No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Post-Traumatic Stress Disorder, A Guide for Primary Care Clinicians and Therapists
Abstract
PTSD is in no way an easy diagnosis for the patient, the provider, or the therapist. It is a diagnosis developed at the border of our capacity to handle extreme stress, a marker diagnosis denoting the limits of our capacity for functioning in the stress of this modern world. For both individuals and society, PTSD marks the limits of our available compassion and our capacity to protect ourselves from the dangers of the environment and other humans. PTSD is often a chronic disease, forming at a place where mind sometimes no longer equals the brain, a point at which individual patient requirements often trump theory and belief.
There are treatments for PTSD that work, and many that do not. This book presents evidence, rather than theory, anecdote, or case report. Psychological approaches including prolonged exposure, imagery rehearsal therapy and EMDR have a greater than 75% positive short-term response when used to treat PTSD. Yet these treatments vary markedly and have different, even contradictory underlying theory and objectives for treatment. Medications, rarely indicated as primary therapy, can be used to treat symptoms and address comorbid PTSD diagnoses. Treatment of sleep apnea in the PTSD population produces a positive effect on symptoms and a reduction in morbidity and mortality across the span of life. Complementary treatments offer the many individuals chronically affected by PTSD assistance in coping with symptoms and opportunities to attempt to functionally integrate their experience of trauma.
... The PTSD levels in the current study are similar to PTSD levels in studies among soldiers deployed in high-conflict areas, which indicated that 17-21% reported PTSD (Kokun et al., 2020;Pagel, 2021;Seal et al., 2009). The findings of the current study may therefore suggest that the harmful effects of handling bodies could be similar to the effect of being physically exposed to the risk of being killed or killing others. ...
In this study, post-traumatic stress disorder (PTSD) was examined among 161 Israeli military reservists who were recruited to gather and identify the bodies and body parts of civilians and soldiers killed in the October 7th 2023 Hamas terror attack on Israel. The aims were to examine PTSD levels as well as the associations between demographic variables, task-related characteristics, coping strategies, well-being, and odds of being diagnosed with PTSD.
Using the PTSD Checklist for DSM-5 (PCL-5), 20% of the participants were found to have PTSD. Logistic regression indicated that a one-point increase in emotion-focused coping via distancing increased the odds of a PTSD diagnosis by 3.76 times; a one-point increase in perceived task difficulty increased the odds by 1.81; and a one-point decrease in well-being increased the odds by 1.06. A significant interaction showed that problem-focused coping was associated with a higher risk of PTSD among younger participants but a lower risk among older ones. Additionally, well-being served as a protective factor for those who perceived the task as mentally difficult.
The study points to the high traumatic potential of handling bodies. It also indicates that the use of distancing oneself from one’s emotions is highly non-adaptive.
... In the United States, disability compensation is available for those with mental health disorders, which while being a crucial resource for the truly afflicted, potentially can drive up fabrication rates 3,4 . Feigning PTSD to access medical treatment, commit insurance, personal injury and other frauds, or in an attempt to evade criminal liability and penalties 24-27 is unfortunately not rare, although some of the cited numbers could be inflated 28 . Because PTSD is a serious mental health condition associated with substance use, mood, anxiety, personality disorder, increased morbidity, and possibly with increased mortality 29,30 , false diagnoses and fabrication of self-reported symptom severity can cause substantial financial drain 31,32 to healthcare systems, divert crucial resources from where they are needed 33 , and interfere with study outcomes by introducing inaccuracies in clinical data 34 . ...
Fabricating symptoms of Post-Traumatic Stress Disorder (PTSD) can hinder accurate clinical assessments via structured diagnostic interviews1,2. Symptom simulation or fabrication is a known problem3,4 in PTSD assessments, with diverse motivations including unmet mental health issues, varied socio-economic factors and the potential for external gain from positive diagnoses. Here we introduce an artificial intelligence (AI) framework referred to as Algorithm VeRITAS (Vetting Response Integrity from cross-Talk in Adversarial Surveys), for detecting symptom fabrication in the context of PTSD diagnosis. In contrast to current approaches to fabrication detection which indirectly assess atypical symptom presentations, and have limited reliability, VeRITAS infers statistical dependencies inherent in true response patterns, flagging responses which violate these subtle constraints. With a study sample of n = 651 patients, VeRITAS has an Area Under the Curve (AUC) of ≧ 0:95 ± 0:02, with sensitivity > 95%, specificity > 88%, and positive likelihood ratio between 9:9 - 19:77. Additionally, VeRITAS is difficult-to-impossible to beat with coaching or training; we demonstrate that having advanced training in mental health diagnosis is not helpful in defeating the algorithm. Our tool offers an objective, diseasespecific, fast (average time ≦ 4 min) detection of simulated or feigned PTSD, and on wider adoption, can potentially help resources and disability concessions reach those genuinely in need, while helping to maintain integrity of clinical data. Moreover, reliably identifying patients who might be fabricating symptoms due to unmet mental health needs or socio-economic compulsions can ultimately improve outcomes in disadvantaged communities.
