scholarly journals Relations between Emotional Expressivity Dimensions and DSM-5 Post-traumatic Stress Disorder Symptom Clusters in a Trauma-Exposed Community Sample

2020 ◽  
Vol 37 (3) ◽  
pp. 116-129
Author(s):  
Ling Jin ◽  
Megan Dolan ◽  
Ateka A. Contractor ◽  
Nicole H. Weiss ◽  
Paula Dranger

AbstractBackground and Objective. A growing body of literature indicates a significant contribution and role of positive and negative emotions (specifically expressivity) in post-traumatic stress disorder's (PTSD) symptomatology. The current study examined the facet-level relationships between emotional expressivity and PTSD. Specifically, we investigated which emotional expressivity dimension (impulse strength, negative emotional expressivity, and positive emotional expressivity) most strongly related to DSM-5 PTSD symptom clusters severity (intrusions, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity). Methods. The sample of 123 trauma-exposed participants seeking mental health treatment completed the PTSD Checklist for DSM-5 (PCL-5) and the Berkeley Expressivity Questionnaire (BEQ). Results. Results of multivariate multiple regression analysis indicated that only intensity of emotion and difficulty in controlling such emotions (i.e., impulse strength) was strongly related to all four PTSD symptom clusters. The valence of emotional expressivity (positive or negative) was not related to any of the PTSD symptom clusters. Conclusions. Study findings highlight the role of emotional expressivity, specifically impulse strength, in PTSD's symptomatology and may inform guidelines for emotion-focused clinical work for trauma-exposed individuals with PTSD symptoms.

2020 ◽  
pp. 088626052095864
Author(s):  
Rachel Wamser-Nanney ◽  
Julia C. Sager

Previous studies have reported that trauma exposure and post-traumatic stress symptoms (PTSS) may increase the risk for parenting difficulties, yet it is not clear whether trauma exposure and PTSS independently contribute to parenting-related indices or whether there is an indirect effect of trauma exposure on parenting-related outcomes through PTSS. Further, the associations between PTSS and parenting outcomes utilizing the most recent Diagnostic and Statistical Manual ( DSM-5) post-traumatic stress disorder (PTSD) criteria are unknown. The aims of the current study were to determine: (a) whether trauma exposure and PTSS are related to parenting indices; (b) if trauma exposure is associated with parenting factors indirectly through PTSS; and (c) whether the DSM-5 PTSD symptom clusters are each linked with parenting outcomes. Participants were 225 trauma-exposed parents ( Mage = 36.81; SD = 8.32) from a Midwestern University or Amazon’s Mechanical Turk (MTurk). Cumulative trauma had an indirect effect on parental satisfaction, support, involvement, limit-setting, and autonomy via PTSS. The specific PTSD symptom clusters also demonstrated distinct ties to parenting outcomes. Higher levels of alterations in reactivity and arousal symptoms were associated with lower parental support and satisfaction, as expected. Avoidance symptoms were also inversely related to parental autonomy. However, a positive relationship was noted between intrusion symptoms and support, and changes in cognitions and mood were unrelated to parenting indices. PTSS may better explain decrements in aspects of parenting than trauma exposure. Certain types of PTSD symptoms, particularly trauma-related changes in reactivity and arousal, may be relevant in understanding and improving parenting outcomes among trauma-exposed parents.


2014 ◽  
Vol 24 (3) ◽  
pp. 249-257 ◽  
Author(s):  
J. White ◽  
J. Pearce ◽  
S. Morrison ◽  
F. Dunstan ◽  
J. I. Bisson ◽  
...  

Aims.Post-traumatic stress disorder (PTSD) is typically associated with high-risk population groups, but the risk of PTSD that is associated with trauma experienced in the community, and effect of changes in diagnostic criteria in DSM-5 on prevalence in the general population, is unknown.Methods.Cross-sectional analysis of population-based data from 4558 adults aged 25–83 years resident in Caerphilly county borough, Wales, UK. Exposure to different traumatic events was assessed using categorisation of free-text descriptions of trauma. PTSD caseness was determined using items assessing Diagnostic and Statistical Manual IV (DSM-IV) and DSM-5 A criteria and the Traumatic Screening Questionnaire.Results.Of the 4558 participants, 1971 (47.0%) reported a traumatic event. The most common DSM-IV A1 qualifying trauma was life-threatening illnesses and injuries (13.6%). The highest risk of PTSD was associated with assaultive violence [34.1%]. The prevalence of PTSD using DSM-IV A criteria was 14.3% (95% confidence interval [CI] = 12.8, 15.9%). Using DSM-5 A criteria reduced the prevalence to 8.0 (95% CI = 6.9, 9.4%), primarily due to exclusion of DSM-IV A1 qualifying events, such as life-threatening illnesses.Conclusions.Nearly one-half of a general community sample had experienced a traumatic event and of these around one in seven was a DSM-IV case of PTSD. Although the majority of research has concentrated on combat, rape and assaultive violence, life threatening illness is a more common cause of PTSD in the community. Removal of this traumatic event in DSM-5 could reduce the number of cases of PTSD by around 6.0%.


