cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.21829502.v1
title: Analyzing small data sets using Bayesian estimation: the case of posttraumatic stress symptoms following mechanical ventilation in burn survivors

description: The analysis of small data sets in longitudinal studies can lead to power issues and often suffers from biased parameter values. These issues can be solved by using Bayesian estimation in conjunction with informative prior distributions. By means of a simulation study and an empirical example concerning posttraumatic stress symptoms (PTSS) following mechanical ventilation in burn survivors, we demonstrate the advantages and potential pitfalls of using Bayesian estimation. First, we show how to specify prior distributions and by means of a sensitivity analysis we demonstrate how to check the exact influence of the prior (mis-) specification. Thereafter, we show by means of a simulation the situations in which the Bayesian approach outperforms the default, maximum likelihood and approach. Finally, we re-analyze empirical data on burn survivors which provided preliminary evidence of an aversive influence of a period of mechanical ventilation on the course of PTSS following burns. Not suprisingly, maximum likelihood estimation showed insufficient coverage as well as power with very small samples. Only when Bayesian analysis, in conjunction with informative priors, was used power increased to acceptable levels. As expected, we showed that the smaller the sample size the more the results rely on the prior specification. We show that two issues often encountered during analysis of small samples, power and biased parameters, can be solved by including prior information into Bayesian analysis. We argue that the use of informative priors should always be reported together with a sensitivity analysis.
DOI: 10.6084/m9.figshare.21829505
title: Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

description: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD), but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD. This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS) in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT) on the association between the two. Consecutive emergency department trauma admissions with qualifying PTSD symptoms (<i>n=</i>501) were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms. The cross-lagged effect of SRS on PTSD was statistically significant (β=−0.12, <i>p</i>=0.01) among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (β=−0.02, <i>p</i>=0.67). Both relationships were non-significant among survivors who received CBT. SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention.
DOI: 10.6084/m9.figshare.21829505.v1
title: Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

description: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD), but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD. This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS) in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT) on the association between the two. Consecutive emergency department trauma admissions with qualifying PTSD symptoms (<i>n=</i>501) were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms. The cross-lagged effect of SRS on PTSD was statistically significant (β=−0.12, <i>p</i>=0.01) among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (β=−0.02, <i>p</i>=0.67). Both relationships were non-significant among survivors who received CBT. SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention.
DOI: 10.6084/m9.figshare.21829508
title: Mental health professionals’ attitudes toward patients with PTSD and depression

description: To date, mental health professionals’ attitudes toward posttraumatic stress disorder (PTSD), compared to other psychiatric disorders such as schizophrenia or depression, have rarely been studied. We assessed mental health professionals’ attitudes toward patients with PTSD compared to patients suffering from depression. Case vignettes of a patient with either PTSD or depression were presented to two samples of mental health professionals: attendees of a conference on posttraumatic stress (<i>N=</i>226) or of a lecture for psychiatry residents (<i>N=</i>112). Participants subsequently completed a questionnaire that assessed their attitude reactions to the presented case. Participants showed similarly positive attitudes toward depression and PTSD. PTSD elicited a more favorable attitude with regard to prosocial reactions, estimated dependency, attributed responsibility, and interest in the case, particularly in mental health professionals specializing in psychotraumatology. Across diagnoses, higher age and longer professional experience were associated with more positive attitudes toward patients. Mental health professionals’ positive attitudes toward patients with depression and PTSD correlate with their specific knowledge about the disorder, their level of professional training, and their years of professional experience. The instruments used, although based on established theoretical concepts in attitude research, were not validated in their present versions.
DOI: 10.6084/m9.figshare.21829511
title: Untested assumptions: psychological research and credibility assessment in legal decision-making

description: Trauma survivors often have to negotiate legal systems such as refugee status determination or the criminal justice system. We outline and discuss the contribution which research on trauma and related psychological processes can make to two particular areas of law where complex and difficult legal decisions must be made: in claims for refugee and humanitarian protection, and in reporting and prosecuting sexual assault in the criminal justice system. There is a breadth of psychological knowledge that, if correctly applied, would limit the inappropriate reliance on assumptions and myth in legal decision-making in these settings. Specific recommendations are made for further study.
DOI: 10.6084/m9.figshare.21829511.v1
title: Untested assumptions: psychological research and credibility assessment in legal decision-making

description: Trauma survivors often have to negotiate legal systems such as refugee status determination or the criminal justice system. We outline and discuss the contribution which research on trauma and related psychological processes can make to two particular areas of law where complex and difficult legal decisions must be made: in claims for refugee and humanitarian protection, and in reporting and prosecuting sexual assault in the criminal justice system. There is a breadth of psychological knowledge that, if correctly applied, would limit the inappropriate reliance on assumptions and myth in legal decision-making in these settings. Specific recommendations are made for further study.
DOI: 10.6084/m9.figshare.21829514
title: Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession

