scholarly journals A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression

2016 ◽  
Vol 46 (12) ◽  
pp. 2571-2582 ◽  
Author(s):  
J. Wild ◽  
K. V. Smith ◽  
E. Thompson ◽  
F. Béar ◽  
M. J. J. Lommen ◽  
...  

BackgroundIt is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions.MethodNewly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews.ResultsIn all, 32 participants (8.3%) developed an episode of PTSD and 41 (10.6%) an episode of MD during follow-up. In all but nine cases (2.3%), episodes had remitted by the next assessment 4 months later. At 2 years, those with episodes of PTSD or MD during follow-up reported more days off work, poorer sleep, poorer quality of life, greater burn-out; and greater weight-gain for those with PTSD. In line with theories of PTSD and depression, analyses controlling for psychiatric and trauma history identified several pre-trauma predictors (cognitive styles, coping styles and psychological traits). Logistic regressions showed that rumination about memories of stressful events at the start of training uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.ConclusionsParticipants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training. Cognitive predictors of episodes of PTSD and MD are promising targets for resilience interventions.

2013 ◽  
Vol 43 (12) ◽  
pp. 2657-2671 ◽  
Author(s):  
O. J. Bienvenu ◽  
J. Gellar ◽  
B. M. Althouse ◽  
E. Colantuoni ◽  
T. Sricharoenchai ◽  
...  

BackgroundSurvivors of critical illnesses often have clinically significant post-traumatic stress disorder (PTSD) symptoms. This study describes the 2-year prevalence and duration of PTSD symptoms after acute lung injury (ALI), and examines patient baseline and critical illness/intensive care-related risk factors.MethodThis prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12 and 24 months after ALI onset. The outcome of interest was an Impact of Events Scale – Revised (IES-R) mean score ⩾1.6 (‘PTSD symptoms’).ResultsDuring the 2-year follow-up, 66/186 patients (35%) had PTSD symptoms, with the greatest prevalence by the 3-month follow-up. Fifty-six patients with post-ALI PTSD symptoms survived to the 24-month follow-up, and 35 (62%) of these had PTSD symptoms at the 24-month follow-up; 50% had taken psychiatric medications and 40% had seen a psychiatrist since hospital discharge. Risk/protective factors for PTSD symptoms were pre-ALI depression [hazard odds ratio (OR) 1.96, 95% confidence interval (CI) 1.06–3.64], ICU length of stay (for a doubling of days, OR 1.39, 95% CI 1.06–1.83), proportion of ICU days with sepsis (per decile, OR 1.08, 95% CI 1.00–1.16), high ICU opiate doses (mean morphine equivalent ⩾100 mg/day, OR 2.13, 95% CI 1.02–4.42) and proportion of ICU days on opiates (per decile, OR 0.83, 95% CI 0.74–0.94) or corticosteroids (per decile, OR 0.91, 95% CI 0.84–0.99).ConclusionsPTSD symptoms are common, long-lasting and associated with psychiatric treatment during the first 2 years after ALI. Risk factors include pre-ALI depression, durations of stay and sepsis in the ICU, and administration of high-dose opiates in the ICU. Protective factors include durations of opiate and corticosteroid administration in the ICU.


Author(s):  
Gabriella Tyson ◽  
Jennifer Wild

The coronavirus pandemic has resulted in many journalists repeatedly covering stories related to human suffering. This study investigates whether these journalists experienced higher rates of psychological distress, post-traumatic stress disorder (PTSD) and depressive symptoms than those who have been working during the pandemic yet covering stories other than COVID-19 and aims to identify what factors may protect journalists from developing trauma-related symptoms. We assessed journalists (n = 120) working during the COVID-19 pandemic using self-report measures. Journalists repeatedly covering COVID-19 stories had significantly higher psychological distress (η2 = 0.04) and PTSD symptoms (η2 = 0.08), but not depression, compared to journalists who did not report on COVID-19. Rumination and numbing in response to unwanted memories predicted PTSD symptoms (R2 = 0.53) and may be risk factors for PTSD in this population. Unhelpful resilience appraisals distinguished journalists who reported on COVID-19 and who developed distressing re-experiencing symptoms from those who similarly reported on distressing material and who did not develop symptoms. Targeting resilience appraisals may be helpful in reducing re-experiencing symptoms after trauma exposure.


2004 ◽  
Vol 185 (4) ◽  
pp. 328-333 ◽  
Author(s):  
Frank G. Njenga ◽  
P. J. Nicholls ◽  
Caroline Nyamai ◽  
Pius Kigamwa ◽  
Jonathan R. T. Davidson

BackgroundMost studies of post-traumatic stress disorder following terrorist attacks are of small samples in industrialised nations and take place months or years after the incident.AimsTo describe reactions following the US embassy bombing in Nairobi and the characteristic features of and risk factors for post-traumatic stress symptoms in a large, non-Western sample soon after the attack.MethodA self-report questionnaire which assessed potential risk factors and identified symptoms matching DSM–IV criteria for post-traumatic stress disorder was answered by 2883 Kenyans, 1–3 months after the bombing.ResultsSymptoms approximating to the criteria for post-traumatic stress disorder occurred in 35%. Factors associated with post-traumatic stress included female gender, unmarried status, lack of college education, seeing the blast, injury, not recovering from injury, not confiding in a friend, bereavement and financial difficulty since the blast. Many other factors were not significant.ConclusionsSpecific factors often cited to predict marked short-term post-traumatic stress were confirmed in this large, non-Western sample.


