Posttraumatic stress disorder (PTSD) symptom profiles among people who have experienced abuse: Findings from the NESARC-III study.

Greater recognition of diversity in psychological responses to traumatic events has led to increased exploration of posttrauma symptom typologies and risk factors for more "complex" presentations. OBJECTIVES: We sought to identify unique PTSD symptom profiles associated with the experience of physical and sexual abuse and to determine whether exposure in childhood, type of abuse, frequency of abuse and familial support were associated with profiles indicating increased symptom complexity. METHOD: We analyzed data from 6,769 American adults (M = 43.93 years, SD = 15.35, 70.9% female) from the National Epidemiologic Survey on Alcohol and Related Conditions-III who reported histories of physical or sexual abuse. Latent Class Analysis was used to identify distinct profiles of the twenty PTSD symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Abuse in childhood, type of abuse, frequency of childhood abuse, emotional support in childhood and a range of demographic variables were compared across classes. RESULTS: Five classes were educed: High All (19.6%), Threat (14.4%), Dysphoric (13.7%), Moderate Threat (29.4%) and Low Symptom (22.9%). Contrary to our hypotheses, trauma exposure in childhood did not predict class membership while type of abuse did. The High All and Dysphoric classes had greater frequency of childhood abuse, lower support in childhood, and a history of sexual abuse when compared to their less complex, predominantly fear-based counterparts (Threat and Moderate Threat classes, respectively). CONCLUSIONS: These constellations of DSM-5 PTSD symptoms may be a proxy for increased "complexity" and may indicate a need for alternative or additional therapeutic interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Visuospatial Working Memory Tasks May Not Reduce the Intensity or Distress of Intrusive Memories.

Cognitive interventions involving visuospatial tasks, such as the game "Tetris" have demonstrated efficacy in reducing the frequency of intrusive memories. However, it remains unclear whether these tasks also reduce the perceived intensity and distress of these memories. We investigated whether either of two visuospatial tasks: a Tetris intervention or Digital Corsi task, following the viewing of an analog trauma (film) resulted in decreased intensity and distress for intrusive memories over the following week, when compared to a control condition. Participants (n = 110) were randomly assigned to task conditions after viewing the film. Linear mixed models indicated no between-group differences for reductions in intensity or distress over the course of the week. These findings highlight an important boundary to the benefits of such visuospatial tasks, in that while they may be associated with reductions in intrusion memory frequency, individuals may nonetheless continue to experience distress when intrusions do occur

Torsional-flexural buckling of unevenly battened columns under eccentrical compressive loading

In this paper, an analytical model is developed to determine the torsional-flexural buckling load of a channel column braced by unevenly distributed batten plates. Solutions of the critical-buckling loads were derived for three boundary cases using the energy method in which the rotating angle between the adjacent battens was presented in the form of a piecewise cubic Hermite interpolation (PCHI) for unequally spaced battens. The validity of the PCHI method was numerically verified by the classic analytical approach for evenly battened columns and a finite-element analysis for unevenly battened ones, respectively. Parameter studies were then performed to examine the effects of loading eccentricities on the torsional-flexural buckling capacity of both evenly and unevenly battened columns. Design parameters taken into account were the ratios of pure torsional buckling load to pure flexural–buckling load, the number and position of battens, and the ratio of the relative extent of the eccentricity. Numerical results were summarized into a series of relative curves indicating the combination of the buckling load and corresponding moments for various buckling ratios.National Natural Science Foundation of China (NSFC) under grant number (No.) 51175442 and Sichuan International Cooperation Research Project under grant No. 2014HH002

Anger and predictors of drop-out from PTSD treatment of veterans and first responders.

Background: Drop-out is an important barrier in treating post-traumatic stress disorder (PTSD) with consequences that negatively impact clients, clinicians and mental health services as a whole. Anger is a common experience in people with PTSD and is more prevalent in military veterans. To date, no research has examined if anger may predict drop-out in military veterans or first responders. Aims: The present study aimed to determine the variables that predict drop-out among individuals receiving residential treatment for PTSD. Method: Ninety-five military veterans and first responders completed pre-treatment measures of PTSD symptom severity, depression, anxiety, anger, and demographic variables. Logistic regression analyses were used to determine if these variables predicted drop-out from treatment or patterns of attendance. Results: Female gender was predictive of drop-out. However, when analysed by occupation female gender was predictive of drop-out among first responders and younger age was predictive of drop-out in military participants. Anger, depression, anxiety and PTSD symptom severity were not predictive of drop-out in any of the analyses. No variables were found to predict attendance patterns (consistent or inconsistent) or early versus late drop-out from the programme. Conclusion: These results suggest that although anger is a relevant issue for treating PTSD, other factors may be more pertinent to drop-out, particularly in this sample. In contrast with other findings, female gender was predictive of drop-out in this study. This may indicate that in this sample, there are unique characteristics and possible interacting variables that warrant exploration in future research

