Special Issue "Mental Health Related to Traumatic and Adverse Experiences"

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Environmental Factors and Global Health".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 11842

Special Issue Editor

Dr. Connie Veazey
E-Mail Website
Guest Editor
Clinical Psychology, Fielding Graduate University, Santa Barbara, CA 93105, USA
Interests: cognitive behavioral therapy; trauma recovery; posttraumatic stress disorder; health psychology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is a wealth of interest and work in the field of trauma recovery. Typically, trauma recovery has focused on researching and understanding the nature of Post-traumatic Stress Disorder (PTSD). However, more recently, the global community is experiencing events which do not fit neatly into the criteria used to define a trauma which would qualify a person for the diagnosis of PTSD according to established medical diagnostic nomenclature (i.e., DSM, ICD). There is growing recognition that events, which we can term “adverse” (e.g., unemployment, chronic medical illnesses, extreme weather events), require a broadening of the standard diagnostic nomenclature to capture their impact on the mental and physical health of individuals.

The field of trauma recovery is broad and includes researchers and health professionals from across a variety of academic and medical disciplines. It is worthwhile to examine adverse events from a multidisciplinary perspective, which can help capture the true impact of such events on people. There is growing focus on outcomes such as sleep disturbance, chronic pain, spiritual impact, community impact, work performance, to name a few. Such a wholistic perspective also informs recovery, in terms of guiding treating professionals in interventions leading to multiple pathways to recovery.

This special issue of Healthcare, entitled “Mental and Physical Health Related to Traumatic and Adverse Experiences”, has the ambitious goal of garnering research and review papers from scholars from across medical and academic disciplines with the hope of identifying work that will contribute to the recognition and recovery of people experiencing traumatic and adverse experiences. Multidisciplinary research projects are especially encouraged. Papers focusing on both Criterion A traumatic events, using traditional diagnostic nomenclature (i.e., PTSD), and those focusing on adverse events, which are typically not considered as Criterion A, but nonetheless lead to similar stress-related outcomes, are welcomed. In addition, papers focusing on recovery, including identification of mental, physical, and alternative health interventions for such traumatic and adverse events will be considered.

Dr. Connie Veazey

Guest Editor

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Keywords

  • Trauma Recovery
  • Traumatic Events
  • PTSD
  • Adverse Events

Published Papers (9 papers)

