The diagnostic criteria of delayed-onset PTSD is that the onset of PTSD symptoms should occur at least 6 months after the traumatic event (DSM-IV; American Psychiatric Association, 2000). In a meta analysis across 11 countries, 25% of all PTSD cases were classified as delayed-onset PTSD (Smid et al., 2009). Existing research on delayed-onset PTSD has predominantly used US data, with a dearth of prospective research in UK military samples.

This study investigated the prevalence of delayed-onset PTSD in UK military personnel and examined the socio-demographic, military and psychological characteristics of delayed-onset PTSD.

The sample comprised 1397 participants from a two phase prospective cohort study of UK military personnel. Delayed-onset PTSD was categorised as participants who did not meet the criteria for probable PTSD (assessed by the PCL-C) at phase 1, but who met the criteria by phase 2.

3.5% of participants met the criteria for delayed-onset PTSD. Subthreshold PTSD, common mental disorder (CMD), poor/fair self-reported health and multiple physical symptoms at phase 1, and the onset of alcohol misuse or CMD between phases 1 and 2, were associated with delayed-onset PTSD.

Delayed-onset PTSD exists in this UK military sample. Military personnel who developed delayed-onset PTSD were more likely to have psychological ill-health at an earlier assessment and clinicians should be aware of potential co-morbidity in these individuals, including alcohol misuse. Leaving the military, or experiencing relationship breakdown, was not associated.

To assess the psychological health of war-traumatized school adolescents in two different geopolitical settings of postwar Bosnia and Herzegovina: Federation of Bosnia-Herzegovina (FBH) and Republic Serbska (RS), 10 years after the Bosnia and Herzegovina 1992–1995 war in regard of ethnicity, gender and age.

The study was carried out in northeast part of Bosnia and Herzegovina, in December 2005. We assessed 408 (267 girls) elementary and secondary school adolescents aged 13.5 ± 1.7 years for war trauma, presence of posttraumatic stress disorder (PTSD), and depression. We used Children's Posttraumatic Stress Reaction Index, and Children's Depression Inventory.

Frequency of trauma experiences in the sample was (mean ± standard deviation=7.0 ± 5.7) with no significant differences between two entities (RS and FBH). Bosniacs had the highest rate of trauma experiences (mean ± standard deviation=7.7 ± 6.4), Serbs had 6.5 ± 4.7 and Croats had 4.2 ± 3.2 (ANOVA F = 5.497, P = 0.004). In the whole sample, 177 (43.4%) of 408 adolescents met criteria for PTSD prevalence respecting the DSM-IV criteria with no significant differ between entities FBH and RS. In the sample, 102 (25%) of 408 adolescents met DSM-IV criteria for depression prevalence, depression prevalence was significantly more frequent amongst adolescents from RS 63 (29.3%) than amongst their peers in FBH 39 (20.2%) of 193 (Chi-Square = 4.437, P = 0.034).

All students experienced war trauma and many had psychological consequences. Bosniacs had the highest rate of trauma experiences. The PTSD prevalence did not differ significantly between entities FBH and RS but the depression prevalence was significantly more frequent amongst adolescents from RS than amongst their peers in FBH.

To estimate frequency, type and severity of the psychological trauma, severity of post-traumatic stress symptoms’ clusters and prevalence of post-traumatic stress disorder (PTSD) among Bosnia-Herzegovina (BH) refugee and internally displaced adolescents after the war 1992–1995.

The sample of 217 pupils (106 females) aged of 15.1 ± 2.1 years consisted from three groups of participants originated from different geographical regions from north-eastern BH: Srebrenica (n = 69), Zvornik (n = 79), and Bijeljina (n = 69), who were exposed to the war catastrophes in the 1992–1995 war and were forced to leave their homes and property during the whole war and after it. War trauma experiences, PTSD symptoms severity and PTSD prevalence of adolescents were evaluated with Bosnia-Herzegovina version of Harvard Trauma Questionnaire (HTQ).

The severity level of PTSD symptoms’ and social dysfunction was most severe in Srebrenica, than in Zvornik and finally in Bijeljina group.

