scholarly journals Post-traumatic stress disorder symptom duration and remission in relation to cardiovascular disease risk among a large cohort of women

2017 ◽  
Vol 47 (8) ◽  
pp. 1370-1378 ◽  
Author(s):  
P. Gilsanz ◽  
A. Winning ◽  
K. C. Koenen ◽  
A. L. Roberts ◽  
J. A. Sumner ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Symptom Duration ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Cvd Risk ◽  
Post Traumatic

BackgroundPrior studies suggest that post-traumatic stress disorder (PTSD) is associated with elevated cardiovascular disease (CVD) risk, but effects of duration and remission of PTSD symptoms have rarely been evaluated.MethodWe examined the association of time-updated PTSD symptom severity, remission and duration with incident CVD risk (552 confirmed myocardial infarctions or strokes) over 20 years in 49 859 women in the Nurses’ Health Study II. Among women who reported trauma on the Brief Trauma Questionnaire, PTSD symptoms, assessed by a screener, were classified by symptom severity and chronicity: (a) no symptoms, (b) 1–3 ongoing, (c) 4–5 ongoing, (d) 6–7 ongoing, (e) 1–3 remitted, (f) 4–7 remitted symptoms. Inverse probability weighting was used to estimate marginal structural logistic regression models, adjusting for time-varying and time-invariant confounders.ResultsCompared with women with no trauma exposure, women with trauma/no PTSD [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.03–1.65] and women with trauma/6–7 symptoms (OR 1.69, 95% CI 1.08–2.63) had elevated risk of CVD; women with remitted symptoms did not have elevated CVD risk. Among women exposed to trauma, every 5 additional years of PTSD symptomology was associated with 9% higher CVD incidence compared with women with trauma/no PTSD.ConclusionsThe findings suggest that alleviating PTSD symptoms shortly after onset may attenuate CVD risk.

scholarly journals Genes and hormones of the hypothalamic–pituitary–adrenal axis in post-traumatic stress disorder. What is their role in symptom expression and treatment response?

2021 ◽  
Author(s):  
Susanne Fischer ◽  
Tabea Schumacher ◽  
Christine Knaevelsrud ◽  
Ulrike Ehlert ◽  
Sarah Schumacher
Keyword(s):  
Hpa Axis ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Alternative Treatments ◽  
Hypothalamic Pituitary Adrenal ◽  
Post Traumatic

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.

Prediction of Outcome for Veterans with Post-Traumatic Stress Disorder Using Constructs from the Transtheoretical Model of Behaviour Change

2007 ◽  
Vol 41 (7) ◽  
pp. 590-597 ◽  
Author(s):  
Kathleen Rooney ◽  
Caroline Hunt ◽  
Leanne Humphreys ◽  
David Harding ◽  
Miriam Mullen ◽  
...  
Keyword(s):  
Transtheoretical Model ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Readiness To Change ◽  
Processes Of Change ◽  
Post Traumatic Stress ◽  
Predictive Utility ◽  
Post Traumatic

Objective: Post-traumatic stress disorder (PTSD) is a disabling condition, sometimes unresponsive to treatment. The aim of the present study was to examine the predictive utility of constructs from the transtheoretical model of behaviour change (TTM) known to predict outcome for other disorders. Method: A sample of 50 veterans presenting for a PTSD treatment programme provided data for this longitudinal study. Variables were assessed at four time-points during the treatment programme. Multiple regression and mixed-effects regression were utilized to determine the predictive utility of variables from the TTM. Results: Allocated stage of change at the time of a 2 day introduction programme predicted follow-up symptom severity, but changes therein during treatment did not predict changes in symptom severity. However, changes in the continuous readiness-to-change variable and behavioural processes of change were predictive of such changes. Conclusions: Despite some difficulties in the application of the TTM to PTSD, the model does appear to predict treatment outcome. Veterans who have increased readiness to change and who make more use of behavioural processes of change are likely to have improved outcomes.

scholarly journals Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis

2015 ◽  
Vol 206 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Mathew Hoskins ◽  
Jennifer Pearce ◽  
Andrew Bethell ◽  
Liliya Dankova ◽  
Corrado Barbui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Stress Disorder ◽  
Positive Impact ◽  
Meta Analysis ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

BackgroundPharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.AimsTo determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.MethodA systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.ResultsSelective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.23, 95% CI −0.33 to −0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.ConclusionsSome drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.

"Efficacy of Cognitive Behavioral Therapy in Post-traumatic Stress Disorder Among Spinal Cord Injury Patients: A Randomized Controlled Pilot Study"

2021 ◽  
Vol 21 (2) ◽  
pp. 143-162
Author(s):  
Anwar Khan ◽  
Faseeh Ullah ◽  
Omer Abid ◽  
Khizra Hafeez Awan
Keyword(s):  
Spinal Cord ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Behavioral Therapy ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Randomized Controlled ◽  
Cord Injury ◽  
Post Traumatic

