Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects an...Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects and cumulative effects of repeated blasts.Therefore,rats were used as the experimental samples to suffer from explosion blasts with different peak air overpressures(167 kPa~482 kPa)and varying number of repeated blasts.The cumulative effect of craniocerebral trauma was most pronounced for moderate repeated blast,showing approximately 95%increase of trauma severity with penta blast,and an approximately 85%increase of trauma severity with penta minor blast.The cumulative effect of craniocerebral trauma from severe,repeated blast has a smaller rate of change compared to the other two conditions.The severity of trauma from penta blast increased by approximately 69%compared to a single blast.Comprehensive physiological,pathological and biochemical analysis show that the degree of neurological trauma caused by repeated blasts is higher than that of single blasts,and the pathological trauma to brain tissue is more extensive and severe.The trauma degree remains unchanged after double blast,increases by one grade after triple or quadruple blast,and increases by two grades after penta blast.展开更多
BACKGROUND Breast cancer(BC)is a common cancer among females in Africa.Being infected with BC in Africa seems like a life sentence and brings devastating experiences to patients and households.As a result,BC is comorb...BACKGROUND Breast cancer(BC)is a common cancer among females in Africa.Being infected with BC in Africa seems like a life sentence and brings devastating experiences to patients and households.As a result,BC is comorbid with trauma,post-traumatic stress disorder(PTSD),and post-traumatic growth(PTG).AIM To identify empirical evidence from peer-reviewed articles on the comorbidity trajectories between BC and trauma,BC and PTSD,and BC and PTG.METHODS This review adhered to the PRISMA guidelines of conducting a systematic review.Literature searches of the National Library of Medicine,Scopus,PubMed,Google Scholar,and Scopus databases were conducted using search terms developed for the study.The search hint yielded 769 results,which were screened based on inclusion and exclusion criteria.At the end of the screening,24 articles were included in the systematic review.RESULTS BC patients suffered trauma and PTSD during the diagnosis and treatment stages.These traumatic events include painful experiences during and after diagnosis,psychological distress,depression,and cultural stigma against BC patients.PTSD occurrence among BC patients varies across African countries,as this review disclosed:90%was reported in Kenya,80%was reported in Zimbabwe,and 46%was reported in Nigeria.The severity of PTSD among BC patients in Africa was based on the test results communicated to the patients.Furthermore,this review revealed that BC patients experience PTG,which involves losing,regaining,and surrendering final control over the body,rebuilding a personified identity,and newfound appreciation for the body.CONCLUSION Patients with BC undergo numerous traumatic experiences during their diagnosis and treatment.Psychological interventions are needed in SSA to mitigate trauma and PTSD,as well as promote PTG.展开更多
AIM To compare the prevalence of psychiatric disorders and early emotional traumas between women with chronic pelvic pain(CPP) and healthy women.METHODS One hundred women in reproductive age,50 of them had CPP(accordi...AIM To compare the prevalence of psychiatric disorders and early emotional traumas between women with chronic pelvic pain(CPP) and healthy women.METHODS One hundred women in reproductive age,50 of them had CPP(according to the criteria set by the International Association for Study of Pain),and 50 were considered healthy after the gynecological evaluation.The eligibility criteria were defined as follows:chronic or persistent pain perceived in the pelvis-related structures(digestive,urinary,genital,myofascial or neurological systems).Only women in reproductive age with acyclic pain for 6 mo,or more,were included in the present study.Menopause was the exclusion criterion.The participants were grouped according to age,school level and socioeconomic status and were individually assessed through DSM-IV Structured Clinical Interview(SCID-I) and Early Trauma Inventory Self-report-short form(ETISR-SF Brazilian version).Descriptive statistics,group comparison tests and multivariate logistics regression were used in the data analysis.RESULTS The early emotional traumas are highly prevalent,but their prevalence did not differ between the two groups.The current Major Depressive Disorder was more prevalent in women with CPP.The CPP was associatedwith endometriosis in 48% of the women.There was no difference in the prevalence of disorders when endometriosis was taken into account(endometriosis vs other diseases:P > 0.29).The current Major Depressive Disorder and the Bipolar Disorder had greater occurrence likelihood in the group of women with CPP(ODDS = 5.25 and 9.0).CONCLUSION The data reinforce the link between mood disorders and CPP.The preview evidences about the association between CPP and early traumas tended not to be significant after a stronger methodological control was implemented.展开更多
