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Peritraumatic reactions during the COVID-19 pandemic -The contribution of posttraumatic growth attributed to prior trauma
Abstract
Trauma survivors who suffer from posttraumatic stress disorder (PTSD) symptoms may be particularly vulnerable when facing the COVID-19 pandemic. Yet trauma exposure may also lead to salutogenic outcomes, known as posttraumatic growth (PTG). Nevertheless, the implications of PTG attributed to prior trauma, for trauma survivors’ adjustment when facing additional stressors, are unclear. Addressing this gap, 528 Israeli trauma survivors were assessed for PTG and PTSD symptoms attributed to prior trauma, as well as peritraumatic stress symptoms related to the pandemic, as part of an online survey. Analyses revealed that being younger, female, quarantined, negatively self-rating one’s health status, and suffering from PTSD symptoms were associated with elevated peritraumatic stress symptoms. Furthermore, PTG attributed to prior trauma made a significant contribution in explaining elevated intrusion, avoidance, and hyperarousal symptoms. The present results point to the need for clinicians to take into account reports of PTG attributed to prior trauma when treating trauma survivors during the current pandemic.
... These factors include age at time of trauma, gender, history of mental disorder, perceived threat, and perceived social support. Specifically, women (Brunet et al., 2001;Freedman et al., 2002;Irish et al., 2011;Neria et al., 2010), younger individuals (Hamam et al., 2021), and individuals with a history of psychiatric disorders have been found to have higher levels of distress or symptomatology during or immediately after exposure to trauma. In addition, previous studies suggest that elevated sense of threat and lower perceived social support (Brunet et al., 2001;Neria et al., 2010) also contribute to elevated peritraumatic reactions. ...
... Given that age, gender, history of mental disorder, perceived threat, and perceived social support have been associated with peritraumatic distress or symptomatology Hamam et al., 2021;Irish et al., 2011;Lapid Pickman et al., 2017;Neria et al., 2010), these factors were treated as covariates in this analysis. Perceived threat was measured by asking respondents to indicate their sense of threat from the rocket attacks during the operation on a scale of 0 ('not at all') to 100 ('highly threatened'). ...
... In line with former studies Hamam et al., 2021;Hammen et al., 2000;Irish et al., 2011;Lapid Pickman et al., 2017;Neria et al., 2010), we found that age, gender, history of mental disorder, elevated levels of perceived threat, and low perceived social support were all related to elevated traumarelated symptoms during the peritraumatic phase. Yet, in our final model, which explored the contribution of all of the study's variables in explaining the probability of belonging to the high symptoms profile, the only factors that were significant (in addition to high sensory responsiveness) were a history of mental disorder, perceived threat, and perceived social support. ...
Background:
War is a highly traumatogenic experience that may result in trauma-related symptoms during exposure. Although most individuals exhibit recovery after the trauma ends, symptomatology during exposure may serve as an initial indicator underlying symptomatology at the posttraumatic phase, hence the imperative to identify risk factors for trauma-related symptoms during the peritraumatic phase. While research has uncovered several factors associated with peritraumatic distress, such as age, gender, history of mental disorder, perceived threat, and perceived social support, the role of sensory modulation has not been explored.
Method:
To address this gap, 488 Israeli citizens were assessed using an online survey for sensory modulation and trauma-related symptoms during rocket attacks.
Results:
Analyses revealed that while the association between high sensory responsiveness and elevated levels of specific trauma-related symptoms is somewhat weak (0.19<r<.0.22), it serves as a major risk factor for developing trauma-related symptoms during the peritraumatic phase in general. Specifically, the risk for elevated symptoms was doubled (OR = 2.11) for each increase in the high sensory-responsiveness score, after controlling for age, gender, history of mental disorder, perceived threat, and perceived social support.
Limitations:
This study relied on convenience sampling and a cross-sectional design.
Conclusions:
The present findings suggest that sensory modulation evaluation may serve as an important screening tool for identifying individuals who are vulnerable to trauma-related symptoms during the peritraumatic phase, and that implementing sensory modulation strategies as part of preventative interventions for PTSD might be effective.
... The first case in Israel of COVID-19 was confirmed on February 21, 2020. Beginning from the second half of March, Israel began enforcing social distancing, banning collective gatherings, closing all educational institutions, and prohibiting venturing out more than 330 ft from one's home (Hamam et al., 2021). Israel imposed limitations on both the public and private sectors. ...
... Thus, trauma survivors may be particularly vulnerable when having to deal with the COVID-19 pandemic. A recent study revealed that suffering from prior PTSD symptoms was associated with elevated peritraumatic stress symptoms during the pandemic (Hamam et al., 2021). ...
... Fifth, the study did not assess exposure to other traumatic events, PTSD, or posttraumatic growth attributed to prior trauma. Future research should consider examining these factors, as they were found to be related to distress during the COVID-19 pandemic (Hamam et al., 2021;Siegel & Lahav, 2021). Finally, as populations continue to be exposed to the COVID-19 threat, future studies should monitor and examine changes over time in individuals' strategies for coping with the situation and whether elevations in their negative emotional state are sustained, reduced, or exacerbated (Cooke et al., 2020). ...
... More than twenty-five studies have analyzed PTG in the context of the COVID-19 pandemic, with most being undertaken during the first six months of the outbreak (Asmundson, Paluszek, & Taylor, 2021;Celdrán, Serrat, & Villar, 2021;Chen & Tang, 2021;Chi et al., 2020;Feng et al., 2021;Gonzalez-Mendez & Díaz, 2021;Hamam et al., 2021;Ikizer, Karanci, Gul, & Dilekler, 2021;Kaloeti, Ardhiani, & Stück, 2021;Koliouli & Canellopoulos, 2021;Kowalski, Carroll, & Britt, 2021;Laslo-Roth, George-Levi, & Margalit, 2020;Liu, Ju, & Liu, 2021;Menculini et al., 2021;Na, Tsai, Southwick, & Pietrzak, 2021;Nie, Tian, & Liang, 2021;Prieto-Ursúa & Jódar, 2020;Robles-Bello, Sánchez-Teruel, & Valencia Naranjo, 2020;Stallard, Pereira, & Barros, 2021;Tomaszek & Muchacka-Cymerman, 2020;Vazquez et al., 2021;Yan et al., 2021;Zeng et al., 2021;Zhang, Shi, Qin Ren, & Wang, 2021;Zhao et al., 2021;Zhou, MacGeorge, & Myrick, 2020). Samples ranged from 119 to 29,118 participants, with the majority drawn from adults in community settings, whereas other studies focused on specific groups: discharged COVID-19 patients, people bereaved because of COVID-19, front-line medical workers, university students, parents, and survivors of prior trauma. ...
... Regarding the latter, one assessed pre-pandemic PTG and evaluated PTG again one year into the pandemic (Na et al., 2021), while the other examined PTG prospectively starting at the beginning of the pandemic and then again at other time points within one-to four-month timeframes as the pandemic progressed (Asmundson et al., 2021;Zhou et al., 2020). The predominant pattern of findings shows that higher PTS is associated with higher PTG (e.g., Asmundson et al., 2021;Hamam et al., 2021;Na et al., 2021;Zhao et al., 2021;Zhou et al., 2020). ...
... The significant positive association between PTS and PTG is consistent with the PTG theoretical proposal that an adverse event must evoke critical levels of trauma to trigger PTG (Tedeschi & Calhoun, 2004), and empirical data showing that higher PTS is related to greater PTG in the context of COVID-19 (Hamam et al., 2021;Tomaszek & Muchacka-Cymerman, 2020). Findings from this study revealed that, even in the presence of high PTS, people with high psychological flexibility were able to identify positive personal changes associated with their experience of the pandemic. ...
The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.
... These studies indicated both metabolic and neuronal mediated mechanisms participating in the exaggerated fear response in the amygdala circuitry [15]. PTG in a clinical setting were commonly noticed with nursing management in diminishing post-traumatic symptoms (PTSS) in cancer survivors, victims of earthquake, natural disaster, and Covid-19 [16][17][18][19][20][21]. The present study was carried out to de ne the underlining hormonal and neuronal mediated cellular molecule mechanisms associated with PTG on ameliorating the PTSS in a rodent model of PTSD using mitochondrial gene array chip containing 1500 metabolic and neuronal genes. ...
... In addition, the CORT, and CORT plus stressed group did not show a signi cant enhanced startle response [10]. A similar strategy was used to promote the resilience process of PTG by introducing nofear stress in a clinical setting with the current required nursing management and bene t for resilience in diminishing post-traumatic symptoms (PTSS) in cancer survivors, victims of earthquake, natural disaster, and Covid-19 [16][17][18][19][20][21]. ...
... Hydrocortisone alleviates anxiety behaviors and nightmares and is initially prescribed in ICU for PTSD patients [48]. The pharmacological intervention further con rmed its e cacy in post-traumatic symptoms (PTSS) in cancer survivors, victim of earthquake, natural disaster, and Covid-19 [16][17][18][19][20][21]. Although psychopharmacological mechanisms of PTG in PTSD remain to be clari ed there is a lot of agreement and commonality with clinical and animal research. ...
The metabolic and neuronal mechanisms underlying the development of posttraumatic growth (PTG) following corticosterone (CORT) therapy in patients with posttraumatic stress disorder (PTSD) are not well defined. In this study, we assess differential gene expression (DEG) profiles associated with mitochondrial function in the amygdala of a PTSD rodent model using a mitochondrial focused gene array chip for both metabolic and neuronal functions. Amygdala tissue samples were excised from four groups of rats (N = 10 each) including: non-stressed control, stressed alone, CORT therapy alone, and CORT therapy with stress. CORT plus stress took place over a three-day period. All groups were sacrificed and assessed after a total of 14 days. Total RNA was isolated, cDNA was synthesized, and gene expression levels were determined using a cDNA microarray. During the development of the anxiety symptom, equivalent to the delayed and exaggerated fear associated with PTSD, 111 DEGs were determined to be statistically significant (p < 0.01) in CORT therapy compared to non-stressed controls. 86 DEGs were determined to be statistically significantly in the CORT with stress administered group in the amygdala complex using stringent criteria ( p < 0.01). Furthermore, ingenuity pathway analysis (IPA) revealed six signaling network pathways in the amygdala complex of the CORT + Stress group. As in the CORT + Stress group, the measurement of acoustic startle showed no significant difference in comparison to the control group. Thus, anxiety was mitigated, and resiliency was increased with CORT therapy. In addition, the Venn diagram analysis indicated that 55 DEGs in the stressed group had 13 DEGs independently non-effected by CORT therapy associated with neuronal signaling networks and 42 DEGs dependently effected by CORT therapy in the stressed group alone. Thus, information provided by a neuronal and metabolic gene array allowed us to determine the expression profile of mitochondrial genes in PTG associated with the amygdala complex of a rodent model of PTSD. This result provides further understanding of the metabolic and neuronal signaling mechanisms associated PTG in the development of PTSD.
... These factors include age at time of trauma, gender, history of mental disorder, perceived threat, and perceived social support. Specifically, women (Brunet et al., 2001;Freedman et al., 2002;Irish et al., 2011;Neria et al., 2010), younger individuals (Hamam et al., 2021), and individuals with a history of psychiatric disorders have been found to have higher levels of distress or symptomatology during or immediately after exposure to trauma. In addition, previous studies suggest that elevated sense of threat and lower perceived social support (Brunet et al., 2001;Neria et al., 2010) also contribute to elevated peritraumatic reactions. ...
... Given that age, gender, history of mental disorder, perceived threat, and perceived social support have been associated with peritraumatic distress or symptomatology Hamam et al., 2021;Irish et al., 2011;Lapid Pickman et al., 2017;Neria et al., 2010), these factors were treated as covariates in this analysis. Perceived threat was measured by asking respondents to indicate their sense of threat from the rocket attacks during the operation on a scale of 0 ('not at all') to 100 ('highly threatened'). ...
... In line with former studies Hamam et al., 2021;Hammen et al., 2000;Irish et al., 2011;Lapid Pickman et al., 2017;Neria et al., 2010), we found that age, gender, history of mental disorder, elevated levels of perceived threat, and low perceived social support were all related to elevated traumarelated symptoms during the peritraumatic phase. Yet, in our final model, which explored the contribution of all of the study's variables in explaining the probability of belonging to the high symptoms profile, the only factors that were significant (in addition to high sensory responsiveness) were a history of mental disorder, perceived threat, and perceived social support. ...
... Some studies have called for its identification as a traumatic event that may cause posttraumatic symptoms (Horesh & Brown, 2020;Kira et al., 2020a). Other studies suggested that the coronavirus crisis should be seen as a traumatogenic event (Hamam et al., 2020;Horesh & Brown, 2020) in light of emerging evidence reporting the pandemic as cues of peritraumatic stress symptoms (i.e., appearing at higher rates among those experiencing trauma, even among those diagnosed for posttraumatic growth; Jiang et al., 2020;Qiu et al., 2020;Wang et al., 2020). Repeated exposure to public disclosure and media reports about the threats of the coronavirus as well as daily reports of numbers of people infected or dead led to increased anxiety levels and increased vulnerability to PTSD (Horesh & Brown, 2020; for a particular report on Israel, see Levaot et al., 2020). ...
