Cyberbullying Linked to Increased Depression and PTSD
January 22, 2020
Science Daily/University of Miami Miller School of Medicine
Cyberbullying had the impact of amplifying symptoms of depression and post-traumatic stress disorder in young people who were inpatients at an adolescent psychiatric hospital, according to a new study published in the Journal of Clinical Psychiatry. The study addressed both the prevalence and factors related to cyberbullying in adolescent inpatients.
"Even against a backdrop of emotional challenges in the kids we studied, we noted cyberbullying had an adverse impact. It's real and should be assessed," said Philip D. Harvey, Ph.D., professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine, who co-authored the paper "Cyberbullying and Its Relationship to Current Symptoms and History of Early Life Trauma."
He says children with a history of being abused were found to be more likely to be cyberbullied, suggesting that assessments for childhood trauma should also include assessments for cyberbullying. Likewise, children who report being cyberbullied should be assessed for a history of childhood trauma.
"Cyberbullying is possibly more pernicious than other forms of bullying because of its reach," Dr. Harvey says. "The bullying can be viral and persistent. To really be bullying, it has to be personal -- a directly negative comment attempting to make the person feel bad."
The study helped to confirm other facts about cyberbullying:
Being online regularly or the amount of time spent on social media weren't determining factors in who was cyberbullied.
Cyberbullying cuts across all economic classes and ethnic backgrounds.
Adolescents who have been bullied in the past had a higher risk of being bullied again.
Studying Cyberbullying's Impact on an Inpatient Psychiatric Population
The study of 50 adolescent psychiatric inpatients ages 13 to 17 examined the prevalence of cyberbullying and related it to social media usage, current levels of symptoms and histories of adverse early life experience.
Conducted from September 2016 to April 2017 at a suburban psychiatric hospital in Westchester County, New York, the study asked participants to complete two childhood trauma questionnaires and a cyberbullying questionnaire.
Twenty percent of participants reported that they had been cyberbullied within the last two months before their admission. Half of the participants were bullied by text messages and half on Facebook. Transmitted pictures or videos, Instagram, instant messages and chat rooms were other cyberbullying vehicles.
Those who had been bullied had significantly higher severity of post-traumatic stress disorder (PTSD), depression, anger, and fantasy dissociation than those who were not bullied.
Links to Childhood Trauma
Participants who reported being cyberbullied also reported significantly higher levels of lifetime emotional abuse on the study's Childhood Trauma Questionnaire than those who were not bullied. These same young people did not report a significantly higher level of other types of trauma (physical abuse, sexual abuse, emotional neglect or physical neglect).
Further studies are needed to establish whether there may be some unique consequence of childhood emotional abuse that makes troubled teens more likely to experience or report cyberbullying.
Conclusions
While all of the participants in this study were psychiatric inpatients, those who had been bullied had significantly higher scores on PTSD, depression, anger, and dissociation scales than those who were not bullied. Dr. Harvey says this finding is consistent with past research.
Dr. Harvey encourages psychologists, psychiatrists and other counselors to routinely ask young people if they were abused or traumatized when they were younger and whether they are being bullied now.
He says adding these questions to the clinical evaluation of adolescents may bring to light symptoms that may have otherwise been ignored. Additionally, factors that may be causing or contributing to those symptoms can be targeted for specific intervention.
Parents and adolescents can take action to discourage bullying, Dr. Harvey says. "It's not hard to block someone on the Internet, whether it's texting, Facebook, Twitter, or sending pictures. Ask why are people choosing you to bully? If it's something you're posting, assess that and make a change."
https://www.sciencedaily.com/releases/2020/01/200122080526.htm
Predicting post-injury depression and PTSD risk
June 5, 2019
Science Daily/University of Pennsylvania School of Nursing
Although injury is unexpected and acute, it can result in long-term health problems and disability. Up to half of all patients experience postinjury depression and posttraumatic stress disorder (PTSD) in the months after injury, increasing suboptimal recovery, disability, and costs for care. For patients like urban black men, some of whom have experienced prior trauma, childhood adversity and neighborhood disadvantage, acute postinjury stress responses are exacerbated.
Addressing the psychological effects of injury can improve health and reduce the negative outcomes of injury. Yet, in a national survey, only seven percent of trauma centers incorporate routine screening for PTSD symptoms.
An original investigation from the University of Pennsylvania School of Nursing (Penn Nursing) explores the risk and protective factors that contribute to postinjury mental health symptoms in urban black men. It finds that those men with violent injuries as compared to non-violent injuries have more severe postinjury mental health symptoms. But importantly it shows the need to take into consideration prior life experiences, such as adverse childhood experiences, neighborhood disadvantage, pre-injury health and psychological resources in addition to acute stress responses to an injury event, in order to identify injured patients at highest risk for poor postinjury mental health outcomes.