Complex posttraumatic stress disorder(Complex PTSD)has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases,11^(th) version, due to be published, two decades after i...Complex posttraumatic stress disorder(Complex PTSD)has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases,11^(th) version, due to be published, two decades after its first initiation. It is described as an enhanced version of the current definition of PTSD, with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation, negative self-cognitions and interpersonal hardship, thus resembling the clinical features commonly encountered in borderline personality disorder(BPD). Complex PTSD is related to complex trauma which is defined by its threatening and entrapping context, generally interpersonal in nature. In this manuscript, we review the current findings related to traumatic events predisposing the above-mentioned disorders as well as the biological correlates surrounding them, along with their clinical features. Furthermore, we suggest that besides the present distinct clinical diagnoses(PTSD; Complex PTSD; BPD), there is a cluster of these comorbid disorders, that follow a continuum of trauma and biological severity on a spectrum of common or similar clinical features and should be treated as such. More studies are needed to confirm or reject this hypothesis, particularly in clinical terms and how they correlate to clinical entities' biological background, endorsing a shift from the phenomenologically only classification of psychiatric disorders towards a more biologically validated classification.展开更多
BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The ...BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.展开更多
There are various types of traumatic stimuli,such as catastrophic events like wars,natural calamities like earthquakes,and personal trauma from physical and psychological neglect or abuse and sexual abuse.Traumatic ev...There are various types of traumatic stimuli,such as catastrophic events like wars,natural calamities like earthquakes,and personal trauma from physical and psychological neglect or abuse and sexual abuse.Traumatic events can be divided into type I and type II trauma,and their impacts on individuals depend not only on the severity and duration of the traumas but also on individuals’self-evaluation of the traumatic events.Individual stress reactions to trauma include posttraumatic stress disorder(PTSD),complex PTSD and trauma-related depression.Trauma-related depression is a reactive depression with unclear pathology,and depression occurring due to trauma in the childhood has gained increasing attention,because it has persisted for a long time and does not respond to conventional antidepressants but shows good or partial response to psychotherapy,which is similar to the pattern observed for PTSD.Because trauma-related depression is associated with high risk of suicide and is chronic with a propensity to relapse,it is necessary to explore its pathogenesis and therapeutic strategy.展开更多
The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients.The potential role of psychological trauma in the ear...The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients.The potential role of psychological trauma in the early developmental stages,and even the existence of adverse childhood experiences,is important to prove,yet it is difficult to do so.A diverse range of methods have been applied,all of which presumably benchmark a big therapeutic step;however,these enthusiastic methods frequently do not last for long.While hypnosis supporters,Freudian and Neo-Freudian disciples can be acute enough to enhance and uncover suppressed memories,modern psychiatry relies mostly on diversely structured interviews.Functional magnetic resonance and its related subtleties might help,but the questions that remain unanswered are numerous and confusing.Connecting early experiences with long-term memory while identifying psychological trauma its importance for the individual’s growth trajectory;thus,it remains an intriguing issue.展开更多
目的分析1995-2023年分娩心理创伤(psychological birth trauma,PBT)研究主题的热点变迁及其发展趋势,为今后开展精准筛查、预防及干预PBT研究提供参考依据。方法检索中国知网、万方数据库、Web of science和Scopus数据库,获取PBT的相...目的分析1995-2023年分娩心理创伤(psychological birth trauma,PBT)研究主题的热点变迁及其发展趋势,为今后开展精准筛查、预防及干预PBT研究提供参考依据。方法检索中国知网、万方数据库、Web of science和Scopus数据库,获取PBT的相关文献,经过人工筛查最终纳入565篇文献。运用CiteSpace对该研究的发文量、关键词进行可视化分析。结果PBT研究始于1995年,预测高峰时期为2026年。高中心性的关键词为创伤后应激障碍、创伤后应激、母婴互动、产后抑郁等。研究前沿多聚焦于分娩方式、分娩满意度等方面。结论目前PBT研究处于发展期,并位于高峰增长的前夕。建议深入研究并探索PBT的最佳干预措施,提升母婴的身心健康水平,并为有效预防及治疗产后精神心理障碍提供最佳证据。展开更多
基金supported by the National Natural Science Foundation of China(Grant No.12372356)Postgraduate Scientific Research In-novation Project of Hunan Province(Grant No.CX20221044).
文摘Repeated blast impacts on personnel in explosive environments can exacerbate craniocerebral trauma.Most existing studies focus on the injury effects of a single blast,lacking in-depth analysis on the injury effects and cumulative effects of repeated blasts.Therefore,rats were used as the experimental samples to suffer from explosion blasts with different peak air overpressures(167 kPa~482 kPa)and varying number of repeated blasts.The cumulative effect of craniocerebral trauma was most pronounced for moderate repeated blast,showing approximately 95%increase of trauma severity with penta blast,and an approximately 85%increase of trauma severity with penta minor blast.The cumulative effect of craniocerebral trauma from severe,repeated blast has a smaller rate of change compared to the other two conditions.The severity of trauma from penta blast increased by approximately 69%compared to a single blast.Comprehensive physiological,pathological and biochemical analysis show that the degree of neurological trauma caused by repeated blasts is higher than that of single blasts,and the pathological trauma to brain tissue is more extensive and severe.The trauma degree remains unchanged after double blast,increases by one grade after triple or quadruple blast,and increases by two grades after penta blast.
