| 1. |
- Aho, Nikolas, et al.
(författare)
-
Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students
- 2017
-
Ingår i: European Journal of Psychotraumatology. - : TAYLOR & FRANCIS LTD. - 2000-8198 .- 2000-8066. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure to traumatic events is clearly associated with a diversity of subsequent mental health problems, with posttraumatic stress disorder (PTSD) as the most prevalent disorder. Epidemiologically, trauma exposure rates are more prevalent than PTSD, indicating that most trauma victims do not develop PTSD. More knowledge is needed to understand the development of the different posttraumatic pathways including the significance of pretraumatic, peritraumatic and posttraumatic risk factors. Objective: To study peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress and to enhance our understanding of peritraumatic reactions as mediators between trauma and later symptomatology. Method: The study was composed of a representative community sample of 5332 second year high school students (mean age 17.3 years) who completed the Juvenile Victimization Questionnaire (SAQ/JVQ), Trauma Symptom Checklist for Children (TSCC) and answered questions about peritraumatic reactions. Mediation effects of peritraumatic reactions on the trauma exposure relationship to symptoms was tested using the PROCESS macro for SPSS. Results: Traumatic events are common (84.1%) and are accompanied in three-quarters of the students with at least one form of peritraumatic reaction. Peritraumatic reactions, especially peritraumatic dissociative reactions, mediate the relationship between trauma exposure and symptoms, and gender moderates the effect of peritraumatic dissociation. This moderating effect was found to be larger for boys than for girls, indicating gender differences in response to trauma. Conclusions: The results indicate the need to screen for peritraumatic reactions as early as possible after a traumatic event in order to identify those at risk for PTSD.
|
|
| 2. |
|
|
| 3. |
- Bondjers, Kristina, et al.
(författare)
-
Similarity in symptom patterns of posttraumatic stress among disaster-survivors : a three-step latent profile analysis
- 2018
-
Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 9:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Individuals express symptoms of posttraumatic stress in various ways, noted for example in the many symptom combinations in the diagnostic manuals. Studies aiming to examine differences of symptom presentations by extracting latent classes or profiles indicate both the presence of subtypes with differing symptomatology and subtypes distinguished by severity levels. Few studies have examined subtype associations with long-term outcomes. Objective: The current study aimed to apply latent profile analysis on posttraumatic stress (PTS) in a highly homogenous sample of Swedish tourists exposed to the 2004 Southeast Asia tsunami and to examine if classes differed in their long-term outcome. Methods: An latent profile analysis was conducted using self-report data collected one year after the disaster from 1638 highly exposed survivors that endorsed 1 symptom of PTS. Associations were examined between the classes and predictors of PTS (loss of a relative or friend, subjective life threat) and levels of PTS at a three-year follow up. Results: The latent profile analysis indicated four classes: minimal, low, moderate, and severe symptoms. The classes were distinguished mainly by their levels of PTS. Loss of a relative or friend and subjective life threat were associated with a higher likelihood of belonging to any other class than the minimal class. The severity level of the classes at one year were predictive of PTS severity at the three-year follow-up. Conclusions: Homogeneous profiles of posttraumatic stress differing mainly in symptom severity were found in this sample of disaster survivors. Profile diversity may be related to sample variation and unmeasured confounders rather than reflect qualitatively different disorders.
|
|
| 4. |
- Bondjers, Kristina, et al.
(författare)
-
Validation of a clinician-administered diagnostic measure of ICD-11 PTSD and Complex PTSD : the International Trauma Interview in a Swedish sample
- 2019
-
Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The recently published ICD-11 includes substantial changes to the diagnosis of posttraumatic stress disorder (PTSD) and introduces the diagnosis of Complex PTSD (CPTSD). The International Trauma Interview (ITI) has been developed for clinicians to assess these new diagnoses but has not yet been evaluated.Objectives: To evaluate the psychometric properties of the Swedish translation of the ITI by examining the interrater agreement, latent structure, internal consistency, and convergent and discriminant validity.Methods: In a prospective study, 186 adults who had experienced a potentially traumatic event were assessed with the ITI and answered questionnaires for symptoms of posttraumatic stress, other psychiatric disorders, functional disability, and quality of life (QoL).Results: The diagnostic rate was 16% for PTSD and 6% for CPTSD. Interrater agreement was satisfactory (α = .76), and confirmatory factor analysis indicated that a two-factor second-20 order model consistent with the ICD-11 model of CPTSD provided acceptable fit to the data. Composite reliability analysis demonstrated that the ITI possessed acceptable internal reliability, and associations with measures of other psychiatric disorders, insomnia, functional disability, and QoL supported the concurrent validity of the ITI.Conclusion: Swedish ITI shows promise as a clinician-administered instrument to assess and diagnose ICD-11 PTSD and CPTSD.
|
|
| 5. |
- Cernvall, Martin, 1980-, et al.
