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Therapeutic interventions
Published in Alison Brodrick, Emma Williamson, Listening to Women After Childbirth, 2020
Alison Brodrick, Emma Williamson
In the service we offer women attending the Birth Trauma service are asked to complete a set of standardised outcome measures at assessment, and again at the end of their intervention. These measures help to inform the clinical assessment and formulation, and also give an indication of clinical change. To capture the range of psychological distress a woman may be experiencing, the data set currently consists of the PHQ-9 measure of depression (Kroenke et al, 2001) and the GAD-7 measure of anxiety (Spitzer et al, 2006). The PHQ-9 and GAD-7 are widely used in mental health services. The most specific outcome measure is the Impact of Event Scale, revised version (IES-R, Weiss & Marmar, 1996), a self-report measure consisting of three subscales reflecting the PTSD diagnostic domains of intrusion, avoidance and hyperarousal. An evaluation of the data routinely collected in the clinic during its first seven years of operation confirmed that women experience significant reductions in scores on all measures of anxiety symptoms (Brodrick et al, 2018). Average total scores on the IES-R measure of PTSD symptoms fell from above to below the clinical cut-off, and general levels of anxiety were also reduced. For women seen postnatally, depression scores were also significantly lower post-intervention than at assessment. Women who were seen for treatment in a subsequent pregnancy did not experience a significant reduction in depression symptoms, but had generally lower depressive symptoms at assessment anyway. This preliminary analysis shows that the Birth Trauma clinic provides effective short-term psychological treatment for women experiencing symptoms of PTSD following childbirth.
Mental health impact of COVID-19 in frontline healthcare workers in a Belgian Tertiary care hospital: a prospective longitudinal study
Published in Acta Clinica Belgica, 2022
Eveline Van Steenkiste, Jessie Schoofs, Shauni Gilis, Peter Messiaen
The Impact of Event Scale-Revised (IES-R) is a 22-item self-report questionnaire that was developed to assess current subjective stress for any life event, both trauma and less intense forms of stress [22]. It shows how much an impactful event is bothering a person. IES-R can be used to diagnose post-traumatic stress disorder (PTSD) based on the DSM-IV criteria and is still widely used [23,24]. Responses are rated on a 5-point scale ranging from 0 ‘not at all’ to 4 ‘extremely’. IES-R total score range from 0 to 88 with higher scores reflecting a more stressful impact event [25,26]. Besides a total score, two subscores can be calculated: intrusion and avoidance [27]. Intrusion is characterized by unbidden visual images, nightmares. Avoidance is characterized by efforts to not think or talk about the event and avoid all kind of reminders of the event [23].
The Anxiety Depression Distress Inventory–27 (ADDI–27): New Evidence of Factor Structure, Item-Level Measurement Invariance, and Validity
Published in Journal of Personality Assessment, 2018
Antonio F. Garcia, Tiffany Berzins, Melina Acosta, Saifa Pirani, Augustine Osman
The Impact of Event Scale–Revised (IES–R) is a widely used 22-item self-report instrument measuring symptoms of PTSD (Weiss, 2007). It contains statements corresponding to symptom Clusters B (IES–R-INT), C (IES–R-AVD), and D (IES–R-HYP) of the DSM–IV–TR. Each of the 22 items is a statement referring to an unspecified Criterion A traumatic event that the participant might have experienced (lifetime occurrence). As with the DTS–17, we expected ADDI–SA scores to be uniquely associated with scores on each of the IES–R scales, based on the documented evidence of a relationship between somatic anxiety and PTSD symptoms.
Hair cortisol predicts avoidance behavior and depressiveness after first-time and single-event trauma exposure in motor vehicle crash victims
Published in Stress, 2020
Katja Petrowski, Susann Wichmann, Jaroslav Pyrc, Susann Steudte-Schmiedgen, Clemens Kirschbaum
For clinical characterization, the following self-report paper-pencil instruments were handed out to the participants both within the first 10 days after the MVC as well as three months post-MVC (except for the ISS). (1) The severity of depressive symptoms was evaluated using the Beck Depression Inventory II (BDI; Beck, Steer, & Brown, 1996; Hautzinger, Keller, & Kühner, 2006) that consists of 21 item groups matching the DSM-IV criteria of a major depressive disorder episode. The respondents are asked to rate the way they felt during the past two weeks with the help of each item group within which the items are arranged in increasing intensity (range: 0–63). The internal consistency was .89. (2) Additionally, participants self-rated PTSD symptom severity anchored to the index event (MVC) on the Posttraumatic Diagnostic Scale (PDS; Foa, 1995; Foa, Cashman, Jaycox, & Perry, 1997). The respondents are asked to rate how much they experienced each of the DSM-IV PTSD core symptoms (intrusion, avoidance, hyperarousal) on a four-point Likert-scale and to indicate which areas of life were impaired due to trauma-related symptoms, e.g. household, occupation, leisure time, or sexuality (range: 0–51). The internal consistency was 0.90. (3) More specifically, the Impact of Event Scale – revised ( IES-R; Horowitz, Wilner, & Alvarez, 1979; Weiss, 2007 ) assessed the frequency of symptom occurrence with respect to intrusion, avoidance and hyperarousal with the help of 22 items (range for the subscales intrusion and hyperarousal: 0–35; range for the subscale avoidance: 0–40). The internal consistency was for the scale intrusions 0.89, for the scale avoidance 0.77, and for the scale hyper arousal 0.89. All questionnaires were handed out in the German language version. (4) The ISS (Baker, OʼNeill, Haddon, & Long, 1974) is an established medical scoring system to assess trauma severity in patients with multiple injuries referring to anatomical regions (head and neck, face, chest, abdomen, extremity; range: 1–75). The ISS rating was evaluated by the trained medical physician of the Department of Trauma & Reconstructive Surgery of the university hospital in Dresden. Three months after the recruitment, participants (none hospitalized at this time) were interviewed by a trained clinical psychologist using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I; Wittchen, 1997). Participants were additionally interviewed concerning their medical history including medication intake.