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The present study aims to review empirical research focusing on traumatic events and posttraumatic stress among children and adolescents in out-of-home placement and identify future directions for research. A search in PsychInfo, ISI, and PubMed for the period 1985–2010 and use of citation alerts from 2006 to 2010 yielded 27 studies meeting our inclusion criteria. The included studies applied a diversity of assessment instruments and methods. Only six studies reported when the traumatic event(s) had occurred and/or time of assessment posttrauma. The studies comprised two main categories of traumatic events: war related trauma and sexual/physical abuse. There was a male majority exposed to studies focusing on war-related trauma, and studies on sexual trauma had a female majority. Studies on war-related trauma included foster children from Africa and Asia, whereas studies on abuse trauma included mainly North American samples. The review reflects a scarcity of empirical studies with a trauma perspective in this vulnerable population.

After the Fukushima nuclear power plant accident, numerous evacuees reported poor mental health status and high-risk perceptions of the health effects of radiation. However, the temporal associations between these variables have not yet been examined. Using data from the Fukushima Health Survey, we examined changes in risk perception of the health effects of radiation over time and assessed the effects of mental health on such changes using logistic regression analysis. Risk perception for delayed effect pertains a brief on health effect in later life (delayed effect), whereas that of genetic effect pertains a brief on health effect of future children and grandchildren (genetic effect). We found that many participants showed consistently high or low-risk perceptions over all three study years (2011–2013) (for delayed effect: 59% and 41% of participants were in the low and high-risk perception groups, respectively; for genetic effect: 47% and 53%, respectively). Stronger traumatic reactions (≥50 on the PTSD Checklist–Specific) significantly affected the odds of being in the high-risk perception group for the delayed and genetic effects, with the associations being strongest soon after the disaster: The adjusted ORs (95%CIs) were 2.05 (1.82–2.31), 1.86 (1.61–2.15), and 1.88 (1.62–2.17) for the delayed effect in 2011, 2012, and 2013, respectively, and 2.18 (1.92–2.48), 2.05 (1.75–2.40), and 1.82 (1.55–2.15) for the genetic effect. As initial mental health status had the strongest impact on later risk perceptions of radiation, it should be considered in early response and communication efforts.

