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Wild, J., K. V. Smith, E. Thompson, F. Béar, M. J. J. Lommen, and A. Ehlers. "A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression." Psychological Medicine 46, no. 12 (June 28, 2016): 2571–82. http://dx.doi.org/10.1017/s0033291716000532.
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BackgroundIt is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions.MethodNewly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews.ResultsIn all, 32 participants (8.3%) developed an episode of PTSD and 41 (10.6%) an episode of MD during follow-up. In all but nine cases (2.3%), episodes had remitted by the next assessment 4 months later. At 2 years, those with episodes of PTSD or MD during follow-up reported more days off work, poorer sleep, poorer quality of life, greater burn-out; and greater weight-gain for those with PTSD. In line with theories of PTSD and depression, analyses controlling for psychiatric and trauma history identified several pre-trauma predictors (cognitive styles, coping styles and psychological traits). Logistic regressions showed that rumination about memories of stressful events at the start of training uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.ConclusionsParticipants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training. Cognitive predictors of episodes of PTSD and MD are promising targets for resilience interventions.
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Hong, Sun-Woo, Kyung-Sook Bang, Hwal Lan Bang, and Jihee Lim. "Attitude and knowledge on PTSD of nursing and paramedic students in Korea." Journal of Korean Academic Society of Nursing Education 26, no. 4 (November 30, 2020): 393–401. http://dx.doi.org/10.5977/jkasne.2020.26.4.393.
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Purpose: This study aimed to identify attitude and knowledge level on post-traumatic stress disorder (PTSD) among nursing and paramedic students.Methods: A questionnaire survey was conducted from December 1st to 20th in 2019. A total of 210 students participated from two universities in Korea. Data were analyzed using descriptive statistics, t-tests and one-way analysis of variance.Results: Students were positive about the government's spending on PTSD treatment (91.4%), and professional training (92.4%). PTSD patients were considered to be more dangerous (68.1%) and violent (42.4%) than the general population. There were no significant differences in attitude and general knowledge on PTSD between nursing and paramedic students. However, general knowledge on PTSD differed according to education experience on PTSD (t=2.04, <i>p</i>=.043). Knowledge scores for PTSD treatment differed significantly according to the academic major (t=2.02, <i>p</i>=.044), and education experience on PTSD (t=2.87, <i>p</i>=.005).Conclusions: The results of this study indicate nursing and paramedic students lack knowledge on PTSD. Therefore, developing curriculum regarding PTSD-related contents in undergraduate and continuing education in both departments is needed to provide better quality health care to people with PTSD.
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Bang, Kyung-sook, Hwal Bang, Sun-Woo Hong, and Jihee Lim. "Validity and Reliability of Korean Version of Post-traumatic Stress Disorder Scale (K-PTSD) Measuring Attitudes and Knowledge of PTSD." Journal of Korean Academic Society of Nursing Education 26, no. 1 (February 28, 2020): 47–55. http://dx.doi.org/10.5977/jkasne.2020.26.1.47.
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Purpose: The aim of this study was to examine the validity and reliability of the Korean version of the PTSD scale (K-PTSD) for measuring attitudes and knowledge of PTSD. Methods: A cross-sectional study design was used. The K-PTSD scale consisted of 8 items for attitudes, 8 items for general knowledge of PTSD, and 3 items for knowledge of PTSD treatment; 211 nursing students and paramedic students participated. Content validity, item analysis, and factor analysis were used to examine the construct validity. Criterion validity was tested by using educational experience with PTSD as a criterion. Cronbach's α was used to identify internal consistency reliability in the attitude scale. Results: Construct validity of the K-PTSD was verified by exploratory factor analysis, with factor loadings for attitude ranging from .59 to .84. Criterion validity in comparing knowledge of PTSD (t=2.02, p=.044) and PTSD treatment (t=3.19, p=.022) showed a significant difference according to PTSD educational experience. Cronbach's α for the attitude scale was .79 and .59. Conclusion: The findings suggest that the K-PTSD is a valid and reliable tool that can measure attitudes and knowledge of PTSD among nursing and paramedic students. However, further study is needed to retest the verification of this scale with more diverse participants.
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Mausz, Justin, Elizabeth Anne Donnelly, Sandra Moll, Sheila Harms, and Meghan McConnell. "Mental Disorder Symptoms and the Relationship with Resilience among Paramedics in a Single Canadian Site." International Journal of Environmental Research and Public Health 19, no. 8 (April 17, 2022): 4879. http://dx.doi.org/10.3390/ijerph19084879.
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There is growing recognition in research and policy of a mental health crisis among Canada’s paramedics; however, despite this, epidemiological surveillance of the problem is in its infancy. Just weeks before the emergence of the COVID-19 pandemic, we surveyed paramedics from a single, large, urban paramedic service in Ontario, Canada to assess for symptom clusters consistent with post-traumatic stress disorder (PTSD), major depressive disorder, and generalized anxiety disorder and to identify potential risk factors for each. In total, we received 589 completed surveys (97% completion rate) and found that 11% screened positive for PTSD, 15% screened positive for major depressive disorder, and 15% screened positive for generalized anxiety disorder, with one in four active-duty paramedics screening positive for any of the three as recently as February 2020. In adjusted analyses, the risk of a positive screen varied as a function of employment classification, gender, self-reported resilience, and previous experience as a member of the service’s peer support team. Our findings support the position that paramedics screen positive for mental disorders at high rates—a problem likely to have worsened since the onset of the COVID-19 pandemic. We echo the calls of researchers and policymakers for urgent action to support paramedic mental health in Canada.
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Smith, Erin, Frederick M. Burkle, Kristine Gebbie, David Ford, and Cécile Bensimon. "Acceptable Limitations on Paramedic Duty to Treat During Disaster: A Qualitative Exploration." Prehospital and Disaster Medicine 33, no. 5 (October 2018): 466–70. http://dx.doi.org/10.1017/s1049023x18000857.
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AbstractIntroductionThe Australian prehospital profession has not yet facilitated a comprehensive discussion regarding paramedic role and responsibility during disasters. Whether paramedics have a duty to treat under extreme conditions and what acceptable limitations may be placed on such a duty require urgent consideration. The purpose of this research is to encourage discussion within the paramedic profession and broader community on this important ethical and legal issue.MethodsThe authors employed qualitative methods to gather paramedic and community member perspectives in Victoria, Australia.ResultsThese findings suggested that both paramedic and community member participants agree that acceptable limitations on paramedic duty to treat during disaster are required. These limitations should be based on consideration of the following factors: personal health circumstances (eg, pregnancy for female paramedics); pre-existing mental health conditions (eg, posttraumatic stress disorder/PTSD); competing personal obligations (eg, paramedics who are single parents); and unacceptable levels of personal risk (eg, risk of exposure and infection during a pandemic).ConclusionIt is only with the engagement of a more broadly representative segment of the prehospital profession and greater Australian community that appropriate guidance on limiting standards of care under extreme conditions can be developed and integrated within prehospital care in Australia.SmithE, BurkleFM Jr., GebbieK, FordD, BensimonC. Acceptable limitations on paramedic duty to treat during disaster: a qualitative exploration. Prehosp Disaster Med. 2018;33(5):466–470.
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Kosydar-Bochenek, Justyna, Bogumił Lewandowski, Dorota Ozga, and Krystyna Woźniak. "Przegląd narzędzi diagnostycznych i metod pomiaru zespołu stresu pourazowego (Posttraumatic Stress Disorder, PTSD) z możliwością wykorzystania wśród ratowników medycznych / Overview of diagnostic tools and Posttraumatic Stress Disorder (PTSD) measurement methods with the possibility of use among paramedics." Pielegniarstwo XXI wieku / Nursing in the 21st Century 15, no. 2 (June 1, 2016): 45–49. http://dx.doi.org/10.1515/pielxxiw-2016-0017.
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Abstract The profession of a paramedic involves a constant contact with traumatic events - road accidents, disasters, acts of violence and so on. As a consequence of such frequent and long-lasting exposure to traumatic events, paramedics are prone to developing PTSD (Posttraumatic Stress Disorder). This is a chronic disorder impacting cognitive, emotional, behavioral and somatic experiences. As a result of a prolonged exposure to stressful events, such condition can be life threatening. There are two ways of diagnosing PTSD: structured interviews and self-rating questionnaires (self-rating scales). The researcher should choose the best method possible relying not only on its procedure. In addition, merit based factors and psychometric parameters should be taken into consideration. The present article provides an overview of both Polish as well as foreign PTSD assessment methods, which could be incorporated into the research conducted in a group of paramedics.
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Gramlich, Michael A., and Sandra M. Neer. "Firefighter-Paramedic With Posttraumatic Stress Disorder, Horrific Images, and Depression: A Clinical Case Study." Clinical Case Studies 17, no. 3 (April 22, 2018): 150–65. http://dx.doi.org/10.1177/1534650118770792.
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Despite the existence of evidence-based treatments for posttraumatic stress disorder (PTSD), no identifiable study reported delivery of exposure therapy for a first responder with PTSD, as well as horrific images that generalized beyond the index trauma to loved ones. Horrific images have been defined as strongly aversive intrusive thoughts such as images of dismembered bodies or disgusting scenes. This clinical case describes the assessment and treatment of Ryan, a 41-year-old, firefighter-paramedic who completed a multifaceted intervention that included imaginal exposure therapy, behavioral activation, and cognitive therapy for depression. PTSD symptoms as measured by the PTSD Checklist for DSM-5 (PCL-5) displayed a clinically significant decrease from 25 at pretreatment to 3 at 2-month-follow-up, indicating Ryan no longer met diagnostic criteria for PTSD. In addition, Ryan endorsed a clinically significant reduction in horrific images from 21 per week at pretreatment to 0 at 2-month-follow-up. Depressive symptoms as measured by the Beck Depression Inventory–Second Edition (BDI-II) demonstrated a clinically significant decrease from 18 at pretreatment to 1 at 2-month-follow-up, indicating Ryan no longer met diagnostic criteria for depression. This clinical case study provides evidence for the feasibility and effectiveness of delivering a multifaceted intervention for a first responder with multiple psychiatric disorders.
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Tew, Joanna, and Richard Ward. "Paramedics at risk? How responding to a terror attack affects mental wellbeing." Journal of Paramedic Practice 16, no. 10 (October 2, 2024): 416–25. http://dx.doi.org/10.12968/jpar.2023.0061.
