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This article discusses the complexities of treating posttraumatic stress disorder (PTSD) and the importance of tailoring therapy to individual patients. The author presents a case study of a man named John who experiences acute stress disorder (ASD) and later develops PTSD after the sudden death of his fiancée. The therapist uses a combination of psychoeducation, cognitive restructuring, and exposure therapy to help John process his guilt and traumatic memories. The article emphasizes the need for therapists to listen to their patients, adapt treatment plans, and acknowledge their own limitations. [Extracted from the article]

Clinical interviewing is the basic method to understand how a person feels and what are the presenting complaints, obtain medical history, evaluate personal attitudes and behavior related to health and disease, give the patient information about diagnosis, prognosis, and treatment, and establish a bond between patient and physician that is crucial for shared decision making and self-management. However, the value of this basic skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness. Instead, the time spent to inquire about problems and life setting may actually help to avoid further testing, procedures, and referrals. Moreover, the dialogue between patient and physician is an essential instrument to increase patient's motivation to engage in healthy behavior. The aim of this paper was to provide an overview of clinical interviewing and its optimal use in relation to style, flow and hypothesis testing, clinical domains, modifications according to settings and goals, and teaching. This review points to the primacy of interviewing in the clinical process. The quality of interviewing determines the quality of data that are collected and, eventually, of assessment and treatment. Thus, interviewing deserves more attention in educational training and more space in clinical encounters than it is currently receiving. [ABSTRACT FROM AUTHOR]

The article discusses the concept of allostatic load and its implications for preventive and clinical practices. Allostasis refers to an organism's ability to maintain stability through change, and it involves various biological systems. Allostatic load refers to the strain on the body caused by chronic stress, which can lead to physical and mental health problems. The article emphasizes the importance of considering allostatic load in clinical decision-making and suggests that interventions targeting allostatic overload can improve health outcomes. The concept of allostatic load is particularly relevant in the field of traumatic stress research, as it can help explain the relationship between trauma exposure, posttraumatic stress disorder (PTSD), and physical health outcomes. The article also highlights the impact of allostatic load in child maltreatment and suggests the need for interventions that address social well-being and perceived safety. Overall, understanding and addressing allostatic load can contribute to the development of effective treatment options and improve health and well-being. [Extracted from the article]

In the field of psychotraumatology, sequential treatment models have been put forward with respect to trauma-related disorders such as posttraumatic stress disorder (PTSD) and, even more so, complex PTSD [[37] [39]]. Once a patient has developed full-blown PTSD, should a distinction be made between "acute PTSD" (one to 3 months post-trauma) and "chronic PTSD" (with symptoms persisting for more than 3 months post-trauma)? The assessment and treatment of residual symptoms following evidence-based trauma-focused treatment has only rarely been mentioned in the literature so far [[56]]. The introduction of diagnostic manuals, such as the first mention of mental disorders in the International Classification of Diseases (ICD-6) in 1948 [[1]] and the Diagnostic and Statistical Manual of Mental Disorders in 1952 [[2]], was a big step forward in the fields of psychiatry and clinical psychology. [Extracted from the article]

Recent years have seen major developments in psychotherapy research that suggest the need to address critical methodological issues. These recommendations, developed by an international group of researchers, do not replace those for randomized controlled trials, but rather supplement strategies that need to be taken into account when considering psychological treatments. The limitations of traditional taxonomy and assessment methods are outlined, with suggestions for consideration of staging methods. Active psychotherapy control groups are recommended, and adaptive and dismantling study designs offer important opportunities. The treatments that are used, and particularly their specific ingredients, need to be described in detail for both the experimental and the control groups. Assessment should be performed blind before and after treatment and at long-term follow-up. A combination of observer- and self-rated measures is recommended. Side effects of psychotherapy should be evaluated using appropriate methods. Finally, the number of participants who deteriorate after treatment should be noted according to the methods that were used to define response or remission. [ABSTRACT FROM AUTHOR]