Posttraumatic Stress Disorder remains one of the most contentious and poorly understood psychiatric disorders. Evolution and Posttraumatic Stress provides a valuable new perspective on its nature and causes. This book is the first to examine PTSD from an evolutionary perspective. Beginning with a review of conventional theories, Chris Cantor provides a clear and succinct overview of the history, clinical features and epidemiology of PTSD before going on to introduce and integrate evolutionary theory. Subjects discussed include: The evolution of human defensive behaviours A clinical perspective of PTSD Defence in overdrive: evolution, PTSD and parsimony This original presentation of PTSD as a defensive strategy describes how the use of evolutionary theory provides a more coherent and successful model for diagnosis, greatly improving understanding of usually mystifying symptoms. It will be of great interest to psychiatrists, psychotherapists, psychologists, and anthropologists. Part I: Posttraumatic Stress Disorder: An Introduction. A Brief History of PTSD. The Long and the Short. The World Wars. Early Conceptualization of Traumatic Reactions. Science and Politics in Recent Times. Muddy Waters. Early Ethological Speculations. Summary. A Clinical Perspective of PTSD. PTSD as a Concept. The DSM-IV Criteria for PTSD. The Nature of Traumas and Frequency of PTSD. The Influence of Perception. Trauma and Symptom Course. War Studies. Complex PTSD. Delayed PTSD. Subthreshold PTSD. Summary. Conventional Theories of PTSD. Learning, Controllability and Predictability. Of Rats and Men. Learned Helplessness. Controllability and Predictability. Flaws of Overly Simplistic Conditioning Theories. Preparedness. Observations From Combat and Torture. Controllability and PTSD. Summary. Myopia and 21st Century Neuroscience. Proximate versus Distal Perspective. The Triune Brain. 21 st century? Facial Emotions. Essential Neuroanatomy of PTSD. Neurochemistry and PTSD. Conditioning Studies and Functional Anatomy. Neurogenesis and Plasticity. Summary. Indelible Memories, Forgetfulness and Defence. The Evolution of Memory and Awareness. State-dependent Memory and Memory Laws. Fear as a Component of a Behavioural Module. Special Police Training Insights. Emotions as Communicational States. Information Processing and PTSD. Summary. Part II: Evolution and Posttraumatic Stress Disorders. The Evolution of Human Defensive Behaviours. Ancestral Origins and Predation Pressure. In the Beginning Learning and Defence. Common Evolutionary Misconceptions. Summary. Reptilian and Mammalian Defences. Predation and Defence. Reptilian Defence. Mammalian Defence. Adaptive Conservatism and Evolutionary Stable Strategies. Summary. Predator Avoidance, Anti-predator Strategies and Foraging. The Functions of Emotions. The Ecology of Threats. Influences of Predation. Vigilance, Prey Decision-making and Activity. Cost, Benefits and Predator Sensitive Foraging. Primate Foraging Decision Studies. Summary. Family Foibles and Early Hominids. The Pathway to Humankind. Hominids. Primate and Great Ape Extrapolations. Group Size in Great Apes. Primate Research Limitations. Paleoanthropology. Hominids as Scavengers and Prey. Hunter-gatherers. Summary. Defence in Overdrive: Evolution, PTSD and Parisomony. An Evolutionary Theory of PTSD. PTSD Symptom Criteria Revisited. Adaptive or Maladaptive: the Relevance of Subthreshold States. Conclusions. Perspectives and Possibilities: Vigilance, Avoidance and Attentive Immobility. Vigilance. Predator Sensitive Foraging and PTSD: Fertile Pasture or Blind Alley? A Zonal Approach to PTSD. Avoidance. Attentive Immobility. Neurophysiology, Diagnostic Research Tests and Beyond. Conclusions. He who Fights and Runs Away...Withdrawal, Aggressive Defence and Numbing. Withdrawal. Refuging. Group Size and Individual Defence. Aggressive Defence. Numbing. Conclusions. The Paradox of Appeasement. A Hidden Problem. Appeasement Functions. A Context for Fear based Appeasement. The Stockholm Syndrome. Complex PTSD. Conclusions. A Last Resort: Tonic Immobility. Desperate Measures. Hysteria or PTSD? Future Research Directions. Conclusions. Agonic Switching, Preparedness and Psychobiological Response Patterns. Why Do We Not All Suffer PTSD if it is Adaptive? Life in Times of Threat. The Agonic Switch. Preparedness. Non-archetypal Traumas. Psychobiological Response Patterns. Trauma Contexts and Responses. Conclusions. Epilogue - PTSD in other Species? Chris Cantor is Adjunct Senior Lecturer in Psychiatry at the University of Queensland, Australia. 'Chris Cantor offers a fascinating theory of evolutionary PTSD... extremely well supported by research references and offers an unusual slant on this important topic.' - Brenda Mallon, Therapy Today, November 2005 Overall Evolution and Post-traumatic Stress is effective in providing a clear yet detailed alternative perspective to PTSD. With the use of evidence-based theories ans frequent case examples, this evolutionary stance may well provide a deeper understanding of the difficulties encountered by people experiencing this form of Trauma. - Kate Lester, from The Journal of Critical Psychology, Counselling and Psychotherapy, (Vol 7, No 3) Autumn 2007

To determine the incidence and severity of symptoms related to the diagnosis of post-traumatic stress disorder (PTSD) in a cohort of general ICU patients. A prospective cohort study 3 months after general ICU discharge. A general ICU in a teaching hospital in northern Scotland. Seventy-eight ICU survivors of general ICU. Patients were contacted 3 months after ICU discharge and asked to complete a telephone assessment of the Davidson Trauma Scale. The median score was 8, with 22% recording a score of at least 27 and 14% meeting the full diagnostic criteria for PTSD. The overall score was not correlated with sex, ICU length of stay, or APACHE II score but was inversely correlated with age and directly correlated with length of mechanical ventilation. The overall score was also related to the patient reporting having visited a GP or a mental health professional for psychological distress previous to ICU. We found a high incidence of symptoms consistent with PTSD 3 months after ICU discharge in this general ICU cohort. This was associated with younger patients and those who visited their GP or a mental health professional complaining of psychological symptoms. Further research and a greater liaison between ICU staff and family practitioners and mental health practitioners is required to better identify individuals at risk and reduce psychological morbidity in this group.

