Browsing by Subject "PTSD"
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- ItemOpen AccessAre maternal symptoms of depression/PTSD and Child Genetic risk scores for depression/PTSD associated with childhood subcortical brain volumes?(2025) Grobler, Anje-Lore; Mufford, Mary; Groenewold, Nynke; Stein, DanThe antenatal period is a critical window for genetic and environmental factors to influence a child's brain development. While previous research in East Asian and European populations has linked child polygenic risk scores (PRSs) for depression and maternal antenatal symptoms (E) to child subcortical brain volumes, these associations remain unexplored in African populations. Moreover, PRSs for post-traumatic stress disorder (PTSD) have not been investigated in relation to child subcortical brain volumes. This study examined: 1) the effects of child genetic risk for depression and PTSD (G), including the interaction with maternal antenatal symptoms of depression and PTSD (G+E or GxE), on child subcortical brain volumes at two years of age; and 2) the genetic architecture of these brain volumes. Using PRS-CSx, PRSs were derived from Psychiatric Genomics Consortium summary statistics, with the Drakenstein Child Health Study (N = 128) as the target dataset. Associations between child genetic risk, maternal antenatal symptoms and child subcortical brain volumes were tested using linear regression. A genome-wide association study (GWAS; N = 163) was used to investigate genetic associations with these subcortical volumes, and trans-ancestry genetic correlations between African and European cohorts were estimated using Popcorn. For depression, model G was associated with larger total thalamus, left thalamus, and left hippocampus volumes, and smaller right thalamus, bilateral putamen and total pallidum volumes. Model GxE was associated with larger bilateral caudate volume. For PTSD, model G was associated with larger total and right putamen and right pallidum volume, and with smaller left putamen and left hippocampus volume. Model G+E was associated with larger total thalamus and right thalamus volumes, and model GxE with larger bilateral caudate volumes. No SNPs reached genome-wide significance, but three SNPs showed trending associations: rs6052713 (left caudate), rs11771415, and rs7317597 (right hippocampus). No significant cross-population genetic correlations were identified. This study provides preliminary evidence of gene-environment interactions influencing child subcortical brain volumes in a South African population. Findings partially align with prior research and highlight the need for larger studies to clarify the mechanisms linking maternal mental health, child genetics, and brain development.
- ItemOpen AccessAssociations between mental health, social cognition, and COVID-19 stress among South African university students(2025) Mlomo, Zintle W; Thomas, Kevin; Pileggi, Lea-AnnThe COVID-19 pandemic has contributed to widespread psychosocial distress, observed in the unprecedented rise in symptoms of common mental disorders (CMDs), including depression, anxiety and post-traumatic stress disorder (PTSD). This surge in mental health complications has been reported across all populations globally, most notably among university students, who are already a vulnerable cohort to CMDs, including PTSD. As integral socio-cognitive mechanisms of emotional regulation and interpersonal functioning, cognitive and affective empathy may potentially protect against or aggravate symptoms of CMDs, including PTSD, respectively. However, there is a scarcity of South African literature exploring this relationship, and relatively few South African studies have investigated students' mental health in the context of the COVID-19 pandemic. The current study employed a descriptive, cross-sectional design and aimed at evaluating the relationship between sociodemographic variables, pandemic-related-stress and exposure, mental health and cognitive and affective empathy, and explore the potentially moderating role of empathy. 534 undergraduate and postgraduate students from the University of Cape Town (UCT) were recruited using convenience sampling to participate in an online survey. Participants were administered a brief demographic questionnaire, the Kessler Psychological Distress Scale (K 10), the Beck Depression Inventory-Second edition (BDI-II), the Beck Anxiety Inventory (BAI), PTSD-Checklist for DSM-5 (PCL-5), the Pandemic Stress Questionnaire (PSQ) and the Interpersonal Reactivity Index (IRI). Overall, the results showed that female biological sex, self-reported history of psychological diagnosis, and earlier year of study were significant sociodemographic predictors of higher symptoms of CMDs, including PTSD. Furthermore, the results showed positive associations between mental health outcomes and affective empathy, and further provided significant evidence of the potentially moderating role of affective and cognitive empathy in the relationship between pandemic-related stress and exposure and mental health outcomes. These findings contribute to the current research gap on empathy and mental health in South Africa and provide further insight into the role of cognitive and affective empathy in relation to mental health in the context of stressful environmental factors. Further research should be conducted to explore additional factors and mechanisms that could explain individual mental health and social cognition in relation to stressful environmental factors
