Int J Emerg Ment Health
· 2014 · PMID 25585481
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In this article, we posit the hypothesis that the January 2010 earthquake in Port-au-Prince reawakened a number of traumas linked to the natural disasters that struck Gonaives in 2004 and 2008. The study set out to evalu...In this article, we posit the hypothesis that the January 2010 earthquake in Port-au-Prince reawakened a number of traumas linked to the natural disasters that struck Gonaives in 2004 and 2008. The study set out to evaluate the PTSD and social support in the affected areas in Gonaives seven years after the disasters. The study covered a sample of 917 participants, of whom 534 (58.23%) were females, aged between 10 and 23 with an average age of 16.03 (SD = 2.65). A variety of scales were used: the Clinician Administered PTSD Scale (CAPS-1); the Traumatic Exposure Severity Scale (TESS); the PTSD Check-List Civilian version (PCL-C); the Impact of Event Scale Revised (IES-R) and the Social Support Questionnaire (SSQ). The results reveal a higher rate of PTSD among the oldest participants, a similarly higher rate of social support among Catholics than among Protestants, a more severe rate of PTSD among school going children and a positive correlation between social support and PTSD.
Int J Emerg Ment Health
· 2014 · PMID 25585480
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Workplace violence (WPV) is a growing problem for healthcare providers, particularly for those in the Emergency department (ED), with its increasing frequency and severity. Characteristics of WPV are similar in different...Workplace violence (WPV) is a growing problem for healthcare providers, particularly for those in the Emergency department (ED), with its increasing frequency and severity. Characteristics of WPV are similar in different parts of the World with different sociocultural and economic status. As this problem remains unsolved, its unwanted effects on mental and physical health of staff become more problematic. The most common psychological affects are reduced job satisfaction and fear. When the reasons of WPV are investigated; lack of preventive policies, educational inadequacy, unwillingness to report assaults as a result of a consideration of violence as a routine by the staff and unmet expectations of patients and their family may be listed. In the short-term, increasing the number of security personnel, flagging the names of the patients with a potential of aggression in the computer system and reducing length of stay in the ED are measures to implement immediately. In the long-term, governments must focus on this subject and develop necessary policies including educational programmes in order to reduce WP, before it is too late for another ED worker.
Three years have passed since the earthquake, in the coastal areas in the disaster area, by population transfer or the like from the temporary housing, the importance of the regeneration and revitalization of the local c...Three years have passed since the earthquake, in the coastal areas in the disaster area, by population transfer or the like from the temporary housing, the importance of the regeneration and revitalization of the local community has been pointed out. This study performed a preliminary study to aim at the psychological inspection about an effect of the horticultural therapy as the means of the local community reproduction support of the disaster area. Forty five women who are living in the coastal area of Miyagi Prefecture participated in this study. They experienced the Great East Japan earthquake in 2011 and suffered some kind of damage caused by the earthquake. The participants were assigned to two groups, the intervention group and the control group, via a random draw using a computer. The HI group attended the horticultural therapy intervention (HT intervention) sessions for 16 weeks. The HT intervention was designed in collaboration with a horticultural therapist and clinical psychologists. This intervention comprised a total of 16 weekly sessions (120 min each) at the community center and 15 minutes per day at participants' homes. We used five psychological measures for an intervention evaluation. The HI group showed a significant increase in post- intervention SCI-2 total scores, post- intervention SCI-2 membership scores, post-intervention SCI-2 influence scores, post- intervention SCI-2 meeting needs scores, post- intervention SCI-2 shared emotional connection scores, and post- intervention RSES score. We believe that these results suggest the effectiveness of the horticultural therapy as the means of the local community reproduction.
Int J Emerg Ment Health
· 2014 · PMID 25585478
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Awareness Integration (AI) is a new model in the field of psychotherapy which synthesizes numerous concepts from cognitive, behavioral, emotional, and body-mind theories. AI aims to enhance self-awareness, increase self-...Awareness Integration (AI) is a new model in the field of psychotherapy which synthesizes numerous concepts from cognitive, behavioral, emotional, and body-mind theories. AI aims to enhance self-awareness, increase self-esteem, release past traumas and psychological blocks, reduce symptoms of anxiety and depression, and promote a clear, realistic, and positive attitude in order to learn and implement new skills for an effective, productive, and functional life. This model allows for release and then integration through flexibly structured questions and expansive interventions that connect core beliefs, emotions, locations in the body where emotions are stored and relevant/original memories. A pilot study indicated a 76% decrease in depression, a 60% decrease in anxiety, a 43% increase in self-esteem, and a 20% increase in self-efficacy after taking part in AI therapy.
