Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway

Refugees have often been exposed to multiple traumas making them prone to mental health problems later. The aim of this study is to describe the prevalence and symptom load of psychiatric disorders in refugees admitted to psychiatric outpatient clinics and to investigate the relationship between multiple exposure to traumatic events, the severity of traumatic symptoms and post-migration stressors. A clinical sample of 61 refugee outpatients from psychiatric clinics in Southern Norway was cross-sectionally examined using three structured clinical interviews (SCID-PTSD, SIDES and MINI) and self-report psychometric instruments (HSCL-25, IES-R). Post-traumatic Stress Disorder (PTSD) was diagnosed in 82% of the patients, while Disorders of Extreme Stress Not Otherwise Specified (DESNOS) was present in 16% of them. Comorbidity was considerable; 64% of the patients had both PTSD and major depression disorder (MDD) and 80% of those who had PTSD had three or more additional diagnoses. Multi-traumatized refugees in outpatient clinics have high prevalence of PTSD, DESNOS, comorbid depression and anxiety disorders. A more severe symptomatology was found in patients diagnosed with both PTSD and DESNOS, than in those diagnosed with only PTSD. Higher rates of unemployment, weak social network and weak social integration were also prevalent in these outpatients, and related to increased psychiatric comorbidity and severity of symptoms. Further research may clarify the existence of a cumulative relationship between pre-resettlement traumas and post-resettlement stressors in the mental health of refugees, which in turn may help to improve therapeutic interventions.     

Person and environmental factors associated with well-being in medical students

Medical students are exposed to demanding academic workloads and are often under considerable psychological strain. This study examined important person and environmental variables that might predict their psychological well-being. Participants were 755 students in years 2-6 from 11 Australian medical schools. A web-based survey assessed well-being, personality, professional expectations, lifestyle expectations, barriers, academic stress, and debt. A hierarchical regression analysis demonstrated that extraversion, conscientiousness, professional expectations, and lifestyle expectations were positively associated with well-being, while academic stress, which was the strongest predictor, neuroticism, and concern about debt were negatively associated. Medical students who displayed a disposition that was outgoing, conscientious, and stable, who were less stressed about their academic workload and their level of debt, and who held higher expectations for their future professional career, and expectations of a balanced lifestyle, had better well-being. Medical educators should be aware of these factors and provide support and strategies that promote well-being to students during medical training.     

Assessment of Disgust Sensitivity in Children With an Age-Downward Version of the Disgust Emotion Scale

The present study examined the psychometric properties of the Disgust Emotion Scale for Children (DES-C). Principal components analysis of the DES-C data revealed five factors reflecting disgust toward (a) rotting foods, (b) injection and blood, (c) odors, (d) mutilation and death, and (e) animals, which were largely in keeping with the intended subscales. The DES-C showed good reliability, excellent convergent validity (as established by correlations with an alternative self-report index of disgust), fairly good predictive validity (as assessed by correlations with measures of fear/anxiety and a behavioral index of disgust), and acceptable parent–child agreement (in particular with the mothers). Importantly, the DES-C proved to perform better on some psychometric indicators than an age-downward version of the Disgust Scale. These findings indicate that the DES-C should be regarded as the preferred scale for measuring disgust sensitivity and its role in the etiology and maintenance of anxiety problems in children.     

Perceived Stress and Comorbid Illness Predict Depressive Symptomatology in People with Coeliac Disease

A high prevalence of depression is found in people with coeliac disease (CD). People with CD who are depressed are less likely to manage their illness effectively, which may lead to complications. Identification of variables associated with depression in people with CD may facilitate early detection and intervention. Participants were 749 members (125 males, 622 females) of the Queensland Coeliac Society (aged 18–88 years), recruited via a mailout. Participants completed the Modified Zung Self‐Rating Depression Scale, the Perceived Stress Scale, and the Perceived Consequences Subscale (from the Revised Illness Perception Questionnaire). Stress (p = .001) and comorbid medical illness (p = .01) were significantly associated with depression in CD. The current study made an original contribution to the body of literature by identifying stress and comorbid medical illness as predictors of depression in CD.     