... Interestingly, the authors found that social ties in general, and social contact with grandchildren in particular, serve as protective factors against mental deterioration (Marini et al., 2020). Another study examined the effects of COVID-19 on people suffering from PTSD and those who showed posttraumatic growth, and found them to be more vulnerable to develop peritraumatic stress symptoms (Hamam et al., 2020). ...
... Moreover, the interest and connection of the older population to their surroundings facilitates a sense of belonging, which was found to be a significant resilience factor against loneliness and suicide (Kinory et al., 2020). One study demonstrated the devastating effect of quarantine restrictions during COVID-19 by decreasing individuals' crucial sense of belonging (Hamam et al., 2020). Furthermore, maintaining meaningful relationships (even by phone), a sense of autonomy, and self-confidence may also contribute to coping with crisis (Bar-Tur & Hadar, 2020). ...
COVID-19 has expanded into a life-threatening global pandemic. We examined COVID-19 effects on trauma measures, loneliness, and death anxiety in senior Israelis. Young and old adults ( N = 277) were recruited through social media. They completed online questionnaires assessing mental status during the crisis. The findings yielded correlations between trauma reactions, death anxiety, and loneliness, age-related change in rates of death anxiety and traumatic symptoms, but not in perceived loneliness. Trauma-related intrusive thinking was predicted by age, loneliness, death anxiety, and being in isolation. Traumatic reactions, as indicated by DSM-V, were observed for young adults, while grandchildren were found to be protective for older adults. Conclusions point to a high risk of postcrisis symptoms in older adults. The article recommends methods for maintaining mental health, highlighting the role of social interaction.
... In a study from Ireland, 1.6% of elderly study subjects had COVID-19-related PTSD [14]. Either factually or due to the limitation mentioned above, a very consistent finding in the current literature is the resilience to PTSD or other forms of psychiatric distress found in the older age group compared to the younger ones [11][12][13][14][15][16][17][18][19][20]. Most of studies link being female to higher incidence of PTSD [16,[19][20][21]. ...
... Either factually or due to the limitation mentioned above, a very consistent finding in the current literature is the resilience to PTSD or other forms of psychiatric distress found in the older age group compared to the younger ones [11][12][13][14][15][16][17][18][19][20]. Most of studies link being female to higher incidence of PTSD [16,[19][20][21]. Further, there is the incidence of enhanced PTSD symptoms if the patients have an existing chronic illness/non-communicable disease [18,22,23]. ...
... Other factors contributing directly to PTSD-like symptoms are intensive care units (ICU) admissions and non-invasive ventilation [12,22]. Psychological distress at the onset of illness, pre-existing psychological disease, and psychotropic drugs are predictive or elevated distress in patients [12,14,[18][19][20]24]. Another directly contributing factor to COVID-19 related PTSD is negatively self-rating one's wellbeing status and high perceived risk of COVID-19 [14,16,19,24]. ...
Background
When COVID-19 was declared a global pandemic in March 2020, almost all countries implemented strict lockdowns and home quarantine orders in order to prevent spread of the virus. These implementations have severely affected the mental health of people all around the world especially the elderly, who are already physically and mentally fragile. There has been an escalation in the prevalence of depression, suicide, anxiety, substance abuse, domestic abuse, and post-traumatic stress disorder (PTSD).
Main body
The aim of our review was to highlight PTSD in the elderly population who has recovered from COVID-19 infection and come up with some recommendations for the future. A thorough literature review was conducted focusing on the impact of COVID-19 on development and progression of PTSD during the pandemic.
Conclusion
Increased allocation of resources by various government and private stakeholders is necessary to prepare for the long-term implications on mental health from the current and future pandemics.
... These impacts, however, differed depending on one's access to individual and system resources. In addition to generally increased internalizing symptoms, individuals with trauma histories reported more anxiety and depression [19], more pandemic-related stress [20], and more posttraumatic stress [21]. COVID-19-related stress was also associated with increased alcohol sales [22] and consumption for those with higher prepandemic drinking [23]. ...
... As a result of contextual stressors and potential past trauma, ABE students may also be more vulnerable to the impacts of the pandemic. Individuals reporting past trauma may have fewer resources, and, as a result, experience more anxiety, depression, and posttraumatic stress during the pandemic [19,20,21]. Our observations suggest that more traumatic events reported by ABE students predicted higher COVID-19-related stress. ...
Systemic barriers contribute to attrition from K-12 education contexts and later involvement in adult education centers, especially among students from minoritized backgrounds. To assess the impact of stress-related risk factors, including trauma exposure and COVID-19-related stress, on ABE students and their barriers to academic and vocational success. Survey methods were used for data collection, and analysis of variance and structural equation modeling were used to test hypotheses. Results showed that past traumatic experiences were more common among ABE students who reported greater social or economic marginalization, especially those identifying as lesbian, gay, or bisexual or with a history of being unhoused. We observed that more traumatic experiences predicted higher COVID-19-related stress and alcohol misuse. Higher COVID-19-related stress, in turn, predicted lower job con dence. ABE students experiencing marginalization face compounded barriers to educational and vocational goals with trauma exposure and COVID-19-related stress. Based on ndings, practice recommendations for ABE centers include targeted psychoeducational resources to offset systemic stressors and bolster academic and vocational attainment, such as on-site service delivery and using ABE centers as service system access points.
... The outbreak of the COVID-19 pandemic has had a negative impact on the daily functioning of individuals, affecting their mood, sense of well-being and, consequently, their overall mental health. Numerous publications on the consequences of COVID-19 have demonstrated symptoms of post-traumatic stress disorder (PTSD), chronic stress, sleep disorders, prevalence of suicidal thoughts, complicated grief, social anxiety, or substance abuse among medical personnel, convalescents, and in the general population (1)(2)(3)(4)(5). According to Lee (6), the nature of the pandemic has led to constant updating of the media news on COVID-19, which may have elevated the experienced level of anxiety. ...
... Our results suggest that persistent thinking and pandemic-related anxiety can mediate the relationship between resilience and well-being. The data obtained correspond with previous reports that indicate an increase in negative psychological consequences during COVID-19 (1)(2)(3)(4)(5). According to researchers, well-being may be compromised during a pandemic by direct and indirect trauma, potential risk perception, disruption of daily routines, reduced social support, and feelings about perceived loss of control (39). ...
Reports to date indicate that the COVID-19 pandemic outbreak has negatively impacted mental health in the general population. On the other hand, positive associations of mental resilience and well-being have been widely demonstrated. The objective of this study was to assess the links between resilience (Brief Resilience Scale), persistent thinking about COVID-19 (Obsession with COVID-19 Scale), coronavirus anxiety (Coronavirus Anxiety Scale), and well-being (World Health Organization's 5-item Well-being Index) using serial mediation. The study considered online survey data from 1,547 Poles aged 18–78 (62% of whom were women). Bootstrap sampling analysis revealed that persistent thinking about COVID-19 (M1) and coronavirus anxiety (M2) partially mediate the relationship between resilience and well-being. The results of this study indicate that persistent thinking may be dysfunctional for mental health, as it inflates pandemic anxiety and disrupts well-being. Moreover, practitioners should focus on interventions enhancing resilience in order to reduce negative mental effects during the spread of a pandemic infectious disease.
... According to Tedeschi and Calhoun (2004), there are many factors that may influence the appearance of PTG in an individual. In general, the predictors of potential PTG can be divided into two categories (Linley & Joseph, 2004): one is individual factors, including demographic characteristics, religious beliefs, cognition, psychological distress, and coping styles (Prieto-Ursúa & Jódar, 2020), and the other is external environmental factors, such as types of trauma events, social support, and social relations (Hamam et al., 2021). In particular, social support is considered to be one of the most important predictors of PTG (Tedeschi & Calhoun, 2004). ...
... In addition, Miao et al. (2021) believed that the anxiety, fear, and other forms of psychological distress caused by COVID-19 would further promote tourists' self-protection-based travel risk avoidance. During the COVID-19 pandemic, negative types of psychological distress such as anxiety, depression, irritability, and somatization have been common in the general population (Hamam et al., 2021). Therefore, in view of the inconsistency in the relationship between psychological distress variables and PTG, we conducted a survey to examine the impact of anxiety, depression and irritability, and somatization caused by COVID-19 on tourists' PTG. ...
Although it is undeniable that the COVID-19 pandemic presented new threats and traumas for human beings, posttraumatic growth that took place after the struggle with this highly challenging crisis cannot be ignored. Therefore, based on the posttraumatic growth theory, the present research focuses on aspects of tourists' positive changes after the COVID-19 outbreak. A total of 1165 potential tourists from 197 cities in 31 provinces of China were analyzed using symmetrical and asymmetrical approaches. The results of the partial least squares test revealed the net effects of social support, psychological distress, and infection risk perception on the three dimensions of tourists’ posttraumatic growth, namely, travel risk aversion, social identity, and altruistic behavior. Fuzzy-set qualitative comparative analysis provided causal recipes for realizing posttraumatic growth, and necessary condition analysis supplemented the necessary antecedents. The implications of the findings and the paths for future research are also presented.
... Selain itu, penyintas trauma, terutama Continuous Traumatic Stress (CTS) berisiko terkena tekanan psikologis kronis terkait COVID-19 karena memiliki gejala kecemasan, depresi, dan stres peritraumatik yang lebih tinggi dibandingkan dengan individu tanpa sejarah atau orang yang selamat dari peristiwa traumatis yang tidak berkelanjutan. Jurnal Muara Ilmu Sosial, Humaniora, dan Seni ISSN 2579-6348 (Versi Cetak) Vol. 5, No. 2, Oktober 2021: hlm 510-520 ISSN-L 2579 Survei daring lain melalui Qualtrics dilaksanakan oleh Hamam et al. (2021) pada 528 warga negara Israel dewasa penyintas trauma (M = 42.61 tahun) untuk menilai gejala PTG (Post-Traumatic Growth), PTSD, dan stress peritraumatik yang terkait dengan pandemi. ...
... Penyebab lain juga dijelaskan oleh Lahav (2020), dengan memberikan argumen bahwa COVID-19 sendiri dan tindakan yang diambil untuk mengendalikan dampak dari virus ini kemungkinan besar memicu stres bagi banyak orang. Sedikit berbeda dengan kedua artikel lainnya, penelitian oleh Hamam et al. (2021) menyimpulkan bahwa COVID-19 dapat memicu munculnya gejala stres peri traumatik. Gangguan peri traumatik ini ditunjukkan sebagai salah satu prediktor terkuat untuk PTSD menurut sebuah meta analisis yang dilakukan oleh Nishi et al. (2012). ...
Survivors of COVID-19 are vulnerable to trauma as a result of experiencing social isolation during treatment, with fear and loneliness that can have long-term impacts on mental health. In this review, some related literature will be identified and evaluated, using a qualitative-based literature review to research yoga as an alternative treatment to reduce PTSD symptoms, alleviate, or even cure PTSD in COVID-19 survivors. Articles screening from several journals was carried out by tracing PubMed’s journal publication database throughout the last five years and also categorizing two keywords as a reference for reviewing articles. The result of this literature review confirms that COVID-19 has a psychological effect on survivors, especially concerning PTSD when viewed from the largest indication. In addition, based on the results of ongoing research, yoga has shown a significant and promising impact in reducing PTSD symptoms. From this, it can be concluded that although there has been no research that directly examines the causality of the related review, yoga can be an alternative treatment to minimize symptoms and relieve PTSD in COVID-19 survivors. Based on the results of the review, there are many aspects that need to be investigated further, such as the influence of frequency and duration of yoga. More literature review and further research are essential for this topic, especially testing yoga programs as an intervention for COVID-19 survivors to determine its effectiveness and whether it can be implemented as a whole in the society, especially those who are COVID-19 survivors. Penyintas COVID-19 tergolong rawan terhadap trauma akibat mengalami isolasi sosial selama perawatan, dengan rasa takut dan kesepian yang dapat memberikan dampak berjangka panjang pada kesehatan mental. Dalam tinjauan kali ini akan dilakukan identifikasi, serta pengevaluasian beberapa literatur terkait, menggunakan tinjauan literatur berbasis kualitatif untuk meneliti yoga sebagai terapi alternatif dalam menurunkan gejala PTSD, meringankan, atau bahkan menyembuhkan PTSD pada penyintas COVID-19. Penyaringan artikel dari beberapa jurnal dilakukan dengan menelusuri database publikasi jurnal PubMed dari lima tahun terakhir dan juga dilakukan kategorisasi dua kata kunci sebagai acuan peninjauan artikel. Hasil tinjauan pada literatur ini menegaskan bahwa COVID-19 memiliki dampak psikologis pada penyintas, terutama PTSD apabila dilihat dari indikasi terbesar. Selain itu, berdasarkan hasil penelitian yang telah berlangsung, yoga menunjukkan dampak yang signifikan dan menjanjikan dalam mengurangi gejala PTSD. Dari sini dapat disimpulkan bahwa walaupun belum ada penelitian yang secara langsung meneliti kausalitas dari peninjauan terkait, yoga dapat menjadi salah satu alternatif terapi untuk meminimalisir gejala dan meringankan PTSD pada penyintas COVID-19. Berdasarkan hasil peninjauan, banyak aspek yang perlu diteliti lebih lanjut seperti pengaruh dari frekuensi dan durasi yoga. Dibutuhkan lebih banyak peninjauan literatur dan penelitian lebih lanjut mengenai topik ini, terutama pengujian program yoga sebagai intervensi pada penyintas COVID-19, untuk mengetahui tingkat keefektifannya dan apakah dapat diimplementasikan secara utuh pada masyarakat, terutama yang merupakan penyintas COVID-19.