Background: Acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) and clinically significant PTSD symptoms (PTSS) are found in 4 and 12% of patients, respectively. We hypothesized that trauma-focused counseling prevents the incidence of ACS-induced PTSS.Methods: Within 48 h of hospital admission, 190 patients with high distress during ACS were randomized to a single-session intervention of either trauma-focused counseling or an active control intervention targeting the general role of stress in patients with heart disease. Blind interviewer-rated PTSS (primary outcome) and additional health outcomes were assessed at 3 months of follow-up. Trial results about prevalence were compared with data from previous studies on the natural incidence of ACS-induced PTSS/PTSD.Results: Intention-to-treat analyses revealed no difference in interviewer-rated PTSS between trauma-focused counseling (mean, 11.33; 95% Cl, 9.23-13.43) and stress counseling (9.88; 7.36-12.40; p = 0.40), depressive symptoms (6.01, 4.98-7.03, vs. 4.71, 3.65-5.77; p = 0.08), global psychological distress (5.15, 4.07-6.23, vs. 3.80, 2.60-5.00; p = 0.11), and the risk for cardiovascular-related hospitalization/all-cause mortality (OR, 0.67; 95% CI, 0.37-1.23). Self-rated PTSS indicated less beneficial effects with trauma-focused (6.54; 4.95-8.14) versus stress counseling (3.74; 2.39-5.08; p = 0.017). The completer analysis (154 cases) confirmed these findings. The prevalence rates of interviewer-rated PTSD (0.5%, 1/190) and self-rated PTSS were in this trial much lower than in meta-analyses and observation studies from the same cardiology department.Conclusions: Benefits were not seen for trauma-focused counseling when compared with an active control intervention. Nonetheless, in distressed ACS patients, individual, single-session, early psychological counseling shows potential as a means to prevent posttraumatic responses, but trauma-focused early treatments should probably be avoided. [ABSTRACT FROM AUTHOR]

Objective: Pain and inflammation during acute myocardial infarction (AMI) have been associated with the development of posttraumatic stress disorder and may also impact negatively on somatic outcome. We investigated the relationship between pain during AMI and levels of circulating proinflammatory (tumor necrosis factor [TNF]-a, interleukin [IL]-6) and anti-inflammatory (IL-33 and tissue growth factor [TGF]-ß 1) cytokines. Methods: Data were collected as part of the Myocardial Infarction - Stress Prevention Intervention (MISPRINT) study. We included 140 patients (mean age 59.6 years, 82.1% male) with high acute psychological distress within 48 h after MI. Fasting blood samples were drawn thereafter to measure cytokine levels. Sociodemographic factors, psychological and medical data, as well as cardiometabolic markers were assessed with questionnaires and patient interviews. Results: Linear regression models showed a significant positive correlation of pain with TGF-β1 (b = 770.91, p = 0.031) and a significant inverse correlation of pain with IL-33 (b = -0.11, p = 0.015) after controlling for age, gender, body mass index, lifetime depression, acute stress disorder symptoms, and the prognostic Global Registry of Acute Coronary Events (GRACE) score. Pain was not associated with IL-6 but with the GRACE score (b = 0.01, p = 0.003). Pain showed no significant association with TNF-α. Conclusion: Pain during MI was associated with anti- but not proinflammatory cytokines. As IL-33 has been shown to be cardioprotective, lower IL-33 levels with more intense pain may suggest a pathway through which increased pain during MI may have an impact on the medical prognosis. [ABSTRACT FROM AUTHOR]

The article discusses a study focusing on the recognition of positive emotions in people with posttraumatic stress disorder (PTSD). Topics discussed include the individuals' exposure to emotional trauma, the effect of medications on the autonomous nervous system, and the level of depression severity in the individuals.

