Latent Growth Mixture Modeling to Estimate Differential PTSD Trajectories and Associated Risk Factors in Psychiatric Staff Following Workplace Violence

Background: Workplace violence (WV) towards psychiatric staff has commonly been associated with Posttraumatic Stress Disorder (PTSD). However, prospective studies have shown that not all psychiatric staff who experience workplace violence experience post-traumatic stress. Purpose: We want to examine the longitudinal trajectories of PTSD in this population to identify possible subgroups that might be more at risk. Furthermore, we need to investigate whether certain risk factors of PTSD might identify membership in the subgroups. Method: In a sample of psychiatric staff from 18 psychiatric wards in Denmark who had reported an incident of WV, we used Latent Growth Mixture Modelling (LGMM) and further logistic regression analysis to investigate this. Results: We found three separate PTSD trajectories: a recovering, a delayed-onset, and a moderate-stable trajectory. Higher social support and negative cognitive appraisals about oneself, the world and self-blame predicted membership in the delayed-onset trajectory, while higher social support and lower accept coping predicted membership in the delayed-onset trajectory. Conclusion: Although most psychiatric staff go through a natural recovery, it is important to be aware of and identify staff members who might be struggling long-term. More focus on the factors that might predict these groups should be an important task for psychiatric departments to prevent posttraumatic symptomatology from work.

Victimization and PTSD in Ugandan Youth

Background: Little is known about post-traumatic stress (PTSD) prevalence rates in community samples. This is especially true for the African continent where child-soldiers, HIV/AIDS affected and orphans have been the target for PTSD prevalence studies. Objectives: The aim of this study is to investigate the indirect and direct exposure to 20 potentially traumatic events and its relation with PTSD in a Ugandan sample of senior 3rd year students and to perform cross-cultural comparisons with previous studies examining this age group. Socio-economic status, coping styles, negative affect, and somatization are further examined. Method: A convenience sample of 408 senior secondary school students, from eight schools, across three major towns, Kampala, Mbarara, and Jinja, were selected. The Harvard Trauma Questionnaire (HTQ) was used to establish PTSD prevalence rates, The Coping Style Questionnaire (CSQ) was used to assess coping styles, and the Trauma Symptom Checklist (TSC) were used to measure negative affect and somatization. Results: The subjects had been exposed to a mean of 6.6 direct events and a mean of 7.2 indirect events. The estimated prevalence rate of PTSD was 37.7% and a further 28.2% reached a subclinical level, missing one symptom to have the full diagnosis. Variables related to a PTSD diagnosis were female gender, number of directly experienced events, emotional coping, negative affect, and somatization. Conclusions: Ugandan youth have been exposed to significantly more potentially traumatic events and negative life events than European youth, and subsequently PTSD prevalence rates are higher. In addition, fewer gender differences are found in the Ugandan sample compared to the European samples.

Attachment styles and PTSD in adolescents in three Nordic Countries

Studies of possible variables influencing development of posttraumatic stress (PTSD) are of great importance in the effort to enhance preventive and interventional methods in the aim to prevail this devastating condition. Despite the vast research in adults, little is still known of adolescents. Although research is scarce, attachment style has been identified to be an influencing factor in adults, and still research in adolescent is almost non-existent. To our knowledge, no prior study has been conducted, looking at the relationship between attachment style, exposure to a broad range of potentially traumatic events, and subsequent PTSD symptoms in a cross cultural perspective. This is the aim of the present study. Procedure: Data was collected from questionnaire surveys of 1283 adolescents (mean age 14.1 years). Measures: PTSD was measured with The Harvard Trauma Questionnaire-Part IV (HTQ);and attachment style was studied using the Revised Adult Attachment Scale (RAAS). Potentially traumatic events were examined using a broad event list of 19 events. Results: Contrary to what was expected, significant cross cultural differences were found in the distribution of securely, preoccupied, and dismissive attached. Around half of the Faroese population was securely attached, contrary to the Danish and Icelandic population, where the majority was dismissive attached. Cross cultural differences were also found in the distribution of attachment style among those adolescents with PTSD. The majority of the Danish adolescent population with PTSD was dismissive attached;the majority of the Faroese adolescent population with PTSD was securely attached, and in the Icelandic adolescents with PTSD were distributed somewhat even between the four attachment styles. Finally, cross cultural differences were identified in which potentially traumatic events had a significant contribution to the variation in PTSD. The results are discussed and clinical recommendations are presented.

Victimization and PTSD in an Indian youth sample from Pune City

Background: Indian adolescents are presumably exposed to a range of potentially traumatizing and negative life events. However, the knowledge on this area is relatively sparse. The present study aims to investigate the prevalence of exposure to potentially traumatizing and negative life events and the occurrence of Posttraumatic Stress Disorder (PTSD) among a specific sample of Indian adolescents. Method: A sample of 411 Indian 9th graders, (M = 14.15 years) from two private schools in Pune City answered a questionnaire about 1) socio-demographical background and 2) the direct or indirect exposure to 20 specific, potentially traumatizing and negative life events. Also, they filled out Part IV of the Harvard Trauma Questionnaire (HTQ-IV) to assess their level of PTSD-symptoms. Results: 70% of the females and 85% of the males had been exposed to or witnessed at least one traumatizing or negative life event. The mean number of experienced events was 2.5. The most common events were: death of someone close, traffic accidents, serious illness, witnessing the injury or killing of others, and coming close to being injured or killed. The prevalence of PTSD was 10%. Males reported higher direct as well as indirect exposure than females to all events, while no significant gender difference was found in the prevalence of PTSD. Living in a single-parent household meant increased risk of developing PTSD. Conclusion: Exposure to potentially traumatizing events was comparable to that seen in similar studies in Western European youth samples. Prevalence of PTSD was also in the same range. This may be attributable to a number of protective factors associated with the specific sample. Males were exposed to more potentially traumatizing events than females, but contradictory to most other studies, no gender difference in prevalence of PTSD was seen. These differences in comparison to earlier studies might reflect cultural and national circumstances that distinguish this Indian sample from Western European countries previously investigated.

The Assessment Screening of Trauma Reactions, Psychopathology and Psychosocial Function in a High-Risk Sample of 4-8-Year-Old Children—A Pilot Study

Background: Multiple traumatization in childhood is a broad term that includes interpersonal trauma experiences such as physical, sexual, and emotional abuse and neglect. Children with a child protection case referred to counseling are likely to be in high risk of multiple exposure to interpersonal trauma. We aim to demonstrate that systematic assessment with validated measures is feasible in this age group. Method: The Center for Interventions of Children and Adolescents (CIBU), Denmark, provided a new assessment screening procedure where 16 caregivers with children in the age of 4 - 8-years-old participated prior to initiating counseling in a public family treatment facility. We utilized the Diagnostic Infant Preschool Assessment (DIPA) and the Strengths and Difficulties Questionnaire (SDQ). The SDQ was compared with Danish norms. Results: The data suggest that psychopathology was present among all 16 children in this high-risk sample. Distribution of disorders showed 93.8% prevalence of comorbidity. All 16 children had difficulties regarding psychosocial functioning when compared to a Danish norm population. Most profound was emotional symptoms and symptoms of hyperactivity and inattention. Conclusion: This study revealed a higher prevalence of psychiatric disorders and higher rates of psychosocial difficulties in referred children than in children from the general population. Overall, children in this study had complex symptom profiles. Thus, a systematic approach may be helpful in public treatment facilities, and we suggest the implementation of valid evidence-based instruments.