Interactive effects of cumulative lifetime traumatic brain injuries and combat exposure on posttraumatic stress among deployed military personnel

Growing research links Traumatic Brain Injury (TBI) with greater posttraumatic stress disorder (PTSD) symptoms. Much of this research has focused on the influence of the presence or severity of a single TBI while neglecting the potential cumulative effects of multiple TBIs incurred across an individual’s lifetime on combat-related PTSD. The present study addressed this gap using a sample of 157 military service members and 4 civilian contractors who underwent structured TBI interviews at a military hospital in Iraq and completed the Combat Experiences Scale (CES) and Posttraumatic Checklist – Military (PCL-M). Results indicated that a greater number of lifetime TBIs were associated with greater PTSD symptoms when accounting for the presence and severity of a recent, deployment-related TBI. Additionally, a significant interaction of number of lifetime TBIs and combat exposure emerged, indicating that exposure to combat yielded greater PTSD symptoms among those with multiple lifetime TBIs compared to those with one or zero lifetime TBIs. These data suggest that incurring multiple TBIs may amplify the link between combat exposure and PTSD and underscore the need to screen for lifetime TBI history.     

Suicide lié au travail et prévention

Regarding social law, work-related suicide can be qualified as a professional risk, in particular as a work accident. It's the option chosen by case-law. The idea is to compensate: qualifying suicide as a work accident provides a social security compensation to the suicided employee's family and, in certain cases, the possibility to sue the employer. But, this case-law does not really question the prevention of the suicide before its commitment. In Labour law, the employer's obligation to prevent risks must face the risk of work-related suicide.     

Effects of behaviour change interventions on physical activity in people with spinal cord injury: A systematic review and meta-analysis

ObjectivesThis review investigated the effectiveness of behaviour-change interventions to improve physical activity (PA) participation in individuals with a spinal cord injury. Additionally, the review sought to analyse the change in PA behaviour that might be expected by utilising behaviour change in PA interventions and what specific intervention characteristics, application of behaviour change theories, and behaviour change techniques are most efficacious.MethodsThe protocol was prospectively registered on PROSPERO: CRD42021252744, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed in this review. Eight databases were comprehensively searched using a well-defined strategy developed in collaboration with an academic liaison librarian. Randomised, non-randomised controlled, and non-controlled studies were included in this review; however, controlled and non-controlled studies were analysed separately. Studies were included if participants were older than 16 years and had an SCI of any cause, level or severity, regardless of the time since injury. The behaviour change technique taxonomy version 1 was used to code the intervention characteristics for behaviour modification. The combined effects across studies were pooled in a meta-analysis, and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool.ResultsThe search retrieved 10,155 titles and abstracts. After duplicate removal and screening against the eligibility criteria, 23 studies were included. The overall effect estimate of the change in PA participation in the controlled trials post-intervention was medium (d = 0.50, 95% CI = 0.31–0.70) in favour of behaviour-targeted interventions. The mean difference in PA volume between pre- and post-intervention was an increase of 22 minutes per week (95% CI = 5.96–38.90). Interventions that provided practical support (d = 0.81, 95% CI = 0.46–1.16), which were individualised (d = 0.62, 95% CI = 0.34–0.90) and that utilised monitoring (d = 0.59, 95% CI = 0.34–0.83) had a greater effect on change to PA than those that were group-based and did not utilise those specific techniques.ConclusionsInterventions that target behaviour change to increase PA in people with SCI appear effective. Utilising behaviour change frameworks and specific behaviour change techniques augments PA uptake and levels, and interventions aimed at improving PA in people with SCI should incorporate a behaviour modification component. More research is needed on the isolated effect of intervention structure parameters and specific behaviour change techniques.     