(författare)
-
A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach
- 2018
-
Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 9:Suppl 1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is a need for accessible interventions in the aftermath of traumatic events with documented efficacy for preventing or reducing negative mental health consequences. The PTSD Coach is a mobile app that has shown to be effective in reducing symptoms of posttraumatic stress (PTSS). Objective: The purpose of the current study was to evaluate the user satisfaction, perceived helpfulness and potential reductions of PTSS and symptoms of depression among participants using the Swedish version of the PTSD Coach. Method: This was an uncontrolled pre-test post-test open trial including participants recruited from the community via advertisement and from an ongoing observational study who had experienced a potentially traumatic event in the last five years. Participants had access to the Swedish PTSD Coach app for four weeks. Results: Eleven participants (mean age = 38.6, female = 8) completed the study. Nine of the participants met criteria for full or partial PTSD. Results from the PTSD Coach Survey indicated that participants found the app slightly to moderately helpful and were slightly to moderately satisfied with the app. Nominal but not statistically significant reductions of medium effect sizes in PTSS (PCL-5) and depression (PHQ-9) from pre- to post-assessment were found. In interviews, participants indicated that they found elements such as learning about PTSD, breathing exercises and monitoring symptoms helpful in managing symptoms. However, several participants indicated that they had not used the app as much as they had intended to. Participants also had suggestions for improvements such as enhanced app structure and better guidance regarding how to use the app. Conclusions: The perceived helpfulness and user satisfaction were slightly lower compared to research on the original version of the app. Experiences from the study are discussed and a future controlled study of the Swedish version of the PTSD Coach is suggested.
|
|
| 6. |
- Doric, A., et al.
(författare)
-
UCLA PTSD reaction index for DSM-5 (PTSD-RI-5): a psychometric study of adolescents sampled from communities in eleven countries
- 2019
-
Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Children and adolescents are often exposed to traumatic events, which may lead to the development of posttraumatic stress disorder (PTSD). It is therefore important for clinicians to screen for potential symptoms that can be signs of PTSD onset. PTSD in youth is a worldwide problem, thus congruent screening tools in various languages are needed. Objective: The aim of this study was to test the general psychometric properties of the Traumatic Stress Disorder Reaction Index for children and adolescents (UCLA PTSD) Reaction Index for DSM-5 (PTSD-RI-5) in adolescents, a self-report instrument intended to screen for trauma exposure and assess PTSD symptoms. Method: Data was collected from 4201 adolescents in communities within eleven countries worldwide (i.e. Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, Palestine-Gaza, Philippines, Portugal, Romania, and Serbia). Internal consistency, discriminant validity, and a confirmatory factor analysis of a four-factor model representing the main DSM-5 symptoms of the PTSD-RI-5 were evaluated. Results: The PTSD-RI-5 total score for the entire sample shows very good reliability (alpha = .92) as well as across all countries included (alpha ranged from .90 to .94). The correlations between anxiety/depressive symptoms and the PTSD-RI-5 scores were below .70 indicating on good discriminant validity. The four-factor structure of the scale was confirmed for the total sample and data from six countries. The standardized regression weights for all items varied markedly across the countries. The lack of a common acceptable model across all countries prevented us from direct testing of cross-cultural measurement invariance. Conclusions: The four-factor structure of the PTSD-RI-5 likely represents the core PTSD symptoms as proposed by the DSM-5 criteria, but there could be items interpreted in a conceptually different manner by adolescents from different cultural/regional backgrounds and future cross-cultural evaluations need to consider this finding.
|
|
| 7. |
- Hagenaars, Muriel A., et al.
