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PTSD

The Role of Natural Disaster in Individual and Relational Adjustment in Sri Lankan Mothers Following the 2004 Tsunami

Citation:

Banford, Alyssa, David C. Ivey, Thulitha Wickrama, Judith Fischer, Anne Prouty, and Douglas Smith. 2016. “The Role of Natural Disaster in Individual and Relational Adjustment in Sri Lankan Mothers Following the 2004 Tsunami.” Disasters 40 (1): 134–57. doi:10.1111/disa.12137.

Authors: Alyssa Banford, David C. Ivey, Thulitha Wickrama, Judith Fischer, Anne Prouty, Douglas Smith

Abstract:

The purpose of this study is to examine the associations between maternal mental health distress symptoms, including depression and post-traumatic stress disorder, the extent to which the presence of a child's disaster-related physical health problem(s) have interfered with daily functioning, and family cohesion over time among Sri Lankan mothers who survived the tsunami on 26 December 2004. Study variables were measured using a self-report questionnaire administered approximately four months after the event and three years later in summer 2008. Univariate, bivariate, and multivariate analyses were conducted. Path analysis was employed to assess the relationships between the key variables over time and the correlations in the study variables at each time point. Among other findings, the results of the path analysis indicated that post-traumatic stress symptom distress four months after the disaster significantly predicted variance in family cohesion three years later. Clinical and empirical research implications are presented and discussed.

Keywords: mental health, mothers, Sri Lanka, tsunami

Topics: Environment, Environmental Disasters, Gender, Women, Health, Mental Health, PTSD Regions: Asia, South Asia Countries: Sri Lanka

Year: 2016

Deployment Experiences, Social Support, and Mental Health: Comparison of Black, White, and Hispanic U.S. Veterans Deployed to Afghanistan and Iraq

Citation:

Muralidharan, Anjana, David Austern, Samantha Hack, and Dawne Vogt. 2016. “Deployment Experiences, Social Support, and Mental Health: Comparison of Black, White, and Hispanic U.S. Veterans Deployed to Afghanistan and Iraq.” Journal of Traumatic Stress 29 (3): 273–78. doi:10.1002/jts.22104.

Authors: David Austern, Samantha Hack, Anjana Muralidharan, Dawne Vogt

Abstract:

Compared to their White counterparts, Black and Hispanic Vietnam-era, male, combat veterans in the United States have experienced discrimination and increased trauma exposure during deployment and exhibited higher rates of postdeployment mental health disorders. The present study examined differences in deployment experiences and postdeployment mental health among male and female Black, Hispanic, and White veterans deployed in support of Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq. Data were drawn from a national survey of veterans (N = 924) who had returned from deployment within the last 2 years. Ethnoracial minority veterans were compared to White veterans of the same gender on deployment experiences and postdeployment mental health. The majority of comparisons did not show significant differences; however, several small group differences did emerge (.02 < η2 < .04). Ethnoracial minority veterans reported greater perceived threat in the warzone and more family-related concerns and stressors during deployment than White veterans of the same gender. Minority female veterans reported higher levels of postdeployment symptoms of anxiety than their White counterparts, which were accounted for by differences in deployment experience. These differences call for ongoing monitoring.

Topics: Armed Conflict, Female Combatants, Male Combatants, Gender, Gender Analysis, Mental Health, PTSD, Trauma, Race Regions: Africa, MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2016

Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort

Citation:

Breyer, Benjamin N., Shona C. Fang, Karen H. Seal, Gayatri Ranganathan, Brian P. Marx, Terence M. Keane, and Raymond C. Rosen. 2016. “Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort.” Journal of Traumatic Stress 29 (3): 229–36. doi:10.1002/jts.22097.