- ItemOpen AccessAssociations between mental health, social cognition, and COVID-19 stress among South African university students(2025) Mlomo, Zintle W; Thomas, Kevin; Pileggi, Lea-AnnThe COVID-19 pandemic has contributed to widespread psychosocial distress, observed in the unprecedented rise in symptoms of common mental disorders (CMDs), including depression, anxiety and post-traumatic stress disorder (PTSD). This surge in mental health complications has been reported across all populations globally, most notably among university students, who are already a vulnerable cohort to CMDs, including PTSD. As integral socio-cognitive mechanisms of emotional regulation and interpersonal functioning, cognitive and affective empathy may potentially protect against or aggravate symptoms of CMDs, including PTSD, respectively. However, there is a scarcity of South African literature exploring this relationship, and relatively few South African studies have investigated students' mental health in the context of the COVID-19 pandemic. The current study employed a descriptive, cross-sectional design and aimed at evaluating the relationship between sociodemographic variables, pandemic-related-stress and exposure, mental health and cognitive and affective empathy, and explore the potentially moderating role of empathy. 534 undergraduate and postgraduate students from the University of Cape Town (UCT) were recruited using convenience sampling to participate in an online survey. Participants were administered a brief demographic questionnaire, the Kessler Psychological Distress Scale (K 10), the Beck Depression Inventory-Second edition (BDI-II), the Beck Anxiety Inventory (BAI), PTSD-Checklist for DSM-5 (PCL-5), the Pandemic Stress Questionnaire (PSQ) and the Interpersonal Reactivity Index (IRI). Overall, the results showed that female biological sex, self-reported history of psychological diagnosis, and earlier year of study were significant sociodemographic predictors of higher symptoms of CMDs, including PTSD. Furthermore, the results showed positive associations between mental health outcomes and affective empathy, and further provided significant evidence of the potentially moderating role of affective and cognitive empathy in the relationship between pandemic-related stress and exposure and mental health outcomes. These findings contribute to the current research gap on empathy and mental health in South Africa and provide further insight into the role of cognitive and affective empathy in relation to mental health in the context of stressful environmental factors. Further research should be conducted to explore additional factors and mechanisms that could explain individual mental health and social cognition in relation to stressful environmental factors
- ItemOpen AccessThe Correlates of Post-Traumatic Stress Disorder in Ambulance Personnel and Barriers Faced in Accessing Care for Work-Related Stress(2022-02-11) Ntatamala, Itumeleng; Adams, ShahiedaWe investigated factors associated with increased risk for post-traumatic stress disorder (PTSD) in ambulance personnel and the barriers faced in accessing support for work-related stress (WRS). A cross-sectional study of 388 ambulance personnel used self-administered questionnaires to assess for PTSD and level of occupational stressors: Impact of Event Scale-Revised, Emergency Medical Services (EMS) Critical Incident Inventory, EMS Chronic Stress Questionnaire, SF-36 Quality of Life and the Connor–Davidson Resilience Scale. The prevalence of PTSD in the study population was 30%. The participants were predominantly female (55%), with a median age of 38 (IQR; 31–44) years. PTSD was associated with smoking (OR = 1.76, 95% CI: 1.05–2.95), illicit drug use (OR = 16.4, 95% CI: 1.87–143.86) and problem drinking (OR = 3.86, 95% CI: 1.80–8.23). A self-reported mental health condition (OR = 3.76, 95% CI: 1.96–7.21), being treated for a medical condition (OR = 1.95, 95% CI: 1.22–3.11), exposure to critical incident stress (OR = 4.27, 95% CI: 2.24–8.15) and chronic WRS (OR = 4.46, 95% CI: 1.93–10.31) were associated with PTSD risk. Barriers to seeking help included concerns that services were not confidential and the negative impact on the participant’s career. The increased levels of WRS, strong associations with substance use and barriers to accessing care offer starting points for workplace interventions to reduce the impact of PTSD in ambulance personnel.
