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Psychological factors such as post-traumatic stress and depression may play an important role in the recovery after whiplash injuries. Difficulties in psychosocial functioning with limitations in everyday life may dominate for some time after the injury. Our study therefore investigates the relationships between pain, post-traumatic stress, depression, and community integration. A set of questionnaires was answered by 191 persons (88 men, 103 women) five years after a whiplash injury to assess pain intensity (visual analogue scale, VAS), whiplash-related symptoms, post-traumatic stress (impact of event scale, IES), depression (Beck depression inventory, BDIII), community integration (community integration questionnaire, CIQ), life satisfaction (LiSat-11). One or more depressive symptoms were reported by 74% of persons; 22% reported scores that were classified as mild to severe depression. The presence of at least one post-traumatic symptom was reported by 70% of persons, and 38% reported mild to severe stress. Total scores of community integration for women were statistically significantly higher than for men. The total VAS score was correlated positively to the IES (r=0.456, P<0.456), the BDI (r=0.646, P<0.001), and negatively to the CIQ (r=-0.300, P<0.001). These results highlight the view that a significant proportion of people experience both pain and psychological difficulties for a long time after a whiplash injury. These findings should be taken into consideration in the management of subjects with chronic whiplash symptoms and may support a multi-professional rehabilitation model that integrates physical, psychological, and psychosocial factors.

We aimed to assess, in socio-cultural context, the level of hatred and revenge in war veterans with post-traumatic stress disorder (PTSD). The sampling frame consisted of 215 Kosova War veterans, randomly selected. The Harvard Trauma Questionnaire was used to assess the prevalence of PTSD and Manchester Short Assessment of Life was used to assess social satisfactions. The participants were asked to declare the strength of feelings of hatred and revenge in the four preceding weeks by using four items scale: not at all, a little bit/sometimes, a lot and extremely. Willingness for action of veterans was assessed using three item scale: yes, no or maybe. A probability level of 0.05 was adopted to be considered as statistically significant for differences among groups. DSM-IV-TR criteria for PTSD (very similar to DSM-V) were met by 52.6% of veterans; the data have confirmed existence of thoughts and fantasies of revenge against opposing forces by 42.8% veterans; at the same level 42.8% manifested feelings of hatred. Fantasies of taking revenge a lot was recorded by 19.5% and extremely by 1.4% of veterans, while hateful thoughts at level a lot were likely expressed by 22.3% and extreme by 2.8% of veterans. It is important to note that 84.7% were confident to act based on their beliefs. Social-economic and cultural factors have played major role in the understanding of psychological problems of traumatized individuals with a direct impact on their ability to function socially. This study has confirmed the urgent need for the establishment of psychological rehabilitation programs as well as programs for the social and economic rehabilitation of War Veterans.

The Greek version of the Davidson Trauma Scale (DTS) was developed to respond to the need of Greek-speaking individuals. The translated questionnaire was administered to 128 HIV outpatients (aged 37.1±9.1) and 166 control patients (aged 32.4±13.4). In addition to the DTS Greek scale, subjects were assessed with two other scales useful for assessing validity. For each factor analyses two components were extracted, based on Cattell's scree test. The two components solution accounted for 55.34% of the total variation in case of frequency variables and 61.45% in case of severity variables. The Cronbach's alpha coefficient and Guttman split-half coefficient of the DTS scale were 0.93 and 0.88 respectively. The test-retest reliability of the Greek version of DTS scale proved to be satisfactory. Individual items had good intra-class correlation coefficients higher than 0.5, which means that all questions have high levels of external validity. The psychometric strength of interview for post-traumatic stress disorder-Greek version it's reliable for its future use, particularly for screening subjects with possible diagnosis of posttraumatic stress disorder.

This study is to establish the validity and reliability of Malay version of Post-traumatic Check List-5 (MPCL-5) among the fire and rescue officers in the state of Selangor, Malaysia.

A cross-sectional study was conducted, which involved 100 firefighters from the state of Selangor, Malaysia. Construct validity, internal consistency, and concurrent validity were performed and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Concurrent validity was tested with validated Malay version of Trauma Screen Questionnaire (TSQ-M).