... Concurrence of both has been reported in a variety of traumatic events [12,13]. Indeed, many individuals have experienced growth simultaneously with considerable levels of TEPT symptoms during the COVID-19 pandemic [14,15]. Research on the relationship between PTSD-PG measures has been focused on identifying general relationships between both constructs in specific traumatic events. ...
... Network results seek to provide further information on how PTSD and PG symptom measures are reinforced during COVID-19, since in addition to higher reported levels of stress symptomatology, high values of PG are also evident during the pandemic event [14,15,25], and such studies report relationships between both concepts during COVID-19. Therefore, it is important to evaluate the simultaneous relationships between the components of such psychological measures using network analysis, to our knowledge this is the first study to include this dynamic method given the stressful event of COVID-19 infection. ...
The aim was to estimate the network analysis between indicators of stress and posttraumatic growth in Peruvian adults infected with COVID-19. A total of 456 Peruvian adults were studied, and two self-report health measures were applied in Spanish: Impact of event scale-6 (IES-6) and Posttraumatic Growth Inventory-Short Form (PTGI-SF). The research was quantitative and correlational in nature, evaluated by means of a Gaussian graphical model of partial correlations and the stability of network relationships were verified by Bootstraping. The most central negative posttraumatic symptoms were between intrusive thoughts and avoidance of intrusive thoughts by COVID-19 (E3 and E5). In the PTGI-SF domain, measures of higher centrality were reported for appreciation for life and religious faith (C2 and C9). The reagent associated with life appreciation (C2) plays the role of intermediary between the connecting pathways of the other core elements in the activation of the network system. The highest relationship was found between the hyper vigilance reagents and concentration problems by COVID-19 (E2 and E6). There were four positive relationships and five negative associations between stress symptoms and posttraumatic growth, the largest effect sizes included the core symptom of avoidance of intrusive thoughts with appreciation for life directly and inverse or negative relationship with spiritual growth.
... The COVID-19 pandemic and strict preventive measures have led to uncertainty, a fear of becoming sick or contracting the virus, traumatic experiences due to mass media coverage, and a low quality of life and impairment in social functions due to changes in behaviors, lifestyles, and habits (Bo et al., 2021;Hamam et al., 2021;Liu et al., 2021). The COVID-19 pandemic has brought many psychosocial problems in daily life. ...
... Some studies explore the impact of the COVID-19 pandemic on mental health but focus less on how to manifest positive outcomes. Traumatic experiences result not only in negative but also in positive outcomes, such as posttraumatic growth, empowerment, making sense of life, and appreciation (Hamam et al., 2021;Karataş, 2020;Yu et al., 2020). ...
Aim: The relationship between posttraumatic growth and meaning and purpose of life during the Coronavirus (COVID-19) pandemic was determined in this study. Methods: This was a descriptive study using a correlational survey model. The sample consisted of 1264 participants aged 18-65 years of age recruited using snowballing sampling. Data were collected online using the Posttraumatic Growth Inventory and the Meaning and Purpose of Life Scale. Results: There was a positive correlation between posttraumatic growth and meaning and purpose life scores. Posttraumatic growth was a predictor variable that explained 12.2% of the total variance of the meaning and purpose of life. Conclusion: Health professionals are responsible for protecting public mental health, identifying risk groups, and planning interventions accordingly during and after such outbreaks as COVID-19.
... For instance, previous studies found that more than half of survivors of severe acute respiratory syndrome (SARS) were diagnosed with PTSD in the post-SARS era (6) and 39% (95% CI: 31-47%) of the Middle East respiratory syndrome (MERS) survivors developed PTSD after 6 months of being discharged from hospitals (7). Many COVID-19 survivors experience physical and mental distress symptoms such as dyspnea, acute respiratory distress (ARDS), gatism, alterations of conscious states, and traumatic medical treatments (e.g., tracheotomy) (4,8), that could trigger PTSS and contribute to lowered quality of life (QOL), functional impairment, frequent rehospitalizations, and financial strain, and/or increased risk for depression, insomnia, and anxiety (9)(10)(11)(12)(13)(14). ...
... PTSS is also associated with a range of negative outcomes such as functional impairment, and increased risk of depression, insomnia, and anxiety (9)(10)(11)(12)(13)(14); presumably both PTSS and associated adverse outcomes lower QOL. Unexpectedly, in this study no significant difference in QOL between COVID-19 survivors with PTSS and without PTSS (P = 0.304) was found. ...
Background: The prevalence of post-traumatic stress symptoms (PTSS) in COVID-19 survivors is unclear. This study examined the prevalence of PTSS and its association with quality of life (QOL) among COVID-19 survivors during the post-COVID-19 era in China.
Methods: This was a comparative, cross-sectional study. PTSS, depressive symptoms, and QOL were assessed with standardized instruments.
Results: A total of 134 COVID-19 survivors and 214 non-infected controls (healthy controls hereafter) were recruited. Among COVID-19 survivors, the PTSS prevalence was 18.66% (95%CI: 11.98–25.34%), which was significantly higher than that (5.61%, 95%CI: 2.50–8.71%) of healthy controls ( P < 0.001). After controlling for covariates, an analysis of covariance (ANCOVA) showed that COVID-19 survivors had a higher PTSS total score than did healthy controls [ F (1,348) = 4.664, P = 0.032]. A separate ANCOVA revealed there were no significant differences in overall QOL between COVID-19 survivors with and without PTSS [ F (1,348) = 1.067, P = 0.304]. A multiple logistic regression analysis showed that more severe depressive symptoms were significantly associated with PTSS in COVID-19 survivors (OR = 1.425, P < 0.001).
Conclusions: PTSS were more severe in COVID-19 survivors compared to healthy controls in the post-COVID-19 era. Considering their negative impact on daily life and functional outcomes, regular assessment and appropriate treatments of PTSS should be conducted in COVID-19 survivors.
... Recently, trauma-related mental health problems due to COVID-19 such as posttrauma stress disorder and traumatic stress also has been examined. The COVID-19 pandemic creates substantial traumatogenic events for everyone, from confirmed patients and healthcare workers to the general public [28][29][30]. Nevertheless, trauma-related reactions and posttraumatic stress disorder (PTSD) due to the novel coronavirus have been addressed relatively less compared to the general psychological problems such as depression and anxiety [30]. ...
... To what extent have you experienced the following items during the COVID-19 epidemic?") [28,29]. The response options ranged from 0 (not at all true) to 4 (extremely true), and the ratings were summed to calculate the total score of peritraumatic distress. ...
The coronavirus disease (COVID-19) pandemic is traumatic and causes a substantial psychological burden on the general public. The aim of the present study is to examine the severity and prevalence of peritraumatic distress among the citizens of Seoul, which conducted preemptive and aggressive social distancing policy before the central government during the early stage of COVID-19. Furthermore, this study aims to explore the associated risk factors for peritraumatic distress, including risk perception, fear, and COVID-19-related experiences. We conducted an online survey to 813 participants at the end of the first wave of COVID-19 in South Korea. Peritraumatic distress inventory (PDI) was used to measure the level of pandemic-related distress. One-third of participants were at risk for the development of clinically elevated peritraumatic distress. The perception of risk, fear of COVID-19, and stigma were significantly associated with elevated levels of distress. Individuals who had poor health, or who spent more than 1 h per day using the media, also expressed a higher level of distress. Moreover, the level of disruption of daily life and financial difficulties due to the COVID-19 pandemic is significantly associated with a higher level of peritraumatic distress. The results of this study highlight the urgent need to develop evidence-based and tailored public mental health interventions, along with various measures to help recovery to daily life.
... Understanding reports of PTG in light of dissociation (Lahav, Bellin, et al., 2016), might clarify the mixed findings in the literature (Helgeson et al., 2006;Linley & Joseph, 2004;Liu et al., 2017;Shakespeare-Finch & Lurie-Beck, 2014), including relations between PTG and lower levels of negative outcomes in some cases (Frazier et al., 2001;Lee et al., 2019;Lev-Wiesel & Amir, 2003) and relations between PTG and elevated levels of negative outcomes (Greene et al., 2015;Hamam et al., 2020;Lahav, Bellin, et al., 2016;Lahav, Kanat-Maymon, et al., 2017;, in others. The former findings might reflect an authentic positive transformation, which could be adaptive, whereas the latter might reflect dissociation-based beliefs of PTG, which could exacerbate survivors' distress (Lahav, Bellin, et al., 2016). ...
Childhood abuse puts individuals at risk for psychopathology and psychiatric symptoms such as posttraumatic stress disorder (PTSD) and anxiety symptoms. At the same time, research has indicated that some survivors report positive transformations in the aftermath of their trauma, known as posttraumatic growth (PTG). Yet the essence of PTG reports is questionable, and some scholars claim that it may reflect maladaptive illusory qualities. Furthermore, according to a recent theoretical model, PTG might be dissociation-based and related to survivors' bonds with their perpetrators. This study aimed to explore these claims by assessing PTG, dissociation, and identification with the aggressor (IWA), as well as PTSD and anxiety symptoms. An online survey was conducted among 597 adult childhood abuse survivors. Study variables were assessed via self-report measures. Analyses indicated positive associations between PTG, dissociation, and IWA. Three distinct profiles were found, reflecting high, medium, and low scores on PTG, dissociation, and IWA. Profile type explained PTSD and anxiety symptoms above and beyond gender, age, and abuse severity. These findings suggest that whereas some childhood abuse survivors might experience a positive transformation subsequent to their trauma, others' PTG reports might reflect dissociative mechanisms and pathological attachments to their perpetrators , and thus might be maladaptive. ARTICLE HISTORY
... El crecimiento psicológico consecuente a la pérdida de un ser querido puede mantenerse a lo largo de la vida (Qasim y Carson, 2020). En el con-texto pandémico actual también se ha reportado la importancia del CPT en la reducción de los síntomas negativos de estrés traumático (Hamam et al., 2021). ...
Network analysis of the Posttraumatic Growth Inventory (PTGI-X) in Peruvian adults with COVID-19 death family members as a function of gender.
Posttraumatic growth network structures were evaluated in males and females who lost a family member to COVID-19 to determine network variations according to sex. Six hundred sixty-nine Peruvian adults (M = 25.41, SD = 1.82) were included using the Posttraumatic Growth Inventory-X (PTGI-X) self-report measure. Two Gaussian plot models of partial correlations were estimated through the qgraph statistical package. The most central network domain items were emotional expression, closeness to others, and greater understanding of life-death issues. The highest connections were reported for items on the measures of personal relationships, appreciation for life, and spiritual-existential change. Both network models were found to be invariant and showed no significant differences at the level of structure and connections, and a difference was reported at the score level on the existential-spiritual change subscale in women.
... Although in some studies post-traumatic symptoms were reported to generally decline since start of the pandemic, they nonetheless continued to be highly prevalent (Chi et al., 2021, Lixia et al., 2022. Yet, despite the adverse persistency of the COVID19 pandemic, Hamam et al. (2021) identified clusters of people who managed to thrive and grow after being exposed to trauma (Bonanno, 2004). This so-called post-traumatic growth (PTG) has been mostly studied in cancer patients (Bussell et al., 2010) and has been associated with positive change experienced as a result of a major life crisis or trauma (Calhoun & Tedeschi, 2014). ...