"Post-Traumatic Stress Disorder (PTSD) develops after exposure to or witnessing traumatic events. PTSD is very common among the Spinal Cord Injury (SCI) patients. PTSD can be successfully treated with the Cognitive Behavioral Therapy (CBT). However, CBT is mostly used in the western countries, so its efficacy in the eastern culture is still not fully known. Keeping this in view, the current study has determined the efficacy of CBT in the treatment of PTSD among the SCI patients in Pakistan. Using a Randomized Controlled Pilot Study design, data were collected through the Clinician-Administered PTSD Scale for DSM-5 from thirty patients admitted to the Paraplegic Center. Trauma-focused CBT(TF-CBT) protocol was applied through fourteen sessions. Data were analyzed by descriptive and multivariate statistics. Findings show that the level of PTSD symptoms gradually decreased from high at baseline (CAPS-5 Mean Scores μ= 3.6) to low during follow-up stage (CAPS-5 Mean Scores μ= 0.89). Results obtained from the present study on the efficacy of CBT are in concurrence with the research findings in other countries. This study supports the efficiency CBT intervention among Pakistani patients who had developed PTSD symptoms after suffering from SCI. Therefore, CBT can be widely used in the management of PTSD in Pakistan."

scholarly journals Perceived stress and post-traumatic stress disorder symptoms among intensive care unit staff caring for severely ill coronavirus disease 2019 patients during the pandemic: a national study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nisha Kader ◽  
Bushra Elhusein ◽  
Nirvana Swamy Kudlur Chandrappa ◽  
Abdulqadir J. Nashwan ◽  
Prem Chandra ◽  
...  
Keyword(s):  
Mental Health ◽  
Intensive Care Unit ◽  
Perceived Stress ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Well Being ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic

Abstract Background Intensive care unit (ICU) staff have faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic, which could significantly affect their mental health and well-being. The present study aimed to investigate perceived stress and post-traumatic stress disorder (PTSD) symptoms reported by ICU staff working directly with COVID-19 patients. Methods The Perceived Stress Scale was used to assess perceived stress, the PTSD Diagnostic Scale for the Diagnostic and Statistical Manual of Mental Disorders (5th edition) was used to determine PTSD symptoms, and a sociodemographic questionnaire was used to record different sociodemographic variables. Results Altogether, 124 participants (57.2% of whom were men) were included in the analysis. The majority of participants perceived working in the ICU with COVID-19 patients as moderately to severely stressful. Moreover, 71.4% of doctors and 74.4% of nurses experienced moderate-to-severe perceived stress. The staff with previous ICU experience were less likely to have a probable diagnosis of PTSD than those without previous ICU experience. Conclusions Assessing perceived stress levels and PTSD among ICU staff may enhance our understanding of COVID-19-induced mental health challenges. Specific strategies to enhance ICU staff’s mental well-being during the COVID-19 pandemic should be employed and monitored regularly. Interventions aimed at alleviating sources of anxiety in a high-stress environment may reduce the likelihood of developing PTSD.

scholarly journals GEROFIT: IMPACT ON PTSD SYMPTOMS AMONG PARTICIPATING VETERANS WITH SELF-REPORTED PTSD

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S34-S34
Author(s):  
Cathy Lee ◽  
Rebecca Melrose ◽  
Erin Blanchard ◽  
Stacy Wilkins ◽  
Steven Castle ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Exercise Program ◽  
Self Report ◽  
Symptom Improvement ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Negative Feelings

Abstract Post-traumatic stress disorder (PTSD) increases risk of medical comorbidities in aging. The Gerofit Program is an exercise program for older Veterans that shows efficacy for physical health. We sought to determine its impact on PTSD. Veterans in Gerofit completed a self-report questionnaire at 3 and 6 months assessing effect of Gerofit on: PTSD symptoms generally, disturbing dreams, avoidance, negative feelings, and irritability. Two hundred twenty-nine Veterans completed the questionnaire. Of these, 56 (24.5%) reported PTSD. None reported worsened PTSD following Gerofit participation. At 3 months, >50% of Veterans reported symptom improvement and this was maintained over 6 months for all items (p>0.05 paired t-test). There was an increase between 3 and 6 months in the percentage who reported “improved a lot” for overall symptoms (16.7% to 22.2%), negative feelings (5.6% to 11.1%) and irritability (0% to 11.1%). Gerofit may offer an effective intervention to improve PTSD symptoms in older Veterans.

Prior disclosure and emotional expression: Interactive effects on post-traumatic stress disorder symptoms

2017 ◽  
Vol 53 (3) ◽  
pp. 189-196 ◽  
Author(s):  
Yung Y Chen ◽  
Min C Kao
Keyword(s):  
Emotional Expression ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Trauma Processing ◽  
Post Traumatic ◽  
Religious Trauma

Background Previous research has revealed mixed findings with regard to the effects of disclosure on trauma recovery. More recently, studies on psychological trauma have found associations among religion, meaning, and health. This study investigated prior disclosure as a moderator for the association between religious emotional expression and adaptive trauma processing, as measured by post-traumatic stress disorder (PTSD) symptoms. Methods Using Pennebaker’s written emotional expression paradigm, 105 participants were assigned to either a conventional trauma-writing condition or religious trauma-writing condition. PTSD symptoms were assessed at baseline and again at one-month post writing. Results A two-way interaction was found between prior disclosure and writing condition on PTSD symptoms at follow-up. For the religious trauma-writing condition only, there was a significant difference between low versus high disclosure participants in PTSD symptoms at follow-up, such that low prior disclosure participants registered fewer PTSD symptoms than high prior disclosure participants, while prior disclosure did not have such effect in the conventional trauma-writing condition. Limitations: This two-way interaction may be further qualified by other important psychosocial variables, such as differences in personality, coping style, social support, or use of prayer as a form of disclosure, which were not assessed in this study. Conclusion Religious emotional expression may encourage adaptive trauma processing, especially for individuals with low prior disclosure. These findings encourage further investigation of the conditions under which disclosure and religion may be a beneficial factor in trauma adaptation and treatment.

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