Posttraumatic symptomatology in children exposed to war

This study examines affective and behavioral symptomatology in two groups of school-age children who were traumatized to different degrees during the war in Croatia (N = 1034). Six self-reported questionnaires were used to assess the following: number and type of war experiences, PTSD symptoms, anxiety, depression, psychosomatic symptoms, and psychosocial adaptation. Canonical discriminant analysis yielded a significant discriminant function that indicates moderate differentiation between the two groups of children according to the assessed symptoms. The results of a 2 x 2 x 2 ANOVAs (gender x age x level of traumatization) indicate that the children's reactions to war traumata varied in respect to all factors, as well as their interaction. The results indicate that gender differences are more prominent in older children. Older girls report more posttraumatic stress reactions, anxiety and depression, but at the same time seem better adapted than boys. Younger children, particularly those who survived more war even report more PTSD symptoms than older children.     

复合伤的"复合效应"中线性与非线性的辩证关系

复合伤的“复合效应”是非线性观在医学研究领域中的一个范例。它不仅具有重要的实际价值,而且具有较高的理论意义。复合伤效应不是单纯的“加重效应”,而是“复合效应”,即可加重,不加重,以至减轻。复合伤的复合效应规律的基本特征和本质是非线性特征,而复合效应中线性与非线性特征的关系是辩证统一的。     

Recontextualising moral injury among military veterans: An integrative theoretical review

Moral injury was originally conceived as a socially-inflicted wound of betrayal experienced by military veterans (Shay, 1994). However, moral injury has since been redefined by psychological researchers as an individualised, predominantly perpetration-driven, and psychopathological phenomenon (e.g., Currier et al., 2015; Jinkerson, 2016). However, social scientific researchers (e.g., Hodgson & Carey, 2017; Molendijk, 2019; Wiinikka-Lydon, 2017) have contested mainstream psychology's medicalisation and decontextualisation of moral injury. This theoretical review integrates insights from across these discourses, and brings them into dialogue with ideas from moral psychology, evolutionary science, and community psychology. The aim of this cross-disciplinary review is to promote a more holistic understanding of moral injury that does justice to its individual and social dimensions. Drawing on these different theoretical strands, this paper proposes that moral injury can be best understood as a psychological wound to basic human needs for social belonging and cohesion. The implications of this integrative understanding of moral injury for applied psychologists and other societal actors are explored. While the relevance of moral injury to civilian populations such as health and social care professionals is clear (e.g., Dombo et al., 2013; French et al., 2021), this paper focuses on military veterans, whose experiences originally prompted the coinage of the term. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.     

Mathematical Abilities in Elementary School Children with Autism Spectrum Disorder

Although clinical practitioners often express concerns about the mathematical functioning of children with autism spectrum disorder (ASD), the field of mathematics remains a relatively unexplored topic in individuals with ASD. Moreover, research findings are fragmentary and hold inconclusive results. The present study aimed to examine whether grade 1 (aged 6–7 years) to 4 (aged 9–10 years) elementary school children with ASD scored significantly different from age‐adequate norms on mathematics. To this end, a multi‐componential approach of mathematics was used. Four domains of mathematics were assessed in 121 children with ASD: procedural calculation, number fact retrieval, word/language problems, and time‐related competences. All children attended general education classrooms, following the standard curriculum, and were coached by integrated educational services. Children with ASD showed a strength in word/language problems in second and fourth grade. There was evidence of a weakness for procedural calculation in first grade and for time‐related competences in first and third grade. In all other cases, average scores were shown. As such, results revealed a profile of strengths, average abilities, and weaknesses in mathematics and highlighted the importance of focusing on different domains of mathematics. Because a high variability in mathematical performance could be observed, we recommend an individual assessment when considering the mathematical trajectory of children with ASD. Copyright © 2015 John Wiley & Sons, Ltd.     

Perceived positive and negative consequences after surviving cancer and their relation to quality of life

Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health‐related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer‐related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty‐one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN‐52 self‐reported version. Data were analysed using mixed methods approach. Overall, 87.8% of the studied sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer‐related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well‐being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well‐being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.