Stress in Clinical Psychology Trainees: Current Research Status and Future Directions

The purpose of this article is to present the current status of the literature related to stress in clinical psychology trainees (CPTs), and to offer research directions for investigating stress in this population and ways to enhance self‐care in these individuals. The following conclusions emerge from the review: (1) CPTs are vulnerable to elevated stress; (2) undue stress can negatively impact CPTs' personal and professional functioning and, in turn, result in less than optimal standards of care for clients; (3) there is a dearth of studies on stress in this population and no published intervention studies; (4) incorporating self‐care strategies into clinical psychology training is recommended; and (5) “third‐wave” cognitive behaviour therapy stress management interventions have been efficacious in comparable populations. In view of the potential costs of elevated stress to trainees themselves and their clients, research on stress and stress management in this population is of a high priority. Broad research agendas are proposed for these two domains. Modifications to clinical training programmes to reduce trainee stress are required and should be evidence‐based and systematically revaluated.     

An Investigation of the Efficacy of Online Expressive Writing for Trauma-Related Psychological Distress in Hispanic Individuals

This study compared the efficacy of 2 online expressive writing protocols for a traumatic/stressful life event in a Hispanic student sample. Participants who had reported a traumatic event were randomly assigned to either the emotion-focused group or the fact-focused group. The emotion-focused group focused their written accounts on emotions and feelings as well as facts about a stressful/traumatic experience, whereas the fact-focused group focused on facts of a stressful/traumatic event. Both groups completed 3 online writing sessions scheduled for 3 consecutive days, a 1-week online follow-up assessment, and a 5-week online follow-up assessment. Both groups statistically significantly reduced trauma symptoms over time with the emotion-focused group demonstrating statistically significantly greater trauma symptom reductions than the fact-focused group at the 5-week follow-up assessment.     

Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

An investigation of adult attachment and coping with exam-related stress

Students differ in how they cope with and manage stress associated with university life. This study investigates associations between adult attachment and coping strategies for exam-related stress. Fifty-seven students at a university in the north of England completed online questionnaires to assess attachment anxiety and avoidance, helpful and unhelpful coping strategies, and positive and negative affect. We found that students who were more avoidant in their attachment relationships were less likely to report using helpful problem-focused and emotion-focused strategies to cope with their exams. We also found that students who were more anxious in their attachment relationships reported using more dysfunctional coping strategies. We discuss the implications of the findings for university pastoral care and academic support systems.     

惊反射在创伤后应激障碍研究中的应用:高唤醒与恐惧抑制

创伤后应激障碍(PTSD)是唯一在诊断标准中包含惊反射改变的精神疾病.相比自我报告法,对惊反射的实验室测量与总体症状关联更紧密,并已积累了较多神经机制研究成果,可作为连接前临床与临床研究的桥梁.在惊反射应用于PTSD研究的初期,它主要作为PTSD患者高唤醒症状的客观指标,但是尚未发现惊反射强度的变化与总体症状的明确关系.近年来,惊反射与情境性焦虑、恐惧抑制等新范式结合,发现特定情境下惊反射改变是PTSD患者特有的表现.惊反射在创伤应激障碍研究中所取得的新进展对PTSD病理机制的探索和临床诊断都有所启发和推进.     

Your heart makes my heart move: Cues of social connectedness cause shared emotions and physiological states among strangers

Two experiments tested the hypothesis that cues of social connectedness could lead even new interaction partners to experience shared emotional and physiological states. In Experiment 1, a confederate prepared for a stress-inducing task. Participants who had been led to feel socially connected to the confederate reported feeling greater stress than participants who had not. In Experiment 2, a confederate ran vigorously in place. Socially-connected participants had greater cardiovascular reactivity (heart rate and blood pressure) than controls. Each study held constant exposure to the confederate. The results suggest that the sharing of psychological and physiological states does not occur only between long-standing relationship partners, but can also result from even subtle experiences of social connectedness. These findings illustrate the dynamic and fluid ways in which important aspects of self can change in response to cues of social relatedness.