(författare)
-
Tetris and Word games lead to fewer intrusive memories when applied several days after analogue trauma
- 2017
-
Ingår i: European Journal of Psychotraumatology. - : TAYLOR & FRANCIS LTD. - 2000-8198 .- 2000-8066. ; 8
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Intrusive trauma memories are a key symptom of posttraumatic stress disorder (PTSD), so disrupting their recurrence is highly important. Intrusion development was hindered by visuospatial interventions administered up to 24 hours after analogue trauma. It is unknown whether interventions can be applied later, and whether modality or working-memory load are crucial factors. Objectives: This study tested: (1) whether a visuospatial task would lead to fewer intrusions compared to a reactivation-only group when applied after memory reactivation four days after analogue trauma exposure (extended replication), (2) whether both tasks (i.e. one aimed to be visuospatial, one more verbal) would lead to fewer intrusions than the reactivation-only group (intervention effect), and (3) whether supposed task modality (visuospatial or verbal) is a critical component (modality effect). Method: Fifty-four participants were randomly assigned to reactivation+Tetris (visuospatial), reactivation+Word games (verbal), or reactivation-only (no task). They watched an aversive film (day 0) and recorded intrusive memories of the film in diary A. On day 4, memory was reactivated, after which participants played Tetris, Word games, or had no task for 10 minutes. They then kept a second diary (B). Informative hypotheses were evaluated using Bayes factors. Results: Reactivation+Tetris and reactivation+Word games resulted in relatively fewer intrusions from the last day of diary A to the first day of diary B than reactivation-only (objective 1 and 2). Thus, both tasks were effective even when applied days after analogue trauma. Reactivation-only was not effective. Reactivation+Word games appeared to result in fewer intrusions than reactivation+Tetris (objective 3; modality effect), but this evidence was weak. Explorative analyses showed that Word games were more difficult than Tetris. Conclusions: Applying a task four days after the trauma film (during memory reconsolidation) was effective. The modality versus working-memory load issue is inconclusive.
|
|
| 8. |
- Hensler, Ida, 1989-, et al.
(författare)
-
PTSD Coach Sweden: A Self-Management App for Trauma-Related Symptoms : A RCT study protocol evaluating a self-help app for posttraumatic stress in a Swedish community sample
- 2019
-
Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 10:S1
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Resources to administer evidence-based care for PTSD and trauma-related complications are scarce, especially in particular geographical areas, during mass casualty situations and for individuals with subclinical symptoms as clinics prioritize more severe cases. Effective interventions for PTSD through technical platforms could disseminate information and self-management strategies to decrease individual suffering and societal costs. Assessment at multiple time points can elucidate which aspects of an intervention that are effective, in addition to the evolution of intervention use and well-being over time. Objective: Evaluate an app-administered self-help intervention (PTSD Coach Sweden) aiming to reduce and manage PTSD symptoms and other related complications. Method: In this trial, 200 participants from Sweden who have experienced a traumatic event in the past two years and who report posttraumatic stress symptoms will be randomized to three months use of the app or waitlist. The primary endpoint is self-rated PTSD symptom severity at three months, with follow-up at six and nine months. Secondary outcomes include depressive symptoms, physical symptoms, functional impairment and health care use. Ecological momentary assessment of health status and use of strategies corresponding to app content is used for 21 days during the first three months.Results: Lessons learned and recommendations from the preparations of app-based intervention trials are presented. Available data from the primary endpoint are presented. Conclusions: App-based interventions hold promise to increase outreach, but further trials are needed. Several challenges introduced when preparing an app-based intervention are discussed.
|
|
| 9. |
|
|
| 10. |
- Luik, Annemarie I, et al.
(författare)
-
Sleep disturbance and intrusive memories after presenting to the emergency department following a traumatic motor vehicle accident : an exploratory analysis.
- 2019
-
Ingår i: European Journal of Psychotraumatology. - : Informa UK Limited. - 2000-8198 .- 2000-8066. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Sleep disturbances are common after traumatic events and have been hypothesized to be a risk factor in the development of psychopathology such as that associated with posttraumatic stress disorder (PTSD). Objective: To assess the association between intrusive memories, a core clinical feature of PTSD, and self-reported sleep disturbance shortly after experiencing or witnessing a motor vehicle accident, and whether a brief behavioural intervention (trauma reminder cue and Tetris gameplay) reduced sleep disturbance post-trauma. Method: The exploratory analyses included 71 participants (mean age 39.66, standard deviation 16.32; 37 women, 52.1%) enrolled in a previously published proof-of-concept randomized controlled trial. Participants were recruited from the emergency department after experiencing or witnessing a traumatic motor vehicle accident. Intrusive memories were assessed with a daily paper-and-pen diary for one week post-trauma, and sleep disturbances with three questions from the Impact of Event Scale-Revised assessing problems initiating sleep, problems maintaining sleep and dreams about the event at one week and one month post-trauma. Missing data were imputed 15 times. Results: The total number of intrusive memories during the first week post-trauma suggested weak to moderate pooled intercorrelations with problems initiating and maintaining sleep. An ordinal regression using imputed data suggested that the intervention had no effect on sleep disturbances, while completers only analyses suggested an improvement in problems maintaining sleep at one week. Conclusions: This exploratory study suggested that experiencing early intrusive memories is related to sleep disturbances. Sleep disturbance might be a particularly important construct to assess in studies involving intrusive memories post-trauma.
|
|