Background: It is largely unknown how quality of life (QoL) changes following accidental injuries. Equally, the mechanisms underlying such changes have not yet been identified in detail. This study of injured accident survivors aimed to: (1) detect a model of change which best explains the observed course of QoL, and (2) identify potential predictor variables. Methods: 323 injured accident survivors were interviewed within 2 weeks of the trauma, and followed up at 6 and 12 months. Latent trajectory modeling was used to analyze the fit of three potential trajectories regarding the observed course of general QoL as measured by the Questions on Life Satisfaction questionnaire. Results: The trajectory model adopting a negative square-root change fitted the observed data best, meaning that shortly after the accident, general QoL decreased strongly with diminishing negative changes occurring later on. Early and prolonged QoL impairment was largely attributable to the initial level of posttraumatic stress as measured by the Clinician-Administered PTSD Scale. To a lesser extent, depressive symptoms also predicted change in subjective QoL, while injury severity showed no direct effect; rather, its impact on QoL was mediated by initial posttraumatic stress. By contrast, reduced occupational functioning was attributable to injury severity rather than psychopathology. Conclusions: When treating injured accident survivors, clinicians should consider symptoms of posttraumatic stress and comorbid depression in order to prevent or mitigate negative changes in QoL. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article focuses on a study regarding the effects of child sexual abuse (CSA) on physical and mental health and the quality of life in contact and non-contact situations in Switzerland; and mentions (CSA) defined by the World Health Organization (WHO) as a violation of laws. Topics discussed include the analysis of adolescents being the victims of CSA.

AbstractBackground:Recent research suggested thatreligious coping, based on dispositional religiousness and spirituality (R/S), is an important modulating factor in the process of dealing with adversity. In contrast to the United States, the effect of R/S on psychological adjustment to stress is a widely unexplored area in Europe. Methods:We examined a Swiss sample of 328 church attendees in the aftermath of stressful life events to explore associations of positive or negative religious coping with the psychological outcome. Applying a cross-sectional design, we used Huber’s Centrality Scale to specify religiousness and Pargament’s measure of religious coping (RCOPE) for the assessment of positive and negative religious coping. Depressive symptoms and anxiety as outcome variables were examined by the Brief Symptom Inventory. The Stress-Related Growth Scale and the Marburg questionnaire for the assessment of well-being were used to assess positive outcome aspects. We conducted Mann-Whitney tests for group comparisons and cumulative logit analysis for the assessmentof associations of religious coping with our outcome variables. Results:Both forms of religious coping were positively associated with stress-related growth (p < 0.01). However, negative religious coping additionally reduced well-being (p = 0.05, β = 0.52, 95 CI = 0.27–0.99) and increased anxiety (p = 0.02, β = 1.94, 95 CI = 1.10–3.39) and depressive symptoms (p = 0.01, β = 2.27, 95 CI = 1.27–4.06). Conclusions:The effects of religious coping on the psychological adjustment to stressful life events seem relevant. These findings should be confirmed in prospective studies.Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: It has been suggested that both adult sexual orientation and the 2nd to 4th finger length ratio (2D:4D) are influenced by prenatal testosterone levels. Bearing this in mind, 2D:4D has been tested as a proxy measure of the putative prenatal testosterone impact on adult human homosexuality, but the results are inconsistent. To date, most studies in this field of research comprise categorical group comparison of heterosexuals and homosexuals with respect to their 2D:4D. Aims: The purpose of our study was to evaluate 2D:4D and the dimensional perspective of sexual orientation in addition to categorical results. Methods: We examined a community-based sample of 409 subjects and calculated correlations of 2D:4D and sexual orientation as a continuum ranging from homosexual to heterosexual. Results: We found a significant negative correlation of 2D:4D with homosexual orientation (fantasy, attraction, activity and general score) in women, but not in men. Conclusions: Our results indicate that with higher prenatal testosterone levels in women, the likelihood of homosexual orientation might increase. We hypothesize a continuous neurohormonal sexual differentiation of the brain, most notably for women, that overrides categories and results in varying dimensions of sexual orientation. This hypothesis contrasts with the predominant suggestion of fixed organizational effects of androgens in the brain and a categorical sexual orientation. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

No abstract available Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]