Polygenic prediction of PTSD trajectories in 9/11 responders

2020 ◽  
pp. 1-9
Author(s):  
Monika A. Waszczuk ◽  
Anna R. Docherty ◽  
Andrey A. Shabalin ◽  
Jiaju Miao ◽  
Xiaohua Yang ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Multiple Testing ◽  
World Trade Center ◽  
Risk Scores ◽  
Generalized Anxiety ◽  
Targeted Prevention ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Growth Mixture Model ◽  
Prospective Longitudinal

Abstract Background Genetics hold promise of predicting long-term post-traumatic stress disorder (PTSD) outcomes following trauma. The aim of the current study was to test whether six hypothesized polygenic risk scores (PRSs) developed to capture genetic vulnerability to psychiatric conditions prospectively predict PTSD onset, severity, and 18-year course after trauma exposure. Methods Participants were 1490 responders to the World Trade Center (WTC) disaster (mean age at 9/11 = 38.81 years, s.d. = 8.20; 93.5% male; 23.8% lifetime WTC-related PTSD diagnosis). Prospective longitudinal data on WTC-related PTSD symptoms were obtained from electronic medical records and modelled as PTSD trajectories using growth mixture model analysis. Independent regression models tested whether six hypothesized psychiatric PRSs (PTSD-PRS, Re-experiencing-PRS, Generalized Anxiety-PRS, Schizophrenia-PRS, Depression-PRS, and Neuroticism-PRS) are predictive of WTC-PTSD outcomes: lifetime diagnoses, average symptom severity, and 18-year symptom trajectory. All analyses were adjusted for population stratification, 9/11 exposure severity, and multiple testing. Results Depression-PRS predicted PTSD diagnostic status (OR 1.37, CI 1.17–1.61, adjusted p = 0.001). All PRSs, except PTSD-PRS, significantly predicted average PTSD symptoms (β = 0.06–0.10, adjusted p < 0.05). Re-experiencing-PRS, Generalized Anxiety-PRS and Schizophrenia-PRS predicted the high severity PTSD trajectory class (ORs 1.21–1.28, adjusted p < 0.05). Finally, PRSs prediction was independent of 9/11 exposure severity and jointly accounted for 3.7 times more variance in PTSD symptoms than the exposure severity. Conclusions Psychiatric PRSs prospectively predicted WTC-related PTSD lifetime diagnosis, average symptom severity, and 18-year trajectory in responders to 9/11 disaster. Jointly, PRSs were more predictive of subsequent PTSD than the exposure severity. In the future, PRSs may help identify at-risk responders who might benefit from targeted prevention approaches.

scholarly journals Differential effect of Hurricane Sandy exposure on PTSD symptom severity: comparison of community members and responders

2019 ◽  
Vol 76 (12) ◽  
pp. 881-887 ◽  
Author(s):  
Adam Gonzalez ◽  
Rehana Rasul ◽  
Lucero Molina ◽  
Samantha Schneider ◽  
Kristin Bevilacqua ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Differential Effect ◽  
Ptsd Symptom ◽  
Traumatic Event ◽  
World Trade Center ◽  
Hurricane Sandy ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Community Members ◽  
Ptsd Symptom Severity

ObjectivesTo evaluate whether the association between Hurricane Sandy exposures and post-traumatic stress disorder (PTSD) symptom severity was greater for exposed community members compared with responders.MethodsData were analysed from three existing studies with similar methodologies (N=1648): two community studies, Leaders in Gathering Hope Together (n=531) and Project Restoration (n=763); and the Sandy/World Trade Center Responders Study (n=354). Sandy-related PTSD symptoms were measured using the PTSD checklist-specific traumatic event and dichotomised as elevated (>30) versus low/no (<30) PTSD symptoms. Sandy exposures were measured with a summed checklist. Multivariable logistic regression was performed to evaluate the differential effect of exposures on PTSD by responder status, adjusting for demographics and time elapsed since Sandy.ResultsResponders were somewhat older (50.5 years (SD=8.3) vs 45.8 years (SD=20.0)), more likely to identify as white (92.4% vs 48.1%) and were male (90.7% vs 38.4%). Responders were less likely to have elevated PTSD symptoms than community members (8.6% vs 31.1%; adjusted OR=0.28, 95% CI 0.17 to 0.46). While exposure was significantly related to elevated PTSD status, the effects were similar for responders and community members.ConclusionsResponders appear to be more resilient to PTSD symptoms post-Sandy than community members. Understanding the mechanisms that foster such resilience can inform interventions aimed at populations that are more vulnerable to experiencing PTSD after natural disasters.