Overall internal consistency reliability was a 0.960 and individual construct Cronbach's alpha ranged from 0.827 to 0.926. The model, which consists of four constructs with 20 items, demonstrated the presence of acceptable loading factors. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) are 0.81, 0.65, 0.31 and 0.95 respectively at an optimum cut-off score of 35.

The Post Traumatic Check List 5 (PCL-5) is the latest tool based on DSM-5 developed recently and still having limited studies on the psychometric properties of the tool in local population and the findings produced are comparable with the results from validation from previous studies. The study limitations are population samples used are considering the minimum numbers of sample for each item for factor analysis and the concurrent validation was tested with the TSQ-M instead of the Clinician Administered PTSD Scale for DSM-5 (CAPS-5).

The study suggested that MPCL-5 is acceptable to be used to measure post-traumatic stress disorder in local populations.

There are limited known validation studies for PCL-5 in local populations and this is the first study done among fire and rescue officers in Malaysia. The results are comparable with findings from previous studies and therefore MPCL-5 are valid and reliable for PTSD screening.

The purpose of this paper is to describe risk and protective factors for symptoms of post-traumatic stress disorder (PTSD) experienced over a 1.5-year period among both frontline and “non-traditional” responders to the 2010 and 2011 earthquakes in Christchurch, New Zealand.

A longitudinal survey administered to Christchurch workers with referents from the city of Hamilton at 6, 12 and 18 months after the 2011 earthquake. Potential risk and protective determinants were assessed by questionnaire items at baseline and over time, the outcome being PTSD as assessed by the PTSD Checklist-Civilian version. A longitudinal latent class analysis identified groups with similar trajectories of PTSD.

A total of 226 individuals, 140 (26 per cent) from Christchurch and 86 (16 per cent) from Hamilton, participated at baseline, 180 at 12 and 123 at 18 months, non-traditional responders forming the largest single group. Two latent classes emerged, with PTSD (21 per cent) and without PTSD (79 per cent), with little change over the 18-month period. Class membership was predicted by high scores in the Social Support and Impact of Events scale items, Health-related Quality of Life scores being protective. PTSD scores indicative of distress were found in females, and predicted by burnout risk, behavioural disengagement and venting.

Non-traditional responders should be screened for PTSD. Social support should be considered with the promotion of adaptive coping mechanisms.

The strength was longitudinal follow-up over an 18-month period, with demonstration of how the potential determinants influenced the course of PTSD over time.

The burden of mental illness is profound and growing. Each year, almost one in three adults in the non-institutionalized community has a diagnosable mental or addictive disorder, and this figure climbs to approximately 40% among emergency departments patients. We described the principal cardiovascular acute disease and their emotional and behavioral consequences where psychological intervention could improve the care pathway and clinical outcome. Peer-reviewed articles from Medline, Psycinfo, Web of Science, Scopus, and Cochrane library, about psychological and psychopathological sequelae in cardiovascular acute disease were searched. The psychological and psychopathological sequelae associated to stroke include emotional and behavioral changes and cognitive impairment. Fear, symptoms of depression, anxiety or specific post-traumatic symptoms like intrusions, hyper-arousal and/or cognitive avoidance are common in people suffering of cardiovascular acute disease treated at emergency departments. In emergency departments, health personnel must recognize psychological and psychopatho-logical sequelae in cardiovascular acute disease in order to develop effective interventions for these patients. Identify factors that are associated with both psychological distress and physical distress and promote interventions aimed at reducing psychological distress and improving psychological health empowerment is an important element to consider in order to offer the best care to vulnerable population as that suffering of cardiovascular acute disease.

