Psychological screening of adults and young people following the Manchester Arena incident

Background: Terrorist attacks have increased globally since the late 1990s with clear evidence of psychological distress across both adults and children and young people (CYP). After the Manchester Arena terrorist attack, the Resilience Hub was established to identify people in need of psychological and psychosocial support. Aims: To examine the severity of symptoms and impact of the programme. Method: The hub offers outreach, screening, clinical telephone triage and facilitation to access evidenced treatments. People were screened for trauma, depression, generalised anxiety and functioning who registered at 3, 6 and 9 months post-incident. Baseline scores were compared between screening groups (first screen at 3, 6 or 9 months) in each cohort (adult, CYP), and within groups to compare scores at 9 months. Results: There were significant differences in adults' baseline scores across screening groups on trauma, depression, anxiety and functioning. There were significant differences in the baseline scores of CYP across screening groups on trauma, depression, generalised anxiety and separation anxiety. Paired samples t-tests demonstrated significant differences between baseline and follow-up scores on all measures for adults in the 3-month screening group, and only depression and functioning measures for adults in the 6-month screening group. Data about CYP in the 3-month screening group, demonstrated significant differences between baseline and follow-up scores on trauma, generalised anxiety and separation anxiety. Conclusions: These findings suggest people who register earlier are less symptomatic and demonstrate greater improvement across a range of psychological measures. Further longitudinal research is necessary to understand changes over time

Validation of the International Trauma Questionnaire – Child and Adolescent Version (ITQ-CA) in a Chinese mental health service seeking adolescent sample

Background. The International Trauma Questionnaire – Child and Adolescent version (ITQ-CA) is a self-report measure that assesses posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on the diagnostic formulation of the 11th version of the International Classification of Diseases (ICD-11). This study aimed to provide a Chinese translation and psychometric evaluation of the ITQ-CA using a sample of mental-health service seeking adolescents in Mainland China. Methods. The ITQ-CA was translated and back-translated from English to simplified Chinese and finalized with consensus from an expert panel. Adolescents ages 12-17 were recruited via convenience sampling from an outpatient psychiatric clinic in Mainland China. Participants completed the ITQ-CA; measures of four criterion variables (depression, anxiety, stress, adverse childhood experiences); and the PTSD Checklist for DSM-5 (PCL-5). Construct validity, concurrent validity, and comparison of PTSD caseness between ICD-11 and DSM-5 measures were assessed. Results. The final sample consisted of 111 Chinese adolescents (78% female; mean age of 15.23), all diagnosed with a major depressive disorder. Confirmatory factor analysis indicated the two-factor second-order model provided optimal fit. All criterion variables were positively and significant correlated with the six ITQ-CA symptom cluster summed scores. In the present sample, 69 participants (62.16%) met symptom criteria for ICD-PTSD or CPTSD using the ITQ-CA, and 73 participants (65.77%) met caseness for DSM-5 PTSD using the PCL-5. Rates of PTSD symptom cluster endorsement and caseness deriving from both diagnostic systems were comparable. Conclusions. The Chinese ITQ-CA has acceptable psychometric properties and confers additional benefits in identifying complex presentations of trauma-related responses in younger people seeking mental health services

Paradoxes and parallels in the global distribution of trauma-related mental health problems.

One can hardly overestimate the value of a healthy mind or underestimate the sacrifices people are willing to make in the pursuit of health and happiness. Yet, during the course of their lives people are likely to be confronted with well-established factors connected to poor health. In this chapter, we focus on mental health, although we are aware of the multifaceted relation between physical and mental health issues. Among the risk and protective factors that are linked to developing mental health problems are female gender, lack of social support, existing mental health problems, lower socioeconomic status, and above all, exposure to adversity and stress (Brewin, Andrews, & Valentine, 2000; Ozer, Best, Lipsey, & Weiss, 2003; Bonanno, Brewin, Kaniasty, & La Greca, 2010; Yehuda et al., 2015). The negative health effect of exposure to external events such as disasters, accidents, severe illness, and loss of close family or a friend has been confirmed in many studies (Bonde et al., 2016; Galea, Nandi, & Vlahov, 2005; Kessler et al., 2017; Neria, Nandi, & Galea, 2008; Reifels, Mills, Dückers, & O’Donnell, 2017; Scott et al., 2013; Yzermans, Van Der Berg, & Dirkzwager, 2009). What the chapters of this book have in common is that they explore cultural aspects of posttraumatic stress disorder (PTSD); however the current chapter is slightly different because of its emphasis on cross-national patterns and the relevance of country-level factors that turn out to be risk and protective factors themselves. Understanding prevalence and predictive factors at the individual and group level is important to design and implement promising prevention, detection, mitigation, and amelioration strategies. On the other hand, cross-national differences in the prevalence of mental illness are important for promoting global mental health, but their determinants are poorly understood. Mental disorders specifically associated with trauma and stress are exceptional in needing external events to have caused psychiatric symptoms for a diagnosis to be made (Maercker et al., 2013). In this chapter, we will present differences in prevalence of trauma-related mental health problems across countries. Also, we will describe how exposure to trauma in national populations, together with cultural and socioeconomic country characteristics, can explain differences in prevalence between countries. By taking interactions between a number of factors into account, we illustrate how national receptive contexts for trauma vary across the world. After having presented findings from recent studies, we will discuss some implications for research and practice. (aut. ref.

