Enhanced priming for trauma-related material in posttraumatic stress disorder

Intrusive reexperiencing in posttraumatic stress disorder (PTSD) has been linked to perceptual priming for trauma-related material. A prospective longitudinal study (N = 69) investigated perceptual priming for trauma-related, general threat, and neutral words in assault survivors with and without PTSD, using a new version of the word-stem completion task. Survivors with PTSD showed enhanced priming for trauma-related words. Furthermore, priming for trauma-related words measured soon after the trauma was associated with subsequent PTSD severity at 3 6, and 9 months. The enhanced priming effect was specific to trauma-related words. Enhanced perceptual priming for traumatic material appears to be one of the cognitive processes operating in PTSD.

Posttraumatic stress disorder following assault: the role of cognitive processing, trauma memory, and appraisals

Two studies of assault victims examined the roles of (a) disorganized trauma memories in the development of posttraumatic stress disorder (PTSD), (b) peritraumatic cognitive processing in the development of problematic memories and PTSD, and (c) ongoing dissociation and negative appraisals of memories in maintaining symptomatology. In the cross-sectional study (n = 81), comparisons of current, past, and no-PTSD groups suggested that peritraumatic cognitive processing is related to the development of disorganized memories and PTSD. Ongoing dissociation and negative appraisals served to maintain PTSD symptoms. The prospective study (n = 73) replicated these findings longitudinally. Cognitive and memory assessments completed within 12-weeks postassault predicted 6-month symptoms. Assault severity measures explained 22% of symptom variance; measures of cognitive processing, memory disorganization, and appraisals increased prediction accuracy to 71%.

Auditory hallucinations and Posttraumatic Stress Disorder within schizophrenia and substance abuse

There is a high prevalence of traumatic events within individuals diagnosed with schizophrenia, and of auditory hallucinations within individuals diagnosed with posttraumatic stress disorder (PTSD). However, the relationship between the symptoms associated with these disorders remains poorly understood. We conducted a multidimensional assessment of auditory hallucinations within a sample diagnosed with schizophrenia and substance abuse, both with and without co-morbid PTSD. Results suggest a rate of co-morbid PTSD similar to those reported within other studies. Patients who suffered co-morbid PTSD reported more distressing auditory hallucinations. However, the hallucinations were not more frequent or of longer duration. The need for a multidimensional assessment is supported. Results are discussed within current theoretical accounts of traumatic psychosis.

Intrusions in trauma and psychosis: information processing and phenomenology

Background: Intrusions are common symptoms of both posttraumatic stress disorder (PTSD) and schizophrenia. Steel et al (2005) suggest that an information processing style characterized by weak trait contextual integration renders psychotic individuals vulnerable to intrusive experiences. This ���contextual integration hypothesis��� was tested in individuals reporting anomalous experiences in the absence of a need-for-care. Methods: Twenty-six low schizotypes and twenty-three individuals reporting anomalous experiences were shown a traumatic film with and without a concurrent visuo-spatial task. Participants rated post-traumatic intrusions for frequency and form, and completed self-report measures of information processing style. It was predicted that, due to their weaker trait contextual integration, the anomalous experiences group would (1) exhibit more intrusions following exposure to the trauma-film; (2) display intrusions characterised by more PTSD qualities and (3) show a greater reduction of intrusions with the concurrent visuo-spatial task. Results: As predicted, the anomalous experiences group reported a lower level of trait contextual integration and more intrusions than the low schizotypes, both immediately after watching the film, and during the following seven days. Their post-traumatic intrusive memories were more PTSD-like (more intrusive, vivid and associated with emotion). The visuo-spatial task had no effect on number of intrusions in either group. Conclusions: These findings provide some support for the proposal that weak trait contextual integration underlies the development of intrusions within both PTSD and psychosis.

Examining vulnerability to involuntary memories in schizophrenia comorbid with post-traumatic stress disorder

The current study explored whether individuals diagnosed with schizophrenia and a high level of PTSD symptoms experience more frequent neutral intrusive memories than individuals diagnosed with schizophrenia with low level PTSD symptoms. Results supported a vulnerability to neutral intrusive memories within the comorbid group, which did not seem to be related to psychotic symptom severity. It is possible that a subgroup of psychotic individuals��� process information in a manner that make them susceptible to frequent intrusive memories, characteristic of a PTSD presentation. A longitudinal study is required to specify the development of this vulnerability so as to inform future interventions.

