scholarly journals Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

2019 ◽  
Vol 50 (13) ◽  
pp. 2154-2170 ◽  
Author(s):  
Amit Lazarov ◽  
Benjamin Suarez-Jimenez ◽  
Ofir Levi ◽  
Daniel D. L. Coppersmith ◽  
Gadi Lubin ◽  
...  

AbstractBackgroundDespite extensive research, symptom structure of posttraumatic stress disorder (PTSD) is highly debated. The network approach to psychopathology offers a novel method for understanding and conceptualizing PTSD. However, extant studies have mainly used small samples and self-report measures among sub-clinical populations, while also overlooking co-morbid depressive symptoms.MethodsPTSD symptom network topology was estimated in a sample of 1489 treatment-seeking veteran patients based on a clinician-rated PTSD measure. Next, clinician-rated depressive symptoms were incorporated into the network to assess their influence on PTSD network structure. The PTSD-symptom network was then contrasted with the network of 306 trauma-exposed (TE) treatment-seeking patients not meeting full criteria for PTSD to assess corresponding network differences. Finally, a directed acyclic graph (DAG) was computed to estimate potential directionality among symptoms, including depressive symptoms and daily functioning.ResultsThe PTSD symptom network evidenced robust reliability. Flashbacks and getting emotionally upset by trauma reminders emerged as the most central nodes in the PTSD network, regardless of the inclusion of depressive symptoms. Distinct clustering emerged for PTSD and depressive symptoms within the comorbidity network. DAG analysis suggested a key triggering role for re-experiencing symptoms. Network topology in the PTSD sample was significantly distinct from that of the TE sample.ConclusionsFlashbacks and psychological reactions to trauma reminders, along with their strong connections to other re-experiencing symptoms, have a pivotal role in the clinical presentation of combat-related PTSD among veterans. Depressive and posttraumatic symptoms constitute two separate diagnostic entities, but with meaningful between-disorder connections, suggesting two mutually-influential systems.

2017 ◽  
Vol 41 (4) ◽  
pp. 645-653 ◽  
Author(s):  
Maria Panagioti ◽  
Ioannis Angelakis ◽  
Nicholas Tarrier ◽  
Patricia Gooding

AbstractInconsistent findings have been reported by previous cross-sectional studies regarding the association between specific posttraumatic stress disorder (PTSD) symptom clusters and suicidality. To advance the understanding of the role of specific PTSD symptoms in the development of suicidality, the primary aim of this study was to investigate the predictive effects of the three specific PTSD symptom clusters on suicidal ideation prospectively. Fifty-six individuals diagnosed with PTSD completed a two-stage research design, at baseline and 13–15 months follow-up. The clinician administered PTSD scale (CAPS) was used to assess the severity of the PTSD symptom clusters and validated self-report measures were used to assess suicidal ideation, severity of depressive symptoms and perceptions of defeat entrapment. The results showed that only the hyperarousal symptom cluster significantly predicted suicidal ideation at follow-up after controlling for baseline suicidal ideation, severity of depressive symptoms and perceptions of defeat and entrapment. These findings suggest that both disorder-specific and transdiagnostic factors are implicated in the development of suicidal ideation in PTSD. Important clinical implications are discussed in terms of predicting and treating suicidality in those with PTSD.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Giulia Buodo ◽  
Caterina Novara ◽  
Marta Ghisi ◽  
Daniela Palomba

The present descriptive study was aimed at evaluating posttraumatic and depressive symptoms and their cooccurrence, in a sample of victims of workplace accidents. Also, posttraumatic negative cognitions were assessed. Eighty-five injured workers were evaluated, using the PTSD Symptom Scale, the Beck Depression Inventory II, and the posttraumatic Cognitions Inventory. 49.4% of injured workers reported both depressive and posttraumatic symptoms of clinical relevance. 20% only reported posttraumatic, but not depressive, symptoms, and 30.6% did not report either type of symptoms. The group with both posttraumatic and depressive symptoms displayed greater symptom severity and more negative cognitions about the self and about the world than the other two groups. The obtained findings indicate that workplace accidents can have a major impact upon the mental health of victims. Early interventions should be focused not only on the prevention or reduction of posttraumatic and depressive symptoms but also on restructuring specific maladaptive trauma-related cognitions.


Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.