Almost one year since the COVID-19 was declared a global pandemic, mental distress remains elevated with high prevalence of post-traumatic stress disorder (PTSD). Yet studies suggest these challenging circumstances might be conducive of post-traumatic growth (PTG). This study aims to investigate the factors associated with growth after the original trauma. A sample of 252 Lebanese adults filled an online survey to determine levels of PTG, PTSD and gratitude using validated self-rating scales. Participants also subjectively evaluated the sources of their distress such as the COVID-19 pandemic, the Beirut port explosion and/or their deteriorating financials. The PTGi-SF evaluated dimensions of growth while the IES-R_22 measured the degree of distress post-trauma. The GQ-6 was used to measure the proneness to experience gratitude daily. Results indicated 41% of participants scored above the cutoff for PTSD symptomatology. Yet, PTSD was positively correlated, alongside gratitude and accumulated subjective distress, with higher levels of PTG. A forward linear regression taking PTG scores as the dependent variable further showed that more gratitude (Beta=0.57), a higher impact of events (Beta=0.16), and knowing anyone who died from COVID-19 (Beta=3.93) were significantly associated with more growth. The study highlights elevated levels of PTSD symptoms in a context of a global pandemic worsened by financial and socio-political instabilities. It mostly identifies personal factors, including high initial symptomatology post-trauma and gratitude, related to the capacity for growth in spite of these accumulating hardships. As such, it advocates the need to investigate and bolster silver linings amidst unprecedented traumas.
... Moreover, a novel study showed that psychological flexibility appeared to buffer the impact of the COVID-19 pandemic on daily functioning [1]. However, previous research has also demonstrated that, following a disaster, chronic psychological dysfunction tended to be higher in individuals exposed to more severe pre-stressors than in those who had never experienced one [10], and that posttraumatic stress symptoms due to past traumatic events were associate to pandemic-related peritraumatic stress symptoms, particularly in women [14]. Further, levels of COVID-related anxiety, depression, and stress symptoms were higher in people who had experienced traumatic events before the pandemic than in people who had not experienced such events [15]. ...
Objectives: The aim of this study was to investigate the consequences of the COVID-19 pandemic in women with non-malignant chronic pain, and to determine whether women exposed to traumatic situations prior to the outbreak would be at a higher risk of negative health impacts.
Methods: A total of 365 women were divided into three subgroups according to whether or not they had experienced a traumatic event prior to COVID-19. They completed an online survey.
Results: Significant differences were found between groups during lockdown: 1) more psychological abuse was experienced by the group of women who had experienced an interpersonal traumatic event prior to the pandemic than in the other subgroups; 2) physical activity levels were higher and scores on pain interference were lower in women in the non-traumatized subgroup than in the other subgroups; 3) pain interference was predicted by pain intensity, decreased social support, and resilience, whereas perceived well-being was predicted by pain interference.
Conclusion: Women who had experienced a traumatic event prior to the pandemic suffered worse consequences of the COVID-19 lockdown, particularly greater pain interference, although resilience was shown to both mitigate pain interference and enhance perceived well-being.
... Furthermore, with no knowledge that a pandemic was on its way, of course, the data collection of this study took place during the first wave of the COVID-19 pandemic in Israel. Studies have indicated the pandemic to be particularly debilitating for trauma survivors (Hamam et al., 2020;Siegel & Lahav, 2021) and to have negative effects on individuals' economic, occupational, and functional domains (e.g., Bareket-Bojmel et al., 2020). Altogether, these aspects limit the study's generalizability and indicate the need for further research among clinical samples of IPV survivors from diverse cultural and social backgrounds, simultaneously taking into account the potential effects of the pandemic. ...
... Furthermore, with no knowledge that a pandemic was on its way, of course, the data collection of this study took place during the first wave of the COVID-19 pandemic in Israel. Studies have indicated the pandemic to be particularly debilitating for trauma survivors (Hamam et al., 2020;Siegel & Lahav, 2021) and to have negative effects on individuals' economic, occupational, and functional domains (e.g., Bareket-Bojmel et al., 2020). Altogether, these aspects limit the study's generalizability and indicate the need for further research among clinical samples of IPV survivors from diverse cultural and social backgrounds, simultaneously taking into account the potential effects of the pandemic. ...
Study questions:
Although most women who are subjected to intimate partner violence attempt to leave their abusive partners, many return, and resultantly are at risk for even greater violence. Research to date has documented relations between several factors (income and economic dependence, frequency of intimate partner violence (IPV), fear of violence escalations, history of childhood abuse, and post-traumatic stress disorder symptoms) and women's returning to their abusive partners. Nevertheless, the contribution of women's emotional bonds with their violent partners, known as identification with the aggressor (IWA), in explaining their perceived likelihood of going back to the relationship, has remained unclear.
Subjects:
The current study, conducted among 258 Israeli women who had left their violent partners, aimed to fill this void.
Methods:
An online survey was conducted. Demographic variables, history of childhood abuse, frequency of IPV, economic dependence on former partner, fear of future violence escalation, post-traumatic stress disorder symptoms, IWA, and perceived likelihood of returning to the relationship, were assessed via self-report questionnaire.
Findings:
Results indicated that two aspects of IWA-becoming hyper-sensitive to the perpetrator and adopting the perpetrator's experience-were related to women's perceived likelihood of returning to the relationship. Furthermore, a logistic regression analysis indicated that only two factors-income and becoming hyper-sensitive to the perpetrator-uniquely contributed to explaining the likelihood of returning to abusive partners. Major implications: The current findings suggest that women's tendency to be highly attuned to their partners' feelings and needs, as a part of IWA, may impede their ability to permanently leave abusive relationships.
... In contrast, a study in Chilean primary care providers found that individuals experiencing multiple stressors before the 2010 earthquake in Chile were more vulnerable to developing MDD or PTSD after the earthquake [23]. Furthermore, a study in Israeli trauma survivors showed that PTG attributed to prior trauma actually sensitized individuals to greater intrusion, avoidance, and hyperarousal symptoms during the COVID-19 pandemic [24]. It is possible that multiple prior stressors can either be protective or handicapping in the face of a future stressor depending upon other factors. ...
The ongoing COVID-19 pandemic has caused significant psychological impact on medical professionals, including medical students, many who have been caring for patients on the frontlines. Understanding how medical students perceive their stressful life experiences is important as the mental health of these future physicians directly impacts their ability to care for patients. We assessed for post-traumatic growth and resilience in the face of traumatic events among a cohort of medical students that attended a medical school located in an early epicenter of the COVID-19 pandemic. Between October 29, 2020 and December 1, 2020, medical students at the Icahn School of Medicine at Mount Sinai in New York City were surveyed on various stressful life events, including COVID-19. We identified specific resilience behaviors, including establishing a supportive social network, relying on a moral compass, and using cognitive flexibility, that medical students commonly used to cope with traumatic experiences. Compared with students who perceived COVID-19 as their most stressful life event, students who perceived other events, such as family issues or serious illness, as most stressful experienced less COVID-related stress (t = -2.2, p = .03), greater posttraumatic growth (t = 4.3, p < .001), and demonstrated more resilient behaviors including establishing and nurturing a supportive social network (t = 2.2, p = .03), developing brain fitness (t = 2.2, p = .03), and finding meaning and purpose in things (t = 2.9, p = .006). This suggests that stressful experiences prior to or in parallel with COVID-19 encouraged posttraumatic growth and development of resilience behaviors that were protective to COVID-19-related stress.
... This implies co-occurrence of PTSD and PTG. Recent studies have reported the presence of both negative psychological reactions and PTG during the COVID pandemic (Tomaszek and Muchacka-Cymerman, 2020;Cui et al., 2021;Hamam et al., 2021). Cui et al. (2021) found the prevalence of positive psychological reactions in 43.7% of nurses in China who reported above average PTG scores. ...
The coronavirus disease 2019 (COVID-19) pandemic has enkindled many mental health problems across the globe. Prominent among them is the prevalence of post-traumatic stress (PTS) with hosts of its precipitating factors being present in the surrounding. With India witnessing severe impact of the second wave of COVID-19, marked by a large number of hospitalizations, deaths, unemployment, imposition of lockdowns, etc., its repercussions on children and adolescents demand particular attention. This study aims to examine the direct and the indirect exposure of COVID-19-related experiences on children and adolescents and its subsequent relationship with PTS and post-traumatic growth (PTG). The direct exposure was operationalized in terms of death or hospitalization in the family, while the indirect exposure was gauged in terms of exposure to media reports of the COVID situation. Data from 412 children and adolescents aged 9–20 years, collected online, revealed 68.9% of them with PTS. Interestingly, 39.8% of those reporting PTS were also experiencing PTG. Arousal appeared to be the most frequently reported characteristics of trauma. The multivariate analysis of variance (MANOVA) endorses significant difference between those with direct and indirect exposures to hospitalization. Those with direct exposure to hospitalization reported higher PTS. The indirect exposure of COVID-19-related news through electronic media was also significantly associated with higher PTS. Exposure through print media did not lead to significant difference in PTS, but those reading only magazines reported significantly higher PTG than not reading magazines. The findings are analyzed in the light of unfolding of events during the second wave of COVID-19 in India.
... Nevertheless, a positive psychological perspective that changes the focus of trauma research to concepts such as posttraumatic growth (PTG) has been increasingly recognized, especially in the non-artificial trauma psychology field [such as earthquake and COVID-19 pandemic; (11,12)]. Stewart (13) defined PTG as positive life changes that follow traumatic events. ...
This study examined the long-term effects of the Wenchuan earthquake among adult survivors. Specifically, it explored the role of perceived social support (PSS) in the relationship between rumination and posttraumatic growth (PTG) and posttraumatic stress disorder (PTSD) symptoms. Data were collected from March to July 2020 using a youth survivor sample ( n = 476) of the 2008 Wenchuan earthquake. Participants were divided into three groups depending on their age when the quake occurred: 6–11 years ( n = 227), 12–15 years ( n = 83), 16–19 years ( n = 166). The results indicated that long-term PTG and PTSD symptom levels varied by age group. Both intrusive and deliberate ruminations had a significant effect on PTG as well as PTSD symptoms. PSS played a mediating role between rumination and PTG, and the mediation mechanisms varied by age group (developmental stages). Moderated analyses revealed that PSS from significant others significantly buffered the indirect effect of rumination on PTSD symptoms. Our findings demonstrated the universal nature of traumatic events encountered during childhood and adolescence development and underscore the importance of examining the developmental context of PTG in investigations on traumatic experiences and their consequences.
... 62 At the same time, cumulative adverse experiences may also have salutogenic effects (i.e., posttraumatic growth, 63 such as positive retrospective appraisals of prior trauma that may improve coping with heightened societal stress). 64 Indeed, SMW with intersecting marginalized identities, including SMW of color, often display resilient stigma-coping strategies, such as embracing positive aspects of the self and engaging in social activism. 55,65 Still, SMW who experience multiple forms of inequality face heightened risk of PTSD and hazardous drinking due to their disproportionate and often compounding experiences of stigma, 66 and as the current study suggests, potentially increased sensitivity to COVID-19-related stress and high-profile police killings of Black people. ...
Trauma-exposed sexual minority women (SMW) are at elevated risk of posttraumatic stress disorder (PTSD) and hazardous drinking compared to trauma-exposed heterosexual women. To understand whether these problems might be exacerbated during times of elevated societal stress, we collected data from a New York-based sample of trauma-exposed SMW between April 2020 and August 2020, a period of notable, compounding societal stressors, including: (a) living in or near one of the first epicenters of the coronavirus disease 2019 (COVID-19) epidemic in the United States and (b) living through multiple high-profile occurrences of racism-related police violence and subsequent racial unrest. SMW (n = 68) completed online self-report questionnaires related to trauma, PTSD symptoms, and alcohol use, and a subset (n = 29) completed semi-structured qualitative interviews. PsycINFO was searched with terms related to SMW, PTSD, and alcohol use to identify studies with samples of SMW from articles published within the last 10 years to which we could compare our sample; this produced nine studies. Welch’s t-tests and Chi-square analyses revealed that SMW within our sample reported significantly higher PTSD symptom severity, probable PTSD, and hazardous drinking indicators (i.e., alcohol use disorder and heavy episodic drinking) between April 2020 and August 2020 compared to similar samples (i.e., trauma-exposed SMW and general samples of SMW) assessed previously. Qualitative reports also indicated that the societal stressors of 2020 contributed to mental and behavioral health concerns. These results underscore the need for integrated PTSD and alcohol use prevention and intervention efforts for trauma-exposed SMW during times of heightened societal stress.
Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.2006132 .
... In addition to the external factors mentioned above, gender difference is also one of the demographic factors that scholars pay the most attention to. Numerous studies have shown that there is a lower incidence of PTSD in males than females [3,7,22,[28][29][30][31]. It is true that previous studies have obtained many intentional conclusions, but it is not clear whether the explanation of these conclusions is valid. ...