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Background: Terror attacks have a significant impact on first responders’ wellbeing, with an associated risk of post-traumatic stress disorder (PTSD). Aims: To improve understanding of how responding to terror attacks affects paramedics’ mental health. Methodology: A literature search was carried out on databases using the PRISMA strategy. Critical appraisal tools were used alongside thematic analysis to appraise and synthesise the literature. Findings: Ten papers were identified. Themes arising regarding risks to responders included: the level of exposure, with the amount related to the risks of developing PTSD and psychopathology; and level of preparedness, with responders carrying out unfamiliar tasks and working outside the scope of practice as well as lacking education on the psychological impact of terror attacks. Conclusion: If paramedics are deployed into terror attack warm zones, policy needs to consider the associated psychological risk. Training should incorporate stress management techniques and education on the extreme emotions these practitioners may experience. More research specifically with the paramedic population is required to understand the risk posed to them and how this may be managed.
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Thomas, Jade. "Mental health difficulties in paramedics: A review of the literature." Counselling Psychology Review 38, no. 2 (December 1, 2023): 18–29. http://dx.doi.org/10.53841/bpscpr.2023.38.2.18.
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BackgroundParamedics are frequently exposed to traumatic events as part of their role. The implications of this constant exposure have suggested that paramedics are at high risk of developing long-term mental health issues such as depression, anxiety, burnout, trauma, PTSD, and suicide.PurposeTo synthesise studies to examine factors that play a role in the development of mental health difficulties in ambulance personnel. As well as, establishing gaps within the literature for further research.Data SourcesFrom the first 77 published journals reviewed from Psycinfo, PsychArticles, CINAHL, Education Research Complete, ERIC and grey literature, 15 studies met the inclusion criteria for this review and were included in the present study.ResultsFindings of this review suggest that the mental health and wellbeing of paramedics are significant issues. In reviewing the research, it was found that several different factors may play a role in the development of mental health difficulties in ambulance personnel. Four main themes were determined, (1) occupational stressors, (2) negative attitude towards emotional expression, (3) peer and social support, and (4) preparing paramedics for mental health challenges.ConclusionsIt is paramount for further research to explore paramedic students’ mental health experiences, as well as a focus on research to investigate a UK paramedic population due to most of the literature focusing on an international population. Psychological support and early interventions should be made a priority for all ambulance workers, as a way of improving the quality of the working life of paramedics.
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Smith, Erin C., and Frederick M. Burkle. "Paramedic and Emergency Medical Technician Reflections on the Ongoing Impact of the 9/11 Terrorist Attacks." Prehospital and Disaster Medicine 34, no. 1 (February 2019): 56–61. http://dx.doi.org/10.1017/s1049023x18001255.
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AbstractIntroductionIn the years following the September 11, 2001 terrorist attacks in New York City (New York USA), otherwise known as 9/11, first responders began experiencing a range of health and psychosocial impacts. Publications documenting these largely focus on firefighters. This research explores paramedic and emergency medical technician (EMT) reflections on the long-term impact of responding to the 9/11 terrorist attacks.MethodsQualitative methods were used to conduct interviews with 54 paramedics and EMTs on the 15-year anniversary of 9/11.ResultsResearch participants reported a range of long-term psychosocial issues including posttraumatic stress disorder (PTSD), anxiety, depression, insomnia, relationship breakdowns and impact on family support systems, and addictive and risk-taking behaviors. Ongoing physical health issues included respiratory disorders, eye problems, and cancers.DiscussionThese findings will go some way to filling the current gap in the 9/11 evidence-base regarding the understanding of the long-term impact on paramedics and EMTs. The testimony of this qualitative research is to ensure that an important voice is not lost, and that the deeply personal and richly descriptive experiences of the 9/11 paramedics and EMTs are not forgotten.SmithEC,BurkleFMJr.Paramedic and emergency medical technician reflections on the ongoing impact of the 9/11 terrorist attacks.Prehosp Disaster Med.2019;34(1):56–61.
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Wojtysiak, Katarzyna, Adriana Wielgus, and Halina Zielińska-Więczkowska. "THE IMPACT OF WORKING CONDITIONS ON STRESS AND ITS EFFECTS IN THE GROUP OF PARAMEDICS: A SYSTEMATIC REVIEW." Humanities & Social Sciences Reviews 9, no. 4 (August 18, 2021): 188–93. http://dx.doi.org/10.18510/hssr.2021.9426.
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Purpose: This is a review to assess the working conditions that affect the stress level of paramedics and their ability to cope with stress. The profession of a paramedic is characterized by constant contact with other people and exposure to many factors, including biological (HIV, flu virus), chemical (causing allergic reactions, burns) physical (noise, low or excessive temperature), psychosocial (aggression, violence, traumatic experiences).
Methodology: This is a Systematic review paper. The PubMed, Cochrane Library, and Google scholar search were used to analyze the problem. The following keywords were used to search for information sources: paramedic, working conditions, medical rescue, ambulance, stress, coping with stress. Articles were selected according to the impact of working conditions on stress and its consequences among the group of paramedics.
Main Findings: The work of a rescuer is a constant action under the influence of a high level of stress and emotions, caused by an unforeseen sequence of events and time pressure. The long-term presence of negative factors is the cause of the appearance of burnout syndrome, rumination, PTSD, and somatic symptoms related to stress in the workplace. It can result in a deterioration of the quality of patient care.
Implications of this study: The above results should be taken into account by units of the emergency medical care system. The paper indicates the occurrence of negative psychological effects of work-related stress and as a consequence the need to train the personnel in the field of stress-coping techniques and to provide emergency medical service workers with mental health monitoring and psychological care in the workplace.
Novelty in this study: There is a lack of systematic reviews of the impact of working conditions on the mental health of workers in emergency medical care services. The paper is an attempt to assess the impact of working conditions on stress and its effects on the group of paramedics and other emergencies medical care system employees.
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Kobelski, Grzegorz, Katarzyna Naylor, Robert Ślusarz, and Mariusz Wysokiński. "Post-Traumatic Stress Disorder among Polish Healthcare Staff in the Era of the COVID-19 Pandemic." Journal of Clinical Medicine 12, no. 12 (June 15, 2023): 4072. http://dx.doi.org/10.3390/jcm12124072.
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Introduction: The COVID-19 pandemic has brought many adverse phenomena, particularly in the area of health for both individuals and society as a whole. Healthcare staff also suffered dire consequences. Aim: The aim of this study was to assess whether the COVID-19 pandemic increased the risk of post-traumatic stress disorder among healthcare professionals in Poland. Material and method: The survey was conducted between 4 April 2022 and 4 May 2022. The study applied the Computer Assisted Web Interview (CAWI) technique using the standardised Peritraumatic Distress Inventory (PDI) questionnaire. Results: The average score obtained by the respondents on the PDI was 21.24 ± 8.97. There was a statistically significant difference between the average PDI score obtained based on the gender of the subject (Z = 3.873, p = 0.0001.) The score obtained amongst nurses was statistically significantly higher compared to the paramedic group (H = 6.998, p = 0.030). There was no statistically significant difference between the average PDI score obtained based on the age of the participants (F = 1.282, p = 0.281), nor with their length of service (F = 0.934, p = 0.424). A total of 82.44% of the respondents received 14 PDI points, the cut-off point indicating the risk of PTSD that was adopted in the study. It was concluded that 6.12% of respondents did not require intervention (<7 PDI score); 74.28% of respondents needed further follow-up for PTSD and a reassessment of the PDI approximately 6 weeks after the initial testing; and 19.59% required coverage for PTSD prevention and mitigation (>28 PDI score). Conclusions: The study has shown a high risk of post-traumatic stress disorder among healthcare professionals in Poland. This risk is related to the gender of the respondents, with an indication of a higher risk of PTSD among women. The results have also shown a correlation between increased risk of post-traumatic stress disorder and occupation, with nurses being the most affected group. In contrast, no association has been found in terms of age and length of service for an increase in the risk of PTSD, following exposure to trauma in relation to healthcare services during the COVID-19 pandemic.
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Figueroa Cabello, Rodrigo Andrés, Tomás León, and Richard Sorensen. "Post-traumatic symptoms in the staff of a mental health inpatient unit after the suicide of a patient: a case report in Chile." Summa Psicológica 13, no. 2 (November 23, 2016): 13–22. http://dx.doi.org/10.18774/448x.2016.13.304.
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BACKGROUND: Multiple studies have shown that the suicide of a patient can produce posttraumatic and depressive symptoms among the mental health care providers, who typically have high levels of baseline burnout. OBJECTIVES: To measure posttraumatic, depressive and burnout symptoms in the staff of an inpatient psychiatric unit after the suicide of a patient. METHODS: Two months after the suicide all the employees were invited to answer, anonymously, the Posttraumatic Check-List (PCL), the Beck Depression Inventory (BDI), and the Maslach Burnout Inventory (MBI), for measuring posttraumatic, depressive, and burnout symptoms, respectively. RESULTS: Over 80% of the staff participated. A total of 17.1% had probable PTSD, 19.5% probable major depression, 24.4% and 14.6% high levels of emotional exhaustion and depersonalization, respectively, and 24.4% low levels of professional accomplishment. The group consisting of nurses, paramedic technicians, and nursing assistants ("nursing staff") had PTSD significantly greater than other workers (p < .001). CONCLUSIONS: Suicide in a psychiatric ward can produce posttraumatic and depressive symptoms among the staff, as high as another kind of traumas. The impact may be greater on the nursing staff. It is essential that organizations involved in the provision or teaching of mental health care incorporate this reality into their agenda, to prevent, mitigate and respond better to this phenomenon.
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Miller, Elisha. "The prevalence of stress and burnout in UK emergency ambulance service workers and its impact on their mental health and well-being." British Paramedic Journal 5, no. 4 (March 1, 2021): 62–63. http://dx.doi.org/10.29045/14784726.2021.3.5.4.62.
