I minori stranieri non accompagnati tra trauma e riparazione. Uno studio su disturbo post-traumatico da stress, ansia, depressione e tendenze dissociative in giovani migranti residenti in comunità The unaccompanied foreign minors between trauma and repair interventions. A study on post-traumatic stress disorder, anxiety, depression and dissociative tendencies in young migrants living in community health centers
01 Jan 2012-
TL;DR: In this paper, the authors describe a set of interventi svolti in centri di pronta accoglienza and comunita residenziali per minori richiedenti asilo politico del territorio barese, focalizing nel contempo l'attenzione sulla valenza terapeutica dei contesti di comunitas relativamente alla configurazione sintomatica in oggetto.
Abstract: RIASSUNTO: Obiettivo: L’obiettivo del presente contributo e quello di descrivere i risultati di un’indagine volta ad esplorare la presenza di sintomi inquadrabili o associati al PTSD in un piccolo gruppo di minori stranieri non accompagnati inseriti in centri di pronta accoglienza e comunita residenziali per minori richiedenti asilo politico del territorio barese, focalizzando nel contempo l’attenzione sulla valenza terapeutica dei contesti di comunita relativamente alla configurazione sintomatica in oggetto. Nello specifico, lo studio effettuato ha inteso, in prima istanza, rilevare la presenza di sintomi riferibili a PTSD, Ansia, Depressione e tendenze Dissociative nel campione preso in esame, verificando la relazione, riscontrata in letteratura, tra la condizione di minore straniero non accompagnato e lo sviluppo del PTSD e/o di sintomi ad esso associati. Un secondo obiettivo ha inteso verificare eventuali differenze statisticamente significative relativamente alla presenza di sintomi inerenti o associati al PTSD in funzione del tempo di permanenza dei minori in comunita. Metodologia e Risultati: La testistica proposta ha evidenziato la presenza di una diffusa sintomatologia caratterizzante il PTSD e i quadri depressivi ed ansiosi. Per quanto riguarda i sintomi riferibili al PTSD, l’analisi del Chi-Quadro mostra come tali sintomi si distribuiscano in maniera statisticamente significativa relativamente ai tempi di permanenza in comunita, al contrario dei sintomi depressivi, ansiosi e delle tendenze dissociative che non mostrano significativita nella distribuzione dei punteggi legati ai singoli tempi presi in considerazione. Conclusioni: Lo studio evidenzia la rilevanza clinica di interventi svolti all’interno di contesti residenziali organizzati sul modello dell’ambiente terapeutico globale. PAROLE CHIAVE: Minori stranieri non accompagnati, PTSD e sintomi correlati, Interventi di comunita.
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TL;DR: The prevalence estimates suggest that specialized mental health care services for the most vulnerable refugee and asylum-seeking populations are needed, and the highly heterogeneous evidence base could be improved by international, methodologically comparable studies with sufficiently large sample sizes drawn randomly among specific refugee populations.
Abstract: The European Union member states received about 385,000 asylum applications from children and adolescents below 18 years in 2015, and 398,000 in 2016. The latest political crises and war have led to an upsurge in refugee movements into European countries, giving rise to a re-evaluation of the epidemiology of psychiatric disorders and mental health problems among young refugees and asylum seekers. We systematically searched five electronic databases and reference lists of pertinent review articles. We then screened the results of forward citation tracking of key articles for relevant studies in the field for the period from January 1990 to October 2017. We dually reviewed citations and assessed risk of bias. We reported the results narratively, as meta-analyses were impeded due to high heterogeneity. We included 47 studies covered in 53 articles. Overall, the point prevalence of the investigated psychiatric disorders and mental health problems varied widely among studies (presenting interquartile ranges): for posttraumatic stress disorder between 19.0 and 52.7%, for depression between 10.3 and 32.8%, for anxiety disorders between 8.7 and 31.6%, and for emotional and behavioural problems between 19.8 and 35.0%. The highly heterogeneous evidence base could be improved by international, methodologically comparable studies with sufficiently large sample sizes drawn randomly among specific refugee populations. The prevalence estimates suggest, nevertheless, that specialized mental health care services for the most vulnerable refugee and asylum-seeking populations are needed. The systematic review protocol was registered in PROSPERO on October 19th, 2017 with the number: CRD42017080039 and is available from: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=80039
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TL;DR: The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type, used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information.