Authors: Benjamin N. Breyer, Shona C. Fang, Terence M. Keane, Brian P. Marx, Gayatri Ranganathan, Raymond C. Rosen, Karen H. Seal

Abstract:

We sought to determine whether posttraumatic stress disorder (PTSD) was associated with sexual health in returned warzone-deployed veterans from the recent Iraq and Afghanistan conflicts. We studied 1,581 males and females from the Veterans After-Discharge Longitudinal Registry, a gender-balanced U.S. Department of Veterans Affairs registry of health care-seeking veterans with and without PTSD. Approximately one quarter (25.1%) of males (n = 198) and 12.7% of females (n = 101) had a sexual dysfunction diagnosis and/or prescription treatment for sexual dysfunction. Both genders were more likely to have a sexual dysfunction diagnosis and/or prescription treatment if they had PTSD compared with those without PTSD (male: 27.3% vs. 21.1%, p = .054; female: 14.9% vs. 9.4%, p = .022). Among the 1,557 subjects analyzed here, males with PTSD had similar levels of sexual activity compared to those without PTSD (71.2% vs. 75.4%, p = .22), whereas females with PTSD were less likely to be sexually active compared to females without PTSD (58.7% vs. 72.1%, p < .001). Participants with PTSD were also less likely to report sex-life satisfaction (male: 27.6% vs. 46.0%, p < .001; female: 23.0% vs. 45.7%, p < .001) compared with those without PTSD. Although PTSD was not associated with sexual dysfunction after adjusting for confounding factors, it was significantly negatively associated with sex-life satisfaction in female veterans with a prevalence ratio of .71, 95% confidence interval [.57, .90].

Topics: Armed Conflict, Female Combatants, Male Combatants, Gender Analysis, Mental Health, PTSD, Trauma, Military Forces & Armed Groups Regions: Africa, MENA, Americas, North America, Asia, Middle East, South Asia Countries: Afghanistan, Iraq, United States of America

Year: 2016

Sexual Trauma and Adverse Health and Occupational Outcomes Among Men Serving in the U.S. Military

Citation:

Millegan, Jeffrey, Lawrence Wang, Cynthia A. LeardMann, Derek Miletich, and Amy E. Street. 2016. “Sexual Trauma and Adverse Health and Occupational Outcomes Among Men Serving in the U.S. Military.” Journal of Traumatic Stress 29 (2): 132–40. doi:10.1002/jts.22081.

Authors: Cynthia A. LeardMann, Derek Miletich, Jeffrey Millegan, Amy E. Street, Lawrence Wang

Annotation:

Although absolute counts of U.S. service men who experience sexual trauma are comparable to service women, little is known about the impact of sexual trauma on men. The association of recent sexual trauma (last 3 years) with health and occupational outcomes was investigated using longitudinal data (2004–2013) from the Millennium Cohort Study. Of 37,711 service men, 391 (1.0%) reported recent sexual harassment and 76 (0.2%) sexual assault. In multivariable models, sexual harassment or assault, respectively, was associated with poorer mental health: AOR = 1.60, 95% CI [1.22, 2.12], AOR = 4.39, 95% CI [2.40, 8.05]; posttraumatic stress disorder: AOR = 2.50, 95% CI [1.87, 3.33], AOR = 6.63, 95% CI [3.65, 12.06]; depression: AOR = 2.37, 95% CI [1.69, 3.33], AOR = 5.60, 95% CI [2.83, 11.09]; and multiple physical symptoms: AOR = 2.22, 95% CI [1.69, 2.92]; AOR = 3.57, 95% CI [1.98, 6.42], after adjustment for relevant covariates. Sexual harassment was also associated with poorer physical health: AOR = 1.68, 95% CI [1.27, 2.22]. Men who reported sexual trauma were more likely to have left military service: AOR = 1.60, 95% CI [1.14, 2.24], and be disabled/unemployed postservice: AOR = 1.76, 95% CI [1.02, 3.02]. Results suggest that sexual trauma was significantly associated with adverse health and functionality extending to postmilitary life. Findings support the need for developing better prevention strategies and services to reduce the burden of sexual trauma on service men.

Topics: Armed Conflict, Male Combatants, Men, Mental Health, PTSD, Trauma, Military Forces & Armed Groups, SV against men Regions: Americas, North America Countries: United States of America

Year: 2016

Developmental Trajectories and Predictors of Prosocial Behavior Among Adolescents Exposed to the 2008 Wenchuan Earthquake

Citation:

Qin, Yanyun, Ya Zhou, Fang Fan, Shijian Chen, Rong Huang, Rouna Cai, and Ting Peng. 2016. “Developmental Trajectories and Predictors of Prosocial Behavior Among Adolescents Exposed to the 2008 Wenchuan Earthquake.” Journal of Traumatic Stress 29 (1): 80–87. doi:10.1002/jts.22064.

