Lasting personality pathology following exposure to catastrophic trauma in adults: Systematic review

Munjiza, Jasna; Law, Vincent; Crawford, Mike

doi:10.1002/pmh.1271

Cited by 14 publications

(14 citation statements)

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“…In other words, it is possible that IPDE caseness observed in some participants in the study has emerged secondary to severe trauma. This would be consistent with the findings from a recent systematic review which suggested that a proportion of adults with no pre-trauma personality pathology appear to go on to develop significant personality problems following the exposure to severe trauma [16]. However, one would need to demonstrate that severe war trauma antedated the outcome (personality pathology) before the observed association could be viewed as evidence for causation which emphasizes the importance of Hill’s temporality criterion [38].…”

Section: Discussionsupporting

confidence: 81%

“…Numerous studies with war veterans and victims of torture have reported higher levels of personality pathology in people with PTSD whatever the cause [11–15]. Whilst some people who had been exposed to war trauma had underlying pre-trauma personality related problems, findings from a recent systematic review of extant literature suggested that a proportion of adults with no pre-trauma personality pathology who are exposed to severe trauma appear to go on to develop significant personality problems [16]. Higher levels of exposure to traumatic events have been consistently associated with the increased risk of having a diagnosis of PTSD [17, 18].…”

Section: Introductionmentioning

confidence: 99%

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Severe war-related trauma and personality pathology: a case-control study

et al. 2017

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BackgroundExposure to war-related trauma has long been recognised to have an adverse effect on mental health. We attempted to investigate whether people who have clinically significant personality-related problems 15 years after a war are more likely to have been exposed to severe war-related trauma than those who do not have significant personality difficulties.MethodsA case –control study was conducted in southern Croatia, fifteen years after the 1991–1995 war. We recruited 268 participants: 182 cases who scored positively on the International Personality Disorder Examination scale (IPDE), and 86 controls who were IPDE negative. Severity of war-related trauma was assessed according to the 17 items on the Harvard Trauma Questionnaire (HTQ) trauma event scale, which were considered to be of severe (catastrophic) nature based on the ICD-10 description of catastrophic trauma and the opinion of trauma experts. All participants also completed measures of mental health (depression, anxiety and PTSD), social functioning and current substance misuse.ResultsCases (IPDE positive) were eight times more likely to report exposure to severe war-related trauma than controls. This association increased after adjustments for demographic factors (OR = 10.1, 95% CI 5.0 to 20.4). The types of severe trauma most frequently reported were either the participants’own life being in direct danger or witnessing extreme violence inflicted on others or the result of violence towards others (murder, torture, seeing burned or disfigured bodies). Prevalences of depression, anxiety and PTSD were high among IPDE positive participants 15 years after exposure to war trauma. Their level of interpersonal dysfunction was considerably higher than that in controls (OR = 10.39, 95% CI 3.51 to 30.75). Alcohol consumption in cases was significantly higher with a mean of 14.24 units per week (sd = 11.03) when compared to controls whose mean number of alcohol units was 9.24 (sd = 7.25), t (73) = 2.16, p < 0.05, mean difference 4.99 (95% CI = 0.39 to 9.60). Similarly, a significantly higher number of cases reported current substance misuse (8.2% vs. 0.0%) X2 (1, n = 268) = 7.51, p < 0.05).ConclusionExposure to severe war-related trauma is a risk factor for interpersonal dysfunction15 years after people were exposed to an armed conflict. These findings have implications for assessing and meeting the long-term mental health needs of people in war-affected regions. Further research needs to be done to increase our understanding about the relationship between severe war trauma and personality related problems.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Severe war-related trauma and personality pathology: a case-control study

et al. 2017

Self Cite

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“…Lastly, compared to people without mental disorders, people with mental disorders had a tremendously increased risk of reporting psychosocial impairments and difficulties ( Munjiza et al, 2014 ; Jobst et al, 2015 ); however, a survey of psychiatric hospitals revealed that inpatients expected to increase their social contacts while attending sports and exercise sessions ( Brand et al, 2016 ). In line with this, Masten et al (2011) showed that neurophysiological responses to peer rejection appeared to be a biomarker for the onset of adolescents’ risk for depression.…”