The prevalence of PTSD statistically significantly differed between Srebrenica group (73.9%), Zvornik group (60.8%) and Bijeljina group of respondents (47.6%) (χ2test = 9.854, df = 2, p = 0.007).

There were regional variations in Bosnia-Herzegovina warfare. Refugee and internally displaced adolescents suffer very frequently from PTSD 3.5 years after war. The most difficult war trauma was in surviving adolescents from Srebrenica, than Zvornik and finally from Bijeljina. PTSD prevalence is highly reported and significantly differed between groups.

The study is a part of a large-scale research project implemented by WHO in Azerbaijan. The study is aimed to determine the rates of depression in internally displaced women as well as to define socio-demographic variables affecting vulnerability to depression.

The screening for depression was carried out among 733 women at the age of 18–65 who had become refugees due to war conflict in Nagorniy Karabakh. 20-item WHO Self-Reporting Questionnaire was used for screening purposes.

19.2% female refugees did not reveal any symptoms of depression. Yet 24,1% of women presented some depressive complaints which did not meet criteria for depressive disorders. 29,6% had mild to moderate depressive disorders and 27% suffered from severe depression.

The high prevalence of depression in refugee women requires development of specific preventive and treatment programs for this population.

In Israel every year approximately 20% of the high school senior students travel to Poland to the “holocaust memorial journey”. They are escorted by a life witness (a holocaust survivor). They enter concentration camps, are encouraged to investigate and share historical survivor stories of family members. The journey is considered an emotional stressor. Reports of both adolescents and escorts stress the “personal and real like quality” that the journey gives to the horrific historical facts. Different aspects of the journey raise public dispute in Israel. One of the issues that critiques raise is the possible induction of mental health problems and specifically PTSD.

To study the occurrence of severe mental health consequences occurring after the adolescent “holocaust memorial journey”. Can the journey help differentiate between a severe stressor and a traumatic event?

A survey about the experience of child and adolescent psychiatrists in Israel was done. Participants were asked about the scope of their professional activity especially their experience with referrals after the holocaust memorial journey.

Fifty Child and Adolescent psychiatrists (approximately 30% of all child and adolescent psychiatrists in Israel) participated. Though they reported more mental health disorders than after other high school journeys, most were exacerbation of preexisting conditions. There was only one report of post traumatic stress disorder.

The holocaust memorial journey is a major stressor, but is not a traumatic event.

During the Tunisian Revolution, health professionals at several emergency departments (ED) in Tunis faced difficult situations characterized by an extremely high throughput of patients who also suffered unusual lesions (gunshot wounds). Facing the omnipresent death during the bloodiest periods of the Revolution did definitely leave its traces on health professionals.

To screen the emergency personnel for acute stress disorder (ASD) and posttraumatic stress disorder (PTSD), and to identify the associated socio-professional risk factors.

A cross-sectional study was undertaken. Fifty medical and paramedical professionals who have worked at the emergency departments of Charles Nicolle, La Rabta and Mongi Slim hospitals in Tunis during the period of January 12, 2011 to January 18, 2011 were invited to complete a questionnaire with items related to the socio-professional and clinical features of each participant as well the Post-Traumatic Stress Questionnaire (PTSQ) and the Perceived Stress Scale (PSS).

Ten (20%) participants met the criteria for PTSD and six (12%) met those for ASD. Risk factors for either disorder include being a nurse and the presence of somatic or psychiatric history. The answer to the question “do you think your latest interventions at the ED had an impact on you?” Could be a simple and rapid screening method of post-traumatic psychiatric disorders with a negative predictive value of 91.3%.

Throughout this study, we emphasize the importance, in such circumstances, of an appropriate screening and an early management of post-traumatic conditions.

Dissociation is a common feature of PTSD and neurobiological evidence distinguish it from nondissociative PTSD. The aim of this study is to investigate brain functional and structural alterations associated with dissociative traits along a continuum in a group of traumatized subjects either developing or non-developing PTSD.

Among 32 traumatized subjects with and without clinical diagnosis of PTSD we identified two subgroups based on the amount of dissociative traits as investigated by Dissociative Experience Scale (DES). Ten subjects had high dissociative traits (D) and 22 lower (ND). MRI and SPECT scans were performed to investigate structural and functional differences, respectively, between subgroups. Statistical Parametric Mapping was implemented for statistical analysis.

