Children exposed to traumatic stress are vulnerable to a variety of stress-related disorders other than classical post-traumatic stress disorder. Several case histories are presented to illustrate some of the diversity of how traumatic stress may manifest in children. African-American children are the main focus of this article as political, economic, social, and morbidity and mortality indicators suggest that African-American children are at high risk for exposure to potentially traumatic stressors. Different presentations of traumatic, stress are discussed in an effort to broaden our understanding of the outcome of traumatic stress to fully help traumatized children.
Abstract Acupuncture and moxibustion, which medical doctors are licensed by the government of Japan to perform, can improve the psychological relationship between doctors and patients, especially when it is disturbed by a "game", a dysfunctional interpersonal interaction that is repeated unintentionally. This advantage is due to the essential properties of acupuncture and moxibustion. Acupuncture and moxibustion are helpful in treating somatoform disorders, especially musculoskeletal symptoms. In Japan, a holistic acupuncture and moxibustion therapy called Sawada-style has been developed. This is based on fundamental meridian points that are considered to have effects on central, autonomic nervous, immune, metabolic, and endocrine systems to regulate the whole body balance. In addition, some of the fundamental points have effects on Qi, blood, and water patterns associated with major depression, generalized anxiety disorder, eating disorders, and somatoform disorders. The fixed protocol of Sawada-style would be suitable for large-scale, randomized, controlled studies in the future. Recent systematic reviews indicate that electroacupuncture would be a useful addition to antidepressant therapy for some symptoms accompanying fibromyalgia. Acupuncture and moxibustion are also recommended for irritable bowel syndrome, instead of Western drug therapy. Surprisingly, the dorsal prefrontal cerebral cortex, which is associated with a method of scalp acupuncture applied for gastrointestinal disorders, has been found to be activated in patients with irritable bowel syndrome. It is quite possible that regulation of this cortical area is related to the effect of scalp acupuncture. This acupuncture method can be effective not only for irritable bowel syndrome but also for other stress-related gastrointestinal disorders.
Introduction. Recent years, both Ukraine and European countries have experienced an abrupt increase in the number of traumatic events and unexpected social changes. This correlates with an increased risk of stress related disorders prevalence. The risk factors for post-traumatic stress disorder include the female gender and type of trauma (man-made). The hormonal status of a woman (oral contraceptives usage) is poorly studied, but is a promising preventive factor for PTSD. Aim. To identify clinically significant difference in post-stress gender reactions and assess the impact of chronic and acute combat stress on the mental and psychosomatic state of the military. Results. At the first stage, military in the war zone were examined (n = 47), 64% were men, mean age was 33 ± 8.3 y. o ., and the average duration of military service was 11.5 months. Men were characterized by an increased levels of guilt, physical aggression, the frequency and amount of alcohol consumption, and occurrence of obsessive-compulsive symptoms, the prevalence of PTSD was 20%. Among women, there was an increase in the levels of resentmen, hostility, anxiety, depression and the severity of stress, high body mass index, the prevalence of PTSD was 23.5% -25.9%. The decrease in the quality of life in women was associated with biological anhedonia (sex, living conditions, physical condition), with social anhedonia (lack of self-realization at work or in society) in men. At the second stage of research, the purpose of which was to assess the psychosomatic effect of combat stress on reproductive function, 54 women aged 33.4 ± 8 y. o. were examined. Half of the women in the service from 1 to 2 years planed a pregnancy, in 5.5% the pregnancy was confirmed by a gynecologist. Women who used oral contraceptives had the highest quality of life levels; PTSD was absent in this category of women. Women whose contraceptive method was barrier (condoms), or they were in menopause had the highest levels of post-traumatic stress and poor quality of life. Gynecological complications were three times more often in women with PTSD. Women had a desire to build a military career and at the same time a desire to become a mother. As a result, this splitting leads to failure in both areas and is often accompanied by psychosomatic problems, such as the inability to get pregnant. Conclusions. The response to stress due to psychological trauma is gender-specific, women are at greater risk of mental health issues. Understanding the gender specific characteristics of a stress response leads to targeted and more effective treatment of PTSD. Future studies should pay particular attention to the hormonal status of women. Research of possible PTSD predictors and effective early intervention strategies right after exposure to trauma is one of the key goals of psychiatry and medical psychology nowadays. ; Актуальність. Протягом останніх років, як Україна, так і країни Європи, пережили різке збільшення кількості травматичних подій та неочікуваних соціальних змін. Все це асоціюється з підвищеним ризиком виникнення психічних розладів, пов'язаних з дією стресу. До факторів ризику виникнення посттравматичного стресового розладу відносять жіночу стать та тип травми (активна участь у бойових діях). Гормональний статус жінки (прийом оральних контрацептивів) маловивчений, проте перспективний