The opening events of the French Revolution have stood as some of the most familiar in modern European history. Traumatic Politics emerges as a fresh voice from the existing historiography of this widely studied course of events. In applying a psychological lens to the classic problem of why the French Revolution’s first representative assembly was unable to reach a workable accommodation with Louis XVI, Barry Shapiro contends that some of the key political decisions made by the Constituent Assembly were, in large measure, the product of traumatic reactions to the threats to the lives of its members in the summer of 1789. As a result, Assembly policy frequently reflected a preoccupation with what had happened in the past rather than active engagement with present political realities. In arguing that the manner in which the Assembly dealt with the king bears the imprint of the behavior that typically follows exposure to traumatic events, Shapiro focuses on oscillating periods of traumatic repetition and traumatic denial. Highlighting the historical impact of what could be viewed as a relatively “mild” trauma, he suggests that trauma theory has a much wider field of potential applicability than that previously established by historians, who have generally confined themselves to studying the impact of massively traumatic events such as war and genocide. Moreover, in emphasizing the extent to which monarchical loyalties remained intact on the eve of the Revolution, this book also challenges the widely accepted contention that prerevolutionary cultural and discursive innovations had “desacralized” the king well before 1789.

Background: Empirical knowledge about the prevalence and potency of reminders several years post-trauma, and how experiences with reminders relate to mental health and functioning, is scarce.Objective: The aim of this study was threefold: (1) systematically describe the type and frequency of trauma reminders experienced by survivors 8.5 years after a terrorist attack; (2) explore the intensity and duration of reactions evoked by various reminders; and (3) examine whether experiences with trauma reminders are associated with psychological distress and level of functioning almost a decade post-trauma.Method: 289 survivors (51.2% females, M age = 27.7, SD = 4.6) of the 2011 massacre on Utøya island, Norway, were interviewed 8.5 years post-terror. Participants were presented with a list of ten potential trauma reminders and asked to rate how frequently they had experienced each one in the past month, and the intensity and duration of the reactions evoked. Current posttraumatic reactions were measured using the UCLA PTSD-RI and the HSCL-8. Associations between experiences with reminders, psychological distress, and functioning, were analysed by linear regressions.Results: At 8.5 years post-terror, approximately 90% of the participants had experienced trauma reminders within the past month (35.6% often or very often). Almost 30% had become distressed, afraid, sad, or experienced bodily reactions to a great or very great extent. The vast majority reported that the reactions only lasted for a few minutes or hours. Frequency of exposure to reminders, and the intensity of the reactions evoked, were significantly associated with psychological distress. Frequency of exposure to trauma reminders was negatively related to the survivors’ level of functioning.Conclusions: Trauma reminders can still be a central source of psychological distress and impaired functioning among survivors almost a decade post-trauma. While everyone who is directly exposed to a terrorist attack does not need psychotherapy, most would probably benefit from psychoeducation about reminders.

Background. Evidence highlights healthcare workers (HCWs) facing outbreaks, particularly the ongoing covid-19 pandemic, are at increased risk of negative mental health outcomes, particularly post-traumatic stress symptoms (PTSS), anxiety and depression. Data from previous outbreaks highlighted the risk for a negative impact on HCWs’ social and occupational functioning, but scant data have investigated this issue in the framework of the covid-19 pandemic. A number of effective interventions have been proposed to support mental health and well-being of HCWs in emerging infectious outbreaks, but it is important to acknowledge the differential impact of mental disorders on different dimensions of functioning. Methods. The study explored the associations between work and social functioning and PTSS, depression and anxiety in a sample of 265 frontline HCWs employed at a major university hospital in Italy (Pisa), facing the first period of the covid-19 pandemic. Individuals were assessed by means of the Impact of Event Scale-Revised (IES-R) for PTSS, the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the General Anxiety Disorder-7 Item (GAD-7) for anxiety symptoms and the Work and Social Adjustment Scale (WSAS) to assess work and social functioning. Results. Higher levels of functioning impairment were found among individuals with moderate to severe acute PTSS, depressive and anxiety symptoms with respect to those without. Acute PTSS and depressive symptoms were predictive factors of impairment in each domain of functioning analyzed. Anxiety symptoms were associated with impairment in both work and home management activities. Frontline activity was associated with impairment in both private and social leisure activities. Conclusions. Long-term perspective studies are warranted to better investigate the psychopathological burden on HCWs’ work and social functioning and to promote adequate intervention strategies.