scholarly journals PTSD and Depressive Symptoms as Potential Mediators of the Association between World Trade Center Exposure and Subjective Cognitive Concerns in Rescue/Recovery Workers

2020 ◽  
Vol 17 (16) ◽  
pp. 5683 ◽  
Author(s):  
Ankura Singh ◽  
Rachel Zeig-Owens ◽  
Laura Rabin ◽  
Theresa Schwartz ◽  
Mayris P. Webber ◽  
...  
Keyword(s):  
New York ◽  
Depressive Symptoms ◽  
Cognitive Decline ◽  
World Trade ◽  
World Trade Center ◽  
Fire Department ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Mediation Analyses ◽  
Trade Center

We observed that World Trade Center (WTC) exposure, post-traumatic stress disorder (PTSD) symptoms and depressive symptoms were associated with subjective cognitive concerns in Fire Department of the City of New York (FDNY) rescue/recovery workers. This follow-up study examined whether PTSD symptoms and/or depressive symptoms mediate the observed association between WTC exposure and subjective cognitive concerns. We included WTC-exposed FDNY workers who completed the Cognitive Function Instrument (CFI), measuring self-perceived cognitive decline (N = 9516). PTSD symptoms and depressive symptoms were assessed using the PCL-S and CES-D, respectively. Multivariable linear regression estimated the association between WTC exposure and CFI score, adjusting for confounders. Mediation analyses followed the methods of Vanderweele (2014). Participants’ average age at CFI assessment was 56.6 ± 7.6 years. Higher-intensity WTC exposure was associated with worse CFI score, an effect that was entirely mediated by PTSD symptoms (%mediated: 110.9%; 95%CI: 83.1–138.9). When substituting depressive symptoms for PTSD symptoms, the WTC exposure–CFI association was largely mediated (%mediated: 82.1%; 95%CI: 60.6–103.7). Our findings that PTSD symptoms and depressive symptoms mediate the association between WTC exposure and subjective cognitive concerns indicate that in the absence of these symptoms, WTC exposure in rescue/recovery workers would not be associated with subjective cognition. Interventions targeting PTSD and depression may have additional value in mitigating cognitive decline in WTC-exposed populations.

Post-traumatic stress disorder symptoms after acute lung injury: a 2-year prospective longitudinal study

2013 ◽  
Vol 43 (12) ◽  
pp. 2657-2671 ◽  
Author(s):  
O. J. Bienvenu ◽  
J. Gellar ◽  
B. M. Althouse ◽  
E. Colantuoni ◽  
T. Sricharoenchai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Prospective Longitudinal

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.

Trajectories of academic burnout in adolescents after the Wenchuan earthquake: A latent growth mixture model analysis

2018 ◽  
Vol 40 (2) ◽  
pp. 183-199 ◽  
Author(s):  
Xiao Zhou ◽  
Rui Zhen ◽  
Xinchun Wu
Keyword(s):  
Wenchuan Earthquake ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Latent Growth ◽  
Growth Mixture Model ◽  
Research Attention ◽  
Academic Burnout ◽  
Growth Mixture ◽  
The Wenchuan Earthquake ◽  
Post Traumatic