After COVID-19 appeared in China in December 2019, the mental health of adolescents, as a vulnerable group in public health emergencies, was negatively affected by the epidemic and the unprecedented prevention and control measures. The purpose of this study was to investigate the factor structure and psychometric properties of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL) among Chinese adolescents. A total of 915 participants completed the PTSD. Confirmatory factor analyses (CFAs) and multi-group CFAs were used to test the factor structure and psychometric properties of PTSD. The CFA results showed that five-factor PCL was the optimal fitting model with satisfactory reliability and validity; moreover, it was suggested that the properties of PCL were invariant across gender, PTSD and asymptomatic groups, early and late adolescents, as well as over time. In summary, PCL is applicable among Chinese adolescents and can be used for effective measurement of PTSD caused by epidemics and to conduct cross-group studies.
... Although PTG may be a meaningful end in and of itself, the presence of PTG does not preclude the presence of symptoms of posttraumatic stress disorder (PTSD), and the two phenomena often co-occur, with moderate PTSD symptoms generally associated with the highest levels of PTG (Garcia et al., 2017;Greenberg et al., 2021;Pietrzak et al., 2021;Tsai et al., 2015;Xu et al., 2019;Yang and Ha, 2019). While some studies have found that PTG is associated with improved functioning and resilience to subsequent traumatic events Boehm-Tabib and Gelkopf, 2021;Tsai et al., 2015), the relationship between PTG and adverse mental health outcomes is mixed, with some studies observing that PTG is unrelated to or positively associated with these outcomes (Hamam et al., 2021;Zoellner and Maercker, 2006). A recent study of nurses found that PTG was inversely correlated with burnout, a state of emotional, mental, and physical exhaustion related to work-related stress, and that this association was mediated by secondary traumatization and moderated by perceived meaning of work (Hamama-Raz et al., 2021). ...
Background:
The COVID-19 pandemic has led to significant mental health consequences for frontline health care workers (FHCWs). However, no known study has examined the prevalence, determinants, or correlates of posttraumatic growth (PTG) in this population.
Methods:
Data were analyzed from a prospective cohort of FHCWs at an urban tertiary care hospital in New York City (NYC). Assessments were conducted during the spring 2020 pandemic peak (Wave 1) and seven months later (Wave 2). Multivariable logistic regression analyses were conducted to identify Wave 1 sociodemographic, occupational, and psychosocial factors associated with PTG at Wave 2, and the association between aspects of PTG with burnout and pandemic-related PTSD symptoms at Wave 2.
Results:
A total 76.8% of FHCWs endorsed moderate or greater PTG; the most prevalent domains were increased appreciation of life (67.0%), improved relationships (48.7%), and greater personal strength (44.1%). Non-White race/ethnicity, greater levels of positive emotions, pandemic-related PTSD symptoms, dispositional gratitude, and feelings of inspiration were independently associated with PTG. At Wave 2, endorsement of spiritual growth during the pandemic was associated with 52% and 44% lower odds of screening positive for pandemic-related PTSD symptoms and burnout, respectively; greater improvement in relationships was associated with 36% lower odds of screening positive for burnout.
Limitations:
Single institution study and use of self-report instruments.
Conclusions:
Nearly 4-of-5 FHCWs report pandemic-related PTG, driven largely by salutogenic factors assessed during the pandemic surge. Interventions to bolster these factors may help promote PTG and mitigate risk for burnout and pandemic-related PTSD symptoms in this population.
... To date, the majority of research on the mental health impact of the COVID-19 pandemic has focused on negative outcomes such as depression, anxiety, posttraumatic stress disorder (PTSD), and suicidality (Czeisler et al., 2020;Ettman et al., 2020;Krishnamoorthy et al., 2020;Na et al., 2021a,b). In contrast, relatively few studies have focused on potentially salutogenic outcomes such as posttraumatic growth (PTG) (Asmundson et al., 2021;Hamam et al., 2021;Pietrzak et al., 2021;Tamiolaki and Kalaitzaki, 2020;Vazquez et al., 2021;Zhai et al., 2021). PTG is defined as positive, meaningful psychological changes that individuals may experience after struggling with traumatic and stressful life events (Zoellner and Maercker, 2006), and has been linked to improved functioning (Tsai et al., 2015), as well as greater resilience to subsequent traumatic events (Tsai et al., 2016). ...
Rationale:
The COVID-19 pandemic has had numerous negative effects globally, contributing to mortality, social restriction, and psychological distress. To date, however, the majority of research on the psychological impact of the COVID-19 pandemic has focused on negative psychological outcomes, such as depression, anxiety, and posttraumatic stress disorder (PTSD).
Objective:
Although there is debate about the constructive vs. illusory nature of post-traumatic growth (PTG), it has been found to be prevalent in a broad range of trauma survivors, including individuals affected by the COVID-19 pandemic. The objective of this study was to identify pre- and peri-pandemic factors associated with pandemic-related PTG in a national sample of U.S. veterans.
Methods:
Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative cohort of 3078 U.S. veterans. A broad range of pre-pandemic and 1-year peri-pandemic factors associated with pandemic-related PTG were evaluated. Curve estimation and receiver operating characteristic curve analyses were conducted to characterize the association between pandemic-related PTSD symptoms and PTG.
Results:
Worries about the effect of the pandemic on one's physical and mental health, PTG in response to previous traumas (i.e., new possibilities and improved interpersonal relationships), and pandemic-related avoidance symptoms were the strongest correlates of pandemic-related PTG. An inverted-U shaped relationship provided the best fit to the association between pandemic-related PTSD symptoms and endorsement of PTG, with moderate severity of PTSD symptoms optimally efficient in identifying veterans who endorsed PTG.
Conclusions:
Results of this study suggest that psychosocial interventions that promote more deliberate and organized rumination about the pandemic and enhance PTG in response to prior traumatic events may help facilitate positive psychological changes related to the COVID-19 pandemic in U.S. military veterans. Longitudinal studies on functional correlates of PTG may help inform whether these changes are constructive vs. illusory in nature.
... El crecimiento postraumático (CPT) es como el kintsugi para la mente, desarrollada en los años 90 por los psicólogos Tedeschi & Calhoun 9 , la teoría del crecimiento postraumático sugiere que las personas pueden salir del trauma o la adversidad habiendo logrado un crecimiento personal positivo. Esta teoría es válida en momentos en que vivimos esta pandemia, que está cambiando la vida de personas de todo el mundo 10 . Crecer a partir de un trauma no es inusual y los estudios apoyan la noción de que el CPT es común y universal en todas las culturas 11 y en diversos grupos de diferentes edades como jóvenes y adolescentes 12 . ...
In the traditional Japanese art of kintsugi, artisans fill the cracks in broken pottery with gold or silver, transforming the damaged pieces into something more beautiful than when they were new.
damaged pieces into something more beautiful than they were when new. Post-traumatic growth (PTG) is like kintsugi for the mind.
the mind, developed in the 1990s by psychologists Tedeschi & Calhoun
Post-traumatic growth theory suggests that people can emerge from trauma or adversity having achieved positive personal growth. This theory is valid at a time times when we are living through this pandemic, which is changing the lives of people all over the world . Growing out of trauma is not unusual and studies support the notion that PTG is common and universal across cultures and in diverse age groups such as youth and adolescents. PTG generates a transformation and challenge in people's fundamental beliefs that leads them to be different from what they were before. The pandemic of COVID-19 may have the ingredients for fostering psychological growth. We are still in the midst of this situation, and we don't yet know what may happen, but it will have serious challenges in our lives. Although the effects may be devastating, it is possible to come out of this adversity with positive consequences. For some people, this event may be a shock to their core belief system, which reinforces the
re-evaluation, reconstruction of psychological and philosophical beliefs and a life approach favorable to their personal growth.
When looking at how people respond to traumatic events, PTG seems to be quite common, it is not something mental health professionals can prescribe or create, but they can facilitate it. It is considered a natural tendency that should be taken into account and encouraged, without trying to make people feel pressured or failures if they do not achieve this growth.
The PTG framework is an integrated approach that includes elements of cognitive-behavioral therapy, along with other aspects that emphasize personal growth. It also has elements of narrative and existential aspects, because traumas often raise existential questions for people about what is important in life, being essential during the COVID-19 pandemic. Most evidence-based trauma treatments provide a "personalized approach" to relieve stress and symptoms such as anxiety
... They emphasized that the cognitive disequilibrium elicited by a traumatic event also activates deliberate rumination, which enables an individual to reconstruct their positive understanding about the posttraumatic self, others, and the world; this reconstruction is actualized as PTG. Given this theoretical assumption, recent studies have demonstrated that in addition to various negative psychological reactions, some individuals have reported experiencing PTG during the COVID-19 pandemic (Cui et al., 2020;Hamam et al., 2021;Tomaszek & Muchacka-Cymerman, 2020), suggesting that among certain individuals, psychological functioning has improved during the pandemic. For example, Cui et al. (2020) found that 43.7% of nurses reported higher-than-average PTG scores, suggesting that PTG may be a prevalent positive psychological reaction. ...
Researchhas shown that posttraumatic reactions can co‐occur in trauma‐exposed individuals. Many studies have assessed the co‐occurring patterns of two types of reactions, but few have assessed the patterns of multiple reactions. To build on existing knowledge, the present study examined co‐occurring patterns of posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and posttraumatic growth (PTG) among adolescents during the COVID‐19 pandemic. Participants (N = 683) were adolescents selected from an area in China severely affected by COVID‐19 who completed the PTSD Checklist, a measure of depression, a PTG inventory, and a cognitive emotional regulation questionnaire. Latent profile analysis and multinomial logistic regression were used for the data analyses. The results showed three heterogeneous patterns characterized by growth (n = 248, 36.3%), distress (n = 101, 14.8%), and struggle (n = 334, 48.9%). Positive refocusing and reappraisal were associated with membership in the growth group compared with distress group, OR = 0.83, 95% CI [0.75, 0.93] and OR = 0.78, 95% CI [0.68, 0.90], whereas rumination, catastrophizing, and “putting into perspective” were associated with membership in the distress group compared with growth group, ORs = 1.15–1.44. These findings suggest that posttraumatic reactions show heterogeneous characteristics: struggle, rather than growth or distress, is common among adolescents during COVID‐19; and distinct cognitive emotional regulation strategies have distinguishing roles in the three patterns of posttraumatic reactions.
... COVID-19-related stressors. Specific stressors related to the COVID-19 pandemic were measured via nine items designed by the research team (Hamam et al., 2021;Lahav, 2020). Participants were asked to indicate (1) how they perceived their own physical health, (2) whether they were currently in quarantine, (3) whether they were living alone during the outbreak, (4) whether they belonged to a high-risk group for COVID-19, (5) whether they had close others who belonged to a high-risk group, (6) whether they were diagnosed with the disease, (7) whether they had close others diagnosed with the disease, (8) whether they had close others who were hospitalized due to the disease, (9) whether they had experienced the loss of close others due to the disease. ...
The COVID-19 pandemic may be experienced as traumatogenic and may fuel or exacerbate psychological distress and trauma-related symptoms. Based on trauma research, one might expect that survivors of childhood abuse would be susceptible to these negative outcomes during the pandemic, and that among this population a stronger relation between emotion regulation difficulties and symptomatology would be found. Aiming to explore these suppositions, an online survey was conducted among 710 Israeli adults. Of them, 370 were childhood abuse survivors. A history of childhood abuse, COVID-19-related stressors, overall psychological distress, and peritraumatic stress symptoms during the pandemic were assessed via self-report measures. Participants with a history of childhood abuse had elevated overall psychological distress as well as peritraumatic stress symptoms during the pandemic, compared to nonabused participants, above and beyond demographic characteristics and COVID-19-related stressors. Emotion regulation difficulties were related to elevated psychological distress and peritraumatic stress symptoms among both childhood abuse survivors and nonabused participants. Nonetheless, a history of childhood abuse moderated the relations between the emotion regulation difficulty of being unable to engage in goal-directed behaviors when distressed (on one hand) and mental outcomes (on the other): Although the associations between inability to engage in goal-directed behaviors, overall psychological distress, and peritraumatic stress symptoms were nonsignificant among nonabused participants, they were significant among childhood abuse survivors. The current findings suggest that a history of childhood abuse might be a risk factor for distress in the face of COVID-19, and that childhood abuse survivors would benefit from clinical interventions that promote emotion regulation skills during this ongoing global health crisis.
... The SARS-CoV-2 virus has so far cost the lives of over two million people around the world, and continues to pose a threat to millions more (Lipsitch et al., 2020). It has therefore been proposed that COVID-19 be considered an ongoing traumatic stressor (Estes & Thompson, 2020;Hamam et al., 2020) that may bring about reactions such as depression and anxiety (Lahav, 2020;Shevlin et al., 2020). Nevertheless, similar to other stressors, the implications of the COVID-19 pandemic vary, with some factors increasing individuals' vulnerability for psychological distress. ...