Authors: Rouna Cai, Shijian Chen, Fang Fan, Rong Huang, Ting Peng, Yanyun Qin, Ya Zhou

Abstract:

This longitudinal study examined the developmental trajectories of prosocial behavior and related predictors among adolescents exposed to the 2008 Wenchuan earthquake. At 6-, 18-, and 30-months postearthquake, we followed a sample of 1,573 adolescents. Self-report measures were used to assess earthquake exposure, postearthquake negative life events, prosocial behavior, symptoms of posttraumatic stress disorder, depression, anxiety, social support, and coping style. Data were analyzed using growth mixture modeling and multinomial logistic regressions. Four trajectories of postearthquake prosocial behavior were identified in the sample: (a) high/enhancing (35.0%), (b) high/stable (29.4%), (c) low/declining (33.6%), and (d) low/steeply declining (2.0%). Female gender, more social support, and greater positive coping were significant factors related to a higher probability of developing the high/enhancing trajectory. These findings may be helpful for us to identify adolescents with poor prosocial behavior after exposure to earthquakes so as to provide them with appropriate intervention.

Topics: Environment, Environmental Disasters, Gender, Gender Analysis, Health, Mental Health, PTSD, Trauma Regions: Asia, East Asia Countries: China

Year: 2016

Mental Health of Female Survivors of Human Trafficking in Nepal

Citation:

Tsutsumi, Atsuro, Takashi Izutsu, Amod K. Poudyal, Seika Kato, and Eiji Marui. 2008. “Mental Health of Female Survivors of Human Trafficking in Nepal.” Social Science & Medicine 66 (8): 1841–47. doi:10.1016/j.socscimed.2007.12.025.

Authors: Atsuro Tsutsumi, Takashi Izutsu, Amod K. Poudyal, Seika Kato, Eiji Marui

Abstract:

Little is known about the mental health status of trafficked women, even though international conventions require that it be con- sidered. This study, therefore, aims at exploring the mental health status, including anxiety, depression and post-traumatic stress disorder (PTSD), of female survivors of human trafficking who are currently supported by local non-governmental organizations (NGOs) in Katmandu, the capital of Nepal, through comparison between those who were forced to work as sex workers and those who worked in other areas such as domestic and circus work (non-sex workers group). The Hopkins Symptoms Checklist-25 (HSCL-25) was administered to assess anxiety and depression, and the PTSD Checklist Civilian Version (PCL-C) was used to eval- uate PTSD. Both the sex workers’ and the non-sex workers’ groups had a high proportion of cases with anxiety, depression, and PTSD. The sex workers group tended to have more anxiety symptoms (97.7%) than the non-sex workers group (87.5%). Regarding depression, all the constituents of the sex workers group scored over the cut-off point (100%), and the group showed a significantly higher prevalence than the non-sex workers (80.8%). The proportion of those who are above the cut-off for PTSD was higher in the sex workers group (29.6%) than in the non-sex workers group (7.5%). There was a higher rate of HIV infection in the sex workers group (29.6%) than in the non-sex workers group (0%). The findings suggest that programs to address human trafficking should include interventions (such as psychosocial support) to improve survivors’ mental health status, paying attention to the category of work performed during the trafficking period. In particular, the current efforts of the United Nations and various NGOs that help survivors of human trafficking need to more explicitly focus on mental health and psychosocial support.

 

Keywords: human trafficking, women, Nepal, mental health, sex work, post-traumatic stress disorder, anxiety, depression

Topics: Gender, Women, Health, Mental Health, PTSD, Trafficking, Human Trafficking, Sex Trafficking Regions: Asia, South Asia Countries: Nepal

Year: 2008

Outcomes and Moderators of a Preventive School-Based Mental Health Intervention for Children Affected by War in Sri Lanka: A Cluster Randomized Trial

Citation:

Tol, Wietse A., Ivan H. Komproe, Mark J.d. Jordans, Anavarathan Vallipuram, Heather Sipsma, Sambasivamoorthy Sivayokan, Robert D. Macy, and Joop T. De Jong. 2012. “Outcomes and Moderators of a Preventive School-Based Mental Health Intervention for Children Affected by War in Sri Lanka: A Cluster Randomized Trial.” World Psychiatry 11 (2): 114–22. doi:10.1016/j.wpsyc.2012.05.008.