превентивний фактор ПТСР. Мета. Виявити клінічно значущі відмінності у гендерних постстресових реакціях та оцінити вплив хронічного та гострого стресу внаслідок перебування в зоні бойових дій на психічний та психосоматичний стан військовослужбовців. Результати. На першому етапі було обстежено військовослужбовців (n = 47), в зоні активних бойових дій, 64% - чоловіки, середній вік 33 ± 8.3 років, середня тривалість перебування на службі 11,5 місяців. Для чоловіків був характерний підвищений рівень почуття провини, фізичної агресії, частоти й кількості вживання алкоголю, поява обсесивно-компульсивних симптомів; поширеність ПТСР склала 20%. Серед жінок простежувалося підвищення рівня образи, індексу ворожості, тривоги, депресії та вираженості стресу, індексу маси тіла; поширеність ПТСР склала 23,5%-25.9%. Зниження якості життя у жінок-військовослужбовців пов'язано з біологічною ангедонією (секс, умови життя, фізичний стан), у чоловіків з соціальною ангедонією (дефіцит самореалізації на роботі або в суспільстві). На другому етапі, метою якого було оцінити психосоматичний вплив бойового стресу на репродуктивну функцію було обстежено 54 жінки віком 33,4±8 років, що одружені (48,1%), мають одну (37%) або дві (33,3%) дитини. Половина жінок, що перебувають на службі від 1 до 2 років планують вагітність; у 5,5% вагітність була підтверджена оглядом гінеколога. Найвищий рівень якості життя мали жінки, які використовували оральні контрацептиви та гормональні препарати, в цієї категорії жінок ПТСР був відсутній. Найвищі рівні посттравматичного стресу та нижчу якість життя мали жінки, методом контрацепції яких був бар'єрний (презервативи), або вони перебували в менопаузі. Гінекологічні ускладнення втричі частіше спостерігались у жінок з ПТСР, ніж без. У жінок спостерігалось бажання побудувати військову кар'єру та одночасно бажання самореалізації в ролі матері. В результаті таке розщеплення призводить до невдачі в обох сферах реалізації та часто супроводжується психосоматичними проблемами, такими як неможливість завагітніти. Висновки. Реакція на стрес в результаті психічної травми гендер специфічна, жінки піддаються більшому ризику виникнення психопатології, вони переживають симптоми й витісняють конфлікти на психосоматичний рівень. Розуміння гендерних особливостей реакції на стрес може призвести до більш цілеспрямованих та більш ефективних методів лікування та профілактики ПТСР. Майбутні дослідження повинні приділяти особливу увагу гормональному статусу жінки. Пошук можливих ранніх предикторів виникнення ПТСР та ефективних стратегій ранніх втручань одразу після дії психічної травми є одним з ключових аспектів сучасної психіатрії та медичної психології.
BACKGROUND: Noninvasive brain stimulation techniques like transcranial direct current stimulation (tDCS) offer potential new approaches to treat stress-related mental health disorders. While the acceptability of tDCS as a treatment tool plays a crucial role in its development and implementation, little is known about tDCS acceptability for users in mental healthcare, especially in the context of stress-related disorders. METHODS: Using a mixed-methods approach, we investigated tDCS acceptability among 102 active duty and post-active military patients with stress-related symptoms (posttraumatic stress disorder, anxiety and impulsive aggression) who participated in a 5-session tDCS intervention. Quantitative dropout and adverse effects data was collected for all patients involved in the sham-controlled tDCS intervention. We additionally explored perspectives on the acceptability of tDCS treatment via a theory-based semi-structured interview. A subgroup of patients as well as their caregivers were interviewed to include the views of both patients and mental healthcare professionals. RESULTS: Quantitative outcomes showed minimal tDCS-related adverse effects (mild itching or burning sensations on the scalp) and high tDCS treatment adherence (dropout rate: 4% for active tDCS, 0% for sham). The qualitative outcomes showed predominantly positive attitudes towards tDCS interventions for stress-related disorders, but only as complementary to psychotherapy. Remarkably, despite the perception that sufficient explanation was provided, patients and caregivers stressed that tDCS treatment comprehension was limited and should improve. Also, the travel associated with frequent on-site tDCS sessions may produce a significant barrier to care for patients with stress-related disorders and active-duty military personnel. CONCLUSIONS: Acceptability numbers and perspectives from military patients and caregivers suggest that tDCS is an acceptable complementary tool in the treatment of stress-related disorders. Critically, however, if ...
Recent studies indicate potential links among work organization, job stress, and work-related musculoskeletal disorders (WRMDs). In this paper we propose several pathways for a theoretical relationship between job stress and WRMDs. These pathways highlight the physiological, psychological, and behavioral reactions to stress that can affect WRMDs directly and indirectly. One model stipulates that psychosocial work factors (e.g., work pressure, lack of control), which can cause stress, might also influence or be related to ergonomic factors such as force, repetition, and posture that have been identified as risk factors for WRMDs. In order to fully understand the etiology of WRMDs, it is important to examine both physical ergonomic and psychosocial work factors simultaneously. Smith and Carayon-Sainfort (1989) have proposed a model of the work system for stress management that provides a useful framework for conceptualizing the work-related factors that contribute to WRMDs. Practical applications of this research include practitioners taking into account psychosocial work factors and job stress in their efforts to reduce and control WRMDs.
