Psychiatric symptoms and moral injury among US healthcare workers in the COVID-19 era

BMC Psychiatry, Год журнала: 2021, Номер 21(1)

Опубликована: Ноя. 5, 2021

Emerging cross-sectional data indicate that healthcare workers (HCWs) in the COVID-19 era face particular mental health risks. Moral injury - a betrayal of one's values and beliefs, is potential concern for HCWs who witness devastating impact acute illness while too often feeling helpless to respond. This study longitudinally examined rates depression, generalized anxiety disorder (GAD), posttraumatic stress (PTSD), moral among United States era. We anticipated finding high levels clinical symptoms would remain stable over time. also expected find positive correlations between injury.

Язык: Английский

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Diagnostic Accuracy and Acceptability of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) Among US Veterans

JAMA Network Open, Год журнала: 2021, Номер 4(2), С. e2036733 - e2036733

Опубликована: Фев. 4, 2021

Posttraumatic stress disorder (PTSD) is a serious mental health that can be effectively treated with empirically based practices. PTSD screening essential for identifying undetected cases and providing patients appropriate care.To determine whether the Primary Care screen Diagnostic Statistical Manual of Mental Disorders (Fifth Edition) (PC-PTSD-5) diagnostically accurate acceptable measure use in Veterans Affairs (VA) primary care clinics.This cross-sectional, diagnostic accuracy study enrolled participants from May 19, 2017, to September 26, 2018. Participants were recruited clinics across 2 VA Medical Centers. Session 1 was conducted person, session completed within 30 days via telephone. A consecutive sample 1594 veterans, aged 18 years or older, who scheduled visit recruited. Data analysis performed March 2019 August 2020.In 1, battery questionnaires. In 2, research assistant administered PC-PTSD-5 participants, then clinician assessor blind results structured interview PTSD.The range cut points overall gender assessed, performance evaluated by calculating weighted κ values.In total, 495 veterans (31%) participated, 396 all measures included analyses. demographically similar population (mean [SD] age, 61.4 [15.5] years; age range, 21-93 years) predominantly male (333 [84.1%]) White (296 394 [75.1%]). The had high levels (area under receiver operating characteristic curve [AUC], 0.927; 95% CI, 0.896-0.959), men (AUC, 0.932; 0.894-0.969), women 0.899, 0.824-0.974). point 4 ideally balanced false negatives positives men. However, women, this resulted numbers (6 [33.3%]). 3 fit better despite increasing number positives. rated as highly acceptable.The an tool settings. Because parameters will change according sample, clinicians should consider characteristics purposes when selecting point.

Язык: Английский

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The impact of the COVID-19 pandemic on the mental health of healthcare workers: study protocol for the COVID-19 HEalth caRe wOrkErS (HEROES) study

Social Psychiatry and Psychiatric Epidemiology, Год журнала: 2022, Номер 57(3), С. 633 - 645

Опубликована: Янв. 21, 2022

Язык: Английский

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Defining and Assessing the Syndrome of Moral Injury: Initial Findings of the Moral Injury Outcome Scale Consortium

Frontiers in Psychiatry, Год журнала: 2022, Номер 13

Опубликована: Июль 5, 2022

Potentially morally injurious events (PMIEs) entail acts of commission (e.g., cruelty, proscribed or prescribed violence) omission high stakes failure to protect others) and bearing witness grave inhumanity, the gruesome aftermath violence), being victim others' trust violations) individual systemic failures protect) that transgress deeply held beliefs expectations about right wrong. Although there is a proliferation interest in moral injury (the outcome associated with exposure PMIEs), has been no operational definition putative syndrome standard assessment scheme measure, which hampered research care this area. We describe an international effort define develop validate Moral Injury Outcome Scale (MIOS) three stages. To ensure content validity, Stage I, we conducted interviews service members, Veterans, clinicians/Chaplains each country, inquiring lasting impact PMIEs. Qualitative analysis yielded six definitions domains PMIEs components within establish parameters syndrome. From domain definitions, derived initial pool scale items. II entailed refinement using factor analytic methods, cross-national invariance testing, internal consistency reliability analyses 34-item MIOS. A 14-item MIOS was invariant reliable across countries had two factors: Shame-Related (SR) Trust-Violation-Related (TVR) Outcomes. In III, total subscale scores strong convergent PMIE-endorsers substantially higher vs. non-endorsers. discuss contextualize results needed substantiate these inaugural findings further explore validity injury, particular examine discriminant incremental validity.

Язык: Английский

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The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline

Annals of Internal Medicine, Год журнала: 2024, Номер 177(3), С. 363 - 374

Опубликована: Фев. 26, 2024

The U.S. Department of Veterans Affairs (VA) and Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for Management Posttraumatic Stress Disorder Acute Disorder. This article summarizes 2023 clinical practice guideline (CPG) its development process, focusing on assessments treatments which evidence was sufficient support a recommendation or against.