文摘BACKGROUND Breast cancer(BC)is a common cancer among females in Africa.Being infected with BC in Africa seems like a life sentence and brings devastating experiences to patients and households.As a result,BC is comorbid with trauma,post-traumatic stress disorder(PTSD),and post-traumatic growth(PTG).AIM To identify empirical evidence from peer-reviewed articles on the comorbidity trajectories between BC and trauma,BC and PTSD,and BC and PTG.METHODS This review adhered to the PRISMA guidelines of conducting a systematic review.Literature searches of the National Library of Medicine,Scopus,PubMed,Google Scholar,and Scopus databases were conducted using search terms developed for the study.The search hint yielded 769 results,which were screened based on inclusion and exclusion criteria.At the end of the screening,24 articles were included in the systematic review.RESULTS BC patients suffered trauma and PTSD during the diagnosis and treatment stages.These traumatic events include painful experiences during and after diagnosis,psychological distress,depression,and cultural stigma against BC patients.PTSD occurrence among BC patients varies across African countries,as this review disclosed:90%was reported in Kenya,80%was reported in Zimbabwe,and 46%was reported in Nigeria.The severity of PTSD among BC patients in Africa was based on the test results communicated to the patients.Furthermore,this review revealed that BC patients experience PTG,which involves losing,regaining,and surrendering final control over the body,rebuilding a personified identity,and newfound appreciation for the body.CONCLUSION Patients with BC undergo numerous traumatic experiences during their diagnosis and treatment.Psychological interventions are needed in SSA to mitigate trauma and PTSD,as well as promote PTG.
基金Supported by CNPq-National Counsel of Technological and Scientific Development,No.471441/2012-0
文摘AIM To compare the prevalence of psychiatric disorders and early emotional traumas between women with chronic pelvic pain(CPP) and healthy women.METHODS One hundred women in reproductive age,50 of them had CPP(according to the criteria set by the International Association for Study of Pain),and 50 were considered healthy after the gynecological evaluation.The eligibility criteria were defined as follows:chronic or persistent pain perceived in the pelvis-related structures(digestive,urinary,genital,myofascial or neurological systems).Only women in reproductive age with acyclic pain for 6 mo,or more,were included in the present study.Menopause was the exclusion criterion.The participants were grouped according to age,school level and socioeconomic status and were individually assessed through DSM-IV Structured Clinical Interview(SCID-I) and Early Trauma Inventory Self-report-short form(ETISR-SF Brazilian version).Descriptive statistics,group comparison tests and multivariate logistics regression were used in the data analysis.RESULTS The early emotional traumas are highly prevalent,but their prevalence did not differ between the two groups.The current Major Depressive Disorder was more prevalent in women with CPP.The CPP was associatedwith endometriosis in 48% of the women.There was no difference in the prevalence of disorders when endometriosis was taken into account(endometriosis vs other diseases:P > 0.29).The current Major Depressive Disorder and the Bipolar Disorder had greater occurrence likelihood in the group of women with CPP(ODDS = 5.25 and 9.0).CONCLUSION The data reinforce the link between mood disorders and CPP.The preview evidences about the association between CPP and early traumas tended not to be significant after a stronger methodological control was implemented.
文摘Complex posttraumatic stress disorder(Complex PTSD)has been recently proposed as a distinct clinical entity in the WHO International Classification of Diseases,11^(th) version, due to be published, two decades after its first initiation. It is described as an enhanced version of the current definition of PTSD, with clinical features of PTSD plus three additional clusters of symptoms namely emotional dysregulation, negative self-cognitions and interpersonal hardship, thus resembling the clinical features commonly encountered in borderline personality disorder(BPD). Complex PTSD is related to complex trauma which is defined by its threatening and entrapping context, generally interpersonal in nature. In this manuscript, we review the current findings related to traumatic events predisposing the above-mentioned disorders as well as the biological correlates surrounding them, along with their clinical features. Furthermore, we suggest that besides the present distinct clinical diagnoses(PTSD; Complex PTSD; BPD), there is a cluster of these comorbid disorders, that follow a continuum of trauma and biological severity on a spectrum of common or similar clinical features and should be treated as such. More studies are needed to confirm or reject this hypothesis, particularly in clinical terms and how they correlate to clinical entities' biological background, endorsing a shift from the phenomenologically only classification of psychiatric disorders towards a more biologically validated classification.