2013 ◽  
Vol 44 (10) ◽  
pp. 2085-2098 ◽  
Author(s):  
R. H. Pietrzak ◽  
A. Feder ◽  
C. B. Schechter ◽  
R. Singh ◽  
L. Cancelmo ◽  
...  

BackgroundPost-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations.MethodData were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11.ResultsCFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time.ConclusionsResults of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.


2019 ◽  
pp. 74-80
Author(s):  
Thi Tan Nguyen ◽  
Van Minh Doan ◽  
Nhat Minh Tran ◽  
Van Hung Nguyen

Post-traumatic Stress Disorder (PTSD) is a mental disorder that develops in people who have experienced or witnessed a serious traumatic event, such as natural catastrophes, sexual assaults, war… Some studies showed that acupuncture was effective for PTSD. However, there is no published research on the treatment of PTSD using acupuncture and cognitive behavioral therapy (CBT) in Vietnam. The aim of this study was to evaluate the effectiveness of treating PTSD using acupuncture combined with CBT in Thua Thien Hue province. Method and subject: This study was an interventional study conducted in two districts of Thua Thien Hue province. Thirty patients were diagnosed with PTSD using Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Participants were assessed on PTSD symptoms using PTSD Checklist for DSM-5 (PCL–5); depression, anxiety and stress status using DASS-21; and other health states before and after treatment. Result: The effectiveness rate of treatment was 83.3% by PCL–5 and 86.7% by DASS-21. The improvement of symptoms after 5 weeks of treatment was statistically significant (p <0.05). Side effects were itch (5.0%), pain (4.3%); bleeding (1.3%); and others (0%). Conclusion: Treatment of PTSD using acupuncture and CBT has a high effectiveness rate on PCL - 5 scale and DASS21 scale. Improvement was similar when evaluated by the two scales. Acupuncture was safe and did not cause any significant side effects. Key words: Post-traumatic Stress Disorder, PTSD, acupuncture, cognitive behavior therapy, CBT, Thua Thien Hue


Author(s):  
Susanne Fischer ◽  
Tabea Schumacher ◽  
Christine Knaevelsrud ◽  
Ulrike Ehlert ◽  
Sarah Schumacher

Abstract Background Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic–pituitary–adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). Methods This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. Results Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. Conclusions Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.


2021 ◽  
Vol 79 (4) ◽  
pp. 1723-1734
Author(s):  
Shlomo Sragovich ◽  
Michael Gershovits ◽  
Jacqueline C.K. Lam ◽  
Victor O.K. Li ◽  
Illana Gozes

Background: We recently discovered autism/intellectual disability somatic mutations in postmortem brains, presenting higher frequency in Alzheimer’s disease subjects, compared with the controls. We further revealed high impact cytoskeletal gene mutations, coupled with potential cytoskeleton-targeted repair mechanisms. Objective: The current study was aimed at further discerning if somatic mutations in brain diseases are presented only in the most affected tissue (the brain), or if blood samples phenocopy the brain, toward potential diagnostics. Methods: Variant calling analyses on an RNA-seq database including peripheral blood samples from 85 soldiers (58 controls and 27 with symptoms of post-traumatic stress disorder, PTSD) was performed. Results: High (e.g., protein truncating) as well as moderate impact (e.g., single amino acid change) germline and putative somatic mutations in thousands of genes were found. Further crossing the mutated genes with autism, intellectual disability, cytoskeleton, inflammation, and DNA repair databases, identified the highest number of cytoskeletal-mutated genes (187 high and 442 moderate impact). Most of the mutated genes were shared and only when crossed with the inflammation database, more putative high impact mutated genes specific to the PTSD-symptom cohorts versus the controls (14 versus 13) were revealed, highlighting tumor necrosis factor specifically in the PTSD-symptom cohorts. Conclusion: With microtubules and neuro-immune interactions playing essential roles in brain neuroprotection and Alzheimer-related neurodegeneration, the current mutation discoveries contribute to mechanistic understanding of PTSD and brain protection, as well as provide future diagnostics toward personalized military deployment strategies and drug design.


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