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Research

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Article
Cultural Bereavement and Mental Distress: Examination of the Cultural Bereavement Framework through the Case of Ethiopian Refugees Living in South Korea
Healthcare 2022, 10(2), 201; https://doi.org/10.3390/healthcare10020201 - 20 Jan 2022
Viewed by 930
Abstract
In South Korea, a mono-ethnic nation, refugees and asylum seekers from culturally distant countries are exposed to cultural bereavement, cultural identity shock, and cultural inconsistency for themselves and their children. Along with biological, psychological, and social factors, this phenomenon is hypothesized as playing [...] Read more.
In South Korea, a mono-ethnic nation, refugees and asylum seekers from culturally distant countries are exposed to cultural bereavement, cultural identity shock, and cultural inconsistency for themselves and their children. Along with biological, psychological, and social factors, this phenomenon is hypothesized as playing a major role in an increased rate of distress among refugees. This study explored the experiences of 11 Ethiopian refugees living in South Korea, and their relevance to cultural bereavement while affirming and suggesting an update for the cultural bereavement framework. The analysis showed the refugees experiencing a slight continuation of dwelling in the past; a sense of guilt due to the fading of one’s culture; different types of anger; and anxiety with relation to the cultural identity of themselves and of their young children. Strong religious beliefs, a continuation of religious practice, informal gatherings within the Ethiopian diaspora, and organized community activities provided an antidote for cultural bereavement. The implication of the result hopes to assist and direct practitioners to identify complex manifestations of mental distress that often get wrongfully labeled as to their causation as well as methods and sources of diagnosis. Any update on the cultural bereavement framework also needs to consult the setting and peculiar circumstances of the displaced people in question. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
Article
Knowledge, Attitudes, and Screening for Obstructive Sleep Apnea and Diabetes Mellitus among War Veterans Seeking Treatment of Posttraumatic Stress Disorder
Healthcare 2021, 9(12), 1698; https://doi.org/10.3390/healthcare9121698 - 08 Dec 2021
Cited by 1 | Viewed by 1000
Abstract
Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders. However, we should not neglect the somatic aspects of PTSD. Associations with cardiovascular diseases (CVD) are particularly concerning because PTSD was associated with an even 53% higher risk for CVD. This [...] Read more.
Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders. However, we should not neglect the somatic aspects of PTSD. Associations with cardiovascular diseases (CVD) are particularly concerning because PTSD was associated with an even 53% higher risk for CVD. This study aimed to analyze the prevalence of several CVD risk factors, especially diabetes mellitus among PTSD patients divided into three groups according to obstructive sleep apnea (OSA) risk stratification (low, intermediate, and high). This cross-sectional study included one hundred male PTSD veterans. The mean age was 53 (40–67) years. The estimated OSA risk was 95% for the whole cohort, and 53% were in the high-risk group. Median HbA1c was 5.6 (4.6–10)%. The hemoglobin A1c (HbA1c) levels showed that 34 patients were in the prediabetes group, and 20 of them fulfilled the criteria for diabetes. However, only 13 of them were aware of their previous diagnosis of diabetes mellitus. In testing knowledge about diabetes, 62% and only 23% of patients knew the correct definition of HbA1c and level of fasting plasma glucose, respectively. Diabetic patients had insufficient knowledge about diabetic complications and treatment. A higher level of PTSD symptoms in veterans was associated with a higher prevalence of OSA. The results strongly support further research and education into early detection of CVD risk factors associated with PTSD. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
Article
Effectiveness, Cost-Utility, and Safety of Neurofeedback Self-Regulating Training in Patients with Post-Traumatic Stress Disorder: A Randomized Controlled Trial
Healthcare 2021, 9(10), 1351; https://doi.org/10.3390/healthcare9101351 - 11 Oct 2021
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Abstract
Post-traumatic stress disorder (PTSD) is characterized by neurophysiological and psycho-emotional problems after exposure to trauma. Several pharmacological and psychotherapy limitations, such as adverse events and low adherence, increase the need for alternative therapeutic options. Neurofeedback is widely used for PTSD management. However, evidence [...] Read more.
Post-traumatic stress disorder (PTSD) is characterized by neurophysiological and psycho-emotional problems after exposure to trauma. Several pharmacological and psychotherapy limitations, such as adverse events and low adherence, increase the need for alternative therapeutic options. Neurofeedback is widely used for PTSD management. However, evidence of its clinical efficacy is lacking. We conducted a randomized, waitlist-controlled, assessor-blinded clinical trial to assess the effectiveness, cost-utility, and safety of 16 sessions of neurofeedback on people with PTSD for eight weeks. Eleven participants were allocated to each group. One and two subjects dropped out from the neurofeedback and control groups, respectively. The primary outcome was PTSD symptom change evaluated using the PTSD Checklist-5 (PCL-5-K). The PCL-5-K levels improved more in the neurofeedback group (44.3 ± 10.8 to 19.4 ± 7.75) than in the control group (35.1 ± 18.5 to 31.0 ± 14.92). The change value was significantly improved in the neurofeedback group (24.90 ± 13.13 vs. 4.11 ± 9.03). Secondary outcomes such as anxiety, depression, insomnia, and quality of life were also improved. In an economic analysis using EuroQol-5D, the incremental cost-per-quality-adjusted life-year was approximately $15,600, indicating acceptable cost-utility. There were no adverse events in either group. In conclusion, neurofeedback might be a useful, cost-effective, and safe intervention for PTSD management. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