... There were also few female participants, which is a commonly reported limitation in the veteran literature (e.g., Song et al., 2021). Evidence for the support of IRT is strongest in civilian samples (Casement & Swanson, 2012), including female participants with histories of sexual trauma (Pagel, 2021). Therefore, the current findings add to knowledge regarding offering IRT to predominantly male veterans with diagnosed PTSD. ...
Objectives
Posttraumatic stress disorder (PTSD) is associated with sleep disturbances including insomnia and nightmares. This study compared cognitive behavioral therapy for insomnia (CBT‐I) with CBT‐I combined with imagery rehearsal therapy (IRT) for nightmares to evaluate if the combined treatment led to greater reductions in trauma‐related sleep disturbances in Australian veterans.
Methods
Veterans with diagnosed PTSD, high insomnia symptom severity, and nightmares (N = 31) were randomized to eight group CBT‐I sessions or eight group CBT‐I + IRT sessions. Self‐reported sleep, nightmare, and psychological measures (primary outcome: Pittsburgh Sleep Quality Index), and objective actigraphy data were collected; the effect of obstructive sleep apnea (OSA) risk on treatment outcomes was also examined.
Results
No treatment condition effects were detected for the combined treatment compared to CBT‐I alone, and no moderating effect of OSA risk was detected. On average, participants from both groups improved on various self‐report measures over time (baseline to 3 months posttreatment). Despite the improvements, mean scores for sleep‐specific measures remained indicative of poor sleep quality. There were also no significant differences between the groups on the actigraphy indices.
Conclusions
The findings indicate that there is potential to optimize both treatments for veterans with trauma‐related sleep disturbances.
... For reprints contact: WKHLRPMedknow_reprints@wolterskluwer.com characteristics of this disorder include a constant review of the traumatic stressor in the mind, re-experiencing it when awake or asleep, avoiding remembering it, and feeling overwhelmed. [7] In particular, nurses are vulnerable to the symptoms of PTSD. PTSD is a mental health problem that affects people who are exposed to potentially traumatic episodes. ...
Abstract
Background: Post‑Traumatic Stress Disorder (PTSD) is a mental disorder that can result from
direct or indirect contact with traumatic events. The current study aimed to evaluate PTSD and
its related factors in nurses caring for COVID‑19 patients. Materials and Methods: This study
was a descriptive correlational study. Using convenience sampling methods, 395 nurses were
enrolled in the study. The study instruments included demographic information, Impact of Event
Scale‑Revised (IES‑R), and General Health and Job Content Questionnaire (JCQ). Data were
analyzed using the Pearson correlation test, t‑test, ANOVA, and multiple regression analysis.
Results: The mean (SD) age and work experience of the participants were 33.79 (6.74) years and
9.47 (6.47) years, respectively. Most nurses (86.60%) experienced PTSD. Multiple linear regression
results showed general health (R2 = 0.51, p = 0.001), job insecurity (R2 = 0.51, p = 0.042), decision
latitude (R2 = 0.51, p = 0.037), and high age (R2 = 0.51, p = 0.049) to be associated with an increase
in PTSD, and having high social support (R2 = 0.51, p = 0.043) was associated with a decrease in
PTSD in nurses. Conclusions: Nurses have experienced high levels of PTSD after the fatal outbreak
of COVID‑19 disease. Stressful conditions associated with an increased likelihood of this disorder
should be identified, and coping skills such as decision latitude (control) and social support should
be strengthened to prevent the symptoms of this disorder in nurses.
In The Tobacco Keeper, Ali Bader delves into the harrowing experiences of Iraqi Jews during the Farhud, a violent pogrom that took place in Baghdad in 1941. The story not only chronicles the immediate physical and emotional toll of the violence but also examines the long-lasting psychological effects that such an experience has on the Jewish community in Iraq. The aim of this article is to examine the literary representation of psychic trauma which is provoked by exposure to a traumatic event in Ali Bader’s The Tobacco Keeper and explore the post-traumatic stress disorders that the traumatized character suffers. The article, through close reading of the novel, attempts to trace and elucidate the myriad emotional, behavioral and psychological predicaments that the protagonist exhibits and experiences after being exposed to the Farhud. The study deploys trauma theory and post-traumatic stress disorders theory to examine the protagonist’s altered perception of reality and the self and the mechanisms he employs to cope with the traumatic event and the extent to which he is able to overcome the impacts of those traumatic experiences.