D vs ND comparison showed significant Gray Matter volume (GMV) increases in the right prefrontal cortex, inferior parietal lobule and temporal pole (comprising adjacent parahippocampal gyrus) and in bilateral medial prefrontal cortex. ND vs D comparison showed a significant GMV reduction in D subjects in the right striatum. By regressing GMV against DES scores, we found a significant positive correlation, largely superimposing to the regions identified by the D vs ND contrast, in bilateral prefrontal and anterior cingulate cortex and temporal poles and in the right inferior parietal lobule. No significant differences were found at SPECT.

Significant structural differences were found between D and ND in prefrontal and anterior temporal cortex in which GM highly correlated with DES scores suggesting a strong neurobiological ground for dissociation and the involvement of such structures in its processing.

Eye movement desensitization and reprocessing (EMDR) is a relevant technique to improve post-traumatic stress disorder (PTSD) symptoms.

To compare the electrophysiological profile of patients suffering post traumatic stress disorder before and after EMDR treatment.

The authors are in search of a specific event-related brain potentials profile for post-traumatic stress disorder (PTSD).

Eight patients suffering from post-traumatic stress disorder (PTSD) following a severe traumatic event, were assessed with event-related brain potentials (ERPs) in a modified oddball paradigm containing auditory standard, target, and novel tones. ERPs were assessed before and after a treatment session using the eye movement desensitization and reprocessing method.

Psychometric assessment revealed a marked improvement of the PTSD symptoms after treatment. Compared to a control group that underwent sham treatment, ERPs of the patients showed morphological changes in the post-treatment recording, suggesting a reduced orienting to novel stimuli and reduced arousal level after the treatment.

EMDR therapy provides clinical improvement and event-related potentials changes that could be used in clinical practice as an interesting marker to assess diagnosis and successful treatment of PTSD.

While the effects of war on individuals, age groups, and communities have been thoroughly studied, there has been relatively little mention in the literature regarding its differential effects on adult children and their parents and their elderly grandparents.

509 participants, 167 elderly parents, 171 adult offspring and 171 adult grandchildren living in the northern and southern regions of Israel were interview after the Second Lebanon War (2006) and the Cast Lead Operation (2008). The participants were sampled by a cluster sampling.

Elderly parents experiences higher levels of PTSD symptoms than their adult children or their adult grandchildren do. Women experience higher levels PTSD symptoms than men and Israeli Arabs and Druze more then Israeli Jews in all three generations.

A policy should be enacted among the local authorities and the governmental offices that would ensure accessibility to and the ability to provide proper care especially for the elderly population during times of war or terror events. In addition, it is important to setup local teams in every local community, to deal with the level of mental and emotional preparedness of the home front and its inhabitants, in case the latter should again become part of the human casualties of the wars and terrorist events that occur in Israel.

Posttraumatic stress disorder is considered the “signature diagnosis” of trauma. Research has shown that PTSD has an abundance of psychiatric comorbidities. Comorbidity is said to be rule rather than exception. The most often psychiatric disorders comorbid with PTSD in combat veterans are alcohol use disorders, major depression, drug abuse, and Cluster B (especially antisocial, but also borderline personality disorders).

The aim of the study was to analyze depressive disorders and PTSD and their relationship, from the aspect of comorbidity.

A retrospective analysis of 347 war veterans' medical histories, who were treated between 1991–2009 at the Military Medical Academy:

The most frequent disorders were the depressive (n = 146/42.1%), among which the adjustment disorder (135/38.9%), followed by major depression (9/2.6%), and dysthymia (2/0.6%). PTSD was diagnosed in 91 veterans (26.2%), and alcoholism in 58 (16.7%). Comorbid disorders were registered in 55 (37.7%) veterans with depressive disorders. The most frequent were arterial hypertension (14/25%), PTSD (8/14.5%) and alcoholism (7/12.7%). In veterans with PTSD, the number of registered comorbid disorders was 27 (29.7%), 11 (40.7%) of them with other anxiety disorders, 8 (29.7%) with somatic and neurological illnesses, 6 (22.2%) with psychotic disorders and 2 (7.4%) with depressive disorders.