Though there is substantial support for the importance of maladaptive appraisals for the development of posttraumatic stress reactions (PTSR), little is known about the long-term temporal relationship between maladaptive appraisals and PTSR beyond the first year after a traumatic event. We aimed to investigate three research questions: (1) Does the level of maladaptive appraisals change over time? (2) Are maladaptive appraisals and PTSR concurrently related to each other in the long term? (3) What is the direction of the temporal relationship between maladaptive appraisals and PTSR? The participants were young survivors after the terror attack at Utøya island in Norway in 2011. We included data measured at 14-15 months, 30-32 months, and 102-108 months post trauma. The participants (  = 315) were all younger than 25 years at the time of the attack (mean age was 18.4, SD = 2.3), and 48.3% were female. The aims were investigated using correlations, paired t-tests, random intercept cross-lagged panel models (RI-CLPM), and cross-lagged panel models (CLPM). We found a significant decrease in PTSR severity from 14-15 months to 30-32 months, and there was a significant increase in the mean level of maladaptive appraisals from 30-32 months to 102-108 months post trauma. Maladaptive appraisals and PTSR were highly associated across the three time points. Stable individual differences seem to account for most of the longitudinal relationship between maladaptive appraisals and PTSR, and we did not find clear indications of a direction of the temporal relationship between the variables. Our results indicate that the level of maladaptive appraisals can be quite stable once established, that they remain associated with PTSR, and that the long-term relationship between maladaptive appraisals and PTSR in the years following a trauma may best be explained by stable individual differences.

The Great East Japan Earthquake triggered a massive tsunami that devastated the coasts of northern Japan on March 11, 2011. Despite the large number of \"resident survivors,\" who have continued to reside on the upper floors of damaged houses, few studies have examined the mental health of these residents. We explored the prevalence and risk factors of post-traumatic stress reaction (PTSR) among resident survivors. A cross-sectional household screening for health support needs was conducted among resident survivors in Higashi-Matsushima city, Miyagi, 2 to 4 months after the tsunami. Questions assessing PTSR were included in the screening interviews. Of 5103 resident survivors, 5.7% experienced PTSR. PTSR risk factors, identified via regression analysis, differed according to the height of house flooding. When house flooding remained below the ground floor, PTSR was significantly associated with being female and regular psychotropic medication intake. These 2 factors in addition to being middle-aged or elderly and living alone were also risk factors when flood levels were above the ground floor. Following the tsunami, PTSR was found in a considerable number of resident survivors. Attention and support for people who use psychiatric medication, their families, and people living alone are suggested as possible directions for public health strategies. (Disaster Med Public Health Preparedness. 2016;page 1 of 8).

Background In communities affected by a disaster, walking can be a feasible form of physical exercise to improve physical and mental health conditions. However, there is limited evidence to support relationships between walking habits and mental health conditions in post-disaster settings. Cross-sectional epidemiological data obtained from a questionnaire survey (conducted in October 2017) of a community affected by the 2011 Great East Japan Earthquake (GEJE) was analyzed to evaluate the relationships. Methods Participants included individuals over 20 years of age ( N = 718) from Shichigahama town in Miyagi prefecture, whose houses were significantly damaged by the GEJE. Their mental health conditions were assessed by the Kessler Psychological Distress Scale (K6), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Impact of Event Scale-Revised (IES-R). Additionally, the questionnaire asked the participants spent duration walking on average and their walking purpose by the following items: (1) longer than 60 min per day, (2) between 30 and 60 min per day, or (3) less than 30 min per day, and whether they walked to maintain healthy living habits (health-conscious walkers) or merely for transportation without considering health consequences (non-health-conscious walkers). These information and mental health indicators were analyzed using analysis of covariance (ANCOVA). Results Among the three walking duration groups of health-conscious walkers, there were significant differences in CES-D and K6 scores ( p = 0.01 and p = 0.04), but not in IES-R scores, considering age, gender, and alcohol drinking habits as covariates. CES-D score was significantly higher among short walkers ( p = 0.004). Among the three walking duration groups of non-health-conscious walkers, there were significant differences in avoidance symptoms, the subdomain of IES-R ( p = 0.01), but not in CES-D, K6, and total IES-R scores, considering the variants. Conclusion Our study suggests that walking durations may positively affect mood, but not PTSR, only when walking is performed with the purpose of maintaining healthy living habits. Walking durations were negatively associated with avoidance symptoms among non-health-conscious walkers in the community affected by the GEJE, indicating that the disaster may have had a long-lasting impact on walking habits.