Posttraumatic stress disorder (PTSD), an anxiety disorder with lifetime prevalence of 7.8%, is characterized by symptoms that develop following exposure to traumatic life events and that cause an immediate experience of intense fear, helplessness or horror. PTSD is marked by recurrent nightmares typified by the recall of intrusive experiences and by extended disturbance throughout sleep. Individuals with PTSD respond poorly to drug treatments for insomnia. The disadvantages of drug treatment for insomnia underline the importance of non-pharmacological alternatives. Thus, the present study had three aims: first, to compare the efficiency of two relaxation techniques (muscular relaxation and progressive music relaxation) in alleviating insomnia among individuals with PTSD using both objective and subjective measures of sleep quality; second, to examine whether these two techniques have different effects on psychological indicators of PTSD, such as depression and anxiety; and finally, to examine how initial PTSD symptom severity and baseline emotional measures are related to the efficiency of these two relaxation methods. Thirteen PTSD patients with no other major psychiatric or neurological disorders participated in the study. The study comprised one seven-day running-in, no-treatment period, followed by two seven-day experimental periods. The treatments constituted either music relaxation or muscle relaxation techniques at desired bedtime. These treatments were randomly assigned. During each of these three experimental periods, subjects' sleep was continuously monitored with a wrist actigraph (Ambulatory Monitoring, Inc.), and subjects were asked to fill out several questionnaires concerned with a wide spectrum of issues, such as sleep, depression, and anxiety. Analyses revealed a significant increase in objective and subjective sleep efficiency and a significant reduction in depression level following music relaxation. Moreover, following music relaxation, a highly significant negative correlation was found between improvement in objective sleep efficiency and reduction in depression scale. The study‘s findings provide evidence that music relaxation at bedtime can be used as treatment for insomnia among individuals with PTSD.

Exposure therapy is a widely used treatment for patients with post-traumatic stress dis -order. It involves reduction of fear through progressive exposure to frightening stimuli in a therapeutic environment. Here we propose a new method designed to improve the effectiveness of exposure therapy. We hypothesized that device-guided breathing during exposure therapy can increase the capability of the patient to undergo effective exposure. The successful application of the method is described for a single patient. Using a device to slow and regularize breathing, the patient was calmed and experienced a greater sense of control and a profound effect of the exposure. The use of the breathing-guiding device is believed to reduce arousal level and excitability of sympathetic “fight-flight” behaviors. The present study suggests that device-guided breathing integrated with exposure therapy may provide a practically feasible and potentially promising non-pharmacological treatment after trauma.

Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and substance use commonly occur simultaneously or subsequent to one another. A gendered vulnerability in biological, environmental, and behavioural risk factors has been registered in the development and escalation of mental illness. Studies have found that women who use drugs experience greater physical and mental health repercussions than men. Women who use drugs present higher rates of depression and anxiety, suicidal tendencies, isolation and general psychological distress. This chapter addresses the most common mental illnesses associated with women who use drugs: depression, anxiety, trauma-related disorders, and eating disorders.

Service members of the US Department of Defense (DoD) have alarmingly high rates of depression, anxiety, probable stress disorders and suicidality, all of which are negative health conditions exacerbated by various external stressors. High-stress work conditions – to include shift work, hazardous territories, high-stakes mission sets and generally disconnected sites – require a work environment that facilitates, rather than inhibits, stress reduction and mental well-being. This paper aims to present “salutogenic design” as an innovative approach: Salutogenic design offers demonstrated architectural solutions that improve health and well-being.

This paper describes salutogenic design strategies beginning with the need for such an approach, the call to action to implement strategic and tactical solutions and the challenges and financial impacts of such a broad and innovative strategy to improve workplace health, well-being and performance in the DoD and beyond. Examples of these strategies, via biophilic design solutions, are presented in the central Table 1 as an easy-to-reference tool and supported by the voluminous literature as referenced, in part, through this research paper.

Salutogenic design strategies offer innovative, financially viable solutions to help mitigate stress and improve workforce well-being while maintaining the highest level of building security requirements in access-controlled spaces and disconnected sites, such as military installations and government compounds.

Issues of mental and physical health are complex and multi-faceted, and they require complex and multi-faceted solutions. Salutogenic design is presented as one facet of that solution: a tangible solution to an often-intangible issue. Further, as a novel approach to address a critical DoD issue, Table 1 bridges the common gap between high-concept design theory and practical construction-application solutions, with positive value to the health, performance, quality-of-life and well-being of service members.

To the best of the author’s knowledge, this paper is the first to approach the DoD’s imperative to reduce service members’ mental stress with “salutogenic design.”