Global Protection and the Health Impact of Migration Interception

In the fourth article in a six-part PLoS Medicine series on Migration & Health, Zachary Steel and colleagues discuss the interception phase of migration and the specific health risks and policy needs associated with this phase

Activation of SGK1 in endometrial epithelial cells in response to PI3K/AKT inhibition impairs embryo implantation

Background: Serum & Glucocorticoid Regulated Kinase 1 (SGK1) plays a fundamental role in ion and solute transport processes in epithelia. In the endometrium, down-regulation of SGK1 during the window of receptivity facilitates embryo implantation whereas expression of a constitutively active mutant in the murine uterus blocks implantation. Methods/Results: Here, we report that treatment of endometrial epithelial cells with specific inhibitors of the phosphoinositide 3-kinase (PI3K)/AKT activity pathway results in reciprocal activation of SGK1. Flushing of the uterine lumen of mice with a cell permeable, substrate competitive phosphatidylinositol analogue that inhibits AKT activation (AKT inhibitor III) resulted in Sgk1 phosphorylation, down-regulation of the E3 ubiquitin-protein ligase Nedd4-2, and increased expression of epithelial Na+ channels (ENaC). Furthermore, exposure of the uterine lumen to AKT inhibitor III prior to embryo transfer induced a spectrum of early pregnancy defects, ranging from implantation failure to aberrant spacing of implantation sites. Conclusion: Taken together, our data indicate that the balanced activities of two related serine/threonine kinases, AKT and SGK1, critically govern the implantation process

Multisite prospective investigation of psychological outcomes following cataract surgery in Vietnam

Copyright © 2017 BMJ Global Health. All rights reserved. Background: Cataract surgery is a low-cost and effective intervention. There is increasing evidence to suggest that cataract surgery is associated with improvements in mobility, overall functioning and reductions in psychological distress. Within lowincome and middle-income countries, cataract surgery has also been documented to lead to reductions in psychological distress; however, differences in economic activity and engagement in paid and domestic work in these countries may moderate such reductions. We aimed to examine the psychological outcomes following cataract surgery among a diverse Vietnamese sample. Methods: We report findings from the VISIONARY study, a 12-month multisite prospective study of cataract surgery outcomes conducted in Vietnam (N=462). Generalised estimating equations (GEEs) were used to identify the variables which were associated with reduced psychological distress. Results: A high proportion of participants (56.6%) reported psychological distress before surgery and severity of psychological distress had decreased by 12 months following surgery (95% CI (4.13 to 4.95)). There were regional differences in the extent of improvement in psychological distress and change in paid and unpaid work. The extent of improvement in visual acuity, male gender, and increase in paid and unpaid work hours were significant predictors of reductions in psychological distress. Conclusions: Cataract surgery appears to result in the greatest reductions in psychological distress in communities where work engagement is highest. Funding: The VISIONARY study was funded by a grant provided by the Fred Hollows Foundation, Australia. During the course of this work, BME was in receipt of an Ian Potter Foundation Fellowship and a National Health and Medical Research Council (NHMRC) fellowship (1072148), SJ received an NHMRC Senior Research Fellowship, MLH was in receipt of a National Heart Foundation Future Leader Fellowship 100034

Confirmatory Factor Analysis of the Nepean Dysphoria Scale in a Clinical Sample

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. The construct of dysphoria has been described inconsistently across a broad range of psychopathology. The term has been used to refer to an irritable state of discontent, but is also thought to incorporate anger, resentment and nonspecific symptoms associated with anxiety and depression, such as tension and unhappiness. The Nepean Dysphoria Scale has been developed to allow assessment of dysphoria, but its factor structure has not yet been investigated in clinical samples. We aimed to determine the latent structure of dysphoria as reflected by the Nepean Dysphoria Scale, using a clinical sample. Adults (N = 206) seeking treatment at a range of mental health services were administered the Nepean Dysphoria Scale. Four putative factor structures were investigated using confirmatory factor analysis: a single-factor model, a hierarchical model, a bifactor model and a four-factor model as identified in previous studies. No model fit the data except for a four-factor model when a revised 22-item version of the original 24-item scale was investigated. A four-factor structure similar to that identified in non-clinical samples was supported, albeit following the removal of two items. The Nepean Dysphoria Scale appears to have utility for the assessment of dysphoria in routine clinical settings