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<sec id="s1"> Aims: To assess the prevalence of burnout among emergency ambulance service workers in one ambulance station; to determine if there are any variances based on socio-demographic information such as gender, clinical grade and length of service; to examine the distinctions between personal, work-related and patient-related burnout; to identify current workplace interventions to reduce stress and burnout that will improve mental health and well-being. </sec> <sec id="s2"> Methods: Mixed methods ‐ the Copenhagen Burnout Inventory (CBI) was utilised, measuring burnout across three domains (personal, work-related and patient-related) alongside collecting demographic information such as gender, role, full-time or part-time employment and length of service. A free-text space was available to provide opinions on causes of burnout and on how current practice can be improved; these were analysed via thematic analysis. </sec> <sec id="s3"> Results: Seventy-eight staff members completed the questionnaire. These were: 16 emergency care assistants, 15 technicians and 47 paramedics. Thirty-eight (48.7%) staff members experienced personal burnout, 42 (53.8%) experienced work-related burnout and 29 (37.1%) experienced patient-related burnout. It was found that those most at risk of burnout were full-time male employees with more than 10 years’ experience and employed within a paramedic position. Six themes were identified through thematic analysis: unnecessary callouts, shift patterns, support options, management, sickness absence and job demands. </sec> <sec id="s4"> Conclusion: Findings suggest that burnout is prevalent within the ambulance service environment and can result in long-term sickness absences and declining mental health. This requires further investigation into causation alongside consideration of preventative measures and interventions to improve ambulance service staff well-being while increasing staff resilience to prevent burnout. Support for managers in recognising symptoms of burnout is also imperative because providing them with the training to recognise a mental health issue, interpret it and promptly treat it can mean the difference between sickness absences, future PTSD, unwell staff presenting at work and staff feeling valued and supported by management. The introduction of mandatory counselling and well-being sessions was also recommended by participants to improve staff mental health and well-being and reduce instances of work-related burnout, while providing financial advantages to the ambulance service with a reduction in additional overtime and sickness payments. </sec>
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Streb, Markus, Pascal Häller, and Tanja Michael. "PTSD in Paramedics: Resilience and Sense of Coherence." Behavioural and Cognitive Psychotherapy 42, no. 4 (May 29, 2013): 452–63. http://dx.doi.org/10.1017/s1352465813000337.
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Background: Paramedics are frequently subjected to traumatic experiences and have higher PTSD prevalence rates than people in the general population. However, the vast majority of paramedics do not develop PTSD. While several risk factors for PTSD have been established, little is known about protective factors. It has been suggested that a good sense of coherence (SOC) and high resilience lower the risk for developing PTSD. Aims: To examine whether SOC and resilience are associated with PTSD severity in paramedics. Method: A cross-sectional study investigated SOC, resilience and PTSD in paramedics (N = 668). PTSD was assessed with the Posttraumatic Stress Diagnostic Scale (PDS); resilience and SOC were measured with the Resilience Scale (RS-11) and the Sense of Coherence Scale (SOC-L9). Further measures included preparation of dealing with traumatic events and availability of psychological help. Results: As expected, both resilience and SOC were negatively correlated with PTSD symptoms. The regression analysis showed that 19.2% of the total variance in symptom severity was explained by these variables. However, SOC was a better predictor than resilience for PTSD severity, as it accounted for more unique variance. Paramedics who were prepared for dealing with work-related traumatic events and who received psychological help had less severe PTSD symptoms and higher SOC scores than paramedics for whom these services were not available. Conclusions: Enhancing resilience, and especially SOC, seems a promising approach to reduce PTSD symptom severity in high risk groups like paramedics.
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Baqai, Kamran. "PTSD in paramedics: history, conceptual issues and psychometric measures." Journal of Paramedic Practice 12, no. 12 (December 2, 2020): 495–502. http://dx.doi.org/10.12968/jpar.2020.12.12.495.
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Post-traumatic stress disorder (PTSD) is more common in paramedics than in the general population because of the stressful and distressing nature of their work. Forms of PTSD associated with chronic stress and repeated trauma are scarcely researched among paramedics. This is striking as this workforce is potentially more likely to be affected by these types of PTSD. Diagnostic processes are still largely based on acute rather than chronic psychological trauma. PTSD diagnosis has been influenced by sociological perceptions of mental illness and changes in diagnostic criteria. Criteria for the diagnosis of PTSD in the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases have changed in the past decade, which may facilitate more appropriate diagnoses of PTSD in paramedics. Paramedics often have a complex aetiology of PTSD resulting from experiences of both chronic and acute events. Questionnaires that cover exposure to both individual and repeated stressful events are required to enable further research in the area of PTSD in paramedics.
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Parobkiewicz, Aleksandra, Michał Ziarko, Julia Krawczyk, and Jagna Jasielska. "Posttraumatic Stress Disorder symptoms in persons involved in road accidents and paramedics." Journal of Medical Science 90, no. 2 (June 29, 2021): e515. http://dx.doi.org/10.20883/medical.e515.
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Aim. The aim of the study was to assess the risk of posttraumatic stress disorder (PTSD) among persons involved in road accidents and paramedics. Little is known about similarity or difference of PTSD symptoms between these two groups involved in accident in voluntary and involuntary way. Material and Methods. Persons involved in road accidents (N = 78) and paramedics (N = 106) completed the Polish version of the Impact of Event Scale–Revised.Results. The percentage of those who reported PTSD symptoms was similar and insignificant among persons involved in road accidents (56%) and among paramedics (45%). A significant difference (p < 0,01) was observed between these groups, however. The total PTSD, intrusions, and avoidance were higher for persons involved in road accidents.Conclusions. Victims, perpetrators, and helpers in road accidents were at a similar risk of PTSD. Peritraumatic interventions are recommended for all these groups.
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Hong, Sun-Woo, Kyung-Sook Bang, Hwal Lan Bang, Hye Jin Hyun, Miyoung Lee, and Yu Na Jung. "Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department." Journal of Korean Academic Society of Nursing Education 29, no. 1 (February 28, 2023): 86–97. http://dx.doi.org/10.5977/jkasne.2023.29.1.86.
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Purpose: This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. Methods: Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé’s test. Results: Compared with emergency room nurses, paramedics were more positive about the government’s spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, <i>p</i>=.021) and education level (F=3.21, <i>p</i>=.042). Resilience scores differed significantly according to sex (t=2.02, <i>p</i>=.045), education level (F=4.10, <i>p</i>=.018), self-reported economic state (F=10.34, <i>p</i><.001), and self-reported health (F=11.57, <i>p</i><.001). Conclusion: The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.
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Roberts, B., N. Makhashvili, J. Javakhishvili, A. Karachevskyy, N. Kharchenko, M. Shpiker, and E. Richardson. "Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey." Epidemiology and Psychiatric Sciences 28, no. 1 (July 27, 2017): 100–111. http://dx.doi.org/10.1017/s2045796017000385.
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AimsThere are an estimated 1.5 million internally displaced persons (IDPs) in Ukraine because of the armed conflict in the east of the country. The aim of this paper is to examine utilisation patterns of mental health and psychosocial support (MHPSS) care among IDPs in Ukraine.MethodsA cross-sectional survey design was used. Data were collected from 2203 adult IDPs throughout Ukraine between March and May 2016. Data on mental health care utilisation were collected, along with outcomes including post-traumatic stress disorder (PTSD), depression and anxiety. Descriptive and multivariate regression analyses were used.ResultsPTSD prevalence was 32%, depression prevalence was 22%, and anxiety prevalence was 17%. Among those that likely required care (screened positive with one of the three disorders, and also self-reporting a problem) there was a large treatment gap, with 74% of respondents who likely required MHPSS care over the past 12 months not receiving it. For the 26% (N = 180) that had sought care, the most common sources of services/support were pharmacies, family or district doctor/paramedic (feldsher), neurologist at a polyclinic, internist/neurologist at a general hospital, psychologists visiting communities, and non-governmental organisations/volunteer mental health/psychosocial centres. Of the 180 respondents who did seek care, 163 could recall whether they had to pay for their care. Of these 163 respondents, 72 (44%) recalled paying for the care they received despite government care officially being free in Ukraine. The average costs they paid for care was US$107 over the previous 12 months. All 180 respondents reported having to pay for medicines and the average costs for medicines was US$109 over the previous 12 months. Among the 74% had not sought care despite likely needing it; the principal reasons for not seeking care were: thought that they would get better by using their own medications, could not afford to pay for health services or medications, no awareness of where to receive help, poor understanding by health care providers, poor quality of services, and stigma/embarrassment. The findings from multivariate regression analysis show the significant influence of a poor household economic situation on not accessing care.ConclusionsThe study highlights a high burden of mental disorders and large MHPSS treatment gap among IDPs in Ukraine. The findings support the need for a scaled-up, comprehensive and trauma-informed response to provision of MHPSS care of IDPs in Ukraine alongside broader health system strengthening.
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Khan, Wahaj Anwar A., Russell Conduit, Gerard A. Kennedy, Ahmed Abdullah Alslamah, Mohammad Ahmad Alsuwayeh, and Melinda L. Jackson. "Sleep and Mental Health among Paramedics from Australia and Saudi Arabia: A Comparison Study." Clocks & Sleep 2, no. 2 (June 8, 2020): 246–57. http://dx.doi.org/10.3390/clockssleep2020019.
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Paramedics face many challenges while on duty, one of which is working different types of shifts. Shift work has been linked to a number of health issues such as insomnia, depression, and anxiety. Besides shift work, Saudi paramedics, a group that has not been investigated for sleep or mental health issues previously, may be facing more demands than Australian paramedics due to lower numbers of paramedics in comparison to the general population. The aim of this study was to investigate the prevalence of sleep and mental health disorders among paramedics in Saudi Arabia and Australia. Paramedics were invited to complete a survey to assess stress, post-traumatic stress disorder (PTSD), depression, anxiety, daytime sleepiness, insomnia, sleep quality, shift work disorder, obstructive sleep apnoea, fatigue, and general health. A total of 104 males Saudi paramedics (M age = 32.5 ± 6.1 years) and 83 males paramedics from Australia (M age = 44.1 ± 12.1 years) responded to the survey. Significantly higher rates of depression, PTSD, insomnia, and fatigue, along with significantly poorer physical functioning were observed among Saudi paramedics in comparison with Australian paramedics. However, Australian paramedics reported significantly poorer sleep quality and general health in comparison to Saudi paramedics. After removing the effect of driving and working durations, outcomes were no longer significant. The higher burden of depression and PTSD among Saudi paramedics may be explained by longer hours spent driving and longer work durations reported by this group. Taking into consideration the outcomes reported in this study, more investigations are needed to study their possible effects on paramedics’ cognition, performance, and safety.
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Wolkow, Alexander, Rachael Harris, Elle Nguyen, Ben Meadley, Shantha M. W. Rajaratnam, Brett Williams, Karen Smith, Kelly-Ann Bowles, Megan L. Dobbie, and Sean P. A. Drummond. "0346 Insomnia in the Initial Months of Emergency Work Is Associated with Future PTSD Symptoms in New Recruit Paramedics." SLEEP 47, Supplement_1 (April 20, 2024): A148—A149. http://dx.doi.org/10.1093/sleep/zsae067.0346.