description: We present a literature review on trauma exposure and spirit possession in <i>low- and middle-income countries</i> (LMICs). Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013–2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients’ sociodemographic characteristics, and its relation to traumatic experiences. The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this systematic literature review.
DOI: 10.6084/m9.figshare.21829514.v1
title: Global mental health and trauma exposure: the current evidence for the relationship between traumatic experiences and spirit possession

description: We present a literature review on trauma exposure and spirit possession in <i>low- and middle-income countries</i> (LMICs). Despite the World Health Organization's objective of culturally appropriate mental health care in the Mental Health Action Plan 2013–2020, and the recommendations of the Inter-Agency Standing Committee to consider local idioms of distress and to collaborate with local resources, this topic still receives very little attention. Pathological spirit possession is commonly defined as involuntary, uncontrollable, and occurring outside of ritual settings. It is often associated with stigmatization, suffering, and dysfunctional behavior. While spirit possession has been discussed as an idiom of distress in anthropological literature, recent quantitative studies have presented support for a strong relationship between traumatic experiences and pathological possession states. The aim of this review was to investigate this relationship systematically in LMICs, in view of the debate on how to address the mental health gap in LMICs. Twenty-one articles, published in peer-reviewed English-language journals between 1994 and 2013, were identified and analyzed with regard to prevalence of possessive trance disorders, patients’ sociodemographic characteristics, and its relation to traumatic experiences. The review and analysis of 917 patients with symptoms of possessive trance disorders from 14 LMICs indicated that it is a phenomenon occurring worldwide and with global relevance. This literature review suggests a strong relationship between trauma exposure and spirit possession with high prevalence rates found especially in postwar areas in African countries. More attention for possessive trance disorders in mental health and psychosocial intervention programs in humanitarian emergency settings as well as in societies in transition in LMICs is needed and justified by the results of this systematic literature review.
DOI: 10.6084/m9.figshare.21829517
title: The “one size fits all” approach to trauma treatment: should we be satisfied?

description: There have been significant advances in the treatment of posttraumatic stress disorder in the last two decades. Further improvements in outcomes will be supported by recognition of the heterogeneity of symptoms in trauma populations and the development of treatments that promote the tailoring of interventions according to patient needs. Collaboration with patients regarding preferences about treatment structure, process, and outcomes is critical and will benefit the effectiveness and quality of treatments as well as the speed of their dissemination. New research methodologies are required that can incorporate important variables such as patient preferences and symptom heterogeneity without necessarily extending already lengthy study times or further complicating study designs. An example of alternative methodology is proposed.
DOI: 10.6084/m9.figshare.21829517.v1
title: The “one size fits all” approach to trauma treatment: should we be satisfied?

description: There have been significant advances in the treatment of posttraumatic stress disorder in the last two decades. Further improvements in outcomes will be supported by recognition of the heterogeneity of symptoms in trauma populations and the development of treatments that promote the tailoring of interventions according to patient needs. Collaboration with patients regarding preferences about treatment structure, process, and outcomes is critical and will benefit the effectiveness and quality of treatments as well as the speed of their dissemination. New research methodologies are required that can incorporate important variables such as patient preferences and symptom heterogeneity without necessarily extending already lengthy study times or further complicating study designs. An example of alternative methodology is proposed.
DOI: 10.6084/m9.figshare.21829523.v1
title: Trauma-related mental health problems among national humanitarian staff: a systematic review of the literature

description: Working in humanitarian crisis situations is dangerous. National humanitarian staff in particular face the risk of primary and secondary trauma exposure which can lead to mental health problems. Despite this, research on the mental health of national staff is scarce, and a systematic analysis of up-to-date findings has not been undertaken yet. This article reviews the available literature on trauma-related mental health problems among national humanitarian staff. It focuses on the prevalence of selected mental health problems in relation to reference groups; sex and/or gender as predictive factors of mental health problems; and the influence of organization types on mental health problems. Three databases were systematically searched for relevant studies published in the English language in peer-reviewed journals. Fourteen articles matched the inclusion criteria. Findings suggest that national staff experience mental health problems and the prevalence of posttraumatic stress disorder, depression, and anxiety among this occupation group is mostly similar to or higher than among reference groups. Research on both substance use disorder and suicidal behavior among national staff is particularly scarce. The relation between sex and/or gender and mental health problems among national staff appears to be complex, and organizational staff support seems to be an important determinant for mental health. All findings call for increased attention from the humanitarian community and further research on the topic.
DOI: 10.6084/m9.figshare.21829523
title: Trauma-related mental health problems among national humanitarian staff: a systematic review of the literature

