grant No.724133035)
文摘Objectives:The present study compared the prevalence and psychosocial factors affecting posttraumatic growth(PTG),posttraumatic stress disorder(PTSD),and psychological distress in nurses,physicians,and medical students.Materials and Methods:In a cross‑sectional study,three groups of medical staff including nurses(n=57),physicians(n=40),and medical students(n=34)who were responsible for the care/treatment of COVID‑19 patients admitted to a general hospital for 4 months responded to Posttraumatic Growth Inventory,Brief Symptom Inventory‑18,Resilience Questionnaire,PTSD Screen,and Social Capital‑Integrated Questionnaire.Results:After the exposure of medical staff to at least 4 months of treatment/care of COVID‑19 patients,PTG prevalence was higher than PTSD(38.2%vs.14.6%),but they experienced some degrees of psychological distress(65.5%).The nurses had 8.33(confidence interval[CI]:2.5–26.7)times higher PTG rate than medical students(P<0.001).Physicists also experienced 5.00(CI:1.4–26.7)times higher PTG than medical students(P<0.001).PTG was aided by age,married status,strong resilience,and high social capital,but gender had no influence.Resilience played an important protective role to prevent the incidence of psychological distress in nurses,medical students,and physicians.Conclusion:Despite the fact that the PTSD and psychological distress were same in the three groups of medical staff,the nurses had a greater rate of PTG than physicians and medical students.
基金supported by Hainan Provincial Natural Science Foundation of China(grant number 821RC1124)the Education Department of Hainan Province(grant number Hnjgzc2022-22)+1 种基金the Hainan Medical University(grant numbers XGZX2020003,HYPY2020028,and HYYB202131)Hainan Province Clinical Medical Center(QWYH202175).
文摘Objective: To identify the moderating effects of cognitive reappraisal(CR) and expressive suppression(ES) on the relationship between posttraumatic stress(PTS) symptoms and posttraumatic growth(PTG) in university students. Methods: The survey included 1 987 Chinese university students who completed questionnaires on PTS symptoms in February 2020, with three follow-up surveys at two-month intervals until August 2020. We assessed CR and ES at February 2020 and PTG at August 2020. Growth mixture modeling was used to classify the PTS symptom trajectories. Multinomial logistic regression was used to recognize the predictors of class membership. The relationships among PTS symptoms, CR, ES, and PTG were examined using multi-group path analysis.Results: Sex, SARS-Co V-2 infection of a family member or friend, number of siblings, CR, and ES were significantly associated with PTS symptoms. Three latent classes were identified: ‘Increasing PTS’(n=205, 10.0%) who had rapid deterioration of PTS symptoms, ‘Moderate PTS’(n=149, 8.0%) who had a high level of PTS symptoms at the beginning and slightly increasing, and ‘Persistent Minimal PTS’(n=1 633, 82.0%), who had slow resolution of PTS symptoms over time. Male, SARS-Co V-2 infection of a family member or friend, and having a lower CR and a higher ES, were more likely to have ‘Increasing PTS’. PTS at February 2020 predicted PTG only in ‘Increasing PTS’ class, and both CR and ES had moderating effects on the conversion between them.Conclusions: Most students recovered from posttraumatic stress of COVID-19 pandemic, but a small proportion expeienced increasing PTS symptoms, and those with this condition may benefit from emotional regulation intervention.
文摘Complex posttraumatic stress disorder(Complex PTSD)has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases,11^(th)version,due to be published,two decades after its first initiation.It is described as an enhanced version of the current definition of PTSD,with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation,negative self-cognitions and interpersonal hardship,thus resembling the clinical features commonly encountered in borderline personality disorder(BPD).Complex PTSD is related to complex trauma which is defined by its threatening and entrapping context,generally interpersonal in nature.In this manuscript,we review the current findings related to traumatic events predisposing the above-mentioned disorders as well as the biological correlates surrounding them,along with their clinical features.Furthermore,we suggest that besides the present distinct clinical diagnoses(PTSD;Complex PTSD;BPD),there is a cluster of these comorbid disorders,that follow a continuum of trauma and biological severity on a spectrum of common or similar clinical features and should be treated as such.More studies are needed to confirm or reject this hypothesis,particularly in clinical terms and how they correlate to clinical entities'biological background,endorsing a shift from the phenomenologically only classification of psychiatric disorders towards a more biologically validated classification.