Язык: Английский

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Integrating Trauma‐Informed Care Into Maternity Care Practice: Conceptual and Practical Issues

Journal of Midwifery & Women s Health, Год журнала: 2017, Номер 62(6), С. 661 - 672

Опубликована: Ноя. 1, 2017

Abstract Adverse childhood experiences have a strong negative impact on health and are significant public concern. experiences, including various forms of child maltreatment, together with their mental sequelae (eg, posttraumatic stress disorder, depression, dissociation) also contribute to adverse pregnancy outcomes preterm birth, low birth weight), poor postpartum health, impaired or delayed bonding. Intergenerational patterns maltreatment disorders been reported that could be addressed in the childbearing year. Trauma‐informed care is increasingly used organizations has potential assist improving maternal infant health. This article presents an overview traumatic adversity, childbearing, technical assistance available from National Center for Trauma‐Informed Care (NCTIC) before articulating some steps conceptualizing implementing trauma‐informed into midwifery other maternity practices.

Язык: Английский

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Developing an optimal short‐form of the PTSD Checklist for DSM‐5 (PCL‐5)

Depression and Anxiety, Год журнала: 2019, Номер 36(9), С. 790 - 800

Опубликована: Июль 29, 2019

Background Although several short-forms of the posttraumatic stress disorder (PTSD) Checklist (PCL) exist, all were developed using heuristic methods. This report presents results analyses designed to create an optimal short-form PCL for DSM-5 (PCL-5) both machine learning and conventional scale development Methods The scales independent datasets collected by Army Study Assess Risk Resilience among Service members. We began a training dataset (n = 8,917) fit with between 1 8 items different statistical methods (exploratory factor analysis, stepwise logistic regression, new method find integer-scored scale) predict dichotomous PTSD diagnoses determined full PCL-5. A smaller subset best was then evaluated in validation sample 11,728) select one based on multiple operating characteristics (area under curve [AUC], calibration, sensitivity, specificity, net benefit). Results Inspection AUCs replication led focus 4-item selected regression. Brier scores showed that number these had comparable calibration (0.015–0.032) AUC (0.984–0.994), but consistently highest benefit across plausible range decision thresholds. Conclusions recommended PCL-5 generates closely parallel those PCL-5, making it well-suited screening.

Язык: Английский

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PTSD and Physical Health

Current Psychiatry Reports, Год журнала: 2018, Номер 20(12)

Опубликована: Окт. 26, 2018

Язык: Английский

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Post-traumatic stress disorder (PTSD) and other trauma-related mental disorders in elite athletes: a narrative review

British Journal of Sports Medicine, Год журнала: 2019, Номер 53(12), С. 779 - 784

Опубликована: Апрель 25, 2019

This narrative review examines post-traumatic stress disorder (PTSD) and other trauma-related disorders—mental health conditions with complex diagnosis treatment considerations—in elite athletes. Athletes may exhibit greater rates of PTSD (up to 13%–25% in some athlete populations) disorders relative the general population. We describe common inciting events leading symptoms athletes, including trauma incurred sports participation through direct physical injury, secondary/witnessed traumatic events, or abusive dynamics within teams. Symptoms significantly impact athletes’ psychosocial sport-related function avoidance, hypervigilance dissociative behaviours, which, turn, delay recovery from musculoskeletal injury. While be among recognition by providers who do not routinely screen for challenging because tendency athletes mask disorders. Early identification suffering symptoms, those acute disorder, prevent progression PTSD, while already meeting criteria improve life functioning performance outcomes. Current evidence supports increasing awareness use screening tools identify benefit trauma-informed medical psychotherapeutic interventions.

Язык: Английский

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The Prevalence of Posttraumatic Stress Disorder in Primary Care: A Systematic Review

Harvard Review of Psychiatry, Год журнала: 2017, Номер 25(4), С. 159 - 169

Опубликована: Май 27, 2017

After participating in this activity, learners should be better able to:• Determine the prevalence of clinician-diagnosed posttraumatic stress disorder (PTSD) primary care patients• Identify questionnaire-ascertained PTSD symptoms patients OBJECTIVE: and patients.A systematic review literature using PRISMA method, searching MEDLINE, CINAHL, Cochrane Database, PsycINFO, EMBASE, Google Scholar, relevant book chapter bibliographies. Studies that reported on prevalence, including point or lifetime ascertained diagnostic interviews self-report questionnaires, from administrative data, among seen were deemed eligible for inclusion. We abstracted data assessment tool, mean questionnaire scores/cutoff scores, time period symptoms, reported.Of 10,614 titles screened, 41 studies The included assessed a total 7,256,826 patients. median across was 12.5%. civilian population 11.1%; special-risk population, 12.5%; veterans, 24.5%. interview-ascertained ranged 2% to 32.5%, questionnaire-based substantial 2.9% 39.1%. Lifetime 14.5% 48.8%. data-based 3.5% 29.2%.PTSD is common settings. Additional research effective generalizable interventions needed.

Язык: Английский

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