Corpus callosum in maltreated children with posttraumatic stress disorder: A diffusion tensor imaging study

Contrary to expectations derived from preclinical studies of the effects of stress, and imaging studies of adults with posttraumatic stress disorder (PTSD), there is no evidence of hippocampus atrophy in children with PTSD. Multiple pediatric studies have reported reductions in the corpus callosum - the primary white matter tract in the brain. Consequently, in the present study, diffusion tensor imaging was used to assess white matter integrity in the corpus callosum in 17 maltreated children with PTSD and 15 demographically matched normal controls. Children with PTSD had reduced fractional anisotropy in the medial and posterior corpus, a region which contains interhemispheric projections from brain structures involved in circuits that mediate the processing of emotional stimuli and various memory functions - core disturbances associated with a history of trauma. Further exploration of the effects of stress on the corpus callosum and white matter development appears a promising strategy to better understand the pathophysiology of PTSD in children. (C) 2007 Elsevier Ireland Ltd. All rights reserved.

Barn och katastrofer : en systematisk litteraturstudie

Syftet med denna litteraturstudie var att belysa ��mnet barn och katastrofer, som hur barn reagerar efter traumatiska h��ndelser, hur de utvecklar Post- Traumatic Stress Disorder (PTSD), hur PTSD behandlas samt hur v��rdpersonal kan hj��lpa barn p�� b��sta s��tt. Studien var en systematisk litteraturstudie. Litteraturen s��ktes via Elin@dalarna, Pub Med och DOAJ. S��kord som anv��ndes f��r att f�� fram relevanta artiklar var: ���adaption���, ���care���, ���catastrophe���, ���children���, ���child���, ���disasters���, ���help���, ���natural disaster���, ���PTSD���, ���react���, ���trauma���. Dessa ord anv��ndes ett och ett samt i kombination med varandra. De vetenskapliga artiklarna som anv��ndes kvalitetsbed��mdes med en kombinerad granskningsmall av Forsberg och Wengstr��m (2003) samt Willman och Stoltz (2002) granskningsmallar f��r kvalitativa och kvantitativa studier. Denna granskning resulterade i ett urval av 16 vetenskapliga artiklar som var publicerade mellan1990 och 2006 och var skrivna p�� svenska eller engelska. S��korden fanns med i artikelns titel eller abstract, samt att dess inneh��ll skulle besvara fr��gest��llningarna som fanns. De studier som granskades i denna uppsats visade att barn reagerar v��ldigt olika beroende p�� deras sociala liv och levnadsstandard, samt hur sv��rt drabbade de blivit av naturkatastrofen. Barns f��rsta reaktioner efter en naturkatastrof var ofta ilska och aggressioner ��ver det intr��ffade, barnen anklagade ofta sig sj��lva f��r det intr��ffade. Barn som levde under sociala missf��rh��llande, utan f��r��ldrar, hem och v��nner l��pte h��gre risk att f�� symtom p�� PTSD, och det var vanligare att flickor fick symtom ��n pojkar. De vanligaste behandlingsmetoderna f��r symtom av PTSD var kognitiv beteendeterapi och l��kemedel. Den viktigaste hj��lpen f��r barn som upplevt en naturkatastrof var att hj��lpa dem tillbaka till det vardagliga livet.

Sjuksk��terskans om��ndertagande av anh��riga f��r att minska risken f��r posttraumatiskt stressyndrom : Omv��rdnad och krishanteringEn systematiskt litteraturstudie

Syftet med denna studie var att unders��ka hur anh��riga upplever det n��r n��rst��ende befinner sig i ett allvarligt sjukdomstillst��nd, samt hur sjuksk��terskan upplever m��tet med anh��riga och hur sjusk��terskan kan p��verka deras krisbearbetning. Metod: Studien genomf��rdes som en systematisk litteraturstudie. Vetenskapliga artiklar s��ktes via databaserna ELIN@Dalarna och PubMed. Artiklarna som anv��ndes var tillg��ngliga i fulltext, skrivna p�� engelska och publicerade mellan 2000-2008. Resultat: Anh��riga kan ha sv��rt att ta in och bearbeta den information som de f��tt om patientens sjukdomstillst��nd. Anh��riga som upplevde att de fick otillr��cklig information om patientens sjukdomstillst��nd hade en ��kad risk att senare utveckla PTSD. Oavsett ��lder p�� patienter med allvarligt sjukdomstillst��nd s�� upplever de anh��riga stress och ett behov av att f�� vara n��ra patienten. Anh��riga upplever situationer olika och ��r d��rf��r i olika behov av hj��lp och st��d. Diskussion: F��r att kunna bem��ta anh��riga i deras upplevelse av att ha en n��rst��ende i ett allvarligt sjukdomstillst��nd, beh��ver sjuksk��terskan mer utbildning och praktisk ��vning av dessa situationer f��r att kunna ge adekvat v��rd. B��de patient och anh��riga beh��ver information och st��d f��r att kunna g�� vidare i sin krisbearbetning.