基金Natural Science Foundation of China(No.30860082)Key Science and Technology Project of Hainan Provinc(No 090209).zdxm2010043)
文摘Objective:To evaluate serum IL-2,IL-4,IL-6.IL-8,TL-10 and TNF-αlevels in posttraumatic stress disorder(PTSD) patients.Methods:We utilized ELISA technology to examine cytokines such as IL-2,IL-4.IL-6.IL-8,IL-10 and TNF-αin serum from 50 well-characterized individuals with a primary DSM-1V PTSD diagnosis,and 50 age- and gender-matched healthy controls.We conservatively employed a Mann-Whitney U testing.Results:Individuals with primary PTSD had significantly elevated peripheral cytokine levels for all 6 different cytokines compared to age- and gender-matched healthy controls(allP【0.01).Conclusions:These findings suggest that a generalized inflammatory state may be present in individuals with PTSD.
基金supported with resources by Department of Veterans Affairs(VA),Health Services Research and Development Service and the Office of Academic Affiliations(TPP 42-013)at Edward Hines VA Hospitalsupported by the following:VA OAA Polytrauma Fellowship to AAH,NIDRR Merit Switzer Research Fellowship Award H133F130011to AAH and the VA RR&D CDA-II RX000949-01A2 to AAH
文摘Alcohol use disorder （AUD）, mild traumatic brain injury （mTBI）, and posttraumatic stress disorder （PTSD） commonly co-occur （AUD ＋ mTBI ＋ PTSD）. These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation （rTMS） is non-invasive and may be an ideal treatment for co-occurring AUD ＋ mTBI ＋ PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD ＋ mTBI ＋ PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.
基金supported by a grant from the National Science and Technology Key Projects of China (2008ZX10002-026)
文摘BACKGROUND: Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010. METHODS: Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires. RESULTS: The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD. CONCLUSIONS: PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.
基金in part by the Wounded Warrior Project(WWP)departmental funds from Home Base:A Red Sox Foundation and Massachusetts General Hospital Program.
文摘Objective: Equine-assisted activities and therapies(EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder(PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury(TBI).Methods: A family member or support person could accompany veterans and participate in the program.One hundred and six participants(veteran n = 62, family n = 44) left the urban environment in an intensive outpatient program(IOP) to attend a two-day, weekend EAAT in rural New Hampshire. Satisfaction surveys were conducted on the last day of the program and examined using thematic analysis.Results: The following themes were reported in the surveys: ability of horses to catalyze emotional rehabilitation, effectiveness of immersion in equine-assisted activities, program’s ability to foster interpersonal relationships and necessity of education about PTSD for staff. Participants also reported enjoying the program as highlighted by qualitative feedback, a mean score of 9.76(standard deviation[SD] = 0.61) as reported by veterans and a mean score of 9.91(SD = 0.29) as reported by family members on a 10-point visual analog scale with higher scores indicating a greater overall experience.Conclusion: These data offer preliminary evidence that an adjunct EAAT program is acceptable for veterans with PTSD and/or TBI participating in an IOP.
基金supported by the Social Development Program of Nantong, No. S2009035
文摘Gap junction blocking agents can inhibit spontaneous discharge frequency in cells. We established a rat model of posttraumatic epilepsy induced using ferric ions. Rats were intraperitoneally injected with carbenoxolone, 20 mg/kg, prior to and 30 minutes after model establishment, once a day for 14 consecutive days. Immunohistochemistry showed glial cell proliferation around a cortical focus and significantly increased connexin expression in posttraumatic epilepsy. However, carbenoxolone pretreatment or treatment significantly reduced connexin expression in the cortex, inhibited glial fibdllary acidic protein expression and ameliorated seizure degree in rats. These findings indicate that large amounts of glial cell proliferation and abnormal gap junction generation play a role in posttraumatic epilepsy, and that carbenoxolone may prevent and treat this disease.
