The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly cooccur following trauma, and their co-occurrence is associated with substantial costs; however, our understanding of the timing and sequencing of these posttrauma mental health conditions is limited. This study examined the trajectories of PTSD symptom severity and substance use among individuals recently exposed to a traumatic event, with a focus on the potential moderating roles of PTSD and SUD diagnoses at the final assessment. Additionally, in attempt to better understand the functional relationship between PTSD symptoms and substance use posttrauma, this study compared models reflecting the theories of self-medication, susceptibility, and mutual maintenance. Participants included 137 individuals who had experienced a traumatic event within 6 months prior to study enrollment. Participants completed four assessments over an approximate 1-year period that included clinician-administered measures for DSM-5 PTSD symptoms and SUD diagnosis and self-report measures of alcohol and drug use. Change over time in PTSD symptoms and substance use by diagnostic status were investigated using growth curve models. Temporal sequencing between PTSD symptom severity and substance use was investigated with bivariate latent difference score structural equation modeling. In line with the conceptualization of PTSD as a disorder of impeded recovery, having a diagnosis of PTSD at the final assessment moderated the trajectory of PTSD symptom severity such that symptom severity declined only among those without PTSD. In contrast, the influence of SUD appeared to be negligible. Both PTSD and SUD diagnoses were associated with initial drug use frequency. However, the relationship between alcohol use and diagnostic status did not reach statistical significance. Regarding temporal relationships between PTSD symptoms and substance use, significant and negative PTSD to change in substance use cross-lagged paths were found across most of the models, while only one significant substance use to change in PTSD severity crosslagged path emerged in the PTSD intrusion with alcohol use model. These results add to a growing body of research suggesting trauma-focused intervention is viable for individuals with PTSD/SUD. Further, examination of potential mediators and moderators of the relation between PTSD and SUD is recommended as a critical focus for future research.

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Stress and Coping of Critical Care Nurses After Unsuccessful Cardiopulmonary Resuscitation

American Journal of Critical Care ◽

10.4037/ajcc2017916 ◽

2017 ◽

Vol 26 (2) ◽

pp. 128-135 ◽

Cited By ~ 14

Author(s):

Dawn E. McMeekin ◽

Ronald L. Hickman ◽

Sara L. Douglas ◽

Carol G. Kelley

Keyword(s):

Critical Care ◽

Symptom Severity ◽

Ptsd Symptom ◽

Institutional Support ◽

Critical Care Nurses ◽

Ptsd Symptoms ◽

Coping Behaviors ◽

Event Scale ◽

Ptsd Symptom Severity ◽

The Impact

Background Participation by a critical care nurse in an unsuccessful resuscitation can create a unique heightened level of psychological stress referred to as postcode stress, activation of coping behaviors, and symptoms of posttraumatic stress disorder (PTSD). Objectives To explore the relationships among postcode stress, coping behaviors, and PTSD symptom severity in critical care nurses after experiencing unsuccessful cardiopulmonary resuscitations and to see whether institutional support attenuates these repeated psychological traumas. Methods A national sample of 490 critical care nurses was recruited from the American Association of Critical-Care Nurses’ eNewsline and social media. Participants completed the Post-Code Stress Scale, the Brief COPE (abbreviated), and the Impact of Event Scale–Revised, which were administered through an online survey. Results Postcode stress and PTSD symptom severity were weakly associated (r = 0.20, P = .01). No significant associations between coping behaviors and postcode stress were found. Four coping behaviors (denial, self-distraction, self-blame, and behavioral disengagement) were significant predictors of PTSD symptom severity. Severity of postcode stress and PTSD symptoms varied with the availability of institutional support. Conclusions Critical care nurses show moderate levels of postcode stress and PTSD symptoms when asked to recall an unsuccessful resuscitation and the coping behaviors used. Identifying the critical care nurses most at risk for PTSD will inform the development of interventional research to promote critical care nurses’ psychological well-being and reduce their attrition from the profession.