Int J Emerg Ment Health
· 2014 · PMID 25345240
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Sex offenders and violent offenders in general that were intoxicated at the time of their offense often claim that they were too intoxicated to know 1) what they were doing at the time of the offense and 2) therefore una...Sex offenders and violent offenders in general that were intoxicated at the time of their offense often claim that they were too intoxicated to know 1) what they were doing at the time of the offense and 2) therefore unable to recall the details of the offense situation the next day. What the literature has to say contradicts the claims of sex offenders or violent offenders who claim they were "out of control" and that they do not recall what they did in the offense situation. Alcohol use (mild to moderate consumption) appears to result in 1) alcohol myopia; 2) increased attentional focus on the more salient emotions (whether negative or positive); 3) improved creative thinking and improved attention to the activity at hand; 4) decreased frontal lobe activity (e.g., lack of concern about consequences or morals); 5) is impacted by alcohol expectancies; and 6) does not prevent an individual from being able to recall activity that occurred while intoxicated when provided cues.
Newmeyer M, Keyes B, Gregory S
… +4 more, Palmer K, Buford D, Mondt P, Okai B
Int J Emerg Ment Health
· 2014 · PMID 25345239
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Mental health service providers are at risk of experiencing compassion fatigue, burnout, and vicarious traumatization as a result of working in difficult contexts or when working with individuals who have experienced tra...Mental health service providers are at risk of experiencing compassion fatigue, burnout, and vicarious traumatization as a result of working in difficult contexts or when working with individuals who have experienced trauma. Numerous studies have examined the mitigating factors in professional caregivers' stress and related prevention strategies thought to be associated with professional self-care. This retrospective study examined the impact of debriefing strategies referred to as Critical Incident Stress Management (CISM) and spirituality in 22 mental health service providers working in a stressful, cross-cultural context. Quantitative analysis of pre and post self-report instruments suggests that training and utilization of CISM techniques may be important in preventing future problems. To the surprise of the researchers, spirituality may not only serve as a protective factor in moderating compassion fatigue, but also increases compassion satisfaction among professional caregivers. Thus, the "Mother Teresa Effect".
Int J Emerg Ment Health
· 2014 · PMID 25345238
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Suicide is one of the major causes of morbidity and mortality amongst children and adolescents. In 2004 the Food and Drug Administration (FDA) issued a "black-box" warning for antidepressants in children and adolescents,...Suicide is one of the major causes of morbidity and mortality amongst children and adolescents. In 2004 the Food and Drug Administration (FDA) issued a "black-box" warning for antidepressants in children and adolescents, stating that these drugs may increase suicidality, a term encompassing both suicidal thoughts and behavior, especially in the first few weeks of treatment. The warning was extended in 2007 to antidepressants prescribed to adults aged 25 and under. The evidence behind this decision stemmed from meta-analyses of antidepressant clinical trials that demonstrated a slight increase in suicidality in those receiving antidepressants versus those treated with a placebo. Due to methods of this pooled data compilation, the relationship between antidepressants and suicidality remains controversial. This report investigates a case where a 14 year old with major depressive disorder (MDD) developed suicidal ideation shortly after being prescribed a selective serotonin reuptake inhibitor (SSRI). Investigating the role antidepressants may play in suicidality suggests the need to explore the neurobiological mechanisms within the serotonin system. This case and its theoretical explanations attempt to bridge the gap between neurobiology and pharmacology in order to better delineate the etiology of this adverse effect.
Hashmi S, Ali SI, Tanwir F
… +3 more, Shamsi TY, Ahmed FR, Rai K
Int J Emerg Ment Health
· 2014 · PMID 25345236
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INTRODUCTION: Chlamydia trachomatis is a frequently encountered condition by general physicians, urologists and infectious diseases specialists. It can affect both genders and causes significant morbidity if not treated...INTRODUCTION: Chlamydia trachomatis is a frequently encountered condition by general physicians, urologists and infectious diseases specialists. It can affect both genders and causes significant morbidity if not treated properly and promptly. In addition, it can cause ophthalmia neonatorum, which manifests as neonatal conjunctivitis in the newborns. METHODOLOGY: The data was collected from fourteen tertiary care hospitals in two provinces of Pakistan during the time period of four months (September-December 2013). Inclusion criteria included all medical practitioners working at those hospitals and there were no limitations of age and gender to participate. The participants were approached through email which included a self administered questionnaire. Written consent was obtained from the participants and the study was approved by the ethical committee of all selected hospital. RESULTS: Overall 130 participants participated with a response rate of 65%. Females were 52.3% and males were 47.7%. In the study 17.7% of male and 29.4% of female participants proclaimed that they referred a patient to an infectious disease specialist in case the diagnosis of Chlamydia was dubious. 72.5% of the male and 55.8% of the female medical practitioners indicated that they yield detailed sexual history from the patients with Chlamydia. Regarding inquiring about the drugs history from the patient at risk of STDs, 22.6% male and 35.3% of female participants informed that they took a detailed drug history. Only 1.5% of the female medical practitioners notified Chlamydia to the partner of diseased patient themselves (provider referral). 24% male and 17.6% female participants had an understanding regarding the definite test of diagnosis for sexually transmitted Chlamydia. CONCLUSION: More sexual health skills development is required in medical practitioners working in Pakistan. The major deficient areas are sexual and drug history taking, management of sexually transmitted diseases and partner notification.