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Abstract Introduction New paramedics commencing emergency work and adjusting to shift work can experience an increase in sleep problems. Sleep disturbances have been closely associated with poor mental health in emergency personnel. It is unknown, however, whether poor sleep experienced in the initial months of emergency work represents an early risk factor for future mental health problems in paramedics. The present study examined whether sleep disturbances in paramedics after 6-months of shift and emergency work were associated with mental health symptoms later in their career. Methods Sleep disorder and mental health symptoms were examined in new recruit paramedics (n=105) after their first 6- and 12-months of shift and emergency work. At each timepoint, participants completed validated self-report measures of insomnia (Insomnia Severity Index), shift work disorder (SWD; SWD Screening Questionnaire), obstructive sleep apnoea (OSA; Berlin Questionnaire), depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), post-traumatic stress disorder (PTSD; PTSD Checklist-5) and trauma exposure (Life Events Checklist-5). Linear regressions examined whether sleep at 6-months (i.e., insomnia, SWD, and OSA) predicted mental health symptoms (i.e., depression, anxiety, and PTSD) at the 12-month follow-up, while controlling for demographics (i.e., age and sex) and mental health symptoms at the 6-month timepoint. Additionally, the regression models examining sleep and PTSD also controlled for trauma exposure at 6-months via the Life Events Checklist-5. Results Increased insomnia symptoms at 6-months of emergency work and shift work significantly predicted higher PTSD symptoms at the 12-month timepoint (b=0.09 [0.03,0.15], p=0.01) while controlling for trauma exposure, PTSD symptoms and demographics at 6-months. Insomnia at 6-months was not, however, related to depression (p=0.36) or anxiety (p=0.42) at follow-up, and OSA and SWD risk at 6-months were not related to any of the mental health outcomes at follow-up (all p>0.05). Conclusion Our findings highlight insomnia symptoms in the initial months of emergency work as an early risk factor for the development of PTSD later in new paramedics’ careers. Given sleep is a largely modifiable factor, this finding highlights the need to investigate interventions that target insomnia early in paramedics’ careers to reduce the risk of future mental health problems in this high-risk occupation. Support (if any)
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Vig, K. D., J. E. Mason, R. N. Carleton, G. J. G. Asmundson, G. S. Anderson, and D. Groll. "Mental health and social support among public safety personnel." Occupational Medicine 70, no. 6 (July 24, 2020): 427–33. http://dx.doi.org/10.1093/occmed/kqaa129.
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Abstract Background Social support may be a protective factor for the mental health of public safety personnel (PSP), who are frequently exposed to potentially psychologically traumatic events and report substantial post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) symptoms. Research examining perceived social support and its association with PTSD and MDD in different PSP categories (e.g. firefighters, paramedics) is limited. Aims To examine differences in perceived social support across PSP and determine whether perceived social support is associated with differences in rates of MDD and PTSD. Methods We asked Canadian PSP, including correctional workers and officers, public safety communications officials, firefighters, paramedics, municipal and provincial police officers, and Royal Canadian Mounted Police (RCMP) officers, to complete an online anonymous survey that assessed socio-demographic information (e.g. occupation, sex, marital status, service years), social supports and symptoms of mental disorders, including PTSD and MDD. Analyses included ANOVA and logistic regression models. Results Perceived social support differed by PSP occupation. RCMP officers reported lower social support than all other PSP except paramedics. For most PSP categories, PSP who reported greater social support were less likely to screen positive for PTSD (adjusted odds ratios [AORs]: 0.90–0.93). Across all PSP categories, greater perceived social support was associated with a decreased likelihood of screening positive for MDD (AORs: 0.85–0.91). Conclusions Perceived social support differs across some PSP categories and predicts PTSD and MDD diagnostic status. Studies involving diagnostic clinical interviews, longitudinal designs and social support interventions are needed to replicate and extend our results.
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Mzahim, Bandr, Fatimah Albrekkan, Ronald Schouten, Ahmad Al-Muhainy, Khaled Al-Surimi, and Nuha Sulaiman Alhumaid. "The Risk of Post-Traumatic Stress Disorder (PTSD) among Frontline Healthcare Workers in Saudi Arabia during the COVID-19 Pandemic: A Cross-sectional Study." Journal of Medicine, Law & Public Health 2, no. 2 (May 1, 2022): 113–22. http://dx.doi.org/10.52609/jmlph.v2i2.50.
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Background: Frontline healthcare workers (HCWs) are at risk of developing post-traumatic stress disorder (PTSD) due to the nature of their work and, due to the additional stress and mental fatigue brought on by the COVID-19 pandemic, this risk has increased significantly. A proper understanding of the risk factors for PTSD in this context is crucial to the development of both preventive and corrective measures that will improve the psychological and emotional health of HCWs and reduce their predisposition to PTSD in the short and long term. This study was conducted to determine the prevalence and associated risk factors of PTSD among frontline HCWs in Riyadh, Saudi Arabia, during the COVID-19 pandemic. Methods: This cross-sectional survey study examined responses from emergency medical services personnel (paramedics, nurses, and physicians) in eleven large public hospitals in Riyadh, Saudi Arabia, between June 01 and July 01, 2020. The total number of respondents was 613. The PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders (PCL-5), a self-administered tool, was used to diagnose PTSD. Additionally, demographic factors, such as age, gender, race, marital status, occupation, and years of experience, were identified, and the effects of these factors were assessed using statistical analysis. Results: The results revealed a prevalence of PTSD of 33.4% among participants. The highest prevalence was found among paramedics and nurses, while physicians had the lowest prevalence. The study also found statistically significant differences in PTSD scores based on marital status, job title, and years of experience. Half of the participants were aware of the availability of psychological/emotional support and perceived the process for obtaining that support to be clear and accessible. Conclusion: Frontline healthcare workers are at increased risk of developing PTSD, with the degree of risk significantly associated with marital status, job title, years of experience, and the accessibility of psychological/emotional support. Healthcare organisations within Saudi Arabia and elsewhere should use this information to strengthen their psychological and emotional support systems and reduce the risk of PTSD in their employees.
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Alaqeel, Meshal K., Nawfal A. Aljerian, Muhannad A. AlNahdi, and Raiyan Y. Almaini. "Post-Traumatic Stress Disorder among Emergency Medical Services Personnel: A Cross-sectional Study." Asian Journal of Medical Sciences 10, no. 4 (June 20, 2019): 28–31. http://dx.doi.org/10.3126/ajms.v10i4.23990.
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Background: Post-Traumatic Stress Disorder is characterized by directly experiencing traumatic events or witnessing, learning, or repetitively experiencing the details of these events. High risk occupations (i.e., EMS personnel) frequently encounter traumatic eventscoping with events exceeding the range of human experiences. Regional lack of studies necessitated the need to report the prevalence of PTSD among healthcare providers in Saudi Arabia (SA).
Aims and Objective: To explore the prevalence of PTSD among EMS personnel.
Materials and Methods: This a descriptive cross-sectional study at King Abdul Aziz Medical City (KAMC), Riyadh, SA among 110 paramedics, emergency medical technicians (EMT), and ambulance drivers who were conveniently selected for this screening. Post-Traumatic Stress Disorder Checklist, the Civilian version, (PCL-C) was used to screen the participants, and cut-off point was 30-35. PTSD symptoms (present & absent) was considered as outcome measure.
Results: Total of 110 participants were contacted, 74 (67%) agreed to participate. Around half of the participants were EMT (52%). Total number of screened individuals is 52, 14 (26.9%) had positive screening, of those, EMT had higher proportion than paramedics (32% vs 20.8%).
Conclusion: This report is the first PTSD prevalence among healthcare providers in SA. The results showed that 26% of EMS personnel had positive screening for PTSD. Attention should be directed toward this issue by regular psychological evaluation and implementing psychological rehabilitation programs for EMS personnel. The study reflects only one center in the city, thus generalization would not be inappropriate.
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Van Eerd, Dwayne, Emile Tompa, Emma Irvin, Doug Gross, Sebastian Straube, Suzette Bremault-Phillips, Joann Varickanickal, and Sharmigaa Ragunathan. "P-600 WORKPLACE POLICIES AND PRACTICES FOR THE PREVENTION OF PTSI WORK DISABILITY." Occupational Medicine 74, Supplement_1 (July 1, 2024): 0. http://dx.doi.org/10.1093/occmed/kqae023.1423.
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Abstract Introduction First responders (FR) such as police, paramedics, and firefighters are routinely exposed to traumatic situations and may suffer from post-traumatic stress injuries (PTSI) as a result. The scientific evidence on optimal treatment and workplace practices for PTSI is not strong. The objective of this project was to examine first responder workplace policies and practices for the prevention of PTSI work disability. Methods The research team worked with a stakeholder advisory committee (police, paramedics, firefighters) to conduct an interview study with FR (workers and manager roles) from Alberta, Canada. A thematic analysis was used for the qualitative interview data. Results We gathered data via interviews with 47 FR members from police (16), fire (16), and paramedic (15) services who shared their experience with PTSI and workplace programs. The data reveal three key themes related to workplace PTSI programs and policies: Improving Culture, Programs under development, and Trusted communication. Three additional themes emerged related to recommendations to improve policies and programs in the workplace: stream-lined processes, better resources, and continuing to reduce stigma. The themes and recommendations from participants provide some practical information about how programs can be improved. Discussion and conclusions The interview data yielded rich descriptions of current workplace PTSI practices. While participants noted that awareness about PTSI and the culture of first responder workplaces there was still room for improvement. Recommendations regarding improved processes and resources were considered paramount. Future research should examine FR workplace program development as well as implementation.
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Ben-Ezra, Menachem, Yuval Palgi, Amit Shrira, Dina Sternberg, and Nir Essar. "Changes in Post-Traumatic Symptom Pattern during and after Exposure to Extreme War Stress: An Uncontrolled, Preliminary Study Supporting the Dose-Response Model." Prehospital and Disaster Medicine 25, no. 1 (February 2010): 38–41. http://dx.doi.org/10.1017/s1049023x00007640.
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AbstractIntroduction:Exposure to prolonged war stress is understudied. While there is debate regarding the empirical data of the dose-response model for post-traumatic stress disorder (PTSD), little is known about how weekly changes in external stress influences the level of PTSD symptoms. The purpose of this study was to measure the relation between objective external stress and PTSD symptoms across time, and thus, gain a deeper understating of the dose-response model.Hypothesis:The study hypothesis postulates that the more severe the external stressor, the more severe the exhibition of traumatic symptoms.Methods:Thirteen special army administrative staff (SAAS) members from the Rambam Medical Center in Haifa attended seven intervention meetings during the war. These personnel answered a battery of questionnaires regarding demographics and PTSD symptoms during each session. A non-parametric test was used in order to measure the changes in PTSD symptoms between sessions. Pearson correlations were used in order to study the relationship between the magnitude of external stressors and the severity of PTSD symptoms.Results:The results suggested that there was a significant relationship between the magnitude of external stressors and the severity of PTSD symptoms. These results are in line with the dose-response model.Conclusions:The results suggest that a pattern of decline in PTSD symptoms confirm the dose-response model for PTSD.