基金Supported by the UNC UNAN FGID Epidemiology Study Project,No.54-1808958.
文摘BACKGROUND Psychosocial and physical trauma are known risk factors for irritable bowel syndrome(IBS),including in war veterans,whereas war exposure in civilians is unclear.Nicaragua experienced two wars,1970-1990:The Sandinistas Revolution(1970s)and The Contra War(1980s).Our aim was to investigate the role of exposure to war trauma in the subsequent development of IBS in the context of an established health surveillance system(11000 households).AIM To investigate in a civilian population the relationship between exposure to war trauma and events and the subsequent development of IBS in the context of an established public health and demographic surveillance system in western Nicaragua.METHODS We conducted a nested population-based,cross-sectional study focused on functional gastrointestinal disorders based on Rome II criteria.1617 adults were randomly selected.The Spanish Rome II Modular Questionnaire and Harvard Trauma Questionnaire were validated in Nicaragua.War exposure was assessed with 10 measures of direct and indirect war trauma and post-war effects.Multiple exposures were defined by≥3 measures.RESULTS The prevalence of IBS was 15.2%[Female(F)17.1%,Male(M)12.0%],war exposure 19.3%(F 9.3%,M 36.7%),and post-traumatic stress disorder(PTSD)5.6%(F 6.4%,M 4.3%).Significant associations with IBS in the civilian population were observed(adjusted by gender,age,socioeconomic status,education):physical and psychological abuse[adjusted odds ratio(aOR):2.25;95%confidence interval:1.1-4.5],witnessed execution(aOR:2.4;1.1-5.2),family member death(aOR:2.2;1.2-4.2),and multiple exposures(aOR:2.7;1.4-5.1).PTSD was independently associated with IBS(aOR:2.6;1.2-5.7).CONCLUSION An enduring association was observed in the Nicaragua civilian population between specific civil war-related events and subsequent IBS.Civilian populations in regions with extended armed conflict may warrant provider education and targeted interventions for patients.
基金Supported by the Science and Technology Project of Zhejiang Provincial,No.GF22H093655Nonprofit Applied Research Project of Huzhou Science and Technology Bureau,2021GYB16.
文摘There are various types of traumatic stimuli,such as catastrophic events like wars,natural calamities like earthquakes,and personal trauma from physical and psychological neglect or abuse and sexual abuse.Traumatic events can be divided into type I and type II trauma,and their impacts on individuals depend not only on the severity and duration of the traumas but also on individuals’self-evaluation of the traumatic events.Individual stress reactions to trauma include posttraumatic stress disorder(PTSD),complex PTSD and trauma-related depression.Trauma-related depression is a reactive depression with unclear pathology,and depression occurring due to trauma in the childhood has gained increasing attention,because it has persisted for a long time and does not respond to conventional antidepressants but shows good or partial response to psychotherapy,which is similar to the pattern observed for PTSD.Because trauma-related depression is associated with high risk of suicide and is chronic with a propensity to relapse,it is necessary to explore its pathogenesis and therapeutic strategy.
文摘The documentation of psychological trauma is obviously a challenge to clinicians while they are diving deep into remote events related to their clients or patients.The potential role of psychological trauma in the early developmental stages,and even the existence of adverse childhood experiences,is important to prove,yet it is difficult to do so.A diverse range of methods have been applied,all of which presumably benchmark a big therapeutic step;however,these enthusiastic methods frequently do not last for long.While hypnosis supporters,Freudian and Neo-Freudian disciples can be acute enough to enhance and uncover suppressed memories,modern psychiatry relies mostly on diversely structured interviews.Functional magnetic resonance and its related subtleties might help,but the questions that remain unanswered are numerous and confusing.Connecting early experiences with long-term memory while identifying psychological trauma its importance for the individual’s growth trajectory;thus,it remains an intriguing issue.
文摘目的分析1995-2023年分娩心理创伤(psychological birth trauma,PBT)研究主题的热点变迁及其发展趋势,为今后开展精准筛查、预防及干预PBT研究提供参考依据。方法检索中国知网、万方数据库、Web of science和Scopus数据库,获取PBT的相关文献,经过人工筛查最终纳入565篇文献。运用CiteSpace对该研究的发文量、关键词进行可视化分析。结果PBT研究始于1995年,预测高峰时期为2026年。高中心性的关键词为创伤后应激障碍、创伤后应激、母婴互动、产后抑郁等。研究前沿多聚焦于分娩方式、分娩满意度等方面。结论目前PBT研究处于发展期,并位于高峰增长的前夕。建议深入研究并探索PBT的最佳干预措施,提升母婴的身心健康水平,并为有效预防及治疗产后精神心理障碍提供最佳证据。
