Can subjective perceptions of trauma differentiate between ICD-11 PTSD and Complex PTSD? A Cross-cultural Comparison of Three African Countries

Background: The primary aim of the current study was to establish the cut-offs scores for the Subjective Traumatic Outlook (STO), a relatively new tool that examines the introspective world view of those exposed to traumatic events. This tool was developed as a complementary scale to be used in conjunction with the observed-phenomenological measures of PTSD. The present study examines the predictive power of STO for distinguishing between PTSD and Complex PTSD (CPTSD) in African countries. Methods: A national representative (based on age and gender) sample of 2554 participants was drawn form three African countries, Nigeria, Kenya and Ghana, who completed the International Trauma Questionnaire (ITQ) and the STO. We conducted a set of analyses examining that alignment of ITQ probable PTSD and CPTSD and different STO cut-off scores. Results: Results suggest that the STO single factor structure was stable across countries, had a strong association with PTSD and CPTSD levels, and had predictive utility in differentiating between PTSD and CPTSD. Moreover, we found that there are different cut-offs for the STO in the different countries. Conclusion: There is a strong but distinctive association between the introspective and the observed-phenomenological approaches of PTSD and CPTSD. Our findings call for more integrative approaches for the assessment of PTSD and CPTSD and suggest that there are cultural differences in STO

Vaccine hesitancy prospectively predicts nocebo side-effects following COVID-19 vaccination

The directionality between vaccine hesitancy and COVID-19 vaccine side-effects has not been hitherto examined. We hypothesized a nocebo effect, whereby vaccine hesitancy towards the second Pfizer vaccination dose predicts subsequent side-effects for a booster dose, beyond other effects. We expected these nocebo effects to be driven by (mis)information in males and prior experience in females. A representative sample of older adults (n = 756, mean age = 68.9 ± 3.43) were questioned in a typical cross-lagged design (wave 1 following a second Pfizer dose, wave 2 after their booster). As hypothesized, earlier vaccine hesitancy predicted subsequent booster side-effects for females (β = 0.10 p = 0.025, f 2 = 0.02) and males (β = 0.34, p < 0.001, f 2 = 0.16); effects were stronger in males (χ2Δ (1) = 4.34, p = 0.03). The (W1-to-W2) side-effect autoregression was stronger in females (β = .34, p < 0.001; males β = 0.18, p < 0.001), χ2Δ (1) = 26.86, p < 0.001. Results show that a quantifiable and meaningful portion of COVID-19 vaccine side-effects is predicted by vaccine hesitancy, demonstrating that side-effects comprise a psychosomatic nocebo component in vaccinated individuals. The data reveal distinct risk levels for future side-effects, suggesting the need to tailor public health messaging

Fatalism and ICD-11 CPTSD and PTSD diagnoses: Results from Nigeria, Kenya & Ghana

Background: Existing research on posttraumatic sequelae suggests a positive association between fatalism and symptoms of posttraumatic stress disorder (PTSD). However, the associations between fatalism and the new ICD-11 diagnosis of complex PTSD (CPTSD) have never been explored before. Objective: The current study explored the association between fatalism and PTSD and CPTSD in samples from three African countries. Methods: A total of 2,524 participants from Nigeria (n = 1018), Kenya (n = 1006), and Ghana (n = 500) completed measures of fatalism (non-judgmental fatalism, current fatalism, pessimistic fatalism, prospective fatalism) and the International Trauma Questionnaire (ITQ). A combination of a Multinomial regressions and path analyses were used to identify fatalism predictors of PTSD and CPTSD versus no diagnosis, and CPTSD versus PTSD, adjusted for demographic variables and trauma exposure. Results: Whereas PTSD was not predicted by any of the fatalism types, compared to no diagnosis, CPTSD was significantly predicted by pessimistic, non-judgmental and current fatalism, both compared to no diagnosis and PTSD. Conclusions: The results broaden the knowledge on potential correlates of the new diagnosis of CPTSD. Addressing fatalistic beliefs by empowering people to think that they can choose their fate should be further explored as a possible target for intervention in the treatment of CPTSD

Prepared and Still Surprised

Farnsworth and Sewell (2010) and Currier (2010) have provided commentaries on our case study of paramedic Mr. G, who was suffering from Acute Distress Disorder and whom we treated employing our "Back to the Future" therapy (BFT) model. These authors identify and discuss a number of important issues raised by our case study. In this response to their commentaries, we focus on three of their important points: how the therapist balances directive versus collaborative roles in working within the BFT model; whether in therapy to address or not to address the "traumatic nucleus" of an ASD victim's initial memories of a traumatic experience; and the types of clients for whom the BFT model is particularly applicable. Our responses to these issues are designed to generally illuminate the BFT model, to make it more applicable for much-needed further research study, and to provide additional guidance for clinicians considering whether and how to employ it with their clients

"Back to the Future": Narrative Treatment for Post-Traumatic, Acute Stress Disorder in the Case of Paramedic Mr. G

This is a case study of the successful treatment of Mr. G. A young paramedic in the Israeli army, Mr. G had recently experienced a severe traumatic event that involved the grisly task of carrying a terrorist's body parts past a dangerous border, while fearing capture or injury. Two days following the event, Mr. G appeared at our Clinic manifesting Acute Stress Disorder (ASD), which included post-traumatic stress symptoms like recurrent, upsetting images of the event; sleep disturbance; dissociation; somatic complaints like vomiting; and difficulty in returning to the military. In assessing and treating Mr. G's problems, we employed a new narrative therapy model that we call "Back to the Future" (named after the American movie), since the approach emphasizes jumping narratively between the past and the future in order to treat the trauma in the present

Vaccine and Psychological Booster: Factors Associated With Older Adults’ Compliance to the Booster COVID-19 Vaccine in Israel

Israel became the first country to offer the booster COVID-19 vaccination. The study tested for the first time the role of sense of control (SOC) due to vaccinations, trust and vaccination hesitancy (VH), and their association with compliance to the booster COVID-19 vaccine among older adults, during the first 2 weeks of the campaign. 400 Israeli citizens (≥ 6 years old), eligible for the booster vaccine, responded online. They completed demographics, self-reports, and booster vaccination status (already vaccinated, booked-a-slot, vaccination intent, and vaccination opposers). Multinomial logistic regression was conducted with pseudo R2 = .498. Higher SOC and lower VH were related to the difference between early and delayed vaccination (booked-a-slot, OR = 0.7 [0.49‐0.99]; 2.2 [1.32‐3.62], intent OR = 0.6 [0.42‐0.98]; 2.7 [1.52‐4.86]), as well as to rejection (OR = 0.3 [0.11‐0.89]; 8.5 [3.39‐21.16]). Increased trust was only related to the difference between early vaccinations and vaccine rejection (OR = 0.3 [0.11‐0.89]). We suggest that SOC, as well as low VH, can be used as positive motivators, encouraging earlier vaccinations in older age