2013 ◽  
Vol 44 (10) ◽  
pp. 2077-2084 ◽  
Author(s):  
R. Naim ◽  
I. Wald ◽  
A. Lior ◽  
D. S. Pine ◽  
N. A. Fox ◽  
...  

BackgroundPost-traumatic stress disorder (PTSD) is a chronic and difficult to treat psychiatric disorder. Objective, performance-based diagnostic markers that uniquely index risk for PTSD above and beyond subjective self-report markers could inform attempts to improve prevention and early intervention. We evaluated the predictive value of threat-related attention bias measured immediately after a potentially traumatic event, as a risk marker for PTSD at a 3-month follow-up. We measured the predictive contribution of attentional threat bias above and beyond that of the more established marker of risk for PTSD, self-reported psychological dissociation.MethodDissociation symptoms and threat-related attention bias were measured in 577 motor vehicle accident (MVA) survivors (mean age = 35.02 years, 356 males) within 24 h of admission to an emergency department (ED) of a large urban hospital. PTSD symptoms were assessed at a 3-month follow-up using the Clinician-Administered PTSD Scale (CAPS).ResultsSelf-reported dissociation symptoms significantly accounted for 16% of the variance in PTSD at follow-up, and attention bias toward threat significantly accounted for an additional 4% of the variance in PTSD.ConclusionsThreat-related attention bias can be reliably measured in the context of a hospital ED and significantly predicts risk for later PTSD. Possible mechanisms underlying the association between threat bias following a potentially traumatic event and risk for PTSD are discussed. The potential application of an attention bias modification treatment (ABMT) tailored to reduce risk for PTSD is suggested.


2013 ◽  
Vol 20 (6) ◽  
pp. 429-433 ◽  
Author(s):  
Aaron Khitab ◽  
John Reid ◽  
Vern Bennett ◽  
G Camelia Adams ◽  
Lloyd Balbuena

BACKGROUND: Several recent studies have reported that post-traumatic stress disorder (PTSD) is a frequent occurrence in survivors of an intensive care unit (ICU) admission.OBJECTIVE: To assess the frequency of PTSD symptoms at three and nine months post-ICU admission and examine possible risk factors that predispose to the development of PTSD symptoms.METHOD: Using the following scales: Davidson Trauma Scale, Impact of Event Scale and the Post-traumatic Symptom Scale, 69 ICU survivors were assessed for PTSD symptoms at three months post-ICU admission. Of the original 69 patients, 37 completed the same questionnaires at the second follow-up at nine months post-ICU admission. Mean symptom levels for avoidance, intrusive thoughts and hyperarousal were calculated, and risk factors for the development of PTSD symptomatology were examined.RESULTS: Depending on which scale was used, 16% to 33% of ICU survivors met the criteria for PTSD at either three or nine months. Younger age and the use of a prescription psychoactive medication at time of ICU admission were both independently associated with a higher risk of developing PTSD symptoms. Interestingly, symptoms of hyperarousal worsened during the follow-up interval for female patients, while they remained constant for males.CONCLUSION: The frequency of PTSD symptoms was high in patients who survived an admission to the ICU. Depending on sex, symptoms may present and evolve differently. The adoption of screening tools and a multicentre ICU database in Canada is recommended to identify patients who are most at risk.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masato Nagai ◽  
Tetsuya Ohira ◽  
Masaharu Maeda ◽  
Seiji Yasumura ◽  
Itaru Miura ◽  
...  

AbstractPost-traumatic stress disorder (PTSD) and obesity share common risk factors; however, the effect of obesity on recovery from PTSD has not been assessed. We examined the association between body mass index (BMI) and recovery from PTSD after the Great East Japan Earthquake. We analyzed 4356 men and women with probable PTSD aged ≥ 16 years who were living in evacuation zones owing to the radiation accident in Fukushima, Japan. Recovery from probable PTSD was defined as Post-traumatic Stress Disorder Checklist-specific scores < 44. Using Poisson regression with robust error variance adjusted for confounders, we compared the prevalence ratios (PRs) and 95% confidence intervals (CIs) for this outcome in 2013 and 2014. Compared with point estimates for normal weight (BMI: 18.5–24.9 kg/m2), especially in 2013, those for underweight (BMI: < 18.5 kg/m2) and obesity (BMI: ≥ 30.0 kg/m2) tended to slightly increase and decrease, respectively, for recovery from probable PTSD. The multivariate-adjusted PRs (95% CIs) for underweight and obesity were 1.08 (0.88–1.33) and 0.85 (0.68–1.06), respectively, in 2013 and 1.02 (0.82–1.26) and 0.87 (0.69–1.09), respectively, in 2014. The results of the present study showed that obesity may be a useful predictor for probable PTSD recovery. Obese victims with PTSD would require more intensive support and careful follow-up for recovery.


2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.


Sign in / Sign up

Export Citation Format

Share Document