Changes in academic burnout in adolescents have attracted much research attention; however, most studies assume that adolescent academic burnout is characterized by overall homogenous change and overlook the heterogeneity of burnout change. To address this issue, this study examined distinct latent trajectories of academic burnout in adolescents following the Wenchuan earthquake, China. Adolescents were surveyed at 1 (T1), 1.5 (T2), 2 (T3), and 2.5 years (T4) after the earthquake. Self-reported questionnaires were administered to 391 participants aged 12- to 19-years-old. The results identified three academic burnout trajectories: Increasing (3.9%), low (85.4%), and decreasing (10.7%). Additionally, intrusive post-traumatic stress disorder (PTSD) symptoms were more likely in the increasing group, avoidance PTSD symptoms were more likely in the decreasing group, and PTSD hyperarousal symptoms were more likely in the decreasing group, but less likely in the increasing group. These findings indicate that adolescents experienced heterogeneous academic burnout changes following the earthquake.

scholarly journals The Intentional Self-Medication of 9/11-Related PTSD Symptoms with Alcohol: 15 Years after the Disaster

2020 ◽  
Vol 17 (15) ◽  
pp. 5327
Author(s):  
Sascha K. Garrey ◽  
Alice E. Welch ◽  
Melanie H. Jacobson ◽  
Robert M. Brackbill ◽  
Lisa M. Gargano
Keyword(s):  
Binge Drinking ◽  
Ptsd Symptom ◽  
World Trade Center ◽  
Symptom Clusters ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Public Health Importance ◽  
Self Medication ◽  
Specific Symptom ◽  
Co Morbidity

The self-medication hypothesis may explain the co-morbidity of affective and substance use disorders. Research shows increased prevalence, frequency, and intensity of binge drinking and post-traumatic stress disorder (PTSD) among those directly exposed to the 9/11 terrorist attacks on the World Trade Center (WTC), however, little is known about PTSD symptomology and intentional self-medication with alcohol (ISMA) among this group. We used WTC Health Registry data (N = 28,935) to describe the relationship between ISMA and specific symptom clusters of probable 9/11-related PTSD, the number of PTSD symptom clusters endorsed, and binge drinking intensity. Multivariable logistic regression models were used to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CI). ISMA was most strongly associated with the hyperarousal PTSD symptom cluster (AOR = 2.04 [1.88, 2.21]) and the endorsement of one (AOR = 1.80 CI [1.65, 1.95]), two (AOR = 2.51 CI [2.28, 2.77]), or three (AOR = 2.84 CI [2.55, 3.17]) PTSD symptom clusters, indicating a clear dose–response relationship. A significant number of 9/11-exposed persons continue to experience PTSD symptoms and engage in ISMA as a potential coping mechanism. Repeated screenings for self-medicative alcohol use among survivors of mass traumas with PTSD symptoms is of public health importance.

Trajectories of PTSD risk and resilience in World Trade Center responders: an 8-year prospective cohort study

2013 ◽  
Vol 44 (1) ◽  
pp. 205-219 ◽  
Author(s):  
R. H. Pietrzak ◽  
A. Feder ◽  
R. Singh ◽  
C. B. Schechter ◽  
E. J. Bromet ◽  
...  
Keyword(s):  
Protective Factors ◽  
World Trade ◽  
World Trade Center ◽  
Risk And Protective Factors ◽  
Psychiatric History ◽  
Risk And Resilience ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Delayed Onset ◽  
Trade Center

BackgroundLongitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders.MethodA total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks.ResultsAmong police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories.ConclusionsTrajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.

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 0038 The Effects of Morning Blue Light Therapy on Insomnia Severity and PTSD Symptoms in a Clinical Sample

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A15-A16
Author(s):  
D Jecmen ◽  
R King ◽  
J Gould ◽  
J Mitchell ◽  
K Ralston ◽  
...  
Keyword(s):  
Blue Light ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Clinical Sample ◽  
Light Therapy ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Placebo Condition ◽  
Ptsd Symptom Severity ◽  
Insomnia Severity

