Foundations of posttraumatic stress disorder: Does early life trauma lead to adult posttraumatic stress disorder?

2011 ◽  
Vol 23 (2) ◽  
pp. 477-491 ◽  
Author(s):  
Laura C. Pratchett ◽  
Rachel Yehuda
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Childhood Abuse ◽  
Childhood Trauma ◽  
Stress Disorder ◽  
Biological Effects ◽  
Subsequent Development ◽  
Causal Link ◽  
Early Life Trauma ◽  
The Impact

AbstractThe effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic–pituitary–adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.

scholarly journals Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma

2021 ◽  
Vol 10 (16) ◽  
pp. 3708
Author(s):  
Nele Assmann ◽  
Eva Fassbinder ◽  
Anja Schaich ◽  
Christopher W. Lee ◽  
Katrina Boterhoven de Haan ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcome ◽  
Posttraumatic Stress ◽  
Childhood Trauma ◽  
Stress Disorder ◽  
Secondary Outcome ◽  
Ptsd Symptoms ◽  
Moderator Effect ◽  
Ptsd Treatment ◽  
The Impact

Patients with posttraumatic stress disorder (PTSD) frequently have comorbid diagnoses such as major depressive disorder (MDD) and anxiety disorders (AD). Studies into the impact of these comorbidities on the outcome of PTSD treatment have yielded mixed results. The different treatments investigated in these studies might explain the varied outcome. The purpose of this study was to examine the impact of these comorbidities on the outcome of two specific PTSD treatments. MDD and AD were analyzed as predictors and moderators in a trial comparing 12 sessions of either eye movement desensitization and reprocessing (EMDR) or imagery rescripting (IR) in 155 adult patients with PTSD from childhood trauma. The primary outcome was reduction of PTSD symptoms (clinician-administered PTSD Scale for DSM-5, CAPS-5) assessed at eight-week follow-up and a secondary outcome was self-report PTSD symptoms (Impact of Event Scale, IES-R). MDD was not a predictor of treatment outcome but did have a significant moderator effect. Patients with MDD showed a better outcome if they were treated with IR, whereas patients without MDD improved more in the EMDR condition. No impact of AD emerged. It seems essential to consider comorbid MDD when planning PTSD treatment to improve treatment outcomes. More research is needed to replicate our findings and focus on different kinds of PTSD treatments and other comorbidities.

Traumatic Stress in the 21st Century

2000 ◽  
Vol 34 (6) ◽  
pp. 896-902 ◽  
Author(s):  
Alexander C. McFarlane
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Childhood Abuse ◽  
Psychological Health ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Chronically Ill ◽  
General Psychiatry ◽  
Severely Mentally Ill ◽  
The Impact

Objective: The introduction to a series of articles on traumatic stress aims to examine the ambivalent relationship between traumatic stress and psychiatry. It provides an outline to the very significant contribution that this field made before the conceptualisation of posttraumatic stress disorder (PTSD) and how the research and theoretical thinking in this field can provide many insights into the relationship between environmental factors and psychological health. It focuses on the relevance of this field to general psychiatry. Result: Posttraumatic stress disorder has emerged as the most common anxiety disorder in women. As well, there are high rates discovered in a range of chronically ill psychiatric patient populations. In particular, strategies for dealing with the issues of childhood abuse and neglect are not often considered by adult psychiatric services for the chronically and severely mentally ill, despite there being important predictors of suicidal behaviour, hospitalisation and prolonged disability. An effective consideration of the available evidence is often complicated by concerns about the impact of financial compensation on the presentation of psychopathology. This is a complex social dialectic whose impact is important to the practise of psychiatry. Equally, this field in itself must avoid becoming excessively rigid in its clinical definitions and the particular interventions which are espoused. Conclusions: The impact of traumatic events on long-term psychological adjustment and physical health have been under estimated. Identification of those at risk is an important issue given that effective treatments are now available. This is an area in which further conceptual thinking is required. It also provides particular opportunities to explore the biological processes of, and interaction between, the environment and the underlying genetic and neurobiological processes which are critical to the modulation of psychopathology.

Childbirth and Posttraumatic Stress Responses

2006 ◽  
Vol 22 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Eelco Olde ◽  
Rolf J. Kleber ◽  
Onno van der Hart ◽  
Victor J.M. Pop
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Responses ◽  
Rating Scales ◽  
Rating Scale ◽  
Stress Disorder ◽  
Traumatic Experience ◽  
Event Scale ◽  
Self Rating ◽  
The Impact

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

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