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Goniewicz, Mariusz, Anna Włoszczak-Szubzda, Ahmed M. Al-Wathinani, and Krzysztof Goniewicz. "The Silent Burden: Investigating Post-Traumatic Stress Disorder and Social Isolation Among Healthcare Workers During COVID-19." Healthcare 12, no. 23 (November 25, 2024): 2360. http://dx.doi.org/10.3390/healthcare12232360.
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Background: The COVID-19 pandemic has significantly impacted the mental health of healthcare professionals, particularly nurses and paramedics. This study investigates the prevalence of Post-Traumatic Stress Disorder (PTSD) and the impact of social ostracism on psychological distress among healthcare workers (HCWs) in Poland, with a focus on exploring the interplay between professional and social factors contributing to their stress. Methods: A cross-sectional survey was conducted between March 2021 and February 2022 with 852 HCWs from four Polish provinces. PTSD symptoms were measured using the PTSD Checklist—Civilian Version (PCL-C), and social ostracism was assessed through a custom-designed questionnaire. Results: Of the participants, 14.1% reported experiencing social ostracism, and 4.9% observed such experiences among colleagues. Those who experienced or witnessed ostracism reported significantly higher PTSD symptoms (p < 0.001). Concerns about personal health and the well-being of older individuals were strongly associated with increased PTSD severity, while concerns for household members were not. Conclusions: Social ostracism exacerbates the psychological burden on healthcare workers, contributing to higher levels of PTSD. This study highlights the need for targeted mental health interventions and support systems, including resilience training and stigma reduction initiatives, to address these challenges. Future research should explore cross-national comparisons and long-term psychological effects among diverse healthcare populations.
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Amamou, B., I. Betbout, A. Ben Haouala, M. Ben Mbarek, I. Merchaoui, R. Jebali, F. Zaafrane, and L. Gaha. "Prevalence and associated factors to Post-Traumatic Stress Disorder (PTSD) and Social Anxiety Disorder (SAD) among health workers in the emergency room." European Psychiatry 66, S1 (March 2023): S681. http://dx.doi.org/10.1192/j.eurpsy.2023.1425.
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Introductionpost-traumatic stress disorder (PTSD) is a mental health illness that can develop after being exposed to one or more traumatic events. This is a serious, long-term emotional response to extreme psychological trauma. As for public health emergencies, it demands large-scale coordination among many staff, and participants, especially medical workers, are exposed to high levels of stress, which can easily lead to psychiatric illnesses such as social anxiety disorder (SAD). Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, yet little is known regarding the nature of this relationship.ObjectivesThe aim of this study is to investigate the prevalence of PTSD and SAD among health workers in the emergency ward and study the relationship between PTSD and SAD and the associated factors to both disorders among health workers in the emergency ward to suggest some solutions to reduce their effects.MethodsThis is a quantitative descriptive cross-sectional study conducted among medical and paramedical health professionals in the emergency rooms of the university hospital of Sahloul and Hached and the regional hospital of Msaken in Tunisia. The data was collected by a questionnaire that included demographic questions and Yes/No questions, as well as several scales to assess the degree of social nxiety (Liebowitz Social Anxiety Scale) and posttraumatic stress disorder (Post-traumatic stress disorder checklist for DSM-5 (PCL-5)).ResultsIn our study, 81 healthcare workers completed the survey. Of the total responding participants 67.9% were females. We noticed that the example was young (58%), also 59.3% had <1 year of experience. The population was slightly predominated by paramedical staff (56.8%), it also had a low married percentage of 38.3. Among the participants 17.3% smoke tobacco, 12.3% drink alcohol, and 3.7% are under cannabis use. We found that 7.4% of the participants had a psychiatric illness. In our study, 38% scored positive for PTSD and for SAD 13.58% had marked social anxiety, 12.35% had severe social anxiety and 3.7% had very severe social anxiety, this is associated rather with the female gender, the younger (age range 20-30 years) and the paramedical staff.PTSD and SAD are more pronounced among those with the fewest years of experience.We obtained a positive Pearson Correlation between PTSD and SAD (r=0.513).ConclusionsPosttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity, especially in the healthcare field. Overall, researchers reveal that the link between PTSD and SAD is complicated, owing to a variety of factors such as a person’s genes, trauma history, and psychological vulnerabilities so large-scale epidemiological investigations are required.Disclosure of InterestNone Declared
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Sui, Shuang Ge, Ming Xiang Wu, Mark E. King, Yan Zhang, Li Ling, Jian Min Xu, Xu Chu Weng, Lian Duan, Bao Ci Shan, and Ling Jiang Li. "Abnormal grey matter in victims of rape with PTSD in Mainland China: a voxel-based morphometry study." Acta Neuropsychiatrica 22, no. 3 (June 2010): 118–26. http://dx.doi.org/10.1111/j.1601-5215.2010.00459.x.
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Sui SG, Wu MX, King ME, Zhang Y, Ling L, Xu JM, Weng XC, Duan L, Shan BC, Li LJ. Abnormal grey matter in victims of rape with PTSD in Mainland China: a voxel-based morphometry study.Objective:This study examined changes in brain grey matter in victims of rape (VoR) with and without post-traumatic stress disorder (PTSD). Previous research has focused on PTSD caused by various traumatic events, such as war and disaster, among others. Although considerable research has focused on rape-related PTSD, limited studies have been carried out in the context of Mainland China.Methods:The study included 11 VoR with PTSD, 8 VoR without PTSD and 12 healthy comparison (HC) subjects. We used voxel-based morphometry to explore changes in brain grey-matter density (GMD) by applying statistical parametric mapping to high-resolution magnetic resonance images.Results:Compared with HC, VoR with PTSD showed significant GMD reductions in the bilateral medial frontal cortex, left middle frontal cortex, middle temporal gyrus and fusiform cortex and significant GMD increases in the right posterior cingulate cortex, postcentral cortex, bilateral precentral cortex and inferior parietal lobule. Compared to VoR without PTSD, VoR with PTSD showed significant GMD reductions in the right uncus, left middle temporal gyrus, and the fusiform cortex, and increases in the left precentral cortex, inferior parietal lobule and right post-central cortex.Conclusion:The findings of abnormal GMD in VoR with PTSD support the hypothesis that PTSD is associated with widespread anatomical changes in the brain. The medial frontal cortex, precentral cortex, posterior cingulate cortex, post-central cortex and inferior parietal lobule may play important roles in the neuropathology of PTSD.
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Feemster, J., T. Steele, Y. Tao, S. Rivera, T. Gossard, L. Teigen, P. Timm, S. McCarter, and E. St. Louis. "0817 Abnormal REM Sleep Atonia Control In Patients With Chronic Post-traumatic Stress Disorder." Sleep 43, Supplement_1 (April 2020): A310—A312. http://dx.doi.org/10.1093/sleep/zsaa056.813.
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Abstract Introduction Post-traumatic stress disorder (PTSD) is characterized by persistent mental and emotional stress following one or more significant physical or psychological traumatic incidents earlier in life. Vivid recall of the events, including traumatic nightmares, and prominent sleep disturbance are usual in PTSD. Previous studies have suggested that PTSD may share some clinical features with idiopathic REM sleep behavior disorder (iRBD) including altered REM sleep without atonia (RSWA) levels. Our group has previously found evidence for altered RSWA control in patients with psychiatric disease, including a pilot sample of PTSD patients with iRBD. We aimed to comparatively analyze RSWA levels between patients with PTSD, PTSD and RBD (PTSD+RBD), iRBD, and controls. Methods We selected 18 PTSD, 18 PTSD+RBD, 15 iRBD, and 51 healthy control patients matched for age and sex from the Mayo Clinic Center for Sleep Medicine’s polysomnography database for RSWA quantification. RSWA amounts in the submentalis (SM) and anterior tibialis (AT) were quantitatively analyzed as a percentage of REM sleep duration, in accordance with previously published methods. Non-parametric analyses were performed to compare RSWA, patient demographics, and PSG data across groups. Significance was set at p < 0.016. Results Patients with PTSD had significantly higher RSWA than controls in all RSWA density measures (p < 0.016 for all). All measures of RSWA, excluding average SM duration, were significantly greater in PTSD+RBD patients compared with controls (p < 0.016 for all). Within the PTSD group, patients on antidepressants did not have significantly higher RSWA in any of the measures. PTSD+RBD patients had significantly higher SM Phasic, AT Any, SM+AT Any, and Tonic RSWA measures than PTSD patients (p < 0.016 for all). Conclusion PTSD patients have significantly higher RSWA than controls, with PTSD+RBD patients having higher RSWA levels than PTSD patients. These data provide the first evidence for abnormal RSWA control in patients with chronic PTSD. This provides evidence of a unique biology in PTSD that could imply a future risk for neurodegenerative disease in PTSD similar to RBD patients. Further prospective studying will need to be performed on patients with PTSD to understand the unique biology. Support
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Kucmin, Tomasz, Adriana Kucmin, Dorota Turska, Andrzej Turski, and Adam Nogalski. "Coping styles and dispositional optimism as predictors of PTSD symptoms intensity in paramedics." Psychiatria Polska 52, no. 3 (June 30, 2018): 557–71. http://dx.doi.org/10.12740/pp/68514.
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Alshahrani, Khalid M., Judith Johnson, Arianna Prudenzi, and Daryl B. O’Connor. "The effectiveness of psychological interventions for reducing PTSD and psychological distress in first responders: A systematic review and meta-analysis." PLOS ONE 17, no. 8 (August 24, 2022): e0272732. http://dx.doi.org/10.1371/journal.pone.0272732.
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Background First responders are faced with stressful and traumatic events in their work that may affect their psychological health. The current review examined the effectiveness of psychological interventions to treat posttraumatic stress disorder (PTSD), anxiety, depression, stress and burnout in first responders. Methods Four databases were searched to identify controlled studies that examined the efficacy of psychological interventions to reduce PTSD symptoms (primary outcome) in first responders (including firefighters, police/law enforcement officers, search and rescue personnel, emergency and paramedics teams). Secondary outcomes were anxiety, depression, burnout, and stress. Results 15 studies were identified, including 10 studies that measured PTSD, 7 studies for anxiety, 10 studies for depression, 7 studies for stress and 1 for burnout. Interventions were associated with a significant reduction in PTSD (SDM = -0.86; 95% CI = -1.34 –- 0.39), depression (SDM = -0.63; 95% CI = -0.94 –-0.32), and anxiety (SDM = -0.38; 95% CI = -0.71 –-0.05) but not stress (SDM = -0.13; 95% CI = -0.51–0.25). CBT-based and clinician-delivered interventions were associated with significantly greater reductions in PTSD than other types of interventions and non-clinician interventions, but no differences were found for depression. There was evidence of moderate to high risk of bias across all studies. Conclusions Psychological interventions are effective in reducing PTSD, depression and anxiety symptoms but not stress in first responders. Further research is needed using high quality randomised designs over longer periods of follow-up.