Brand S, Otte D, Petri M
… +4 more, Decker S, Stübig T, Krettek C, Müller CW
Int J Emerg Ment Health
· 2014 · PMID 25345235
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Posttraumatic stress disorder (PTSD) is possibly an overlooked diagnosis of victims suffering from traffic accidents sustaining serious to severe injuries. This paper investigates the incidence of PTSD after traffic acci...Posttraumatic stress disorder (PTSD) is possibly an overlooked diagnosis of victims suffering from traffic accidents sustaining serious to severe injuries. This paper investigates the incidence of PTSD after traffic accidents in Germany. Data from an accident research unit were analyzed in regard to collision details, and preclinical and clinical data. Preclinical data included details on crash circumstances and estimated injury severity as well as data on victims' conditions (e.g. heart rate, blood pressure, consciousness, breath rate). Clinical data included initial assessment in the emergency department, radiographic diagnoses, and basic life parameters comparable to the preclinical data as well as follow-up data on the daily ward. Data were collected in the German-In-Depth Accident Research study, and included gender, type of accident (e.g. type of vehicle, road conditions, rural or urban area), mental disorder, and AIS (Abbreviated Injury Scale) head score. AIS represent a scoring system to measure the injury severity of traffic accident victims. A total 258 out of 32807 data sets were included in this analysis. Data on accident and victims was collected on scene by specialized teams following established algorithms. Besides higher AIS Head scores for male motorcyclists compared to all other subgroups, no significant correlation was found between the mean maximum AIS score and the occurrence of PTSD. Furthermore, there was no correlation between higher AIS head scores, gender, or involvement in road traffic accidents and PTSD. In our study the overall incidence of PTSD after road traffic accidents was very low (0.78% in a total of 32.807 collected data sets) when compared to other published studies. The reason for this very low incidence of PTSD in our patient sample could be seen in an underestimation of the psychophysiological impact of traffic accidents on patients. Patients suffering from direct experiences of traumatic events such as a traffic accident and presenting with signs of clinically significant distress or impairment in social interactions should be treated in a team approach including not only trauma surgeons and surgical skilled staff but also psychophysiological experienced physicians.
Bracken-Scally M, McGilloway S, Gallagher S
… +1 more, Mitchell JT
Int J Emerg Ment Health
· 2014 · PMID 25345234
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Much is known about the negative impact of emergency services work, but no studies, to date, have investigated its long-term consequences. This cross-sectional study assesses the possible long-term effects on quality of...Much is known about the negative impact of emergency services work, but no studies, to date, have investigated its long-term consequences. This cross-sectional study assesses the possible long-term effects on quality of life, of trauma exposure and emergency work in a sample of retirees from the Irish emergency services (n = 169) and a comparison group of non-emergency service retirees (n = 140). A multi-questionnaire postal survey was administered to assess quality of life (QoL; WHOQOL-BREF), experiences of trauma, and trauma symptoms (PSS-SR). QoL was significantly better in non-emergency retirees, whilst this group also had significantly fewer trauma symptoms. Incidents involving children were identified by a large proportion of emergency retirees as being particularly difficult to manage. The findings address a significant gap in our knowledge around the possible longer-term effects of emergency services work in an often neglected sub-group. Factors associated with increased QoL and reduced symptoms of PTSD are discussed, as are some possible recommendations for the future.