These findings suggest that war trauma produces broad psychopathological effects, as evidenced by multiple disorders arising independently in the wake of trauma. Multiaxial assessment of posttraumatic depression, especially considering first and fourth axis of the DSM-IV-TR, is necessary for a precise diagnostic process that allows the selection of appropriate treatments.

120 patients were divided in experimental (depression-PTSD) and control (depression-only) group and evaluated using the following instruments: MADRS, HDRS-17 and QIDS-SR. The statistical analysis was performed by mean of Student t-test and Mann -Whitney U test.

Symptoms which differed most significantly between the two groups were: On MADRS instrument inner tension, sleep disturbances trouble concentrating, lassitude, inability to feel and pessimistic thoughts (p,0,001). On HDRS-17 instrument:: early, middle and late insomnia, agitation, work and activities (p < 0,001). On QIDS instrument: early, middle and late insomnia, concentration, interest and decision-making (p < 0,001).

The depression is accompanied by the increased activity of the brain centers engaged in the processing of emotional informations - the very regions that are “switched - off” in PTSD. Depressive symptoms comorbid to PTSD are not the results of the increased activation of the neural circuits by the two pathophysiological processes, but there is the case of differential engagement of neural networks in which stimulation from the lbrain structures responsible for generation of emotional input, increasingly arrives into the prefrontal brain structures, in which more intense and deeper emotional processing takes place causing more intense experience of emotional stimuli and bridging the connection from perceptual and cognitive contents up to affective and visceral centers of the organismus.

Devastating floods from July to September 2010 broke all previous records of havoc caused by natural disasters in Pakistan. Flood caused 20 million people to loose their homes, profession and community making them internally displaced. Devastating consequences are still continuous within the country.

To find out the prevalence of anxiety, depression and post-traumatic stress disorder among flood affected Internally Displaced Persons (IDPs) of Sind.

To find out psychiatric morbidity in IDPs so that proper attention should be paid to rehabilitation of these effectees and psychiatric support should be provided specially to those who are more affected by psychological trauma.

Cross sectional study conducted in Razzakabad, an area located in periphery of Karachi. PTSD prevalence was measured using the Harvard Trauma Questionnaire and levels of anxiety and depression were measured using the Hopkins Symptom Checklist-25. SPSS 17 was used for data entry and analysis.

Total 303 subjects were included in this study out of which 55% were females.The total Scores on Hopkins symptoms checklist - 25 (HSCL-25) and on Harvard trauma Questionnaire were significantly high and psychiatric morbidity was present in 42% of the population. The presence of psychological distress was more in females (65.6%) (p = .05).32% of the subjects had symptoms of PTSD.44% of the population was screened positive for anxiety and depression symptoms were present in 39% of the population.

Besides being displaced from their residence exposure to trauma come out to be the important causative factor in creating psychological disturbance among IDPs.

Posttraumatic stress disorder (PTSD) is usually associated with poor psychosocial functioning. A broad range of international researches assess the influence of stressful events, such as war, on the quality of life of veterans.

To assess the general quality of life of Serbian war veterans one decade after war.

Analysis of socio-demographic data and data obtained from the general quality of life questionnaire, SF-36 in three groups of war veterans.

The research was conducted May to October 2008, in two phases: the field survey on 2370 male veterans and targeted survey of mental health on the subsample of 295 veterans. Assessment included self-assessment tests and clinician administered psychological tests conducted by two trained interviewers. Clinician administered PTSD scale (CAPS) was used in sub-grouping the sample on veterans with current PTSD (n = 26), lifetime PTSD (n = 59) and non-PTSD veterans (n = 210).

Lower quality of life according to SF-36 subscales significantly correlates with the poor financial status and degree of disability. The values of all scales were significantly lower in veterans with PTSD comparing to other groups, and significantly lower in veterans with lifetime PTSD comparing to non-PTSD veterans. The diagnosis of PTSD was statistically confirmed predictor of lower quality of life in relation to all scales. Veterans had significantly worse results than the male population from 25–74 years in Serbia (Health Survey of Serbian Population, 2006).

The quality of life assessment confirms significant vulnerability of Serbian war veterans, especially those with chronic PTSD.

