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Trauma exposure and factors associated with ICD-11 PTSD and complex PTSD in adolescence: a cross-cultural study in Japan and Lithuania
- E. Kazlauskas, L. Jovarauskaite, K. Abe, C. R. Brewin, M. Cloitre, I. Daniunaite, Y. Haramaki, S. Hihara, A. Kairyte, Y. Kamite, K. Sugimura, S. Thoresen, P. Zelviene, I. Truskauskaite-Kuneviciene
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 31 / 2022
- Published online by Cambridge University Press:
- 11 July 2022, e49
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- Article
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- Open access
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Aims
Cross-cultural studies of posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on ICD-11 diagnostic criteria are scarce, especially in adolescence. The study aimed to evaluate the trauma exposure, prevalence and factors associated with PTSD and CPTSD in general populations of adolescents in Lithuania and Japan.
MethodsThe study sample comprised 1746 adolescents from Lithuania (n = 832) and Japan (n = 914), 49.8% female. The mean age of study participants was 15.52 (s.d. = 1.64), ranging from 12 to 18 years. ICD-11 posttraumatic disorders were assessed using the International Trauma Questionnaire – Child and Adolescent version (ITQ-CA).
ResultsMore than half of the adolescents in a total sample (61.5%) reported exposure to at least one traumatic event in their lifetime, 80.0% in Lithuania and 44.6% in Japan, with a higher prevalence of interpersonal trauma in Lithuania and more natural disaster exposure in Japan. The prevalence of PTSD was 5.2% (95% CI 3.8–6.9%) and 2.3% (95% CI 1.4–3.5%), CPTSD 12.3% (95% CI 10.1–14.7%) and 4.1% (95% CI 2.9–5.5%) in Lithuanian and Japanese samples, respectively. Cumulative trauma exposure, female gender, loneliness and financial difficulties in family predicted both PTSD and CPTSD in the total sample. Loneliness discriminated CPTSD v. PTSD in both Lithuanian and Japanese samples.
ConclusionsThis cross-cultural study is among the first which reported different patterns of trauma exposure in Asian Japanese and Lithuanian adolescents in Europe. Despite differences in trauma exposure and PTSD/CPTSD prevalence, we found similar predictors in both studies, particularly the importance of cumulative trauma exposure for PTSD/CPTSD, and social interpersonal factors for the risk of CPTSD. The study supports the universality of traumatic stress reactions to adverse life experiences in adolescence across cultures and regions and highlights different levels of traumatisation of adolescents in various countries.
Alteration of type A behavior and its effect on cardiac recurrences in post myocardial infarction patients: summary results of the recurrent coronary prevention project
- from Section 6 - Behavioural interventions in medicine
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- By M. Friedman, Harvard University Health Services, C. E. Thoresen, Harvard University Health Services, J. J. Gill, Harvard University Health Services, D. Ulmer, Harvard University Health Services, L. H. Powell, Harvard University Health Services, V. A. Price, Harvard University Health Services, B. Brown, Harvard University Health Services, L. Thompson, Harvard University Health Services, D. D. Rabin, Harvard University Health Services, W. S. Breall, Harvard University Health Services, E. Bourg, Harvard University Health Services, R. Levy, Harvard University Health Services, T. Dixon, Harvard University Health Services
- Edited by Andrew Steptoe, St George's Hospital Medical School, University of London, Jane Wardle, Imperial Cancer Research Fund, London
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- Book:
- Psychosocial Processes and Health
- Published online:
- 05 August 2016
- Print publication:
- 24 November 1994, pp 478-506
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Summary
Abstract
One thousand thirteen post myocardial infarction patients were observed for 4.5 years to determine whether their type A (coronary-prone) behavior could be altered and the effect such alteration might have on the subsequent cardiac morbidity and mortality rates of these individuals. Eight hundred sixty-two of these individuals were randomly assigned either to a control section of 270 participants who received group cardiac counseling or an experimental section of 592 participants who received both group cardiac counseling and type A behavioral counseling. The remaining 151 patients, serving as a “comparison group,” did not receive group counseling of any kind. Using the “Intention-to- Treat” principle, we observed markedly reduced type A behavior at the end of 4.5 years in 35.1% of participants given cardiac and type A behavior counseling compared with 9.8% of participants given only cardiac counseling. The cumulative 4.5-year cardiac recurrence rate was 12.9% in the 592 participants in the experimental group that received type A counseling. This recurrence rate was significantly less (p< 0.005) than either the recurrence rate (21.2%) observed in the 270 participants in the control group or the recurrence rate (28.2%) in those of the comparison group not receiving any special treatment. After the first year, a significant difference in number of cardiac deaths between the experimental and control participants was observed during the remaining 3.5 years of the study. Overall, the results of this study demonstrate for the first time, within a controlled experimental design, that altering type A behavior reduces cardiac morbidity and mortality in post infarction patients. (AM HEART J 1986; 112:653).
Persons who exhibited an emotional syndrome characterized by a continuously harrying sense of time urgency and easily aroused freefloating hostility (i.e. type A behavior pattern) were observed in 1959 to have a sevenfold greater prevalence and in 1975 a significantly greater incidence of clinical coronary heart disease (CHD) than persons not exhibiting these two emotional components (i.e., type B persons).
Ever since this observed associational relationship between the presence of type A behavior and the prevalence and incidence of clinical CHD, hundreds of studies have been designed to investigate further the nature of this association.