Ikeshita K, Shimoda S, Norimoto K
… +5 more, Arita K, Shimamoto T, Murata K, Makinodan M, Kishimoto T
Int J Emerg Ment Health
· 2014 · PMID 25345233
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Suicide is an adverse event that can occur even when patient are hospitalized in psychiatric facilities. This study delineates the demographic characteristics of suicide attempts in mental hospitals and psychiatric wards...Suicide is an adverse event that can occur even when patient are hospitalized in psychiatric facilities. This study delineates the demographic characteristics of suicide attempts in mental hospitals and psychiatric wards of general hospitals in Japan, a country where the suicide rate is remarkably high. Analyses of incident reports on serious suicide attempts in psychiatric inpatients were performed using prefectural incident records between April 1, 2001, and December 31, 2012. Suicide reports were included for 35 incidents that occurred over 11 years, and demonstrated that 83% of patients (n = 29) committed suicide and 17% (n = 6) survived their attempt with serious aftereffects, such as cognitive impairment or persistent vegetative state. The male/female ratio of inpatient suicide was 1.5:1. The mean age of the attempters was 50.5 years (SD = 18.2). The most common psychiatric diagnoses for those with suicide incident reports were schizophrenia spectrum disorders (51.4%) and affective disorders (40%). Hanging (60%) was the most common method of suicide attempt, followed by jumping in front of moving objects (14.3%) and jumping from height (11.4%). Fifty-four percent of suicides (n = 19) occurred within hospital sites and the remainder (46%; n = 16) occurred outside hospital sites (e.g., on medical leave or elopement) while they were still inpatients.
Int J Emerg Ment Health
· 2014 · PMID 25345232
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This study used an exploratory design with a hermeneutic approach. The aim was to increase the understanding of the emotional responses of family members during the patient's critical care. Interviews from the main resea...This study used an exploratory design with a hermeneutic approach. The aim was to increase the understanding of the emotional responses of family members during the patient's critical care. Interviews from the main researcher's previous study about relatives of patients in an intensive care unit (ICU) were used. Two of these interviews were chosen, one with the mother and one with the father of an adult young patient, who became critically ill and admitted to a general ICU in south-west Sweden. The present study identified six feelings describing the emotional responses of the family members. The family members experienced feelings of uncertainty, feelings of abandonment, feelings of desertion from the loved one, feelings of being close to the deathbed, feelings of being in a no-man's-land and feelings of attachment. The experienced feelings described in this article can contribute to expanding healthcare professionals understanding of the family members' emotional responses during the patient's critical care.
There are not many personal reflection pieces about professional resilience published as health care professionals are still among the least likely to raise their own personal problems--especially in the field of emergen...There are not many personal reflection pieces about professional resilience published as health care professionals are still among the least likely to raise their own personal problems--especially in the field of emergency health care. Writing afirst person piece about the journey to finally finding professional resilience, I describe factors faced by many new and mid-level professionals that are not written about in academic journals yet contribute to: premature career termination, poor customer service/patient care, and lack of motivation. I conclude with a way forward that could be a map for others currently struggling with their career choice. As a mid level psychologist, I can now look back on the past 8 years of my development and see the obstacles I was faced with. The irony is that at the time I knew they were challenging times, but I lacked a context for them, and did not know what normal was. Now that I am a relatively safe distance away from those hard years, I can appreciate more fully what resilience means to me, and respect the years I spent secretly in crisis. This article is a blend of academic information about professional resilience and compassion fatigue, contrasted by those very concepts playing out in my own life. The recommendations I provide for leaders and those in the thick of a professional burn out are concepts I know would have made a difference to me, even in survival mode.
Semlitz L, Ogiwara K, Weissbecker I
… +5 more, Gilbert E, Sato M, Taniguchi M, Ishii C, Sawa C
Int J Emerg Ment Health
· 2013 · PMID 24558747
International Medical Corps and TELL, a local mental health non-profit organization in Japan, collaborated to develop localized Psychological First Aid (PFA) training of welfare and volunteer organizations supporting sur...International Medical Corps and TELL, a local mental health non-profit organization in Japan, collaborated to develop localized Psychological First Aid (PFA) training of welfare and volunteer organizations supporting survivors of the Japan March 11, 2011 triple disaster The trainings significantly increased participants 'perceived competency in applying PFA principles and in interacting with the disaster affected populations in a safe manner The collaboration between International Medical Corps and TELL in developing, implementing and evaluating the training has potential to inform PFA activities in other disaster affected settings.
In a previous article in this journal, Gunn, Lester and McSwain provided evidence that the ten warnings signs for suicide proposed by the American Association for Suicidology are valid for predicting suicidal ideation an...In a previous article in this journal, Gunn, Lester and McSwain provided evidence that the ten warnings signs for suicide proposed by the American Association for Suicidology are valid for predicting suicidal ideation and behavior A video posted on YouTube by a 15-year-old girl scored 8-9 out of 10 for these signs. Thirty-nine days after positing the video, the girl killed herself.