Authors: Wietse A. Tol, Ivan H. Komproe, Mark J.d. Jordans, Anavarathan Vallipuram, Heather Sipsma, Sambasivamoorthy Sivayokan, Robert D. Macy, Joop T. De Jong

Abstract:

We aimed to examine outcomes, moderators and mediators of a preventive school-based mental health intervention implemented by paraprofessionals in a war-affected setting in northern Sri Lanka. A cluster randomized trial was employed. Subsequent to screening 1,370 children in randomly selected schools, 399 children were assigned to an intervention (n=199) or waitlist control condition (n=200). The intervention consisted of 15 manualized sessions over 5 weeks of cognitive behavioral techniques and creative expressive elements. As- sessments took place before, 1 week after, and 3 months after the intervention. Primary outcomes included post-traumatic stress disorder (PTSD), depressive, and anxiety symptoms. No main effects on primary outcomes were identified. A main effect in favor of intervention for conduct problems was observed. This effect was stronger for younger children. Furthermore, we found intervention benefits for spe- cific subgroups. Stronger effects were found for boys with regard to PTSD and anxiety symptoms, and for younger children on pro-social behavior. Moreover, we found stronger intervention effects on PTSD, anxiety, and function impairment for children experiencing lower levels of current war-related stressors. Girls in the intervention condition showed smaller reductions on PTSD symptoms than waitlisted girls. We conclude that preventive school-based psychosocial interventions in volatile areas characterized by ongoing war-related stress- ors may effectively improve indicators of psychological wellbeing and posttraumatic stress-related symptoms in some children. However, they may undermine natural recovery for others. Further research is necessary to examine how gender, age and current war-related expe- riences contribute to differential intervention effects.

Keywords: armed conflict, political violence, post-traumatic stress disorder, anxiety, depression, school-based intervention, prevention, Sri Lanka

Topics: Armed Conflict, Gender, Girls, Boys, Health, Mental Health, PTSD, Violence Regions: Asia, South Asia Countries: Sri Lanka

Year: 2012

Controlled Trial of Psychotherapy for Congolese Survivors of Sexual Violence

Citation:

Bass, Judith K., Jeannie Annan, Sarah McIvor Murray, Debra Kaysen, Shelly Griffiths, Talita Cetinoglu, Karin Wachter, Laura K. Murray, and Paul A. Bolton. 2013. “Controlled Trial of Psychotherapy for Congolese Survivors of Sexual Violence.” New England Journal of Medicine 368 (23): 2182–91. doi:10.1056/NEJMoa1211853.

Authors: Judith K. Bass, Jeannie Annan, Sarah McIvor Murray, Debra Kaysen, Shelly Griffiths, Talita Cetinoglu, Karin Wachter, Laura K. Murray, Paul A. Bolton

Abstract:

Background Survivors of sexual violence have high rates of depression, anxiety, and post-traumatic stress disorder (PTSD). Although treatment for symptoms related to sexual violence has been shown to be effective in high-income countries, evidence is lacking in low-income, conflict-affected countries.

Methods In this trial in the Democratic Republic of Congo, we randomly assigned 16 villages to provide cognitive processing therapy (1 individual session and 11 group sessions) or in- dividual support to female sexual-violence survivors with high levels of PTSD symptoms and combined depression and anxiety symptoms. One village was excluded owing to concern about the competency of the psychosocial assistant, resulting in 7 villages that provided therapy (157 women) and 8 villages that provided individual support (248 wom- en). Assessments of combined depression and anxiety symptoms (average score on the Hopkins Symptom Checklist [range, 0 to 3, with higher scores indicating worse symp- toms]), PTSD symptoms (average score on the PTSD Checklist [range, 0 to 3, with higher scores indicating worse symptoms]), and functional impairment (average score across 20 tasks [range, 0 to 4, with higher scores indicating greater impairment]) were performed at baseline, at the end of treatment, and 6 months after treatment ended.