文摘Background: Posttraumatic stress disorder(PTSD) is a common and debilitating disorder among war veterans. Although complementary and alternative therapies are gaining acceptance in the treatment of PTSD, the efficacy of animal-based therapies in this disorder is unknown. The goal of equine-assisted psychotherapy(EAP) is to improve the social, emotional, and/or cognitive functions of individuals with PTSD.Objective: This study aims to explore the effects of EAP on PTSD symptoms. We hypothesized that veterans with PTSD who participate in a standardized EAP program for 1 h per week for 6 weeks would experience decreased PTSD symptoms and would demonstrate increased resilience as compared with individuals who do not receive EAP intervention.Design, setting, participants and interventions: We conducted a sequentially assigned, two-arm parallel group trial comparing 6 weeks of EAP with standard, previously established, ongoing PTSD therapy.Therapy was conducted at a community EAP facility in conjunction with an academic University Hospital. Twenty adult veterans with symptomatic PTSD completed the study. Ten adult veterans with previously diagnosed PTSD were assigned to EAP and received directed interaction with trained horses for one hour a week in groups of 3 or 4 individuals, while also continuing their previously established therapies. A certified therapist supervised the sessions, and a professional horse handler was also present.Results were compared with those from 10 adult veterans who only received their standard previously established PTSD care as prescribed by their provider.Main outcome measures: Changes in salivary cortisol, scores for the PTSD Check List-Military Version(PCL-M) and the Connor-Davidson Resilience Scale(CD-RISC) after 6 weeks of study were measured.Results: Of the 20 enrolled patients, 10 served in Afghanistan, 5 served in Iraq, and 3 served in Vietnam. Subjects were(47 ± 14) years old, were predominantly male, and had a body mass index of(29 ± 7) kg/m2. They had(9.2 ± 6.1) years of military service and carried 66% ± 37% service-connected disability. PCL-M scores declined significantly in both groups and CD-RISC scores increased significantly in the EAP group. There was no difference between the groups with respect to the magnitude of change.Conclusion: As compared to the control group, a 6-week EAP program did not produce a statistically significant difference with respect to PCL-M and CD-RISC scores, or salivary cortisol. However, our results suggest that EAP may work as well as standard therapy with respect to these parameters. This study supports further inquiry into EAP as a potentially efficacious alternative for veterans suffering from PTSD.Trial registration: ClinicalTrials.gov NCT #03039361.
基金This study did not receive grant support.Our thanks are extended to all of the participants in this study and to the universities for their support with recruitment
文摘Objectives: To examine a conceptual model of posttraumatic growth (PTG) with the inclusion of family resilience as a mediator,and social support,individual resilience,maternal care,and family members' intimacy after trauma as protective factors.Methods: A cross-sectional questionnaire survey was carried out in a sample of 134 college nursing students who had a parent with a non-congenital disability.The Socio-demographic Information Questionnaire,the Chinese version of Perceived Social Support Scale (PSSS),10-item Connor-Davidson Resilience Scale (CD-RISC10),Parental Bonding Instrument (PBI),Family Resilience Assessment Scale (FRAS) and the Posttraumatic Growth Inventory (PTGI) were used to collect data.Results: Results showed that social support,individual resilience,maternal care,and family members' intimacy after trauma positively predicted family resilience (β=0.41,0.20,0.20,0.22,all P<0.01),respectively,and indirectly predicted PTG through family resilience.Family resilience positively predicted PTG (β =0.25,P < 0.01).Moreover,individual resilience directly positively predicted PTG (β =0.25,P < 0.001).Conclusions: Family resilience could facilitate PTG in nursing students in the face of parental disability.Interventions to promote PTG among college nursing students who have experienced parental disability should consider individual or family resilience-based intervention.