Interpersonal complementarity in responses to auditory hallucinations in psychosis

Objectives. Models of interpersonal relating have proposed that people are drawn to respond to others according to a principle of complementarity, whereby perceived hostility elicits reciprocal hostility and perceived dominance elicits submission. This study examined interpersonal appraisals and responses to auditory hallucinations, to determine whether this principle predicts how patients respond to hallucinated voices. Design and methods. Thirty-five participants with schizophrenia or schizoaffective disorder rated their internal ‘relationship’ with their auditory verbal hallucinations using the Structural Analysis of Social Behaviour, in addition to completing measures of voice-related distress and depression. Results. Participants were able to ascribe almost the full range of interpersonal relating behaviours to their voices reliably, with some notable exceptions for voices' ‘responses’ to being directly addressed. Appraisals of voice hostility very strongly predicted reciprocal hostile responses, but perceptions of voice control were only weakly associated with submission to voices. Perceived voice hostility was also associated with voice-related distress and perceived voice control was associated with depression. Conclusions. Individual differences in responses to auditory hallucinations appear to reflect normal interpersonal responses to appraisals of voice hostility and affiliation. However, voice hearers do not readily submit to voice control and other factors may be of importance in determining this response

Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder

Item does not contain fulltextOBJECTIVE: Posttraumatic stress disorder (PTSD) is reliably associated with reduced brain volume relative to healthy controls, in areas similar to those found in depression. We investigated whether in a PTSD sample brain volumes in these areas were related to reporting specific symptoms of PTSD or to overall symptom severity. METHOD: Structural MRI scans were obtained from 28 participants diagnosed with PTSD according to DSM-IV-TR. Participants reported the extent of individual PTSD symptoms using the Posttraumatic Diagnostic Scale. Voxel-based morphometry applying the Dartel algorithm implemented within SPM5 was used to identify volumetric changes, related to PTSD total, symptom cluster, and individual symptom scores. RESULTS: Brain volume was unrelated to overall PTSD severity, but greater reexperiencing scores predicted reduced volumes in the middle temporal and inferior occipital cortices. Increased reports of flashbacks predicted reduced volume in the insula/parietal operculum and in the inferior temporal gyrus. CONCLUSION: The data illustrate the value of analyses at the symptom level within a patient population to supplement group comparisons of patients and healthy controls. Areas identified were consistent with a neurobiological account of flashbacks implicating specific abnormalities in the ventral visual stream

The effect of hypnotically induced somatoform dissociation on the development of intrusions after an aversive film

Contains fulltext : 73467.pdf (publisher's version ) (Closed access)Peritraumatic dissociation is thought to effect trauma information encoding, leading to PTSD symptoms like intrusive memories. Most studies have focused on peritraumatic psychological dissociation. The present experiment studied the impact of hypnotically induced somatoform dissociation (dissociative non-movement) versus deliberate non-movement during an aversive film on intrusion development. Seventy-nine participants were randomised into three conditions: dissociative non-movement (catalepsy), deliberate non-movement, and non-restricted control. Participants recorded their intrusions of the film in a diary for one week. In the dissociative non-movement condition, catalepsy effectively provoked somatoform dissociation. Spontaneous somatoform dissociation across conditions was positively related to implicit bias to film-related words and negatively related to explicit recall, but was not related to intrusion frequency. Dissociative non-movement and deliberate non-movement conditions combined had more intrusions than controls. However, the dissociative non-movement group did not have more intrusions than deliberate non-movement and control groups combined. The implications of these findings are discussed