Objectives: The COVID-19 pandemic is an ongoing stressor that may have detrimental effects on mental health. Theoretical and empirical literature implies that individuals who are characterized by catastrophic appraisals of somatic cues, a tendency known as anxiety sensitivity, as well as by older subjective age, might be particularly vulnerable to depression and anxiety during the pandemic. Furthermore, subjective age might moderate the relations between anxiety sensitivity with depression and anxiety symptoms. Yet, research to date has not explored the contribution of both anxiety sensitivity and subjective age in explaining distress following stress in general, nor in light of the current COVID-19 pandemic. Method: Filling this gap, a convenience sample of 828 participants, (M age = 43.98, SD = 14.06), filled questionnaires measuring background variables, COVID-19 related stressors, anxiety sensitivity, subjective age, and anxiety and depression symptoms during the pandemic. Results: Positive associations were found between anxiety sensitivity and subjective age, on the one hand, and anxiety and depression symptoms, on the other. Furthermore, subjective age moderated the associations between anxiety sensitivity with depression and anxiety symptoms. Although higher levels of anxiety sensitivity were related to depression and anxiety during the pandemic, these associations were stronger among participants with an older subjective age. Discussion: The findings are consistent with theories that view subjective age as an intra-individual construct involved in modulating important mental health outcomes in the context of coping with stress.
... The SARS-CoV-2 virus has so far cost the lives of over two million people around the world, and continues to pose a threat to millions more (Lipsitch et al., 2020). It has therefore been proposed that COVID-19 be considered an ongoing traumatic stressor (Estes & Thompson, 2020;Hamam et al., 2020) that may bring about reactions such as depression and anxiety (Lahav, 2020;Shevlin et al., 2020). Nevertheless, similar to other stressors, the implications of the COVID-19 pandemic vary, with some factors increasing individuals' vulnerability for psychological distress. ...
Objectives
The COVID-19 pandemic is an ongoing stressor that may have detrimental effects on mental health. Theoretical and empirical literature implies that individuals who are characterized by catastrophic appraisals of somatic cues, a tendency known as anxiety sensitivity, as well as by older subjective age, might be particularly vulnerable to depression and anxiety during the pandemic. Furthermore, subjective age might moderate the relations between anxiety sensitivity with depression and anxiety symptoms. Yet, research to date has not explored the contribution of both anxiety sensitivity and subjective age in explaining distress following stress in general, nor in light of the current COVID-19 pandemic.
Method
Filling this gap, a convenience sample of 828 participants, (Mage = 43.98, SD = 14.06), filled questionnaires measuring background variables, COVID-19 related stressors, anxiety sensitivity, subjective age, and anxiety and depression symptoms during the pandemic.
Results
Positive associations were found between anxiety sensitivity and subjective age, on the one hand, and anxiety and depression symptoms, on the other. Furthermore, subjective age moderated the associations between anxiety sensitivity with depression and anxiety symptoms. Although higher levels of anxiety sensitivity were related to depression and anxiety during the pandemic, these associations were stronger among participants with an older subjective age.
Discussion
The findings are consistent with theories that view subjective age as an intra-individual construct involved in modulating important mental health outcomes in the context of coping with stress.
... More specifically, CM plays a significant role in PD, increasing the risk of neurocognitive (Mørkved et al., 2020;Schalinski et al., 2018), social cognition (Kilian et al., 2018), behavioural problems and functioning (Copeland et al., 2018). Therefore, individuals with PD and CM survivors may be particularly vulnerable when facing the COVID-19 pandemic (Hamam et al., 2021). That is, COVID-19 related measures might contribute to a more severe and unstable illness course, characterized by an increased risk of neurocognitive difficulties (e.g. ...
... PTG has been mostly studied in samples of war veterans (Mark et al., 2018), people who survived a natural disaster (García et al., 2015), victims of sexual violence (Bakaityté et al., 2020), oncological patients, or people diagnosed with other serious diseases (Hamama-Raz et al., 2019). Currently, research is focusing on COVID-19 pandemic and its relationship with PTG (Hamam et al., 2021). Working with such specific groups could have narrowed the focus of research on traumatic events to the most extreme ones (e.g., war, natural disaster) despite the fact that people are experiencing a wider range of traumatic events throughout their lives (Brooks et al., 2016). ...
Despite its negative connotation, surviving trauma can result in improvements in some of the domains of one’s life. This phenomenon is known as posttraumatic growth and is usually measured using the Posttraumatic Growth Inventory (PTGI). Given the ambiguous results of the existing validation studies, the present study aimed to verify the psychometric properties of the Slovak version of the (PTGI) in a representative sample of Slovak citizens. Although the results suggest that a modified one-factor structure fitted the data best, other issues such as extremely high correlations between the latent factors, related to the PTGI’s factor structure were observed. It is likely that the application of the latent variable model does not represent the essence of PTG adequately and the network approach thus appears to be a far more suitable conceptualization of PTG. More detailed information on between-person differences and within-person changes in PTG could help to tailor more effective interventions or preventative programs.
... PTSD prevalence is particularly high among people in self-isolation , demonstrating the adverse impacts of reduced social interaction. Other risk factors for COVID-19-related PTSD include higher COVID-19 exposure (i.e., through diagnosis or close contact with an infected individual), female gender, and prior history of PTSD symptoms (Hamam et al., 2020). ...
Posttraumatic stress disorder (PTSD) is associated with coronavirus disease 2019 (COVID-19) risk factors, such as hypertension and obesity. Associations between PTSD and COVID-19 outcomes may affect Veterans Health Administration (VA) services, as PTSD occurs at higher rates among veterans than the general population. While previous research has identified the potential for increased PTSD prevalence resulting from COVID-19 as a public health concern, no known research examines the effect of pre-existing PTSD on COVID-19 test-seeking behavior or infection. This study aimed to evaluate pre-existing PTSD as a predictor of COVID-19 testing and test positivity. The sample consisted of 6,721,407 veterans who sought VA care between March 1, 2018 and February 29, 2020. Veterans with a previous PTSD clinical diagnosis were more likely to receive COVID-19 testing than veterans without PTSD. However, among those with available COVID-19 test results (n = 168,032), veterans with a previous PTSD clinical diagnosis were less likely to test positive than veterans without PTSD. Elevated COVID-19 testing rates among veterans with PTSD may reflect increased COVID-19 health concerns and/or hypervigilance. Lower rates of COVID-19 test positivity among veterans with PTSD may reflect increased social isolation, or overrepresentation in the tested population due to higher overall use of VA services. As the COVID-19 pandemic continues, the identification of patient-level psychiatric predictors of testing and test positivity can facilitate the targeted provision of medical and mental health services to individuals in need.
... The construct describes positive trauma effects emerging as a result of attempts made to cope with the stressorthey pertain to changes in the perception of self, in the nature and experience of relationships with others and in one's general philosophy of life (Calhoun & Tedeschi, 2006). Latest studies point to the onset of PTG in individuals experiencing trauma related to COVID-19, as well as to negative relations between PTG and anxiety intensity during the pandemic (Hamam et al., 2021;Tomaszek & Muchacka-Cymerman, 2020). ...
Reports to date have shown that the SARS-CoV-2 pandemic may have a negative impact on individuals' mental health. The purpose of this study was to assess the relation between ego-resiliency, social support, coronavirus anxiety and trauma effects. The study employed the Polish adaptation of the Coronavirus Anxiety Scale (CAS). It involved 515 individuals aged 18-78. The Polish version of CAS revealed satisfactory internal consistency (α = 0.86). Structural equation modeling indicated that ego-resiliency (the Ego-Resiliency Scale) and social support (the Multidimensional Scale of Perceived Social Support) were correlated and negatively predicted the severity of the novel coronavirus anxiety (CAS). Moreover, the level of anxiety showed positive correlation with negative trauma effects (the short form of the Changes in Outlook Questionnaire). The scores indicate the need for practitioners to focus on interventions which elevate ego-resiliency and perceived social support to improve mental health during the SARS-CoV-2 pandemic.
The mental health difficulties of trauma survivors during the COVID-19 pandemic have been under-reported. This study explored the moderating role of trauma history and trauma type (interpersonal and non-interpersonal) in the association between COVID-19-related stressors and depression, anxiety, and stress. A sample of n = 321 participants ages 19 to 71 (M = 36.63, SD = 10.36) was recruited from across the United States through MTurk. Participants reported the number of COVID-19-related stressors, trauma history and psychological symptoms. Hierarchical multiple regression analyses, controlling for age, race, ethnicity, gender, education, and income levels, were used to determine (a) whether COVID-19-related stressors are associated with adverse mental health outcomes; (b) whether trauma history and (c) trauma type moderated this association. Results revealed significant interactions; for those with a trauma history, exposure to COVID-19-related stressors was associated with higher levels of depression (β = .21, p < .05) and anxiety (β = .19, p < .05). For those with a history of interpersonal trauma specifically, COVID-19-related stressors were associated with depression (β = .16, p < .05) more so than for those without a trauma history. These findings highlight the vulnerability of trauma survivors to the unprecedented COVID-19-related stress.
The COVID-19 pandemic has resulted in economic hardship, psychological stress, anxiety,
and depression in a significant proportion of the global population. However, the bidirectional effectsof social isolation and pre-existing or developed psychological stress could inform sexual behaviorsand affect digital dating outcomes. Additionally, it is unknown whether intimate behaviors andrelationships have been equally affected across the genders during the COVID-19 pandemic. The purpose of this study is to contrast the course of intimate relationships pre-and post-COVID-19, with a focus on diverse genders, digital dating, mental health, and behavior. A review of the dating landscape during COVID-19 is developed in this study, encompassing themes including diverse genders, sexual orientation, demographic characteristics, sexual behavior, the state of psychological
wellbeing, and interactions with digital dating apps. The authors reviewed the trends and challenges of digital romance. Dating before and during the pandemic is explored, discussing how COVID-19 experiences may inform future romantic partnerships. Mobile dating applications saw a surge in downloads and usage across popular platforms, including Tinder (3 billion swipes in March 2020) and Ok Cupid (700% increase in dates), with the top 20 dating apps gaining 1.5 million daily users. Cross-sectionally, being younger, single, and having higher levels of stress was a predictor of higher
dating-app usage during the COVID-19 lockdowns. Risky sexual behavior and having multiple sexual partners were reduced during social distancing as there was an increased worry of contracting the virus. Heightened incidents of domestic/intimate partner abuse have caught the headlines in several countries. COVID-19 during lockdown has also posed barriers to accessing support and help from sexual and mental health services.
Objectives
While there have been some studies examining the post-traumatic growth (PTG) responses to the COVID-19 pandemic, few have been longitudinal studies exploring the changes over time or examining the underlying psychological PTG mechanisms. This study examined whether baseline perceived emotional intelligence (EI) predicted PTG through self-esteem and emotional regulation (ER) in a five-month follow-up study conducted on Chinese adolescents during the COVID-19 pandemic.
Methods
Validated measures were completed by 2090 participants, which assessed both the perceived EI and the PTG 1 month after a nationwide lockdown in China, with 1609 of these participating in the follow-up five months later. Structural equation models (SEM) were then used to explore the paths between the variables.
Results
As hypothesized, the follow-up survey found that the baseline perceived EI predicted PTG, ER, and self-esteem outcomes. The SEM analyses also revealed that self-esteem and ER significantly mediated the association between EI and PTG.
Limitations
Studies of three or more waves may be more suitable for longitudinal mediation analyses. Self-assessment reports may have subjective effects.
Conclusions
It was concluded that perceived EI might improve PTG in adolescents following the COVID-19 pandemic, and self-esteem and ER program training could be helpful in promoting PTG.
In this study, it is aimed that the experiences of post-traumatic growth in individuals treated for coronavirus (COVID-19) are examined. In this research, in-depth individual interviews were carried out with those over the age of 18 years old who had been diagnosed and completed treatment for COVID 19 and agreed to participate to the research. The research was conducted with 16 individuals (22-45 years) who met the research criteria. A phenomenological qualitative research method was used for this study. The data was gathered over the internet-based teleconferencing programs (Zoom, Google Meeting, Skype, etc.) in order to prevent the spread of COVID-19. The thematic analysis method was used in the data analysis. In consequence of the qualitative data analysis, two categories were obtained as " Effects of COVID-19" and "Post Traumatic Growth." In the category of the effects of COVID-19, three themes and five subordinate themes were established, and in the category of post-traumatic growth, two themes and eight subordinate themes were established. As a result of the research, it was established that the perspectives of individuals who experienced this sickness on life and their self-perception were positively developed, their relationships were strengthened, and the support resources surrounding them positively affected them during the period. The research presents significant experiences with regard to planning and implementing interventions aimed at the factors that promote psychological growth in COVID-19 patients.
Objective: To examine the effects of coronavirus disease-2019 (COVID-19) exposure, expressive suppression/cognitive reappraisal, and demographic variables on post-traumatic stress symptoms (PTS) among Chinese.
Methods: Participants were recruited by social media through WeChat and 6 049 Chinese (aged from 17 to 63 years; median=24) from 31 provinces were included in the study. PTS symptoms, expressive suppression, and cognitive reappraisal were assessed after the outbreak of COVID-19. A regression mixture analysis was conducted in Mplus 7.