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Halpern, Janice, Robert G. Maunder, Brian Schwartz, and Maria Gurevich. "Downtime after Critical Incidents in Emergency Medical Technicians/Paramedics." BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/483140.
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Effective workplace-based interventions after critical incidents (CIs) are needed for emergency medical technicians (EMT)/paramedics. The evidence for a period out of service post-CI (downtime) is sparse; however it may prevent posttraumatic stress disorder (PTSD) and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores). Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between<30 minutes and end of shift, with>1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.
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Pagani, M., D. Nardo, F. Flumeri, D. Salmaso, J. Looi, A. Sanchez-Crespo, S. A. Larsson, Ö. Sundin, G. Högberg, and S. Bejerot. "Volumetric Changes in PTSD and in a Subgroup of PTSD Patients not Responding to EMDR Psychotherapy." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70588-7.
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Background:Several studies have reported limbic structures volume decrease in Post-Traumatic Stress Disorder (PTSD). However, in PTSD the effect of therapy on brain structures has seldom been investigated. The aim of the study was to evaluate the grey matter (GM) loss in occupational related PTSD and to assess the volumetric differences between patients responding (R) and non-responding (NR) to psychotherapy.Methods:Pre-EMDR MRI data of 21 train drives who did develop PTSD (S) and 22 who did not develop PTSD (NS) after person-under-the-train accidents were compared. Within S further comparisons were made between 10 R to Eye Movement Desensitisation Reprocessing (EMDR) therapy and 5 NR. Data were analysed by optimised voxel-based morphometry as implemented in Statistical Parametric Mapping.Results:As compared to NS, S showed a significant GM volume reduction in precuneus, lingual gyrus, posterior cingulate and parahippocampal cortex. The R>NR comparison highlighted a significant GM reduction in NR in bilateral posterior cingulate, left middle frontal cortex and right parahippocampal, insular and temporal cortices.Conclusions:Comparing two large groups of subjects significant GM volumetric reductions were found in PTSD in posterior limbic structures. NR showed, as compared to R, volume reduction in cortical structures including posterior cingulate and parahippocampal cortex. These latter two structures seem to be the hallmark for both PTSD diagnosis and therapy outcome prediction.
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Pagani, M., D. Nardo, F. Flumeri, D. Salmaso, J. Looi, A. Sanchez-Crespo, S. A. Larsson, Ö. Sundin, G. Högberg, and S. Bejerot. "Volumetric Changes in PTSD and in a Subgroup of PTSD Patients not Responding to EMDR Psychotherapy." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71290-8.
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Background:Several studies have reported limbic structures volume decrease in Post-Traumatic Stress Disorder (PTSD). However, in PTSD the effect of therapy on brain structures has seldom been investigated. the aim of the study was to evaluate the grey matter (GM) loss in occupational related PTSD and to assess the volumetric differences between patients responding (R) and non-responding (NR) to psychotherapy.Methods:Pre-EMDR MRI data of 21 train drives who did develop PTSD (S) and 22 who did not develop PTSD (NS) after person-under-the-train accidents were compared. Within S further comparisons were made between 10 R to Eye Movement Desensitisation Reprocessing (EMDR) therapy and 5 NR. Data were analysed by optimised voxel-based morphometry as implemented in Statistical Parametric Mapping.Results:As compared to NS, S showed a significant GM volume reduction in precuneus, lingual gyrus, posterior cingulate and parahippocampal cortex. the R>NR comparison highlighted a significant GM reduction in NR in bilateral posterior cingulate, left middle frontal cortex and right parahippocampal, insular and temporal cortices.Conclusions:Comparing two large groups of subjects significant GM volumetric reductions were found in PTSD in posterior limbic structures. NR showed, as compared to R, volume reduction in cortical structures including posterior cingulate and parahippocampal cortex. These latter two structures seem to be the hallmark for both PTSD diagnosis and therapy outcome prediction.
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Hsiao, Yin Ying, Wei Hung Chang, I. Chun Ma, Chen-Long Wu, Po See Chen, Yen Kuang Yang, and Chih-Hao Lin. "Long-Term PTSD Risks in Emergency Medical Technicians Who Responded to the 2016 Taiwan Earthquake: A Six-Month Observational Follow-Up Study." International Journal of Environmental Research and Public Health 16, no. 24 (December 7, 2019): 4983. http://dx.doi.org/10.3390/ijerph16244983.
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Although several factors associated with posttraumatic stress disorder (PTSD) in disaster rescue workers were identified in previous studies, the results were inconsistent. This study aimed to explore the prognostic factors of PTSD among disaster rescuers using different screening tools. A 6.4 magnitude earthquake struck southern Taiwan on February 6, 2016. Emergency medical technicians (EMTs) who responded to the earthquake were recruited. The initial survey was conducted one month after the earthquake using a standardized, self-reported, paper-based questionnaire. After six months, we re-evaluated the EMTs using the same questionnaire that was used in the baseline survey. A total of 38 EMT-paramedics were enrolled in the final analysis. Significant differences in PTSD scores at baseline existed between EMTs with and without certain risk factors. The interaction between survey time and risk factors was not significant, but several risk factors correlated with a nonsignificant improvement in the PTSD score after the 6-month follow-up. Perfectionism personality characteristics and several specific field experiences (managing injured patients, managing dead victims, managing dead victims who were pregnant, managing emotionally distraught families, or guilty feelings during the missions) might affect different subdomains of PTSD symptom improvement. Disaster rescuers should be followed up after their missions, regardless of their age, gender, or previous experience with disaster response. EMTs with certain personality characteristics or who are involved in specific field operations should be carefully monitored during and after disaster rescue missions.
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Rusmana, Nandang, Anne Hafina, Yadi Ruyadi, Lutfi Nur, and Muchamad Riduwan. "Symptoms of Posttraumatic Stress Disorder in Middle School Students After the Covid-19 Outbreak." Jurnal Kajian Bimbingan dan Konseling 8, no. 2 (March 23, 2023): 137–46. http://dx.doi.org/10.17977/um001v8i22023p137-146.
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Abstract: COVID-19 bears various traumatic impacts on students. This study aims to identify PTSD symptoms in junior and senior high school students after the COVID-19 outbreak. The study was conducted using a cross-sectional survey method. Meanwhile, the data was collected using a problem checklist instrument. Further, the obtained data were analyzed using non-parametric statistics with the Mann-Whitney test to identify differences in PTSD symptoms based on gender and level of education. The results of the analysis show that symptoms appear in every physical, emotional, mental, behavioral, and spiritual aspect. Besides, we also found a significant difference in the level of anxiety disorder between male and female students after COVID-19, while there is no significantly distinct anxiety disorder between junior and senior high school students. In the end, we recommended that more in-depth research regarding the forms of intervention to reduce PTSD in students should be carried out. Abstrak: COVID-19 telah memberikan berbagai dampak traumatik bagi siswa. Penelitian ini bertujuan untuk mengidentifikasi gejala PTSD pada siswa jenjang SMP dan SMA setelah pandemi COVID-19. Penelitian dilakukan menggunakan metode survey cross-sectional dengan teknik random sampling untuk pengumpulan data. Pengumpulan data dilakukan dengan menggunakan instrumen daftar cek masalah. Analisis data dilakukan menggunakan statistik non-parametrik dengan uji Mann Whitney untuk melihat perbedaan gejala PTSD berdasarkan jenis kelamin dan jenjang pendidikan. Berdasarkan hasil analisis menunjukkan bahwa gejala muncul pada setiap aspek fisik, emosi, mental, perilaku, dan spiritual. Selain itu, terdapat perbedaan yang signifikan tingkat gejala PTSD pasca COVID-19 antara siswa laki-laki dan perempuan dan tidak terdapat perbedaan yang signifikan antara jenjang pendidikan SMP dan SMA. Peneliti memberikan rekomendasi untuk melakukan penelitian lebih mendalam terkait bentuk intervensi yang dapat dilakukan untuk mereduksi PTSD pada siswa di sekolah
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Peterson, B., A. Castelnovo, B. Riedner, R. Herringa, and S. Jones. "1003 Sleep Spindle Abnormalities In Youth With Ptsd." Sleep 43, Supplement_1 (April 2020): A381. http://dx.doi.org/10.1093/sleep/zsaa056.999.
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Abstract Introduction Sleep disturbance is central to the phenomenology of PTSD across the lifespan with up to 90% of youth with PTSD reporting sleep disturbance. Subjective sleep dysfunction has also been linked to the development, maintenance and severity of the disorder. However, to date there have been no objective EEG assessments of sleep in youth with PTSD, and little is known about how the disease impacts specific sleep features. Methods Ten youth with PTSD (aged 14.5±3.2; CAPS-CA score 60.5±25.3) and ten age-and sex-matched typically developing youth (TD) (aged 14.7±3.2) completed two non-consecutive overnight high-density EEG (256-channel) polysomnography sleep studies. Prior to sleep on one night, participants performed an emotion processing task. Group differences in sleep macrostructure variables were assessed with two-way ANOVA, and group differences in all-night spectral density were assessed using unpaired t-tests. An automatic algorithm was used to detect spindle amplitude, duration, and density topographically. Statistical non-parametric mapping (SnPM) cluster testing was used to determine significantly different topographic differences between groups. Results No significant group differences were observed in sleep macrostructure variables. All-night spectral density analysis revealed increased power in PTSD youth relative to TD youth in the sigma band on both task and baseline nights. PTSD youth showed higher spindle duration, higher integrated spindle activity, and higher spindle amplitude globally both nights relative to TD youth. The increase in spindle duration achieved significance in a robust frontal cluster on both nights (43-channel cluster (p = .044) on baseline night, 66-channel cluster (p = .019) on task night). Conclusion Structural and functional abnormalities of the prefrontal cortex are a prominent feature of pediatric PTSD. The observed increase in spindle duration may represent another marker of impaired cortical function in youth with PTSD reflecting a failure of cortical inhibition of the thalamically-generated spindle rhythm. Support K08 MH100267 to RH, Wisconsin Institute for Sleep and Consciousness Pilot Award to SJ
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Wild, Jennifer, Shama El-Salahi, Gabriella Tyson, Hjördis Lorenz, Carmine M. Pariante, Andrea Danese, Apostolos Tsiachristas, et al. "Preventing PTSD, depression and associated health problems in student paramedics: protocol for PREVENT-PTSD, a randomised controlled trial of supported online cognitive training for resilience versus alternative online training and standard practice." BMJ Open 8, no. 12 (December 2018): bmjopen—2018–022292. http://dx.doi.org/10.1136/bmjopen-2018-022292.