Abstract: Types of Rating Scale The value of this one, and its limitations, can best be considered against its background, so it is useful to consider the limitations of the various rating scales extant. They can be classified into four groups, the first of which has been devised for use on normal subjects. Patients suffering from mental disorders score very highly on some of the variables and these high scores serve as a measure of their illness. Such scales can be very useful, but have two defects: many symptoms are not found in normal persons; and less obviously, but more important, there is a qualitative difference between symptoms of mental illness and normal variations of behaviour. The difference between the two is not a philosophical problem but a biological one. There is always a loss of function in illness, with impaired efficiency. Self-rating scales are popular because they are easy to administer. Aside from the notorious unreliability of self-assessment, such scales are of little use for semiliterate patients and are no use for seriously ill patients who are unable to deal with them. Many rating scales for behaviour have been devised for assessing the social adjustment of patients and their behaviour in the hospital ward. They are very useful for their purpose but give little or no information about symptoms. Finally, a number of scales have been devised specifically for rating symptoms of mental illness. They cover the whole range of symptoms, but such all-inclusiveness has its disadvantages. In the first place, it is extremely difficult to differentiate some symptoms, e.g., apathy, retardation, stupor. These three look alike, but they are quite different and appear in different settings. Other symptoms are difficult to define, except in terms of their settings, e.g., mild agitation and derealization. A more serious difficulty lies in the fallacy of naming. For example, the term "delusions" covers schizophrenic, depressive, hypochrondriacal, and paranoid delusions. They are all quite different and should be clearly distinguished. Another difficulty may be summarized by saying that the weights given to symptoms should not be linear. Thus, in schizophrenia, the amount of anxiety is of no importance, whereas in anxiety states it is fundamental. Again, a schizophrenic patient who has delusions is not necessarily worse than one who has not, but a depressive patient who has, is much worse. Finally, although rating scales are not used for making a diagnosis, they should have some relation to it. Thus the schizophrenic patients should have a high score on schizophrenia and comparatively small scores on other syndromes. In practice, this does not occur. The present scale has been devised for use only on patients already diagnosed as suffering from affective disorder of depressive type. It is used for quantifying the results of an interview, and its value depends entirely on the skill of the interviewer in eliciting the necessary information. The interviewer may, and should, use all information available to help him with his interview and in making the final assessment. The scale has undergone a number of changes since it was first tried out, and although there is room for further improvement, it will be found efficient and simple in use. It has been found to be of great practical value in assessing results of treatment.
29,488 citations
Book•
01 Jan 1979
TL;DR: An apparatus for measuring at least two of the following characteristics of a fluid; pH, partial pressure of dissolved gas or gases therein, inorganic ion concentration, hemoglobin, temperature, and the like, the apparatus comprising a vessel having a flow channel for fluid passing therethrough and means for inducing turbulence in the channel at specified locations.
Abstract: An apparatus for measuring at least two of the following characteristics of a fluid; pH, partial pressure of dissolved gas or gases therein, inorganic ion concentration, hemoglobin, temperature, and the like, the apparatus comprising a vessel having a flow channel for fluid passing therethrough and means for inducing turbulence in the channel at specified locations; sensors for the above enumerated fluid characteristics located in the vessel along the channel and within the area of induced turbulent flow; and integral heat-exchanging means e.g., cartridge heaters, within the vessel and external solid state circuitry for maintaining or achieving a preselected temperature in a fluid passing through the vessel and in the sensors. Also disclosed is such an apparatus adapted to the analysis of very small quantities of fluids, e.g., blood, including components for sample storage and transfer, preheating, propulsion and electronic read out and display.
11,686 citations
TL;DR: Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumAs.
Abstract: Background: Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated lifetime prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode. Methods: Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey. Results: The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years. Conclusions: Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas. (Arch Gen Psychiatry. 1995;52:1048-1060)
9,690 citations
Book•
01 Jan 1978TL;DR: In this article, the effects of repetition of the "strange situation" on infants' behavior at home and in the classroom were discussed, as well as the relationship between infants' behaviour in the situation and their mothers' behaviour at home.
Abstract: Part I: Introduction 1. Theoretical Background Part II: Method 2. Procedures 3. Measures and Methods of Assessment Part III: Results 4. Descriptive Account of Behavior in Each Episode 5. Normative Trends across Episodes 6. An Examination of the Classificatory System: A Multiple Discriminate Function Analysis 7. Relationships between Infant Behavior in the Strange Situation and at Home 8. Relationships between Infant Behavior in the Strange Situation and Maternal Behavior at Home 9. A Review of Strange-Situation Studies of One-Year-Olds 10. A Review of Strange-Situation Studies of Two- to Four-Year-Olds 11. The Effects of Repetition of the Strange Situation 12. Subgroups and Their Usefulness Part IV: Discussion 13. Discussion of Normative Issues 14. Individual Differences: In Light of Contrasting Paradigms 15. An Interpretation of Individual Differences Appendix I: Instructions to Mother Appendix II: Instructions for Coding and Tabulating Frequency of Behaviors Appendix III: Scoring System for Interactive Behaviors Appendix IV: Maternal Caregiving and Interaction Scales Appendix V: Secure Base Behavior At Home Appendix VI: Supplementary Statistical Findings
8,726 citations