Results A total of 65% of participants in the therapy group and 52% of participants in the indi- vidual-support group completed all three assessments. Mean scores for combined de- pression and anxiety improved in the individual-support group (2.2 at baseline, 1.7 at the end of treatment, and 1.5 at 6 months after treatment), but improvements were signifi- cantly greater in the therapy group (2.0 at baseline, 0.8 at the end of treatment, and 0.7 at 6 months after treatment) (P<0.001 for all comparisons). Similar patterns were ob- served for PTSD and functional impairment. At 6 months after treatment, 9% of par- ticipants in the therapy group and 42% of participants in the individual-support group met criteria for probable depression or anxiety (P<0.001), with similar results for PTSD.

Conclusions In this study of sexual-violence survivors in a low-income, conflict-affected country, group psychotherapy reduced PTSD symptoms and combined depression and anxi- ety symptoms and improved functioning. 

 

Topics: Armed Conflict, Gender, Women, Health, Mental Health, PTSD, Sexual Violence, SV against women Regions: Africa, Central Africa Countries: Democratic Republic of the Congo

Year: 2013

The Gender-Specific Terror of El Salvador and Guatemala: Post-traumatic Stress Disorder in Central American Refugee Women

Citation:

Aron, Adrianne, Shawn Corne, Anthea Fursland, and Barbara Zelwer. 1991. “The Gender-Specific Terror of El Salvador and Guatemala: Post-traumatic Stress Disorder in Central American Refugee Women.” Women’s Studies International Forum 14 (1): 37–47. doi:10.1016/0277-5395(91)90082-S.

Authors: Adrianne Aron, Shawn Corne, Anthea Fursland, Barbara Zelwer

Abstract:

A taxonomy of three broad categories describes the forms of sexual abuse commonly found in El Salvador and Guatemala, where gender-specific political repression traumatizes people and gives rise to Post-Traumatic Stress Disorder (PSTD). If the psychological problems of Central American women refugees are to be addressed meaningfully, we must attend not only to the special characteristics of the assaults they have endured, but also to features of the pre-trauma environment in which they lived, and the post-trauma experience of exile. Of particular importance is the distinction between institutionalized and noninstitutionalized sexual assault; that is, assault sanctioned by the government as a normative act of social control versus assault which is considered deviant, criminal, and punishable by law. A case study of a Central American refugee woman suffering from PSTD is presented, to illustrate the psychological symptoms attendant to trauma and the use of sexual abuse as a form of political repression.

Topics: Displacement & Migration, Refugees, Gender, Women, Health, PTSD, Sexual Violence, SV against women Regions: Americas, Central America Countries: El Salvador, Guatemala

Year: 1991

Waging Gendered Wars: U.S. Military Women in Afghanistan and Iraq

Citation:

Eager, Paige Whaley. 2014. Waging Gendered Wars: U.S. Military Women in Afghanistan and Iraq. New York: Routledge. https://www.routledge.com/Waging-Gendered-Wars-US-Military-Women-in-Afghanistan-and-Iraq/Eager/p/book/9781409448464.

Author: Paige Whaley Eager

Abstract:

Waging Gendered Wars examines, through the analytical lens of feminist international relations theory, how U.S. military women have impacted and been affected by the wars in Iraq and Afghanistan. Although women were barred from serving formally in ground combat positions within the U.S. armed forces during both wars, U.S. female soldiers are being killed in action. By examining how U.S. military women's agency as soldiers, veterans, and casualties of war affect the planning and execution of war, Whaley Eager assesses the ways in which the global world of international politics and warfare has become localized in the life and death narratives of female service personnel impacted by combat experience, homelessness, military sexual trauma, PTSD, and the deaths of fellow soldiers.
 
(Routledge)

Keywords: politics & international relations, gender politics, political philosophy, U.S. politics, security studies, war & conflict studies

Topics: Armed Conflict, Combatants, Female Combatants, Gender, Women, Health, PTSD, Trauma, Militarized livelihoods, Military Forces & Armed Groups, Security

Year: 2014

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