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Article
Individuals with Major Depressive Disorder Report High Scores of Insecure-Avoidant and Insecure-Anxious Attachment Styles, Dissociative Identity Symptoms, and Adult Traumatic Events
Healthcare 2021, 9(9), 1169; https://doi.org/10.3390/healthcare9091169 - 06 Sep 2021
Cited by 2 | Viewed by 1369
Abstract
Objective: Individuals with major depressive disorder (MDD) report more issues in social interaction compared to the general population. Moreover, dimensions of dissociation are considered dysfunctional strategies to cope with adverse life events. In this regard, current symptoms of MDD could be associated with [...] Read more.
Objective: Individuals with major depressive disorder (MDD) report more issues in social interaction compared to the general population. Moreover, dimensions of dissociation are considered dysfunctional strategies to cope with adverse life events. In this regard, current symptoms of MDD could be associated with traumatic events that occurred in childhood and in adult life. Given this background, the aim of the present study was to explore the associations between attachment styles as a proxy of quality of social interaction, dimensions of dissociation, and childhood and adult traumatic life events among individuals with MDD. Method: A total of 300 individuals with MDD (mean age: 31.31 years; 58.7% female) took part in this study. They completed a series of questionnaires on sociodemographic information, attachment styles, dimensions of dissociation, and childhood and adult traumatic life events. Results: Prevalence rates for attachment styles were as follows: anxious/ambivalent attachment style—71.7%; avoidant/dependent attachment style—13%; secure/close attachment style—15.3%. Compared to the general population, the participants reported higher prevalence rates of insecure attachment styles. Current symptoms of dissociation were associated with adult but not childhood traumatic life events. An anxious attachment style was associated with higher scores of dissociation. Conclusion: Psychotherapeutic treatment of individuals with MDD should consider the individuals’ challenging attachment styles and their risk of dissociation. While it is important to consider both adult and childhood traumatic events, in this research, more recent trauma occurring in adulthood was associated with current symptoms of dissociation. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
Article
When Nurses Become Patients. Validation of the Content of the Diagnostic Label Professional Traumatic Grief
Healthcare 2021, 9(8), 1082; https://doi.org/10.3390/healthcare9081082 - 23 Aug 2021
Cited by 3 | Viewed by 794
Abstract
(1) Background: The Covid-19 pandemic has put our healthcare systems to the test, exposing their vulnerability and demanding a high degree of commitment and dedication from healthcare teams to confront and contain the disease. In this sense, nursing professionals have played a prominent [...] Read more.
(1) Background: The Covid-19 pandemic has put our healthcare systems to the test, exposing their vulnerability and demanding a high degree of commitment and dedication from healthcare teams to confront and contain the disease. In this sense, nursing professionals have played a prominent role in the treatment of complex cases that have required hospitalisation and have manifested pre-existing health complications or mortality. This unprecedented situation made it difficult to regulate the emotional impact and manage grief, often turning it into a traumatic grief whose psychological and emotional manifestations are increasingly evident but very little researched in the current context. (2) Purpose: Validation of the definition, defining characteristics and related factors for the proposal of the nursing diagnosis of professional traumatic grief. (3) Method: Based on Fehring’s content validation model, the label name, defining characteristics and other related factors were agreed upon by Spanish experts. (4) Results: The content validity index was 0.9068. A total of 21 defining characteristics were validated by the experts, as all of them scored above 0.6. With respect to the related factors of the proposed 10, all were validated. (5) Conclusion: The present study supports the proposal to develop a nursing diagnosis for professional traumatic grief. The use of standardised language is only the first step in establishing professional traumatic grief as a diagnostic category. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
Article
The Relationship between Differentiation of Self and Psychological Adjustment to Separation
Healthcare 2021, 9(6), 738; https://doi.org/10.3390/healthcare9060738 - 16 Jun 2021
Cited by 2 | Viewed by 846
Abstract
Many individuals suffer negative mental health consequences such as anxiety and depression following separation from a romantic partner and/or co-parenting conflict due to divorce. Consequently, treating the psychological aftermath of divorce and partner separation remains a predominant concern for mental health practitioners. According [...] Read more.
Many individuals suffer negative mental health consequences such as anxiety and depression following separation from a romantic partner and/or co-parenting conflict due to divorce. Consequently, treating the psychological aftermath of divorce and partner separation remains a predominant concern for mental health practitioners. According to family systems theory, high interdependence and low differentiation of self are associated with a lessened capacity for managing anxiety or adapting to stressful events since intense emotions may inhibit the ability to cope. To assess the relationship between differentiation of self and psychological adjustment to separation, 84 divorced adults completed an online survey. Multiple regression analysis demonstrated that a model based on fusion with others, I-position, and emotional cutoff was a statistically significant predictor of lonely/negativity. Bivariate correlation analyses confirmed significant linear relationships between fusion with others, lonely/negativity, and co-parenting conflict. No differences between genders were found. There is a continuing need to develop interventions to address the negative consequences of divorce, help reduce emotional suffering, and encourage healthy co-parenting. Individuals struggling with psychological adjustment post-divorce, or those seeking education for managing the psychological effects of divorce and co-parenting, may benefit from counseling strategies that incorporate an assessment of differentiation of self and psychological adjustment to separation. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