"The intersection of prior trauma and adversity, prior exposure to challenging neighborhood disadvantage, and poorer preinjury health and functioning should not be overlooked in the midst of acute injury care when assessing for the risk of postinjury mental health symptoms," said lead-investigator Therese S. Richmond, PhD, CRNP, FAAN, the Andrea B. Laporte Professor of Nursing, and Associate Dean for Research & Innovation.
Results of the study are set for publication in an upcoming issue of JAMA Surgery in an article titled "Contributors to Postinjury Mental Health in Urban Black Men With Serious Injuries."
The three-and-a-half-year study focused on outcomes in more than 600 urban black men who were hospitalized for serious injury. The researchers followed study participants for three months after hospital discharge to access for depression and PTSD symptoms. Almost one half of study participants met the diagnostic criteria for depression and/or PTSD at follow-up.
"This study takes a life-trajectory approach, helps inform potential points of intervention to improve outcomes, and adds to understanding both risk and protective factors across the life trajectory in an understudied group at high risk for injury," said Richmond. "We must integrate psychological care into the very essence of trauma care if we are to improve outcomes from serious injuries. Because symptoms develop after hospital discharge, further developing and using screening instruments designed to predict the future development of postinjury mental health problems is warranted to focus services on those patients at highest risk."
https://www.sciencedaily.com/releases/2019/06/190605133516.htm
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Mental health disorders common following mild head injury
Risk factors for neuropsychiatric conditions after concussion
January 30, 2019
Science Daily/NIH/National Institute of Neurological Disorders and Stroke
A new study reveals that approximately 1 in 5 individuals may experience mental health symptoms up to six months after mild traumatic brain injury (mTBI), suggesting the importance of follow-up care for these patients. Scientists also identified factors that may increase the risk of developing post-traumatic stress disorder (PTSD) and/or major depressive disorder following mild mTBI or concussion through analysis of the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study cohort.
"Mental health disorders after concussion have been studied primarily in military populations, and not much is known about these outcomes in civilians," said Patrick Bellgowan, Ph.D., NINDS program director. "These results may help guide follow-up care and suggest that doctors may need to pay particular attention to the mental state of patients many months after injury."
In the study, Murray B. Stein, M.D., M.P.H., professor at the University of California San Diego, and his colleagues investigated mental health outcomes in 1,155 people who had experienced a mild TBI and were treated in the emergency department. At three, six, and 12 months after injury, study participants completed various questionnaires related to PTSD and major depressive disorder. For a comparison group, the researchers also surveyed individuals who had experienced orthopedic traumatic injuries, such as broken legs, but did not have head injury.
The results showed that at three and six months following injury, people who had experienced mTBI were more likely than orthopedic trauma patients to report symptoms of PTSD and/or major depressive disorder. For example, three months after injury, 20 percent of mTBI patients reported mental health symptoms compared to 8.7 percent of orthopedic trauma patients. At six months after injury, mental health symptoms were reported by 21.2 percent of people who had experienced head injury and 12.1 percent of orthopedic trauma patients.
Dr. Stein and his team also used the data to determine risk factors for PTSD and major depressive disorder after mTBI. The findings revealed that lower levels of education, self-identifying as African-American, and having a history of mental illness increased risk. In addition, if the head injury was caused by an assault or other violent attack, that increased the risk of developing PTSD, but not major depressive disorder. However, risk of mental health symptoms was not associated with other injury-related occurrences such as duration of loss of consciousness or posttraumatic amnesia.
"Contrary to common assumptions, mild head injuries can cause long-term effects. These findings suggest that follow-up care after head injury, even for mild cases, is crucial, especially for patients showing risk factors for PTSD or depression," said Dr. Stein.
This study is part of the NIH-funded TRACK-TBI initiative, which is a large, long-term study of patients treated in the emergency department for mTBI. The goal of the study is to improve understanding of the effects of concussions by establishing a comprehensive database of clinical measures including brain images, blood samples, and outcome data for 3,000 individuals, which may help identify biomarkers of TBI, risk factors for various outcomes, and improve our ability to identify and prevent adverse outcomes of head injury. To date, more than 2,700 individuals have enrolled in TRACK-TBI.
A recent study coming out of TRACK-TBI suggested that many TBI patients were not receiving recommended follow-up care.
"TRACK-TBI is overturning many of our long-held beliefs around mTBI, particularly in what happens with patients after they leave the emergency department. We are seeing more evidence about the need to monitor these individuals for many months after their injury to help them achieve the best recovery possible," said Geoff Manley, M.D., professor at the University of California San Francisco, senior author of the current study and principal investigator of TRACK-TBI.
Future research studies will help identify mental health conditions, other than PTSD and major depressive disorder, that may arise following mTBI. In addition, more research is needed to understand the biological mechanisms that lead from mTBI to mental health problems and other adverse outcomes, such as neurological and cognitive difficulties.
https://www.sciencedaily.com/releases/2019/01/190130112717.htm