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PTSD symptom severity and impulsivity among firefighters: Associations with alcohol use

Psychiatry Research ◽

10.1016/j.psychres.2019.06.039 ◽

2019 ◽

Vol 278 ◽

pp. 315-323 ◽

Cited By ~ 3

Author(s):

Brooke A. Bartlett ◽

Lia J. Smith ◽

Antoine Lebeaut ◽

Jana K. Tran ◽

Anka A. Vujanovic

Keyword(s):

Alcohol Use ◽

Symptom Severity ◽

Ptsd Symptom ◽

Ptsd Symptom Severity

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The invisible scars of emotional abuse: a common and highly harmful form of childhood maltreatment

BMC Psychiatry ◽

10.1186/s12888-021-03134-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Camila Monteiro Fabricio Gama ◽

Liana Catarina Lima Portugal ◽

Raquel Menezes Gonçalves ◽

Sérgio de Souza Junior ◽

Liliane Maria Pereira Vilete ◽

...

Keyword(s):

Childhood Maltreatment ◽

Symptom Severity ◽

Emotional Abuse ◽

Negative Binomial ◽

Ptsd Symptom ◽

Traumatic Experiences ◽

Student Sample ◽

Increased Risk ◽

Ptsd Symptom Severity ◽

The Impact

Abstract Background Childhood maltreatment (CM) is unfortunately widespread globally and has been linked with an increased risk of a variety of psychiatric disorders in adults, including posttraumatic stress disorder (PTSD). These associations are well established in the literature for some maltreatment forms, such as sexual and physical abuse. However, the effects of emotional maltreatment are much less explored, even though this type figures among the most common forms of childhood maltreatment. Thus, the present study aims to investigate the impact of each type of childhood maltreatment, both individually and conjointly, on revictimization and PTSD symptom severity using a nonclinical college student sample. Methods Five hundred and two graduate and undergraduate students participated in the study by completing questionnaires assessing lifetime traumatic experiences in general, maltreatment during childhood and PTSD symptoms. Bivariate and multivariate negative binomial regressions were applied to examine the associations among childhood maltreatment, revictimization, and PTSD symptom severity. Results Our results showed that using bivariate models, all types of CM were significantly associated with revictimization and PTSD symptom severity. Multivariate models showed that emotional abuse was the type of maltreatment associated with the highest incidence rates of revictimization and PTSD symptom severity. Conclusions These data provide additional evidence of the harmful effects of childhood maltreatment and its long-term consequences for individuals’ mental health. Notably, the findings highlight the importance of studying the impacts of emotional abuse, which seems to be a highly prevalent, understudied, and chronic form of maltreatment that is as toxic as other maltreatment forms.

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Investigating Relationships Among Distress Tolerance, PTSD Symptom Severity, and Alcohol Use

Journal of Psychopathology and Behavioral Assessment ◽

10.1007/s10862-020-09842-3 ◽

2021 ◽

Author(s):

Rachel Ranney ◽

◽

Shiva Edalatian Zakeri ◽

Salpi Kevorkian ◽

Lance Rappaport ◽

...

Keyword(s):

Alcohol Use ◽

Symptom Severity ◽

Distress Tolerance ◽

Ptsd Symptom ◽

Ptsd Symptom Severity

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Bidirectional relationship of posttraumatic stress disorder (PTSD) symptom severity and alcohol use over the course of integrated treatment.

Psychology of Addictive Behaviors ◽

10.1037/adb0000564 ◽

2020 ◽

Vol 34 (4) ◽

pp. 506-511 ◽

Cited By ~ 3

Author(s):

Jessica C. Tripp ◽

Matthew J. Worley ◽

Elizabeth Straus ◽

Abigail C. Angkaw ◽

Ryan S. Trim ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Alcohol Use ◽

Posttraumatic Stress ◽

Symptom Severity ◽

Stress Disorder ◽

Ptsd Symptom ◽

Integrated Treatment ◽

Bidirectional Relationship ◽

Ptsd Symptom Severity ◽

Relationship Of

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Psychiatric morbidity and protracted symptoms in recovered COVID-19 patients

10.1101/2020.10.07.20208249 ◽

2020 ◽

Author(s):

Burç Çağrı Poyraz ◽

Cana Aksoy Poyraz ◽

Yeşim Olğun ◽

Özge Gürel ◽

Sena Alkan ◽

...