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IntroductionEmergency workers dedicate their lives to promoting public health and safety, yet suffer higher rates of post-traumatic stress disorder (PTSD) and major depression (MD) compared with the general population. They also suffer an associated increased risk for physical health problems, which may be linked to specific immunological and endocrine markers or changes in relevant markers. Poor physical and mental health is costly to organisations, the National Health Service and society. Existing interventions aimed at reducing risk of mental ill health in this population are not very successful. More effective preventative interventions are urgently needed. We first conducted a large-scale prospective study of newly recruited student paramedics, identifying two cognitive factors (rumination and resilience appraisals) that predicted episodes of PTSD and MD over a 2-year period. We then developed internet-delivered cognitive training for resilience (iCT-R), a supported online intervention, to modify cognitive predictors. This protocol is for a randomised controlled trial to evaluate the efficacy of the resilience intervention.Methods and analysis570 student paramedics will be recruited from participating universities. They will be randomly allocated to iCT-R or to supported online training of an alternative, widely available intervention or to training-as-usual. Follow-up will occur after the intervention/standard practice period and at 6, 12 and 24 months. Primary outcomes include rates of PTSD and MD and subsydnromal PTSD and MD, measured by the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, the Patient-Health Questionnaire-9 and the Post-traumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Secondary outcomes include measures of resilience, rumination, anxiety, psychological distress, well-being, salivary cortisol, plasma levels of C-reactive protein, smoking and alcohol use, weight gain, sleep problems, health-related quality of life, health resource utilisation and productivity.Ethics and disseminationThe Medical Sciences Inter-Divisional Research Ethics Committee at the University of Oxford granted approval, reference: R44116/RE001. The results will be published in a peer-reviewed journal. Access to raw data and participant information will be available only to members of the research team.Trial registration numberISRCTN16493616; Pre-results.
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Strelchuk, Daniela, Gemma Hammerton, Jazz Croft, Jon Heron, Stanley Zammit, Nicola Wiles, and Katrina Turner. "T112. PTSD AS A MEDIATOR OF THE RELATIONSHIP BETWEEN TRAUMA AND PSYCHOTIC EXPERIENCES." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S273. http://dx.doi.org/10.1093/schbul/sbaa029.672.
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Abstract Background Trauma exposure is linked to the development of psychotic illnesses, but little is known about potentially modifiable mechanisms underlying this relationship. Despite the high prevalence of PTSD symptoms in psychotic illnesses, only a few studies have examined the role of PTSD as a mediator, and these were all cross-sectional. This study aims to examine whether PTSD symptoms mediate the relationship between trauma and psychotic experiences (PE), using data from a large birth cohort study. Methods We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to test whether: a) PTSD symptoms (at age 15) mediate the relationship between childhood trauma (age 0–14 years) and adolescent frequent or distressing psychotic experiences (age 12–18 years) (study of adolescent PE; n = 2,952), and b) PTSD symptoms (reported at age 24 for traumatic event occurring before age 19) mediate the relationship between childhood/adolescent trauma (age 0–17 years) and incident frequent or distressing psychotic experiences in early adulthood (age 19–24 years) (study of adult PE; n = 2,492). Associations between the variables of interest were examined with logistic regression, and mediation with the parametric g-computation formula. As sensitivity analyses, we i) examined broader and narrower psychotic outcomes, ii) included a measure of psychotic-like experiences at age 14 years as an intermediate confounder in the mediation model for adolescent psychotic experiences, and iii) repeated analyses using imputed data. Results Exposure to trauma was associated with increased odds of psychotic experiences and PTSD symptoms both in adolescence and early adulthood (p<0.001). The association between PTSD and psychotic experiences was stronger in adolescence (p<0.001) than in adulthood (p=0.03). There was moderate evidence that PTSD symptoms mediated the relationship between childhood trauma and adolescent psychotic experiences (proportion mediated 14%), though evidence of mediation was much weaker for adult PE (proportion mediated 8%). In sensitivity analyses we observed similar results when using imputed data, and when modelling psychotic experiences at age 14 as an intermediate confounding for the adolescent PE outcome. The proportion mediated increased when examining more narrowly defined outcomes (19% for adolescent psychotic disorder). Discussion These findings provide some evidence consistent with the thesis that psychotic experiences and disorder can occur consequent to PTSD symptoms after trauma exposure. Targeting PTSD symptoms might help prevent the occurrence of psychotic experiences and disorder in people with a trauma history.
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Michael, Tanja, Markus Streb, and Pascal Häller. "PTSD in Paramedics: Direct Versus Indirect Threats, Posttraumatic Cognitions, and Dealing With Intrusions." International Journal of Cognitive Therapy 9, no. 1 (March 2016): 57–72. http://dx.doi.org/10.1521/ijct.2016.9.1.57.
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Nardo, D., G. Högberg, F. Flumeri, H. Jacobsson, S. A. Larsson, T. Hällström, and M. Pagani. "Self-rating scales assessing subjective well-being and distress correlate with rCBF in PTSD-sensitive regions." Psychological Medicine 41, no. 12 (June 15, 2011): 2549–61. http://dx.doi.org/10.1017/s0033291711000912.
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BackgroundThe aim of this study was to investigate the distribution of the regional cerebral blood flow (rCBF) in occupational-related post-traumatic stress disorder (PTSD) subjects and to seek possible correlations between brain perfusion and self-rating scales (SRS) in order to cross-check their diagnostic value and to look for their neural correlates.MethodA total of 13 traumatized underground and long-distance train drivers developing (S) and 17 not developing (NS) PTSD who had experienced a ‘person under train’ accident or who had been assaulted at work underwent clinical assessment and 99mTc-HMPAO SPECT imaging during autobiographical trauma scripts. Statistical parametric mapping was applied to analyse rCBF changes in S as compared with NS and to search for correlations between rCBF and the administered SRS scores, modelling age, months to SPECT and the ratio ‘grey matter/intra-cranial volume’ as nuisance variables.ResultsSignificantly higher activity was observed during trauma script in left posterior and anterior insula, posterior cingulate, inferior parietal lobule, precuneus, caudate and putamen in PTSD subjects as compared with the trauma-exposed control group. Impact of Event Scale and World Health Organisation (10) Well-Being Index scores highly correlated with tracer uptake to a great extent in the same regions in which rCBF differences between S and NS were found.ConclusionsThese findings support the involvement of insular, cingulate and parietal cortices (as well as the basal ganglia) in the pathogenesis of PTSD and in the processing of related subjective well-being and distress.
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Xue, Qichao, Jingcai Zhang, Jian He, and Chunwei Zhang. "Control Performance and Robustness of Pounding Tuned Mass Damper for Vibration Reduction in SDOF Structure." Shock and Vibration 2016 (2016): 1–15. http://dx.doi.org/10.1155/2016/8021690.
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This paper investigates the control performance of pounding tuned mass damper (PTMD) in reducing the dynamic responses of SDOF (Single Degree of Freedom) structure. Taking an offshore jacket-type platform as an example, the optimal damping ratio and the gap between mass block and viscoelastic material are presented depending on a parametric study. Control efficiency influenced by material properties and contact geometries for PTMD is analyzed here, as well as robustness of the device. The results of numerical simulations indicated that satisfactory vibration mitigation and robustness can be achieved by an optimally designed PTMD. Comparisons between PTMD and traditional TMD demonstrate the advantages of PTMD, not only in vibration suppression and costs but also in effective frequency bandwidth.
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Kucmin, Tomasz, Malgorzata Plowas Goral, Adam Nogalski, and Agnieszka Mikula-Mazurkiewicz. "Are Polish paramedics more prone to PTDS than general population?" Resuscitation 83 (October 2012): e4. http://dx.doi.org/10.1016/j.resuscitation.2012.08.013.
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Colherinhas, Gino B., Maura A. M. Shzu, Suzana M. Avila, and Marcus V. G. de Morais. "A parametric study of a tower controlled by a pendulum tuned mass damper: beam modelling." MATEC Web of Conferences 211 (2018): 14006. http://dx.doi.org/10.1051/matecconf/201821114006.
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This paper models a tower with a passive Pendulum Tuned Mass Damper (PTMD) with Finite Elements (FE) using the resources and capabilities of commercial software ANSYS. Although structural control of high and slender towers using PTMDs are widely studied in literature, it was not found yet studies modelling the PTMD with ANSYS. This FE model is called by a routine coded in MATLAB to find the relation between the mass, length, stiffness, and damping coefficient of the pendulum in function of the high vibration amplitudes at the top of the tower (defined as a beam element type). This parametric study of the dynamic behaviour of the PTMD + FE beam structural model is analysed and its results are compared to a genetic optimization developed in other researches to find the best pendulum parameters.
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Mysliwiec, Vincent, Matthew Brock, Panagiotis Matsangas, Kristi Pruiksma, Tyler Powell, Shana Hansen, Jennifer Martin, et al. "0734 Gender Differences in US Military Personnel with Insomnia, Obstructive Sleep Apnea & Comorbid Insomnia and Obstructive Sleep Apnea." SLEEP 46, Supplement_1 (May 1, 2023): A323. http://dx.doi.org/10.1093/sleep/zsad077.0734.