Patienters upplevelse av livskvalitet efter hj��rtstopp samt hur livet p��verkades hos n��rst��ende : En litteratur��versikt

Syfte: Syftet med denna systematiska litteraturstudie var att beskriva hur patienter upplevde sin livskvalitet efter ett hj��rtstopp samt hur n��rst��ende upplevde att livet p��verkades efter en anh��rigs hj��rtstopp. Metod: S��kningar efter artiklar skedde via PubMed, CINAHL och Medline. Inklusionskriterierna var att artiklarna skulle vara skrivna p�� svenska eller engelska, prim��rk��llor samt publicerade i vetenskapliga tidskrifter mellan 2000-2012. Huvudresultat: Livskvaliteten p��verkades inom flera omr��den hos patienterna. Det aktiva dagliga livet (ADL) och/eller den fysiska f��rm��gan var f��rs��mrad, dock rapporterades en tillfredsst��llande livskvalitet och en god ADL niv�� 15 ��r efter hj��rtstoppet. Tr��tthet var uttalat hos patienterna vilket p��verkade livskvaliteten negativt. ��ven n��rst��ende upplevde en ��kad tr��tthet med till��gg av andra fysiska symtom. Posttraumatiskt stressyndrom (PTSD) var vanligt hos patienterna men p��verkade endast den fysiska upplevelsen av livskvalitet. Oro, ��ngest och depression var vanligt f��rekommande hos patienter och var korrelerat till en s��mre livskvalitet. Dessa symtom var ��ven vanliga hos n��rst��ende. Sociala relationer upplevdes som viktiga hos b��de patienter och n��rst��ende. Livskvalitet upplevdes i relation med n��rst��ende. Kvinnor upplevde en s��mre social funktion ��n m��n. N��rst��ende k��nde sig isolerade och var r��dda f��r att uppr��ra sin partner. Slutsats: Att ��verleva ett hj��rtstopp p��verkar patientens livskvalitet b��de fysiskt, psykiskt och socialt. ��ven n��rst��ende p��verkas i h��g grad. B��de patienter och n��rst��ende skulle vara behj��lpliga av st��d och v��gledning tiden efter hj��rtstopp. St��dgrupper f��r n��rst��ende i liknande situationer ans��gs kunna minska den psykiska p��frestningen. Sjuksk��terskans roll var att tidigt f��rs��ka identifiera patienter och n��rst��ende i riskzonen f��r att utveckla stressyndrom.

Suicidality in Obsessive-Compulsive Disorder: Prevalence and Relation to Symptom Dimensions and Comorbid Conditions

Funda����o de Amparo �� Pesquisa do Estado de S��o Paulo (FAPESP)

Role of stressful and traumatic life events in obsessive-compulsive disorder

Whilst genetic factors are thought to contribute to the development of obsessive-compulsive disorder (OCD), the role of environmental factors in OCD is only beginning to be understood. In this article, we review the influence of stress-related factors in OCD. Overall, studies indicate that: patients with OCD frequently report stressful and traumatic life events before illness onset, although these rates do not seem to be significantly different from those described in other disorders; the association between OCD and post-traumatic stress disorder (PTSD) might result from symptom overlap, although cases of patients developing OCD after PTSD and showing obsessive-compulsive symptoms that were unrelated to trauma have been described fairly consistently; it is unclear whether patients with OCD and a history of stress-related factors (including stressful life events, traumatic life events or comorbid PTSD) may respond better or worse to the available treatments; and comorbid PTSD may modify the clinical expression of OCD-although controlled studies comparing pre-versus post-traumatic OCD patients are still unavailable. In conclusion, there is a growing evidence to suggest a role for stress-related factors in OCD. Although the available literature does not confirm the existence of a post-traumatic subtype of OCD, it does call for further systematic research into this topic. �� 2011 Future Medicine Ltd.

Towards a post-traumatic subtype of obsessive-compulsive disorder

We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS. �� 2011 Elsevier Ltd.

Late-onset obsessive-compulsive disorder: Risk factors and correlates

Conselho Nacional de Desenvolvimento Cient��fico e Tecnol��gico (CNPq)