description: Working in humanitarian crisis situations is dangerous. National humanitarian staff in particular face the risk of primary and secondary trauma exposure which can lead to mental health problems. Despite this, research on the mental health of national staff is scarce, and a systematic analysis of up-to-date findings has not been undertaken yet. This article reviews the available literature on trauma-related mental health problems among national humanitarian staff. It focuses on the prevalence of selected mental health problems in relation to reference groups; sex and/or gender as predictive factors of mental health problems; and the influence of organization types on mental health problems. Three databases were systematically searched for relevant studies published in the English language in peer-reviewed journals. Fourteen articles matched the inclusion criteria. Findings suggest that national staff experience mental health problems and the prevalence of posttraumatic stress disorder, depression, and anxiety among this occupation group is mostly similar to or higher than among reference groups. Research on both substance use disorder and suicidal behavior among national staff is particularly scarce. The relation between sex and/or gender and mental health problems among national staff appears to be complex, and organizational staff support seems to be an important determinant for mental health. All findings call for increased attention from the humanitarian community and further research on the topic.
DOI: 10.6084/m9.figshare.21829529
title: Biological correlates of complex posttraumatic stress disorder—state of research and future directions

description: Complex posttraumatic stress disorder (PTSD) presents with clinical features of full or partial PTSD (re-experiencing a traumatic event, avoiding reminders of the event, and a state of hyperarousal) together with symptoms from three additional clusters (problems in emotional regulation, negative self-concept, and problems in interpersonal relations). Complex PTSD is proposed as a new diagnostic entity in ICD-11 and typically occurs after prolonged and complex trauma. Here we shortly review current knowledge regarding the biological correlates of complex PTSD and compare it to the relevant findings in PTSD. Recent studies provide support to the validity of complex PTSD as a separate diagnostic entity; however, data regarding the biological basis of the disorder are still very limited at this time. Further studies focused on complex PTSD biological correlates and replication of the initial findings are needed, including neuroimaging, neurobiochemical, genetic, and epigenetic investigations. Identification of altered biological pathways in complex PTSD may be critical to further understand the pathophysiology and optimize treatment strategies.
DOI: 10.6084/m9.figshare.21829529.v1
title: Biological correlates of complex posttraumatic stress disorder—state of research and future directions

description: Complex posttraumatic stress disorder (PTSD) presents with clinical features of full or partial PTSD (re-experiencing a traumatic event, avoiding reminders of the event, and a state of hyperarousal) together with symptoms from three additional clusters (problems in emotional regulation, negative self-concept, and problems in interpersonal relations). Complex PTSD is proposed as a new diagnostic entity in ICD-11 and typically occurs after prolonged and complex trauma. Here we shortly review current knowledge regarding the biological correlates of complex PTSD and compare it to the relevant findings in PTSD. Recent studies provide support to the validity of complex PTSD as a separate diagnostic entity; however, data regarding the biological basis of the disorder are still very limited at this time. Further studies focused on complex PTSD biological correlates and replication of the initial findings are needed, including neuroimaging, neurobiochemical, genetic, and epigenetic investigations. Identification of altered biological pathways in complex PTSD may be critical to further understand the pathophysiology and optimize treatment strategies.
DOI: 10.6084/m9.figshare.21829161
title: Improving the understanding and treatment of complex grief: an important issue for psychotraumatology

description: In the Netherlands, every year 500,000 people are confronted with the death of a close relative. Many of these people experience little emotional distress. In some, bereavement precipitates severe grief, distress, and dysphoria. A small yet significant minority of bereaved individuals develops persistent and debilitating symptoms of persistent complex bereavement disorder (PCBD) (also termed prolonged grief disorder), posttraumatic stress disorder, and depression. Knowledge about early identification of, and preventive care for complex grief has increased. Moreover, in recent years there has been an increase in treatment options for people for whom loss leads to persistent psychological problems. That said, preventive and curative treatments are effective for some, but not all bereaved individuals experiencing distress and dysfunction following loss. This necessitates further research on the development, course, and treatment of various stages of complex grief, including PCBD. “Complex grief” is an informal term referring to debilitating, non-normative grief. It will likely be named Prolonged Grief Disorder in the forthcoming ICD-11. It is named Persistent Complex Bereavement Disorder in DSM-5. Research on the development, course, and treatment of complex grief is needed. This research should address different stages and manifestations of complex grief.
DOI: 10.6084/m9.figshare.21829161.v1
title: Improving the understanding and treatment of complex grief: an important issue for psychotraumatology

description: In the Netherlands, every year 500,000 people are confronted with the death of a close relative. Many of these people experience little emotional distress. In some, bereavement precipitates severe grief, distress, and dysphoria. A small yet significant minority of bereaved individuals develops persistent and debilitating symptoms of persistent complex bereavement disorder (PCBD) (also termed prolonged grief disorder), posttraumatic stress disorder, and depression. Knowledge about early identification of, and preventive care for complex grief has increased. Moreover, in recent years there has been an increase in treatment options for people for whom loss leads to persistent psychological problems. That said, preventive and curative treatments are effective for some, but not all bereaved individuals experiencing distress and dysfunction following loss. This necessitates further research on the development, course, and treatment of various stages of complex grief, including PCBD. “Complex grief” is an informal term referring to debilitating, non-normative grief. It will likely be named Prolonged Grief Disorder in the forthcoming ICD-11. It is named Persistent Complex Bereavement Disorder in DSM-5. Research on the development, course, and treatment of complex grief is needed. This research should address different stages and manifestations of complex grief.