Keyword(s):

Symptom Severity ◽

Ptsd Symptom ◽

Demographic Data ◽

Acute Infection ◽

Psychiatric Morbidity ◽

Depression Scale ◽

Binary Logistic Regression Analysis ◽

Cross Sectional ◽

Ptsd Symptom Severity ◽

The Impact

AbstractWe investigated the psychiatric symptomatology and the protracted symptoms in recently recovered COVID-19 patients. This cross-sectional study assessed 284 patients recruited from a tertiary hospital. Patients completed a web-based survey on socio-demographic data, past medical/psychiatric history, and additional information relevant to the outbreak conditions. The psychiatric status was assessed using the Impact of Events Scale-Revised (IES-R), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and MINI suicidality scale. Patients completed a checklist for the acute symptom burden and protracted symptoms that were experienced after the acute infection. After a mean of 50 days following the diagnosis of COVID-19, 98 patients (34.5%) reported clinically significant PTSD, anxiety, and/or depression, with PTSD being the most common condition reported (25.4%). One hundred and eighteen patients (44.3%) reported one or more protracted symptom(s), with fatigue, muscle aches, alteration of smell/taste, headache and difficulty in concentration, being the most common symptoms reported. Predictors of PTSD symptom severity were the female gender, past traumatic events, protracted symptoms, perceived stigmatization, and a negative view on the seriousness of the COVID-19 pandemic. Binary logistic regression analysis showed that PTSD symptom severity was the sole independent predictor of the presence of protracted symptoms. Our results suggest that COVID-19 patients may be prone to substantial psychological distress in the first months after the infection. The protracted symptoms were also frequent in this period, and these were related to the posttraumatic psychiatric morbidity. Both the psychiatric morbidity and the protracted symptoms were independent of the initial infection severity. Further research on the neurobiological commonalities between the protracted symptoms and PTSD in COVID-19 patients is warranted.

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Associations between posttraumatic stress disorder and substance use: a longitudinal investigation of individuals recently exposed to trauma

10.32920/ryerson.14644506 ◽

2021 ◽

Author(s):

Sonya G. Wanklyn

Keyword(s):

Posttraumatic Stress Disorder ◽

Substance Use ◽

Alcohol Use ◽

Posttraumatic Stress ◽

Symptom Severity ◽

Stress Disorder ◽

Ptsd Symptom ◽

Traumatic Event ◽

Ptsd Symptoms ◽

Ptsd Symptom Severity

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly cooccur following trauma, and their co-occurrence is associated with substantial costs; however, our understanding of the timing and sequencing of these posttrauma mental health conditions is limited. This study examined the trajectories of PTSD symptom severity and substance use among individuals recently exposed to a traumatic event, with a focus on the potential moderating roles of PTSD and SUD diagnoses at the final assessment. Additionally, in attempt to better understand the functional relationship between PTSD symptoms and substance use posttrauma, this study compared models reflecting the theories of self-medication, susceptibility, and mutual maintenance. Participants included 137 individuals who had experienced a traumatic event within 6 months prior to study enrollment. Participants completed four assessments over an approximate 1-year period that included clinician-administered measures for DSM-5 PTSD symptoms and SUD diagnosis and self-report measures of alcohol and drug use. Change over time in PTSD symptoms and substance use by diagnostic status were investigated using growth curve models. Temporal sequencing between PTSD symptom severity and substance use was investigated with bivariate latent difference score structural equation modeling. In line with the conceptualization of PTSD as a disorder of impeded recovery, having a diagnosis of PTSD at the final assessment moderated the trajectory of PTSD symptom severity such that symptom severity declined only among those without PTSD. In contrast, the influence of SUD appeared to be negligible. Both PTSD and SUD diagnoses were associated with initial drug use frequency. However, the relationship between alcohol use and diagnostic status did not reach statistical significance. Regarding temporal relationships between PTSD symptoms and substance use, significant and negative PTSD to change in substance use cross-lagged paths were found across most of the models, while only one significant substance use to change in PTSD severity crosslagged path emerged in the PTSD intrusion with alcohol use model. These results add to a growing body of research suggesting trauma-focused intervention is viable for individuals with PTSD/SUD. Further, examination of potential mediators and moderators of the relation between PTSD and SUD is recommended as a critical focus for future research.

Download Full-text