Results: A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID- 19 exposures on PTS symptoms: (1) Class 1 (mildly PTS symptoms, 80.9%), (2) Class 2 (moderate PTS symptoms, 13.0%), and (3) Class 3 (high PTS symptoms, 6.1%). The results demonstrated that the young, women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms; and they had more expression inhibition and less cognitive reappraisal in three latent classes.
Conclusions: The findings suggest that more attention needs to be paid to vulnerable groups such as the young, women and people with responsibilities and concerns for others. Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.
The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18–22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.
Huge citizens expose to social media during a novel coronavirus disease (COVID-19) outbroke in Wuhan, China. We assess the prevalence of mental health problems and examine their association with social media exposure. A cross-sectional study among Chinese citizens aged≥18 years old was conducted during Jan 31 to Feb 2, 2020. Online survey was used to do rapid assessment. Total of 4872 participants from 31 provinces and autonomous regions were involved in the current study. Besides demographics and social media exposure (SME), depression was assessed by The Chinese version of WHO-Five Well-Being Index (WHO-5) and anxiety was assessed by Chinese version of generalized anxiety disorder scale (GAD-7). multivariable logistic regressions were used to identify associations between social media exposure with mental health problems after controlling for covariates. The prevalence of depression, anxiety and combination of depression and anxiety (CDA) was 48.3% (95%CI: 46.9%-49.7%), 22.6% (95%CI: 21.4%-23.8%) and 19.4% (95%CI: 18.3%-20.6%) during COVID-19 outbroke in Wuhan, China. More than 80% (95%CI:80.9%-83.1%) of participants reported frequently exposed to social media. After controlling for covariates, frequently SME was positively associated with high odds of anxiety (OR = 1.72, 95%CI: 1.31–2.26) and CDA (OR = 1.91, 95%CI: 1.52–2.41) compared with less SME. Our findings show there are high prevalence of mental health problems, which positively associated with frequently SME during the COVID-19 outbreak. These findings implicated the government need pay more attention to mental health problems, especially depression and anxiety among general population and combating with “infodemic” while combating during public health emergency.
The consequences of the COVID-19 pandemic on mental health and implications for clinical practice - Andrea Fiorillo, Philip Gorwood
The issue:
Coronavirus-19 (COVID-19) is transforming every aspect of our lives. Identified in late 2019, COVID-19 quickly became characterized as a global pandemic by March of 2020. Given the rapid acceleration of transmission, and the lack of preparedness to prevent and treat this virus, the negative impacts of COVID-19 are rippling through every facet of society. Although large numbers of people throughout the world will show resilience to the profound loss, stress, and fear associated with COVID-19, the virus will likely exacerbate existing mental health disorders and contribute to the onset of new stress-related disorders for many.
Recommendations:
The field of traumatic stress should address the serious needs that will emerge now and well into the future. However, we propose that these efforts may be limited, in part, by ongoing gaps that exist within our research and clinical care. In particular, we suggest that COVID-19 requires us to prioritize and mobilize as a research and clinical community around several key areas: (a) diagnostics, (b) prevention, (c) public outreach and communication, (d) working with medical staff and mainstreaming into nonmental health services, and (e) COVID-19-specific trauma research. As members of our community begin to rapidly develop and test interventions for COVID-19-related distress, we hope that those in positions of leadership in the field of traumatic stress consider limits of our current approaches, and invest the intellectual and financial resources urgently needed in order to innovate, forge partnerships, and develop the technologies to support those in greatest need. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Importance
Health care workers exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed.
Objective
To assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China.
Design, Settings, and Participants
This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from 1257 health care workers in 34 hospitals from January 29, 2020, to February 3, 2020, in China. Health care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 were eligible.
Main Outcomes and Measures
The degree of symptoms of depression, anxiety, insomnia, and distress was assessed by the Chinese versions of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, and the 22-item Impact of Event Scale–Revised, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes.
Results
A total of 1257 of 1830 contacted individuals completed the survey, with a participation rate of 68.7%. A total of 813 (64.7%) were aged 26 to 40 years, and 964 (76.7%) were women. Of all participants, 764 (60.8%) were nurses, and 493 (39.2%) were physicians; 760 (60.5%) worked in hospitals in Wuhan, and 522 (41.5%) were frontline health care workers. A considerable proportion of participants reported symptoms of depression (634 [50.4%]), anxiety (560 [44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers (eg, median [IQR] Patient Health Questionnaire scores among physicians vs nurses: 4.0 [1.0-7.0] vs 5.0 [2.0-8.0]; P = .007; median [interquartile range {IQR}] Generalized Anxiety Disorder scale scores among men vs women: 2.0 [0-6.0] vs 4.0 [1.0-7.0]; P < .001; median [IQR] Insomnia Severity Index scores among frontline vs second-line workers: 6.0 [2.0-11.0] vs 4.0 [1.0-8.0]; P < .001; median [IQR] Impact of Event Scale–Revised scores among those in Wuhan vs those in Hubei outside Wuhan and those outside Hubei: 21.0 [8.5-34.5] vs 18.0 [6.0-28.0] in Hubei outside Wuhan and 15.0 [4.0-26.0] outside Hubei; P < .001). Multivariable logistic regression analysis showed participants from outside Hubei province were associated with lower risk of experiencing symptoms of distress compared with those in Wuhan (odds ratio [OR], 0.62; 95% CI, 0.43-0.88; P = .008). Frontline health care workers engaged in direct diagnosis, treatment, and care of patients with COVID-19 were associated with a higher risk of symptoms of depression (OR, 1.52; 95% CI, 1.11-2.09; P = .01), anxiety (OR, 1.57; 95% CI, 1.22-2.02; P < .001), insomnia (OR, 2.97; 95% CI, 1.92-4.60; P < .001), and distress (OR, 1.60; 95% CI, 1.25-2.04; P < .001).
Conclusions and Relevance
In this survey of heath care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 in Wuhan and other regions in China, participants reported experiencing psychological burden, especially nurses, women, those in Wuhan, and frontline health care workers directly engaged in the diagnosis, treatment, and care for patients with COVID-19.
Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
The Coronavirus Disease 2019 (COVID-19) epidemic emerged in Wuhan, China, spread nationwide and then onto half a dozen other countries between December 2019 and early 2020. The implementation of unprecedented strict quarantine measures in China has kept a large number of people in isolation and affected many aspects of people’s lives. It has also triggered a wide variety of psychological problems, such as panic disorder, anxiety and depression. This study is the first nationwide large-scale survey of psychological distress in the general population of China during the COVID-19 epidemic.
Objectives:
The 2019-nCoV from Wuhan, China is now recognized as a public health emergency of global concern.
Methods:
To update the control measures in public health authorities, we reviewed the currently available literature.
Results:
Some of the epidemiologic characteristics were identified. However, considerable uncertainties are still present to provide the updated guidance of control measures to public health authorities.
Conclusion:
Additional studies based on detailed information on confirmed cases would be valuable.
European Psychiatry 2020: Moving forward - Volume 63 - Andrea Fiorillo, Sophia Frangou
Mechanisms for the association between posttraumatic stress disorder (PTSD) symptoms and cardiovascular diseases remain poorly understood. The present study examined associations among PTSD symptoms, appraisals of a current stressor, baseline cardiovascular indices, and cardiovascular responses to the stressor, including appraisals as a potential mediator of PTSD symptoms and cardiovascular responses. A sample of 125 undergraduates provided information about demographics, physical health, trauma history, and PTSD symptoms. Weight, height, blood pressure (BP), and heart rate (HR) measurements were obtained. During a modified Trier Social Stress Task, appraisals of the stressor were assessed and BP and HR were measured again. Findings suggest that PTSD symptoms are associated with current physical health (resting BP and HR) and more negative appraisals of the stressor; in turn, more negative appraisals were associated with increases in cardiovascular response. In particular, threat appraisal mediated the relationship between PTSD symptoms and increases in systolic BP response.
Background
Post-traumatic growth is defined as positive psychological, social or spiritual growth after a trauma.
Objectives
This systematic review aimed to identify studies that quantitatively measured post-traumatic growth among (ex-) military personnel, to determine whether there is evidence of growth in this context and whether such growth is associated with any sociodemographic, military, trauma or mental health factors.
Data sources
The electronic databases PsycInfo, OVIDmedline and Embase were searched for studies published between 2001 and 2017.
Study eligibility criteria and participants
Papers were retained if they involved military or ex-military personnel, where some had been deployed to Iraq or Afghanistan.
Study appraisal
Quality assessment was conducted on all studies.
Results
21 studies were retained. The Post-Traumatic Growth Inventory was employed by 14 studies: means ranged from 32.60 (standard deviation = 14.88) to 59.07 (23.48). The Post-Traumatic Growth Inventory Short Form was used by five studies: means ranged from 17.11 (14.88) to 20.40 (11.88). These values suggest moderate growth. Higher levels of social support, spirituality and rumination and minority ethnicity were most frequently associated with more post-traumatic growth.
Limitations
The involved studies may lack generalisability and methodological quality.
Conclusions
Overall, this paper confirms that negative reactions to trauma, particularly post-traumatic stress disorder, are not the only possible outcomes for service personnel, as moderate post-traumatic growth can also be observed.
Implications of key findings
Interventions aimed at helping current and former armed forces personnel to identify and promote post-traumatic growth post-conflict may be beneficial for their well-being.
Background:
There is a large treatment gap for common mental disorders (CMD), with wide variation by world region. This review identifies factors associated with formal health service utilisation for CMD in the general adult population, and compares evidence from high-income countries (HIC) with that from low-and-middle-income countries (LMIC).
Methods:
We searched MEDLINE, PsycINFO, EMBASE and Scopus in May 2016. Eligibility criteria were: published in English, in peer-reviewed journals; using population-based samples; employing standardised CMD measures; measuring use of formal health services for mental health reasons by people with CMD; testing the association between this outcome and any other factor(s). Risk of bias was assessed using the adapted Mixed Methods Appraisal Tool. We synthesised the results using "best fit framework synthesis", with reference to the Andersen socio-behavioural model.
Results:
Fifty two studies met inclusion criteria. 46 (88%) were from HIC. Predisposing factors: There was evidence linking increased likelihood of service use with female gender; Caucasian ethnicity; higher education levels; and being unmarried; although this was not consistent across all studies. Need factors: There was consistent evidence of an association between service utilisation and self-evaluated health status; duration of symptoms; disability; comorbidity; and panic symptoms. Associations with symptom severity were frequently but less consistently reported. Enabling factors: The evidence did not support an association with income or rural residence. Inconsistent evidence was found for associations between unemployment or having health insurance and use of services. There was a lack of research from LMIC and on contextual level factors.
Conclusion:
In HIC, failure to seek treatment for CMD is associated with less disabling symptoms and lack of perceived need for healthcare, consistent with suggestions that "treatment gap" statistics over-estimate unmet need for care as perceived by the target population. Economic factors and urban/rural residence appear to have little effect on treatment-seeking rates. Strategies to address potential healthcare inequities for men, ethnic minorities, the young and the elderly in HIC require further evaluation. The generalisability of these findings beyond HIC is limited. Future research should examine factors associated with health service utilisation for CMD in LMIC, and the effect of health systems and neighbourhood factors.
Trial registration:
PROSPERO registration number: 42016046551 .
Background: The death of a child of any age can be traumatic and can leave bereaved parents experiencing negative psychological outcomes. Recent research has shown the potential utility for understanding more about the development of post-traumatic growth following bereavement.
Objective: This paper sought to identify the aspects of post-traumatic growth experienced by bereaved parents and the factors that may be involved in facilitating or preventing post-traumatic growth.
Methods: A systematic search of peer-reviewed articles with a primary focus on positive personal growth in bereaved parents was conducted. Thirteen articles met the inclusion criteria, and were analysed and synthesized according to common and divergent themes.
Results: Bereaved parents were able to experience elements of growth proposed by the post-traumatic growth model (changes in self-perception, relationships, new possibilities, appreciation of life and existential views). The papers also indicated that (1) mothers appeared to experience more growth than fathers, (2) cultural variation may impact on some participants’ experience of growth, and (3) participants were able to identify growth only once some time had passed. Potential facilitators of post-traumatic growth involved making meaning, keeping ongoing bonds with the child, being with bereaved families, and family and personal characteristics. Social networks were identified as having the potential to be either a facilitator or a barrier to growth.
Conclusions: In addition to experiencing grief, bereaved parents may experience aspects of post-traumatic growth, and a variety of factors have been identified as potential facilitators and barriers of these changes. The findings may have implications for support services (e.g. expert-by-experience services).
Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3–2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5–4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.