Combining management research with infectious disease epidemiology, we propose a new perspective on mental disorders in a business context. We suggest that—similar to infectious diseases—clinical diagnoses of depression, anxiety, and stress-related disorders can spread epidemically across the boundaries of organizations via social contagion. We propose a framework for assessing the patterns of disease transmission, with employee mobility as the driver of contagion across organizations. We empirically test the proposed mental disorder transmission patterns by observing more than 250,000 employees and more than 17,000 Danish firms over a period of 12 years. Our findings reveal that when organizations hire employees from other, unhealthy organizations (those with a high prevalence of mental disorders), they "implant" depression, anxiety, and stress-related disorders into their workforces. Employees leaving unhealthy organizations act as "carriers" of these disorders regardless of whether they themselves have received a formal diagnosis of a mental disorder. The effect is especially pronounced if the newcomer holds a managerial position.
STUDY OBJECTIVE: To determine whether there is a relationship between musculoskeletal disorders and presumed symptoms of stress. DESIGN: Cross sectional and mixed longitudinal cohort study. Longitudinal data were collected at baseline (1973) and at re-examinations in 1978 and 1983. SETTING: Community based. PARTICIPANTS: Study sample was drawn from employees who had worked for at least 15 months at government owned Valmet metal factories in Finland, and comprised 902 men and women out of a total eligible population of 2653; 74% of the women and 63% of the men took part in both re-examinations. MEASUREMENTS AND MAIN RESULTS: Musculoskeletal disorders were measured as rheumatic symptoms, clinical findings and presence of chronic specific diseases. Eighteen symptoms of stress were combined in a stress symptoms score. Stress symptoms were associated with rheumatic symptoms and clinical findings in all sex/occupational class groups at first examination (baseline); and the prevalence of chronic musculoskeletal disease was associated with stress symptoms in men and in blue collar women (skilled and semiskilled workers). The mean stress symptom score of 1973 and 1978 predicted the level of rheumatic symptoms and clinical findings in 1983, allowing for the relevant score at baseline. The mean score also predicted the incidence of disease during the second half of the follow up in women and in blue collar men. Rheumatic symptoms covaried with the stress symptoms. Change in stress symptoms was predicted by indices of musculoskeletal disorders. CONCLUSIONS: The results suggest that stress symptoms and musculoskeletal disorders are reciprocally related.
Resiliance and Health - 26th Conference of the European Health Psychology Society, Prague, Czech Republic, 21st - 25th August 2012 ; The military participants in Peace Operations are exposed to adverse and potentially traumatic situations that can have consequences on mental health. With the Iraq and Afghanistan wars,have taken place several studies in order to assess the military returning from these conflicts. This research aimed to assess the prevalence of PostTraumatic Stress Disorder and associated pathology in a sample of 241 portuguese militaries engaged in Peace Operations in 2011 (Kosovo and Afghanistan) and to understand the relation between psychosocial variables and PTSD. The evaluation methods used in this study were the traumatic event (PCL-M), emotional adjustment (SCL-90-R), self-esteem (SERTHUAL), coping (ETC) and social support (MDSS). The results showed that 34% of the militaries were exposed to traumatic events, 5% were in the PTSD criteria and 15% revealed significant PTSD symptomatology. Furthermore, this study intends to contribute to the implementation of preventive programmes and monitoring military intervention of referenced with PTSD.
Introduction Sleep is important for optimal physical health and vitality. Recent studies have shown that individuals with visual impairments may be at risk for sleep problems. This research examines the prevalence of sleep problems among those with retinal disorders and the possibility of a genetic link. Methods Subjects with retinitis pigmentosa ( n = 33), Stargardt's disease ( n = 31) and age-related macular degeneration ( n = 43) were recruited from the ophthalmology department of Montreal Children's Hospital. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Genetic testing was conducted by the Radboud University Medical Center in Nijmegen, Netherlands. Retinal genes were identified as having retina only or pineal and retinal expression. Results The expression patterns of genes causing retinal disorders did not predict sleep quality. The PSQI indicated poor sleep quality in 56% of participants with retinitis pigmentosa, 48% of those with Stargardt's disease, and 53% of those with age-related macular degeneration. The ESS showed that daytime sleepiness was experienced by 20% of individuals with retinitis pigmentosa or Stargardt's disease, and by only one individual with age-related macular degeneration. Discussion Approximately 50% of people with retinal disease have sleep problems. This number compares with up to one-third of the general population. Gene expression did not correlate with sleep quality, and the explanation for such a large percentage of sleep disorders needs further investigation. Implications for practitioners Eye care and rehabilitation specialists need to be aware of the high prevalence of poor sleep quality in individuals with retinal disorders, since this situation may have an important impact on memory and learning, both of which are vital in successful rehabilitation.