- ItemOpen AccessDSM-5: a collection of psychiatrist views on the changes, controversies, and future directions(BioMed Central Ltd, 2013) Nemeroff, Charles; Weinberger, Daniel; Rutter, Michael; MacMillan, Harriet; Bryant, Richard; Wessely, Simon; Stein, Dan; Pariante, Carmine; Seemuller, Florian; Berk, Michael; Malhi, Gin; Preisig, Martin; Brune, Martin; Lysaker, PaulThe recent release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association has led to much debate. For this forum article, we asked BMC Medicine Editorial Board members who are experts in the field of psychiatry to discuss their personal views on how the changes in DSM-5 might affect clinical practice in their specific areas of psychiatric medicine. This article discusses the influence the DSM-5 may have on the diagnosis and treatment of autism, trauma-related and stressor-related disorders, obsessive-compulsive and related disorders, mood disorders (including major depression and bipolar disorders), and schizophrenia spectrum disorders.
- ItemOpen AccessPost-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys(BioMed Central, 2016-07-22) Stein, Dan J; Karam, Elie G; Shahly, Victoria; Hill, Eric D; King, Andrew; Petukhova, Maria; Atwoli, Lukoye; Bromet, Evelyn J; Florescu, Silvia; Haro, Josep M; Hinkov, Hristo; Karam, Aimee; Medina-Mora, María E; Navarro-Mateu, Fernando; Piazza, Marina; Shalev, Arieh; Torres, Yolanda; Zaslavsky, Alan M; Kessler, Ronald CBackground: Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease and lead to subsequent post-traumatic stress disorder (PTSD). However, the relevant literature originates in only a few countries, and much remains unknown about MVC-related PTSD prevalence and predictors. Methods: Data come from the World Mental Health Survey Initiative, a coordinated series of community epidemiological surveys of mental disorders throughout the world. The subset of 13 surveys (5 in high income countries, 8 in middle or low income countries) with respondents reporting PTSD after lifethreatening MVCs are considered here. Six classes of predictors were assessed: socio-demographics, characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent history of prior mental disorders. Logistic regression was used to examine predictors of PTSD. Mental disorders were assessed with the fully-structured Composite International Diagnostic Interview using DSM-IV criteria. Results: Prevalence of PTSD associated with MVCs perceived to be life-threatening was 2.5 % overall and did not vary significantly across countries. PTSD was significantly associated with low respondent education, someone dying in the MVC, the respondent or someone else being seriously injured, childhood family adversities, prior MVCs (but not other traumatic experiences), and number of prior anxiety disorders. The final model was significantly predictive of PTSD, with 32 % of all PTSD occurring among the 5 % of respondents classified by the model as having highest PTSD risk. Conclusion: Although PTSD is a relatively rare outcome of life-threatening MVCs, a substantial minority of PTSD cases occur among the relatively small proportion of people with highest predicted risk. This raises the question whether MVC-related PTSD could be reduced with preventive interventions targeted to high-risk survivors using models based on predictors assessed in the immediate aftermath of the MVCs.
- ItemOpen AccessPredictors of post-traumatic stress disorder among ambulance personnel in the western cape province(2021) Ntatamala, Itumeleng Mmoko Theophelus; Adams, ShahiedaObjective: To determine the factors associated with an increased risk for PTSD in ambulance personnel and the barriers faced in accessing support for work related stress (WRS). Methods: A cross-sectional study of voluntary participants comprising 388 ambulance personnel was conducted. Participants completed self-administered questionnaires: Impact of Event Scale-Revised (IES-R), EMS Critical Incident Inventory (CII), EMS Chronic Stress Questionnaire (EMSCSQ), SF-36 Quality of Life questionnaire (SF-36) and Connor-Davidson Resilience Scale (CD-RISC) which were used to assess PTSD and level of occupational stressors. Results: The prevalence of PTSD in the study population was 30%. Participants were predominantly female (55%), median age 38 (IQR; 31 - 44) years with a professional qualification (83%). Those with PTSD were more likely current smokers (OR=1.76, 95% CI: 1.05 - 2.95), current illicit drug users (OR=16.4, 95% CI: 1.87 - 143.86) and problem drinkers (OR=3.86, 95% CI: 1.80 - 8.23). A self-reported mental health condition (OR=3.76, 1.96 - 7.21), being treated for a medical condition (OR=1.95, 1.22 - 3.11), exposure to chronic WRS (OR=1.05, 1.04 - 1.07) and high critical incident stress score (OR=1.03, 1.02 - 1.04) were positively associated with PTSD risk. Barriers to seeking help for WRS included concerns that services were not confidential, and that the participant's career would be negatively affected. Conclusion: The PTSD prevalence in ambulance personnel is considerably higher than that found in previous studies conducted among this occupational group in the Western Cape. Identified risk factors should inform interventions designed to support ambulance personnel and a greater focus on addressing barriers to accessing care is needed.