Assessment ◽  
2021 ◽  
pp. 107319112098388
Author(s):  
Kevin M. King ◽  
Max A. Halvorson ◽  
Kevin S. Kuehn ◽  
Madison C. Feil ◽  
Liliana J. Lengua

There is a small body of research that has connected individual differences in negative urgency, the tendency to report rash actions in response to negative emotions, with self-report depressive and anxiety symptoms. Despite the conceptual overlap of negative urgency with negative emotionality, the tendency to experience frequent and intense negative emotions, even fewer studies have examined whether the association of negative urgency with internalizing symptoms hold when controlling for negative emotionality. In the current study, we estimated the bivariate association between negative urgency and internalizing symptoms, tested whether they remained significant after partialling out negative emotionality, and tested whether these effects generalized to real-time experiences of negative emotions. We used data from five independent samples of high school and college students, assessed with global self-report ( n = 1,297) and ecological momentary assessment ( n = 195). Results indicated that in global self-report data, negative urgency was moderately and positively associated with depressive and anxiety symptoms, and the partial association with depressive symptoms (but not anxiety symptoms) controlling for negative emotionality remained significant and moderate in magnitude. This pattern was replicated in ecological momentary assessment data. Negative urgency may convey risk for depressive symptoms, independent of the effects of negative emotionality.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ana Beatriz Bozzini ◽  
Jessica Mayumi Maruyama ◽  
Tiago N. Munhoz ◽  
Aluísio J. D. Barros ◽  
Fernando C. Barros ◽  
...  

Abstract Background This longitudinal study explored the relationship between trajectories of maternal depressive symptoms and offspring’s risk behavior in adolescence contributing to an extremely scarce literature about the impacts of maternal depression trajectories on offspring risk behaviors. Methods We included 3437 11-year-old adolescents from the 2004 Pelotas Birth Cohort Study. Trajectories of maternal depressive symptoms were constructed using Edinburgh Postnatal Depression Scale (EDPS) from age 3 months to 11 years. We identified five trajectories of maternal depressive symptoms: “low” “moderate low”, “increasing”, “decreasing”, and “chronic high”. The following adolescent outcomes were identified via self-report questionnaire and analyzed as binary outcome –yes/no: involvement in fights and alcohol use at age 11. We used logistic regression models to examine the effects of trajectories of maternal depressive symptoms on offspring’s risk behavior adjusting for potential confounding variable. Results Alcohol use and/or abuse as well as involvement in fights during adolescence, were not significantly associated with any specific trajectory of maternal depressive symptoms neither in the crude nor in the adjusted analyses. Conclusion Alcohol use and involvement in fights at age 11 were not associated with any specific trajectory of maternal depression.


Author(s):  
Simi Prakash K. ◽  
Rajakumari P. Reddy ◽  
Anna R. Mathulla ◽  
Jamuna Rajeswaran ◽  
Dhaval P. Shukla

AbstractTraumatic brain injury (TBI) is associated with a wide range of physiological, behavioral, emotional, and cognitive sequelae. Litigation status is one of the many factors that has an impact on recovery. The aim of this study was to compare executive functions, postconcussion, and depressive symptoms in TBI patients with and without litigation. A sample of 30 patients with TBI, 15 patients with litigation (medicolegal case [MLC]), and 15 without litigation (non-MLC) was assessed. The tools used were sociodemographic and clinical proforma, executive function tests, Rivermead Post-Concussion Symptom Questionnaire, and Beck Depression Inventory. Assessment revealed that more than 50% of patients showed deficits in category fluency, set shifting, and concept formation. The MLC group showed significant impairment on verbal working memory in comparison to the non-MLC group. The performance of both groups was comparable on tests of semantic fluency, visuospatial working memory, concept formation, set shifting, planning, and response inhibition. The MLC group showed more verbal working memory deficits in the absence of significant postconcussion and depressive symptoms on self-report measures.


Author(s):  
Kayla N LaRosa ◽  
Erin MacArthur ◽  
Fang Wang ◽  
Hui Zhang ◽  
Haitao Pan ◽  
...  

Abstract Objective Secondary outcomes from a published feasibility and acceptability trial were examined to explore the effect of bright white light (BWL) on quality of life (QoL) and depressive symptoms compared to dim red light (DRL) control in adolescents and young adults (AYAs) receiving cancer-directed therapy. Methods Fifty-one AYAs (12–22 years, 51% male) newly diagnosed with cancer were randomized to receive 8 weeks of BWL (n = 26) or DRL (n = 25). The CDI-2 (total score, negative mood/physical symptoms, interpersonal problems, ineffectiveness, and negative self-esteem) and parent- and self-report PedsQL (total score and subscales of physical, emotional, social, and school QoL) were completed at multiple timepoints. Results BWL produced improvements in self-reported total depression (d = −.64; 95% confidence interval [CI] = −1.26, −0.01), negative self-esteem (d = −.80; 95% CI = −1.43, −.14), negative mood/physical symptoms (d = −.73; 95% CI = −1.36, −0.08), ineffectiveness (d = −.43; 95% CI = −1.04, .19), total self-reported QoL (d = .41; 95% CI = −.16, .96), emotional (d = .78; 95% CI = .19, 1.37), school functioning (d = .48; 95% CI = −.09, 1.04), and parent-reported school functioning (d = .66; 95% CI = 0.02, 1.33). BWL reported a greater rate of improvement than DRL for total depression (β = .49, p < .05) and self-esteem (β = .44, p < .05), and parent-reported school functioning (β = −1.68, p < .05). Conclusions BWL improved QoL and depressive symptoms for AYAs with cancer. These findings will inform larger randomized controlled trials.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017173 ◽  
Author(s):  
Jinghui Wang ◽  
Xiaohang Wu ◽  
Weiyi Lai ◽  
Erping Long ◽  
Xiayin Zhang ◽  
...  