The controversy regarding the nature of posttraumatic growth includes two main competing claims: one which argues that posttraumatic growth reflects authentic positive changes and the other which argues that posttraumatic growth reflects illusory defenses. While the former might suggest that posttraumatic growth enhances intimacy and close relationships, the latter might imply that posttraumatic growth hinders interpersonal relations. The present study aimed to test these claims by investigating the association between posttraumatic growth and dyadic adjustment over time at both the individual and dyadic levels, and the potential role of posttraumatic stress symptoms. Former prisoners of war and comparable war veterans and their wives (n = 229) were assessed twice, 30–31 (T1) and 35–38 (T2) years after the 1973 Yom Kippur War in Israel, with regard to posttraumatic growth, posttraumatic stress symptoms and dyadic adjustment. Results indicated that posttraumatic growth was associated with both elevated posttraumatic stress symptoms and low dyadic adjustment among both husbands and wives. Posttraumatic stress symptoms at T1 and T2 mediated the association between posttraumatic growth and dyadic adjustment. Wives' posttraumatic growth at T1 predicted posttraumatic growth and dyadic adjustment of the husbands at T2. The higher the wives' posttraumatic growth, the higher the posttraumatic growth and the lower the dyadic adjustment of the husbands in the subsequent measure. The findings suggest that posttraumatic growth reflects defensive beliefs which undermine marital relationships and that posttraumatic growth might be transmitted between spouses and implicated in the deterioration of the marital relationship over time.
Treatment of survivors of childhood sexual abuse (CSA) poses difficult challenges for therapists. This is, namely, because of the wide array of powerful countertransference (CT) reactions. A vast amount of literature exists which describes these patterns. However, discussion until now has predominantly focused on the reaction of therapists to the negative effects of the trauma.
The present chapter addresses an aspect of CT that, to the best of the authors’ knowledge, has yet to receive any attention in the literature on trauma: countertransference in response to reports of gains or positive changes after trauma. This has been defined in the literature as posttraumatic growth (PTG). Exploring countertransferencial reactions to PTG and the mutual effects that occur between the two, will provide further insight into the phenomenon of PTG. It will also assist therapists in assuming responsibility for their part in the appearance of PTG and the ways it unfolds in therapy. Five distinct positions of countertransference will be presented: dissociated therapist; therapist as perpetrator; therapist as neglectful parent; therapist as rescuer; and mourning therapist. The authors argue that these positions should be considered as reenactments of dissociated self-states and relational dynamics, rooted in the original trauma, that must be worked through in psychotherapy in order to foster integration and healing.
The 2013-2016 Ebola outbreak in Guinea, Liberia and Sierra Leone was the worst in history with over 28 000 cases and 11 000 deaths. Here we examine the psychosocial consequences of the epidemic. Ebola is a traumatic illness both in terms of symptom severity and mortality rates. Those affected are likely to experience psychological effects due to the traumatic course of the infection, fear of death and experience of witnessing others dying. Survivors can also experience psychosocial consequences due to feelings of shame or guilt (e.g. from transmitting infection to others) and stigmatization or blame from their communities. At the community level, a cyclical pattern of fear occurs, with a loss of trust in health services and stigma, resulting in disruptions of community interactions and community break down. Health systems in affected countries were severely disrupted and overstretched by the outbreak and their capacities were significantly reduced as almost 900 health-care workers were infected with Ebola and more than 500 died. The outbreak resulted in an increased need for health services, reduced quality of life and economic productivity and social system break down. It is essential that the global response to the outbreak considers both acute and long-term psychosocial needs of individuals and communities. Response efforts should involve communities to address psychosocial need, to rebuild health systems and trust and to limit stigma. The severity of this epidemic and its long-lasting repercussions should spur investment in and development of health systems.
This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record
A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.
Objective:
Research suggests that, after a traumatic event, survivors can experience positive change (posttraumatic growth), but the relation of these changes to overall psychological adjustment (resilience) and psychological distress (posttraumatic symptoms; PTS), as well as the relation to possible contributors, is still unclear. The study examines posttraumatic growth (PTG) among women survivors of childhood sexual abuse (CSA), looking at the relation of PTG to the women's cognitive strategies (past self-blame, self-forgiveness, perception of control and hope), resilience and PTS.
Methods:
Self-report questionnaires were completed by 100 women survivors of CSA.
Results:
Findings show that the main contributors to PTG were demographic-familial variables (birth order and number of siblings) and cognitive strategies (self-blame and hope).The relationship between resilience and PTG was curvilinear: The highest levels of PTG occurred when resilience levels were moderate. Variance in PTG was also explained by an interaction between resilience and PTS.
Conclusions:
Cognitive strategies and familial variables can contribute to PTG. The complex relations between PTG, resilience and PTS might help professionals better understand different trajectories of adjustment among trauma survivors. (PsycINFO Database Record
Empirical studies (n = 39) that documented positive change following trauma and adversity (e.g., posttraumatic growth, stress‐related growth, perceived benefit, thriving; collectively described as adversarial growth) were reviewed. The review indicated that cognitive appraisal variables (threat, harm, and controllability), problem‐focused, acceptance and positive reinterpretation coping, optimism, religion, cognitive processing, and positive affect were consistently associated with adversarial growth. The review revealed inconsistent associations between adversarial growth, sociodemographic variables (gender, age, education, and income), and psychological distress variables (e.g., depression, anxiety, posttraumatic stress disorder). However, the evidence showed that people who reported and maintained adversarial growth over time were less distressed subsequently. Methodological limitations and recommended future directions in adversarial growth research are discussed, and the implications of adversarial growth for clinical practice are briefly considered.
Objective
The novel coronavirus (COVID-19) is a substantial stressor that could eventuate in psychological distress. Evidence suggests that individuals previously exposed to traumatic events, and particularly to continuous traumatic stress (CTS), might be more vulnerable to distress when facing additional stressors. This study aimed to investigate these suppositions in the context of the ongoing shelling of Israel from the Israel-Gaza border, which continues even amidst the COVID-19 crisis.
Method
An online survey was conducted among Israel's general population. The sample included 976 participants. Seven-hundred-and-ninety-three participants had been exposed to traumatic events, with 255 participants reporting CTS. Trauma exposure, COVID-19-related stressors, and psychological distress related to COVID-19 (anxiety, depression, and peritraumatic stress symptoms) were assessed.
Results
Most participants reported experiencing at least one psychiatric symptom related to COVID-19. Being younger, female, not in a relationship, having a below-average income, being diagnosed with the disease, living alone during the outbreak, having a close other in a high-risk group, and negatively self-rating one's health status were associated with elevated distress. Individuals who had been exposed to trauma, and to CTS in particular, had elevated anxiety, depression, and peritraumatic stress symptoms compared to individuals without such a history or to survivors of non-ongoing traumatic events. CTS moderated the relations between PTSD symptoms, anxiety symptoms, and peritraumatic stress symptoms, with significantly stronger relations found among individuals exposed to CTS.
Limitations
This study relied on convenience sampling.
Conclusions
Trauma survivors, and particularly traumatized individuals exposed to CTS, seem at risk for psychological distress related to COVID-19.
As the COVID-19 outbreak peaks, millions of individuals are losing their income, and economic anxiety is felt worldwide. In three different countries (the USA, the UK, and Israel: N = 1200), the present study addresses four different sources of anxiety: health-related anxiety, economic-related anxiety, daily routine-change anxiety, and anxiety generated by social isolation. We hypothesized that, economic anxiety would have a similar or greater effect, compared to health anxiety. Results show that in all three countries, the levels of economic and health anxiety were essentially equal, and both surpassed routine-change and isolation anxiety. Although the COVID-19 crisis originated in the health field, this study emphasizes the need to move from a generalized concept of anxiety to specific types of distress, most notably economic anxiety. Economic anxiety results in serious mental and physical health problems and should be attended to by clinical professionals and by policy makers.
Objective: This study examined whether attributing a cause of a community fire to a human-made vs. natural disaster moderated the association between peritraumatic distress (PD) and posttraumatic stress (PTSD) symptoms, as well as between PD and posttraumatic growth (PTG).
Method: Participants lived in Israeli communities affected by wide-scale fires in November 2016. At Time 1 (within one month of the fires), 390 participants completed measures. At Time 2 (four months after the fires), 223 of the original participants completed follow-up-questionnaires. Participants reported their PD symptoms at Time 1, and their beliefs regarding the cause of the fire, PTSD symptoms, and PTG at Time 2.
Results: Higher levels of PD at Time 1 were associated with higher levels of both PTSD symptoms and PTG at Time 2. Participants who believed that the fires were more of a human-made than natural disaster had stronger associations between PD and PTSD symptoms, and stronger associations between PD and PTG.
Conclusions: Attributions regarding the cause of a disaster may be related to both PTSD symptoms as well as PTG. Balanced and responsible public announcements regarding the causes of traumatic events may reduce the deleterious effects in the aftermath of a traumatic event.
In addition to being a public physical health emergency, Coronavirus disease 2019 (COVID-19) affected global mental health, as evidenced by panic-buying worldwide as cases soared. Little is known about changes in levels of psychological impact, stress, anxiety and depression during this pandemic. This longitudinal study surveyed the general population twice - during the initial outbreak, and the epidemic's peak four weeks later, surveying demographics, symptoms, knowledge, concerns, and precautionary measures against COVID-19. There were 1738 respondents from 190 Chinese cities (1210 first-survey respondents, 861 second-survey respondents; 333 respondents participated in both). Psychological impact and mental health status were assessed by the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21), respectively. IES-R measures PTSD symptoms in survivorship after an event. DASS -21 is based on tripartite model of psychopathology that comprise a general distress construct with distinct characteristics. This study found that
there was a statistically significant longitudinal reduction in mean IES-R scores (from 32.98 to 30.76, p<0.01) after 4 weeks. Nevertheless, the mean IES-R score of the first- and second-survey respondents were above the cut-off scores (>24) for PTSD symptoms, suggesting that the reduction in scores was not clinically significant. During the initial evaluation, moderate-to-severe stress, anxiety and depression were noted in 8.1%, 28.8% and 16.5%, respectively and there were no significant longitudinal changes in stress, anxiety and depression levels (p>0.05). Protective factors included high level of confidence in doctors, perceived survival likelihood and low risk of contracting COVID-19, satisfaction with health information, personal precautionary measures. As countries around the world brace for an escalation in cases, Governments should focus on effective methods of disseminating unbiased COVID-19 knowledge, teaching correct containment methods, ensuring availability of essential services/commodities, and providing sufficient financial support.
Objectives: We aimed to use a dyadic approach to assess the effects of veterans' posttraumatic stress disorder symptoms (PTSS) and siblings' secondary PTSS, as well as veterans' and siblings' relationship quality, on primary and secondary posttraumatic growth (PTG). Method: A volunteers' sample of 106 dyads of Israeli combat veterans and their close-in-age siblings responded to self-report questionnaires in a cross-sectional, dyadic design study. Results: Veterans' primary PTG was positively associated with siblings' secondary PTG. Veterans' PTSS and siblings' secondary PTSS were associated with higher levels of primary and secondary PTG, respectively. Furthermore, among veterans, warmth in siblings' relationships was associated with higher levels of primary PTG. However, among siblings, rivalry in sibling relationships was associated with lower levels of secondary PTG. Conclusions: Both veterans' and siblings' PTSS are only related to their own PTG. Moreover, perception of siblings' relationship quality might have a differential effect on PTG among veterans and their siblings.
K E Y W O R D S positive psychology, posttraumatic stress disorder, relationships
The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
Despite increasing interest in the mental health of aging veterans, the pathogenic and salutogenic ramifications of war have not been investigated among aging veterans who received decorations of valor. Filling this gap, 73 Israeli decorated veterans (DVs) and 73 non-decorated veterans (n-DVs) (Mage = 68.5) were assessed for posttraumatic stress symptoms (PTSS), depression and anxiety 18 and 45 years after the war, and for posttraumatic growth (PTG) 45 years after the war. Analyses revealed deteriorating posttraumatic avoidance among n-DVs but not among DVs, and significantly lower rates of anxiety and depression and higher rates of PTG among the DVs. These findings suggest that factors related to being a DV may foster resilience to posttraumatic sequelae and are potentially conducive to PTG in later life. Though the study precludes making causal inferences, it serves as a springboard for future investigations into positive mechanisms underlying DVs’ relative resilience and growth in later life.
An outbreak of novel coronavirus (2019-nCoV) that began in Wuhan, China, has spread rapidly, with cases now confirmed in multiple countries. We report the first case of 2019-nCoV infection confirmed in the United States and describe the identification, diagnosis, clinical course, and management of the case, including the patient's initial mild symptoms at presentation with progression to pneumonia on day 9 of illness. This case highlights the importance of close coordination between clinicians and public health authorities at the local, state, and federal levels, as well as the need for rapid dissemination of clinical information related to the care of patients with this emerging infection.
Background:
In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia.
Methods:
In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020.
Findings:
Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure.
Interpretation:
The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection.
Funding:
National Key R&D Program of China.