Section: Introductionmentioning

confidence: 99%

Acute Bouts of Exercising Improved Mood, Rumination and Social Interaction in Inpatients With Mental Disorders

et al. 2018

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Background: Studies at the macro level (such as longer-term interventions) showed that physical activity impacts positively on cognitive-emotional processes of patients with mental disorders. However, research focusing on the immediate impact of acute bouts of exercise (micro level) are missing. The aim of the present study was therefore to investigate whether and to what extent single bouts of moderately intense exercise can influence dimensions of psychological functioning in inpatients with mental disorders.Method: 129 inpatients (mean age: 38.16 years; 50.4% females) took part and completed a questionnaire both immediately before and immediately after exercising. Thirty inpatients completed the questionnaires a second time in the same week. The questionnaire covered socio-demographic and illness-related information. Further, the questionnaire asked about current psychological states such as mood, rumination, social interactions, and attention, tiredness, and physical strengths as a proxy of physiological states.Results: Psychological states improved from pre- to post-session. Improvements were observed for mood, social interactions, attention, and physical strengths. Likewise, rumination and tiredness decreased. Mood, rumination, and tiredness further improved, when patients completed the questionnaires the second time in the same week.Conclusion: At micro level, single bouts of exercise impacted positively on cognitive-emotional processes such as mood, rumination, attention and social interactions, and physiological states of tiredness and physical strengths among inpatients with mental disorders. In addition, further improvements were observed, if patients participated in physical activities a second time.

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“…Rather, the events of all episodes of each show can be considered to happen simultaneously among the total population of the series. Therefore, the authors argue that it is appropriate to analyse fictional depictions of psychological disorders using the methodological approach described above and comparing the prevalence rates within the Star Trek series with realworld prevalence rates found in the literature (World Health Organization 2003; Pearson et al 2006;Plassman et al 2007;Richardson et al 2010;Sar 2011;Munjiza et al 2014; National Institute of Mental Health 2016).…”

Section: Methods: Quantitative Analysis -Frequencies and Prevalence Rmentioning

confidence: 99%

From Bones to Brain: 50 Years of Star Trek and Changes in the Stigmatization of Psychological Disorders

Basilowski

Schönfeld²,

Esser

et al. 2018

Curr Psychol

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The Star Trek franchise currently includes five spin-off series and 13 motion pictures. Star Trek's central theme is the utopian future of mankind, but the series does not disregard issues that were socially relevant for its time of production. Therefore, Star Trek has functioned as a representation of history throughout its 50-year lifespan. This paper conducts a comparative analysis of fictional representations of psychological disorders and corresponding treatments to retrace the cultural changes in the portrayal and treatment of psychological disorders from the 1960s to the turn of the millennium. Video material produced between 1966 and 1999 was analysed with a focus on psychological disorders and coded according to the ICD-10. The results of the quantitative analysis indicate that the different Star Trek series demonstrate similar patterns of percentage distributions for psychological disorders. The qualitative analysis shows that psychological disorders were portrayed and treated in an increasingly realistic fashion. Changes in society's attitude towards psychological disorders can be comprehensively illustrated through Star Trek episodes produced through 1999. Psychological phenomena are increasingly destigmatized, and the necessity of treatment has not been disregarded.

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Lasting personality pathology following exposure to catastrophic trauma in adults: Systematic review

Abstract: A minority of adults who are exposed to severe trauma appear to go on to develop significant personality pathology. The observed personality disturbance is multifarious and more extensive than the prototype described in ICD-10.

Cited by 14 publications

References 59 publications

Severe war-related trauma and personality pathology: a case-control study

Severe war-related trauma and personality pathology: a case-control study

Acute Bouts of Exercising Improved Mood, Rumination and Social Interaction in Inpatients With Mental Disorders

From Bones to Brain: 50 Years of Star Trek and Changes in the Stigmatization of Psychological Disorders

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