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Abstract Introduction Women constitute approximately 17% of the military. Yet, relatively little is known regarding sleep disorders and comorbid diagnoses effecting this gender. The aim of this study was to determine if there were gender-related differences in symptoms of sleep disorders and sleep-related impairment, comorbid sleep, behavioral medicine, and traumatic brain injury (TBI) diagnoses and polysomnographic (PSG) variables in military personnel with insomnia, OSA, and comorbid insomnia and OSA (COMISA). Methods Participants were 372 military personnel (46.2% females, 53.8% males) with an average age of 37.7±7.46 years and median BMI of 28.4 (5.50) kg/m2. Based on clinical evaluation and video-PSG, participants were diagnosed with insomnia (n = 118, 71.2% female), OSA (n = 118, 28.8% female) and COMISA (n = 136, 39.7% female). Insomnia severity, excessive daytime sleepiness, sleep quality, nightmare disorder, sleep impairment, fatigue, posttraumatic stress disorder (PTSD), anxiety, depression symptoms, and traumatic brain injury (TBI) were evaluated with validated questionnaires. Descriptive statistics, parametric and non-parametric pairwise comparisons and effect-size analyses were used to assess differences between sexes in terms of variables of interest. Results Female service members had significantly greater symptoms of nightmare disorder, PTSD, anxiety, and depression than their male counterparts. There were no significant differences between males and females with insomnia or OSA in sleep-related symptoms, impairment, or PSG based apnea-hypopnea index (AHI). Male service members with COMISA had a significantly greater AHI; females with COMISA had significantly greater symptoms of nightmare disorder, PTSD and anxiety. Conclusion In the largest study to date to clinically evaluate sleep disorders in military personnel, COMISA was the most frequent diagnosis. Surprisingly, there were minimal differences in self-reported symptoms of sleep disorders and PSG characteristics. However, male servicemembers with COMISA have more severe sleep disordered breathing while female servicemembers with COMISA have greater mental health morbidity. Military service may result in distinct sleep disorder phenotype(s). Support (if any) This work was supported by the Defense Health Agency, Defense Medical Research and Development Program, Clinical Research Intramural Initiative for Military Women’s Health (DM170708; Mysliwiec) and the US Air Force (USAF) Air Force Materiel Command (AFMC), Wright Patterson Air Force Base, Ohio (FA8650-18-2-6953; Peterson).
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McGill, Makenna B., Alexandra L. Clark, and David M. Schnyer. "18 Vascular Risk, Cerebral White Matter, and Executive Functioning in Vietnam-Era Veterans with Traumatic Brain Injury and/or Post-Traumatic Stress Disorder: A Department of Defense Alzheimer’s Disease Initiative (DoD-ADNI) Study." Journal of the International Neuropsychological Society 29, s1 (November 2023): 127–28. http://dx.doi.org/10.1017/s1355617723002229.
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Objective:Research indicates that Veterans with a history of traumatic brain injury (TBI) are at increased risk for dementia. Although the precise mechanisms underlying this relationship are poorly understood, remote TBI may exacerbate normal age-related changes to cerebral white matter (WM) and result in cognitive decline. However, Veterans commonly experience a constellation of mental (e.g., post-traumatic stress disorder [PTSD] and depression) and vascular (e.g., diabetes, hypertension, obesity) health conditions that have also been implicated in pathologic cerebral WM and cognitive aging trajectories. Therefore, the present study sought to (1) clarify the effects of remote TBI within the context of PTSD, depression, and vascular risk on WM micro- and macrostructure, and (2) explore if WM integrity is associated with cognition in a sample of Vietnam-Era Veterans.Participants and Methods:The sample consisted of 195 male Veterans ages 60-80 (mean age=69.3) enrolled in the Department of Defense-Alzheimer’s Disease Neuroimaging Initiative (DoD-ADNI) study. 102 Veterans met criteria for TBI by sustaining a head-injury that resulted in a loss of consciousness, alteration of consciousness, or post-traumatic amnesia. Current and/or lifetime PTSD was designated by scores >30 on the Clinician-Administered PTSD Scale. The Geriatric Depression Scale was used as a continuous measure of depression. A vascular risk score (0-3) was calculated based on diabetes, hypertension, and obesity (BMI >30 kg/m2). An executive functioning composite was created by averaging sample-specific z-scores for Trail Making Tests (A and B), with higher scores indicating worse performance. Voxelwise analysis of WM microstructure (fractional anisotropy [FA]) was conducted with Tract-Based Spatial Statistics (TBSS), using non-parametric permutation testing with threshold-free cluster enhancement. SPM’s Lesion Segmentation Tool was used to investigate WM macrostructure (WM hyperintensity [WMH] volume). Lesion probability maps were masked to restrict WMH volume calculations to WM. Robust regression using M-estimation and predictive R2 calculated using 10-fold cross-validation examined WMH volume, predictor, and cognitive associations. Age was a covariate in all WM analyses, and education was a covariate in all cognitive analyses.Results:TBSS analysis revealed widespread, significant negative relationships between vascular risk and FA across numerous WM tracts (p’s<0.05). These associations remained significant after adjusting for TBI history, PTSD, and depression. TBSS identified significant positive relationships between executive functioning performance and FA across similar brain regions (p’s<0.05). Robust regressions revealed that vascular risk significantly predicted WMH volume (p=0.006; ß=0.161; R2=0.093), whereas TBI history, PTSD, and depression did not (p’s=0.107-0.166; ß's=-0.089-0.101). WMH volume significantly predicted executive functioning (p=0.002; ß=0.216; R2=0.105), whereas TBI history, PTSD, depression, and vascular risk did not (p’s=0.123-0.888; ß's=-0.012-0.125).Conclusions:Our results suggest that vascular health, relative to remote TBI, PTSD, and depression, may be more robustly associated with cerebral WM micro- and macrostructure in older Veterans. Furthermore, poorer WM integrity is associated with poorer cognitive performance. These findings underscore the importance of vascular health interventions in preventing negative brain and cognitive aging outcomes in Veterans, independent of TBI history. Future studies might leverage other neuroimaging modalities (e.g., functional MRI) to further investigate the effects of vascular health on aging in Veterans with a history of TBI.
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Chen, Zihao, Liangming Zhang, Jianwen Dong, Peigen Xie, Bin Liu, Qiyou Wang, Ruiqiang Chen, et al. "Percutaneous transforaminal endoscopic discectomy compared with microendoscopic discectomy for lumbar disc herniation: 1-year results of an ongoing randomized controlled trial." Journal of Neurosurgery: Spine 28, no. 3 (March 2018): 300–310. http://dx.doi.org/10.3171/2017.7.spine161434.
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OBJECTIVEA prospective randomized controlled study was conducted to clarify whether percutaneous transforaminal endoscopic discectomy (PTED) results in better clinical outcomes and less surgical trauma than microendoscopic discectomy (MED).METHODSIn this single-center, open-label, randomized controlled trial, patients were included if they had persistent signs and symptoms of radiculopathy with corresponding imaging-confirmed lumbar disc herniation. Patients were randomly allocated to the PTED or the MED group by computer-generated randomization codes. The primary outcome was the Oswestry Disability Index (ODI) score 1 year after surgery. Secondary outcomes included scores of the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain and physical function scales, EuroQol Group’s EQ-5D , and the visual analog scales for back pain and leg pain. Data including duration of operation, in-bed time, length of hospital stay, surgical cost and total hospital cost, complications, and reoperations were recorded.RESULTSA total of 153 participants were randomly assigned to 2 treatment groups (PTED vs MED), and 89.5% (137 patients) completed 1 year of follow-up. Primary and secondary outcomes did not differ significantly between the treatment groups at each prespecified follow-up point (p > 0.05). For PTED, there was less postoperative improvement in ODI score in the median herniation subgroup at 1 week (p = 0.027), 3 months (p = 0.013), 6 months (p = 0.027), and 1 year (p = 0.028) compared with the paramedian subgroup. For MED, there was significantly less improvement in ODI score at 3 months (p = 0.008), 6 months (p = 0.028), and 1 year (p = 0.028) in the far-lateral herniation subgroup compared with the paramedian subgroup. The total complication rate over the course of 1 year was 13.75% in the PTED group and 16.44% in the MED group (p = 0.642). Five patients (6.25%) in the PTED group and 3 patients (4.11%) in the MED group suffered from residue/recurrence of herniation, for which reoperation was required.CONCLUSIONSOver the 1-year follow-up period, PTED did not show superior clinical outcomes and did not seem to be a safer procedure for patients with lumbar disc herniation compared with MED. PTED had inferior results for median disc herniation, whereas MED did not seem to be the best treatment option for far-lateral disc herniation.Clinical trial registration no.: NCT01997086 (clinicaltrials.gov).
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Hu, Xinyu, Jing Wang, Heze Guo, Kai Jiang, Wenjing Tang, and Wei Xia. "Investigations of 2D PtS2’s Saturable Absorption Characteristic and Its Optimization to OPO’s Operation." Nanomaterials 12, no. 10 (May 13, 2022): 1670. http://dx.doi.org/10.3390/nano12101670.
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A 6.2 nm-thickness platinum disulfide (PtS2) film was prepared by electron beam evaporation with post vulcanization. The nonlinear transmittance was measured by power scanning method and the modulation depth is fitted to be 13%. Based on the transmittance curve, saturable absorption parameters of PtS2 are calculated with inhomogeneously broadening mechanism, including 6.4298 × 10−19 cm−2 ground-state absorption cross-section, 2.5927 × 10−19 cm−2 excited-state absorption cross-section, and 1.043 ms excited-state lifetime. The PtS2 film combined with active time management was implemented to modulate the fundamental light of optical parametric oscillator (OPO). Owing to the nonlinear absorption property of PtS2, the operation of Q-switched OPO was optimized in both the experiment and dynamical theory. In particular, the conversion efficiency was experimentally improved by 13.2%. The pump-to-signal conversion efficiency went up to 3.29%, which is the highest conversion value reported so far. The theoretical values fit the experiment well, which are from the Gaussian rate equations with PtS2’s saturable-absorption characteristic.
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Groll, Dianne L., Rosemary Ricciardelli, R. Nicholas Carleton, Greg Anderson, and Heidi Cramm. "A Cross-Sectional Study of the Relationship between Previous Military Experience and Mental Health Disorders in Currently Serving Public Safety Personnel in Canada." Canadian Journal of Psychiatry 65, no. 5 (December 13, 2019): 330–37. http://dx.doi.org/10.1177/0706743719895341.
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Objective There is an increased incidence of some mental health disorders such as post-traumatic stress disorder (PTSD) in some members of the military and in some public safety personnel (PSP) such as firefighters, police officers, paramedics, and dispatchers. Upon retirement from the armed forces, many individuals go on to second careers as PSP. Individuals with prior military experience may be at even greater risk than nonveterans for developing mental health disorders. The present study was designed to examine the relationship between prior military service and symptoms of mental health disorders in PSP. Methods This is a cross-sectional, observational study. Data for this study were collected from an anonymous, web-based, self-report survey of PSP in Canada. Invitations to participate were sent to PSP via their professional organizations. Indications of mental disorder(s) and symptom severity were assessed using well-validated self-report screening measures. Results Of the survey respondents who provided this information, 631 (6.8%) had prior armed forces experience; however, not all responses were complete. Ex-military PSP reported significantly more exposure to traumatic events and were approximately 1.5 times more likely to screen positive for indications of PTSD, mood, anxiety, or acute stress disorders and to have contemplated suicide than those without prior armed forces experience. Conclusions In our study, individuals in PSP with prior service experience in the armed forces were more likely to screen positive for indicators of some mental health disorders. Accordingly, mental health practitioners should inquire about previous service in the armed forces when screening, assessing, and treating PSP.