Introduction
Post-traumatic stress disorder (PTSD) is a prevalent challenge faced by individuals following traumatic events. Given the substantial impact of PTSD on the well-being of young people, comprehensive assessment of the available evidence can inform more effective prevention and intervention strategies to support the mental health and resilience of children in the African context. Despite its high incidence, there has been no up-to-date systematic synthesis of evidence to measure the magnitude of PTSD in pediatric populations in Africa. This systematic review and meta-analysis aim to quantify the prevalence of PTSD and identify associated factors in this vulnerable population.
Methods
A systematic search was conducted across multiple databases, including PubMed, Embase, Scopus, Science Direct, and the search engines Google Scholar and Google, covering the period from 2014 up to May 15, 2024. The primary objective of this search was to identify relevant studies. Subsequently, a meta-analysis was performed using random-effects models to estimate the pooled effect size for each outcome of interest. Additionally, subgroup analysis was conducted to explore potential sources of heterogeneity, with study characteristics considered as covariates.
Results
The pooled prevalence estimate for post-traumatic stress disorder (PTSD) among pediatric individuals was 36% (95% CI: 28–44%). Notably, significant heterogeneity existed among the studies (I² = 98.41%, p value < 0.001), prompting us to employ a random effect model analysis. Furthermore, our meta-analysis revealed that children above 14 years of age and those who experienced family deaths due to traumatic events were significantly associated with PTSD.
Conclusion
This systematic review and meta-analysis revealed that the prevalence of PTSD among pediatric individuals aged 0–18 years in Africa was high. Notably, older children and those who experienced family deaths due to traumatic events were at a significantly higher risk of developing PTSD. These findings underscore the need for early intervention, age-specific support, and trauma-informed care to address the mental health challenges faced by pediatric populations.
The COVID-19 pandemic has increased the number of victims of trafficking in persons due to economic constraints. Victims of trafficking in persons experience various problems as a result of their traumatic experiences, making them vulnerable to experiencing indications of post-traumatic stress disorder (PTSD). Individuals with PTSD experience impairment in social functioning for more than six months. This research aims to determine the description of PTSD in trafficking victims, which can be seen from five aspects, namely re-experiencing, avoidance, negative alternations, hyperarousal, and social aspects. This research is descriptive research with quantitative methods. Respondents of this study were victims of trafficking in persons at the Kusuma Bongas Foundation in Indramayu using a census sample that used all members of the population as many as 32 people. The data collection instrument used was guided by the PTSD screening standard measurement tool published by DSM-V, namely PTSD Checklist-5 (PCL-5) with the addition of question items on social aspects. This instrument has been tested valid and reliable. The data collection technique used is the distribution of questionnaires with the home visit method. The results showed that there were 10 victims of trafficking who experienced indications of PTSD at the Kusuma Bongas Foundation with a percentage of 31.25% and all aspects of PTSD were included in the low category. The results of the problem analysis show that avoidance aspects and social aspects have high scores. The results showed that respondents tended to experience disturbances in their social aspects so that they needed a treatment program with reference to the perspective of social work
Background
Post-traumatic stress disorder (PTSD) is a common disorder among survivors of war-combat. Along with the spread of CVOID-19, the May 2021 war against Gaza Strip increased the chance for PTSD among university students living in the Gaza Strip, hence, this study aimed to assess level of PTSD among university students following Israeli war against the Gaza Strip in May 2021.
Methodology
This cross-sectional study targeted all university students in Gaza Strip. The Impact Event Scale-Revised (IES-R) {which has 3 domains; intrusion, avoidance, and hyper-arousal} was used to assess PTSD among participants.
Results
The results showed that only 4.3% of the participants had not symptoms of PTSD while 88.7% showed severe symptoms of PTSD. The mean for IES-R score was 2.55. The highest mean of IES-R domains related to “Intrusion” (mean = 2.77) followed by “Avoidance” (mean = 2.28) and “Hyper-arousal” (mean = 2.01). Differences between males and females, participants who got injured and those who did not, participants who had a family member got injured and those who hadn’t, participants who had a relative/a friend got injured and those who hadn’t, participants who had a family member killed during the war and those who hadn’t, and participants who had a relative or a friend killed during the war and those who hadn’t were all statistically significant.
Conclusion
The findings showed that university students living in the Gaza Strip suffered from severe PTSD following the May 2021 war. This level of PTSD shows the need for special intervention programs to diminish level of stress and trauma among these students after the war, especially with the spread of COVID-19 pandemic which increases their stress level.
ResearchGate has not been able to resolve any references for this publication.