ObjectivesDepression and depressive symptoms are common mental disorders that have a considerable effect on patients’ health-related quality of life and satisfaction with medical care, but the prevalence of these conditions varies substantially between published studies. The aim of this study is to conduct a systematic review and meta-analysis to provide a precise estimate of the prevalence of depression or depressive symptoms among outpatients in different clinical specialties.DesignSystematic review and meta-analysis.Data sources and eligibility criteriaThe PubMed and PsycINFO, EMBASE and Cochrane Library databases were searched to identify observational studies that contained information on the prevalence of depression and depressive symptoms in outpatients. All studies included were published before January 2016. Data characteristics were extracted independently by two investigators. The point prevalence of depression or depressive symptoms was measured using validated self-report questionnaires or structured interviews. Assessments were pooled using a random-effects model. Differences in study-level characteristics were estimated by meta-regression analysis. Heterogeneity was assessed using standard χ2tests and the I2statistic. The study protocol has been registered with PROSPERO under number CRD42017054738.ResultsEighty-three cross-sectional studies involving 41 344 individuals were included in this study. The overall pooled prevalence of depression or depressive symptoms was 27.0% (10 943/41 344 individuals; 95% CI 24.0% to 29.0%), with significant heterogeneity between studies (p<0.0001, τ2=0.3742, I2=96.7%). Notably, a significantly higher prevalence of depression and depressive symptoms was observed in outpatients than in the healthy controls (OR 3.16, 95% CI 2.66 to 3.76, I2=72.0%, χ2=25.33). The highest depression/depressive symptom prevalence estimates occurred in studies of outpatients from otolaryngology clinics (53.0%), followed by dermatology clinics (39.0%) and neurology clinics (35.0%). Subgroup analyses showed that the prevalence of depression and depressive symptoms in different specialties varied from 17.0% to 53.0%. The prevalence of depression and depressive symptoms was higher among outpatients in developing countries than in outpatients from developed countries. Moreover, the prevalence of depression and depressive symptoms in outpatients slightly decreased from 1996 to 2010. Regarding screening instruments, the Beck Depression Inventory led to a higher estimate of the prevalence of depression and depressive symptoms (1316/4702, 36.0%, 95% CI 29.0% to 44.0%, I2=94.8%) than the Hospital Anxiety and Depression Scale (1003/2025, 22.0%, 95% CI 12.0% to 35.0%, I2=96.6%).ConclusionOur study provides evidence that a significant proportion of outpatients experience depression or depressive symptoms, highlighting the importance of developing effective management strategies for the early identification and treatment of these conditions among outpatients in clinical practice. The substantial heterogeneity between studies was not fully explained by the variables examined.


1989 ◽  
Vol 14 (3) ◽  
pp. 166-174 ◽  
Author(s):  
Betty C. Epanchin ◽  
Mary Sue Rennells

The primary purpose of this study was to investigate parents' and teachers' sensitivity to the unhappiness and depression of 110 elementary-aged undercontrolled children being treated in an inpatient program. Sensitivity was operationally defined as congruence between the child's responses on two self-report measures (Children's Depression Inventory and Hopelessness Scale for Children) and the adults' behavioral ratings of the children on behavior checklists (Child Behavior Checklist and Teacher Report Form). The first hypothesis that children's self-reports of depressive symptoms would not be significantly correlated with parents' and teachers' ratings of depressive symptomatology was supported. Secondly, it was hypothesized that there would be no differences in the level of self-reported depressive symptoms when children who were rated as depressed by their parents and teachers were compared with children rated as not depressed by their parents and teachers. This was also supported. Finally, it was hypothesized that children who reported significant levels of depressive symptomatology would be rated by their parents and teachers as having more behavior problems than children who did not report significant levels of depressed symptomatology. This was partially supported. The implications of these results in relation to identification and treatment are discussed.


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