Abstract Introduction Individuals with Post Traumatic Stress Disorder (PTSD) often present with insomnia, which may exacerbate other symptoms of the disorder. Morning Blue Light Therapy (BLT) can regulate circadian rhythms and may even improve sleep and mood in individuals with major depressive disorder. However, it is unclear whether morning BLT could also be an effective treatment for the insomnia associated with PTSD. We investigated whether 6 weeks of daily morning BLT would improve insomnia severity and symptom presentation in individuals with PTSD in comparison to a placebo condition of amber light (ALT). We hypothesized that changes in insomnia severity would correlate with improvement in PSTD symptom severity. Methods Forty-one participants with a clinical diagnosis of PTSD were randomized to receive 6 weeks of either daily morning BLT (n=22) or ALT (n=19). Insomnia and PTSD symptom severity were evaluated at pre- and post-treatment using the Insomnia Severity Index (ISI) and the Clinician-Administered PTSD Scale (CAPS) for DSM-5, respectively. Results Both groups showed a significant decrease in their PTSD symptom severity (p&lt;0.001) and insomnia severity (p&lt;0.001) over the 6-week treatment period. However, improvement in insomnia severity significantly predicted improvements in PTSD symptom severity for the BLT group only (BLT: r =0.542, p=0.009; ALT: r=-0.095, p=0.699). The difference between the two correlation coefficients was significant (Z=-2.07, p=0.039). Conclusion The results suggest that morning BLT may be effective in improving PTSD symptoms by regulating the circadian rhythm and improving sleep. While ALT also led to improved PTSD symptom severity, it appears that those changes cannot be explained by improved sleep and may have other underlying mechanisms (e.g., placebo effect). Morning BLT may be a promising adjunctive method to bolster current treatment approaches for PTSD. Because of its ease of administration, it could be easily added to ongoing treatment as usual. This approach warrants further research. Support US Army Medical Research and Materiel Command: W81XWH-14-1-0570

scholarly journals Handgrip Strength of World Trade Center (WTC) Responders: The Role of Re-Experiencing Posttraumatic Stress Disorder (PTSD) Symptoms

2019 ◽  
Vol 16 (7) ◽  
pp. 1128 ◽  
Author(s):  
Soumyadeep Mukherjee ◽  
Sean Clouston ◽  
Roman Kotov ◽  
Evelyn Bromet ◽  
Benjamin Luft
Keyword(s):  
Depressive Symptoms ◽  
Symptom Severity ◽  
World Trade ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Handgrip Strength ◽  
World Trade Center ◽  
Ptsd Symptoms ◽  
Trade Center ◽  
Ptsd Symptom Severity

Background: This study sought to examine whether handgrip strength (HGS), a measure of muscle strength and a biomarker of aging, was associated with post-traumatic stress disorder (PTSD) in a cohort of World Trade Center (WTC) responders at midlife. Methods: HGS was assessed utilizing a computer-assisted hand dynamometer administered to a consecutive sample of men and women (n = 2016) who participated in rescue and recovery efforts following the World Trade Center (WTC) attacks and subsequently attended monitoring appointments in Long Island, NY. PTSD symptom severity and depressive symptoms were assessed using the PTSD specific-trauma checklist (PCL-S) and the Patient Health Questionnaire (PHQ-9). General linear models were used to examine the association of WTC-related PTSD with HGS after adjusting for confounders. Results: The sample was at midlife (mean age = 53.3) when assessed, and 91.3% were men. Nearly 10% of the sample had probable PTSD (PCL ≥ 44) with concomitant depression (PHQ ≥ 10), while 5.1% had probable PTSD without depression. Average HGS was 57.4 lbs. (95% confidence interval (95% CI): 56.6–58.1) among men and 36.1 lbs. (95% CI = 33.8–38.5) among women. Mean HGS of those with probable PTSD with concomitant depression was lower (45.9 lbs., 95% CI = 43.6–48.2) than responders with only PTSD (49.1 lbs., 95% CI = 46.0–52.4) and those without PTSD or depression (57.5 lbs., 95% CI = 56.2–57.8). Subdomain analyses of PTSD symptoms revealed that re-experiencing symptoms at enrollment (p = 0.003) was associated with lower HGS after adjusting for depressive symptoms and other confounders. Discussion: Results suggested that higher WTC-related PTSD symptom severity was associated with lower HGS. Results support ongoing work suggesting that PTSD may be associated with more rapid physical aging. The potential for developing interventions that might simultaneously improve physical and mental health in the aftermath of trauma may be considered.

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