Wives of PTSD affected war veterans experience a wide range of psychosocial difficulties including secondary traumatic stress (STS).

To compare level of STS symptoms, emotional functioning and perceived quality of life between wives of PTSD affected veterans, wives of veterans without PTSD and wives of non-veterans in Croatia. To investigate the effect of veterans’ PTSD, wives’ knowing of the veterans’ war trauma, and wives’ personal war experiences on STS.

A total of 150 married women participated in the study. Fifty wives of PTSD affected veterans were recruited through Referral Center for Psychotrauma Rijeka, while 50 wives of veterans without PTSD and 50 wives of non-veterans were recruited using the snowball method. Sociodemographic questionnaire, Brief Symptom Inventory, Manchester short assessment of quality of life, and Modified questionnaire for secondary traumatization were administrated.

Thirty-six percent of wives of PTSD affected veterans meet the criteria for secondary traumatic stress disorder. Wives of PTSD affected veterans report significantly higher level of STS symptoms compared with wives of non-PTSD veterans. Also, wives of PTSD affected veterans report higher level of psychological difficulties and have lower percieved quality of life compared with other two groups. Multifactor analysis shows main effect of wives' knowing the veteran's traumatic event on STS, and main effect of veterans' PTSD on emotional functioning of their wives.

Clinicians working with war related PTSD should be aware of secondary traumatic effect on the spouses. Systemic approach in psychotherapeutic treatment of PTSD should be considered.

Previous studies have shown that living with war veterans with PTSD influences psychological well-being of their wives.

To examine the presence of secondary traumatic stress (STS) symptoms, current psychological symptoms, and perceived quality of life among wives of war veterans.

To compare the level of psychological symptoms and perceived quality of life between wives of veterans with PTSD, without PTSD, and wives of non-veterans.

Wives of veterans with PTSD (N = 50) were recruited through their partners/war veterans treated for PTSD in Referral Center for Psychotrauma Rijeka, Croatia. Wives of veterans without PTSD (N = 50) and wives of non-veterans (N = 50) were recruited using the snow-balling method. Sociodemographic questionnaire, Brief symptom inventory, Manchester Short Assesment of Quality of Life and Modified questionnaire for secondary traumatization were administrated.

Thirty-six percent of wives of PTSD affected veterans met the criteria for STSD. Wives of veterans with PTSD have significantly higher level of STS symptoms compared with wives of veterans without PTSD, and higher level of psychological symptoms and lower perceived quality of life compared with other two groups. STS symptoms are positively correlated with psychological symptoms and negatively with perceived quality of life. Main effect on STS symptoms has wives’ knowledge of partner's war traumatic event while the main effect on wives’ psychological symptoms has presence of PTSD in husbands.

The results of our study confirm the concept of STS as psychological consequnce of knowing partner's war traumatic event, while emotional burnout is related with living with PTSD symptoms.

The purpose of this survey has been studying the status of working memory and the ability of retrieval specific memory materials from autobiographical memory among PTSD veteran's young children.

The sample contains 131 high school students in 3 groups: PTSD and non-PTSD veteran's young children and young children of healthy person. They are somewhat controlled in the age and academic performance.Research instrument, were including: Beck Depression Inventory, SpielbergerState-Trait Anxiety Inventory, the index of working memory of Wechsler III Test, and Autobiographical Memory Test. Data analysis has been done by the method of descriptive statistics, One way Analysis Of Variance, Scheffe Fallow-up Test.

The results indicate that PTSD veteran's children have lower performance in working and autobiographical memory tasks than healthy person's children have shown. The research also indicates that the state of depression and anxiety in PTSD veteran's children is higher than healthy person's children, while in these 3 components (working memory, autobiographical memory, and anxiety) between PTSD veteran's children and Non-PTSD veteran's children there is no significant differences but in the depression component there was a significantdifference between them. Other research findings have shown that Non-PTSD veteran's children compared with healthy person's children have lower performance in working memory tasks, while in autobiographical memory tasks there was no significant difference, between these two groups. Levels of anxiety in Non-PTSD veteran's children were lower than healthy person's children, there is no significant difference between them in depression.

Neurocognitive aspects and cognitive processes can be done in future.