- ItemOpen AccessThe Impact of Extreme Weather Events on Mental Health in Africa: A Mixed-Methods Systematic Review(2022) Deglon, Michaele; Dalvie, Mohamed Aqiel; Abrams, AmberIntroduction: The psychosocial impacts of extreme weather events are contributing to the burden of mental illness, exacerbated by pre-existing vulnerabilities. Despite an emerging global interest in this association, Africa remains poorly represented in the literature. Methods: A mixed-methods systematic review of peer-reviewed studies was conducted to determine the adverse mental health outcomes associated with extreme weather events in Africa (2008-2021). The review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: A total of 12 204 peer-reviewed articles were identified of which 12 were retained for analysis. These studies were all conducted in 8 countries in Sub-Saharan Africa. Adverse mental health outcomes were identified resulting from flood (n=4), drought (n=4), extreme heat (n=1), bushfire (n=1), and multiple events (n=2). Findings included pathological outcomes with predictable symptomatology including mood disorders; trauma- and stressor-related disorders; and suicide. Additionally, conditions indicating psychological distress which were below the pathological threshold including emotion regulation difficulties, disturbed sleep, alcohol use, stress, and anxiety. The quantitative evidence for the association between extreme weather events and mental health was limited primarily by a lack of longitudinal data, exposure gradient, and comparison to an unaffected group, as well as a failure to provide an objective exposure measure. The qualitative evidence for this association was complimentary but without sufficient clinical measurement these outcomes cannot be verified as psychological morbidities. In addition, this review provided insight into the mental health of vulnerable communities affected by extreme weather events including those living in poverty, farmers, pastoralists, women, and children. Conclusion: This review provided some preliminary evidence for the association between extreme weather events and adverse mental health outcomes for populations in Africa. The review also provides insight to vulnerable populations affected by extreme weather events. Future research with stronger designs and methodologies are recommended.
- ItemOpen AccessTrauma and posttraumatic stress disorder in South Africa(2015) Atwoli, Lukoye; Stein, Dan; Koenen, KarestanObjective: The main aim of this thesis is to analyze data from the South African Stress and Health (SASH) study and , for the first time, generate information on the epidemiology of traumatic event s (TEs) and posttraumatic stress disorder (PTSD), and on the association of TEs with other psychopathological and physical health outcomes. Methods: A literature review was done to provide information current knowledge in the field. Cross - tabulations, Chi - squared tests and logistic regression analyses were then conducted SASH data to determine the prevalence of the different types of trauma and PTSD and the associations between the sociodemographic variables and TEs and PTSD on the one hand, and TEs and PTSD, other psychopathology and chronic physical conditions on the other . Results: The most common traumatic events were the unexpected death of a loved one and witnessing trauma. Lifetime prevalence of PTSD was 2.3%, and the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk and burden were both highest for witnessing trauma. Witnessing trauma was commonest among males and those with low - average education. There was statistically significant association between witnessing and PTSD, mood, and anxiety disorders. Exposure to any TE significantly increased the odds of all the physical conditions, and the odds of having a physical condition were directly related to the number of lifetime traumatic events. Sexual violence and unexpected death of a loved one significantly increased the odds of all the e physical conditions assessed, while war events were only associated with respiratory conditions. Apart from war events, accidents and witnessing trauma were associated with the fewest physical conditions. Conclusions: Consistent with the literature, trauma and PTSD in South Africa are not distributed according to the socio - demographic factors or trauma types observed in other countries. Witnessing trauma is common in South Africa and increases the risk of mood and anxiety disorders. Finally, TE exposure is associated with chronic physical conditions in a dose - response manner. Trauma interventions must therefore focus also on those not directly affected, and routine evaluation for chronic physical conditions is recommended for survivors of all trauma.