Article
The Glucocorticoid Receptor Gene (NR3C1) 9β SNP Is Associated with Posttraumatic Stress Disorder
Healthcare 2021, 9(2), 173; https://doi.org/10.3390/healthcare9020173 - 05 Feb 2021
Cited by 3 | Viewed by 972
Abstract
Posttraumatic stress disorder (PTSD) has been associated with glucocorticoid (GC) hypersensitivity. Although genetic factors account for 30–46% of the variance in PTSD, no associations have been found between single nucleotide polymorphisms (SNPs) of the GC receptor (GR) gene (NR3C1) and risk [...] Read more.
Posttraumatic stress disorder (PTSD) has been associated with glucocorticoid (GC) hypersensitivity. Although genetic factors account for 30–46% of the variance in PTSD, no associations have been found between single nucleotide polymorphisms (SNPs) of the GC receptor (GR) gene (NR3C1) and risk for this disorder. We studied the association of five SNPs in the GR gene (rs10052957, rs6189/rs6190, rs6195, rs41423247, and rs6198) and haplotypes with PTSD, in a group of Portuguese male war veterans (33 with lifetime PTSD, 28 without). To determine whether the 9β SNP (rs6198) was associated with chronically altered cortisol levels, we evaluated hair cortisol concentrations (HCC) in a sample of 69 veterans’ offspring. The 9β variant (G allele) was significantly associated with lifetime PTSD under a dominant model of inheritance. The 9β variant was also significantly associated with severity of current PTSD symptoms. The haplotype analysis revealed an association between a common haplotype comprising the 9β risk allele and lifetime PTSD. Carriers of the 9β risk allele had significantly lower HCC than non-carriers. We found the 9β risk allele and a haplotype comprising the 9β risk allele of the GR gene to be associated with PTSD in veterans. This 9β risk allele was also associated with lower HCC in their offspring. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
Article
Incidence of Post-Traumatic Stress Disorder after Coronavirus Disease
Healthcare 2020, 8(4), 373; https://doi.org/10.3390/healthcare8040373 - 30 Sep 2020
Cited by 32 | Viewed by 3255
Abstract
Background: The coronavirus disease (COVID-19) emerged from China and rapidly spread to many other countries. In this study, we investigated the prevalence of post-traumatic stress disorder (PTSD) among patients with COVID-19 who were treated and discharged from a university hospital in Daegu, [...] Read more.
Background: The coronavirus disease (COVID-19) emerged from China and rapidly spread to many other countries. In this study, we investigated the prevalence of post-traumatic stress disorder (PTSD) among patients with COVID-19 who were treated and discharged from a university hospital in Daegu, Korea. Methods: In total, 64 patients who were diagnosed with COVID-19 and then hospitalized, treated and discharged from the university hospital between February and April 2020 participated in our study. We conducted telephone interviews with the participants and evaluated the presence of PTSD using the Post-Traumatic Stress Disorder Checklist-5 (PCL-5) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; score range: 0–80). If a score of ≥33 was obtained, then a diagnosis of PTSD was made. We analyzed the association between PTSD and demographic and clinical characteristics using the Mann–Whitney U and chi-square tests. Results: In total, 13 patients had a PCL-5 score of ≥33, which indicated that 20.3% (n = 64) of the patients had PTSD. No significant differences were observed in demographic characteristics, including, sex, age, hospitalization time and duration after discharge, between patients with PTSD and those without PTSD. Conclusions: The prevalence rate of PTSD was 20.3% in patients with COVID-19 who had been hospitalized, treated and discharged. Accordingly, clinicians should be aware of the high possibility of PTSD among COVID-19 patients. Mental health interventions supporting the mental health of patients should be provided to affected patients. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)

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Case Report
Postpartum Psychosis after Traumatic Cesarean Delivery
Healthcare 2021, 9(5), 588; https://doi.org/10.3390/healthcare9050588 - 16 May 2021
Cited by 1 | Viewed by 1009
Abstract
An emergency cesarean delivery can be a traumatic childbirth experience for a woman and a risk factor for postpartum psychosis, especially in a patient with a history of bipolar disorder. This article describes the case of a pregnant woman with an unknown history [...] Read more.
An emergency cesarean delivery can be a traumatic childbirth experience for a woman and a risk factor for postpartum psychosis, especially in a patient with a history of bipolar disorder. This article describes the case of a pregnant woman with an unknown history of bipolar disorder who developed an acute psychotic reaction during the procedure of an emergency caesarian section and switched to mania. The purpose of this case study is for perinatal health care professionals to identify suspicious symptoms and promptly refer to psychiatric services so as to ensure the mother’s and the newborn’s safety. This case study highlights the importance of assessing women with bipolar disorder or a previous psychotic episode for the risk of psychiatric complications in pregnancy and after childbirth. Midwifery education on perinatal mental health is crucial for the detection of suspicious symptoms and early referral to a specialist. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
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