文摘Posttraumatic stress disorder(PTSD) has been associated with significantly greater incidence of heart disease.Numerous studies have indicated that health problems for individuals with PTSD occur earlier in life than in the general population. Multiple mechanistic pathways have been suggested to explain cardiovascular disese(CVD)risk in PTSD,including neurochemical,behavioral,and immunological changes. The present paper is a review of recent research that examines cardiovascular and immune risk profiles of individuals with PTSD. First,we address the relatively new evidence that the constellation of risk factors commonly experienced in PTSD fits the profile of metabolic syndrome. Next we examine the findings concerning hypertension/blood pressure in particular. The literature on sympathetic and parasympathetic responsivity in PTSD is reviewed. Last,we discuss recent findings concerning immune functioning in PTSD that may have a bearing on the high rates of CVD and other illnesses. Our primary goal is to synthesize the existing literature by examining factors that overlap mechanistically to increase the risk of developing CVD in PTSD.
文摘Because posttraumatic stress disorder(PTSD) is a highly debilitating condition, prevention is an important research topic. This article reviews possible prevention approaches that involve the administration of drugs before the traumatic event takes place. The considered approaches include drugs that address the sympathetic nervous system, drugs interfere with the hypothalamic-pituitary-adrenal(HPA) axis, narcotics and other psychoactive drugs, as well as modulators of protein synthesis. Furthermore, some thoughts on potential ethical implications of the use of drugs for the primary prevention of PTDS are presented. While there are many barriers to overcome in this field of study, this paper concludes with a call for additional research, as there are currently no approaches that are well-suited for regular daily use.
基金the Science and Technology Foundation of Fujian Province, No. 2007F5045the Program for New Century Excellent Talents in Fujian Province University, No. NCETFJ-0702
文摘The present study observed the dynamic expression of CD133, nuclear factor-κB and glial fibrUlary acidic protein in the hippocampal CA3 area of the experimental posttraumatic epilepsy rats to investigate whether gliosis occurs after posttraumatic epilepsy. CD133 and nuclear factor-κB expression was increased at 1 day after posttraumatic epilepsy, peaked at 7 days, and gradually decreased up to 14 days, as seen by double-irnmunohistochemical staining. Glial fibrillary acidic protein/nuclear factor-EB double-labeled cells increased with time and peaked at 14 days after posttraumatic epilepsy. Results show that activation of hippocampal neural stem cells and glial proliferation after posttraumatic epilepsy-induced oxidative stress increases hippocampal glial cell density.
基金Science and Technology Development Plan Project of Suzhou(SKJYD2021035)Science and Technology Development Plan Project of Suzhou(SKJYD2022078)The Key Project Research Fund of the Second Affiliated Hospital of Wannan Medical College(YK2023Z04)。
文摘BACKGROUND:Postpartum posttraumatic stress disorder(PTSD)can occur in women who give birth after emergency admission.The identification of risk factors for this condition is crucial for developing effective preventive measures.This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission.METHODS:Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023.The patients’general conditions and perinatal clinical indicators were recorded.The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum.Multivariate logistic regression analysis was performed to identify risk factors.RESULTS:A total of 276 puerperae were included,with a PTSD incidence of 20.3% at six weeks postpartum.Multivariate logistic regression analysis identified emergency cesarean section(odds ratio[OR]=2.102;95%confidence interval[CI]:1.114-3.966,P=0.022),admission to the emergency department after midnight(12:00 AM)(OR=2.245;95%CI:1.170-4.305,P<0.001),and cervical dilation(OR=3.203;95%CI:1.670–6.141,P=0.039)as independent risk factors for postpartum PTSD.Analgesia pump use(OR=0.500;95%CI:0.259–0.966,P=0.015)was found to be a protective factor against postpartum PTSD.CONCLUSION:Emergency cesarean section,admission to the emergency department after midnight,and cervical dilation were identified as independent risk factors for postpartum PTSD,while analgesic pump use was a protective factor.These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.
