Israeli Civilians under Heavy Bombardment: Prediction of the Severity of Post-Traumatic Symptoms

2009 ◽  
Vol 24 (5) ◽  
pp. 389-394 ◽  
Author(s):  
Eli Somer ◽  
Aviva Zrihan-Weitzman ◽  
Tiffany Fusé ◽  
Holly Parker ◽  
Ben Dickstein ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Trauma Exposure ◽  
Similar Degree ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Symptom Severity ◽  
Life Threat ◽  
Prior Trauma ◽  
Ptsd Symptomatology

AbstractContext:The military conflict that occurred between Lebanon and Israel in July and August of 2006 was characterized by the heavy bombardment of specific geographic regions in Israel, resulting in considerable civilian casualties and property damage.Objective:Israeli civilians directly and indirectly exposed to bombardment were compared on exposure to the recent bombardment, trauma history, perceived life threat and peritraumatic dissociation during the recent bombardment, and current post-traumatic stress disorder (PTSD) symptom severity.Design, Setting, and Participants:Following the conflict, data were collected by telephone from 317 Israeli residents randomly selected from two towns that were subject to differing levels of exposure to the bombardment.Intervention(s):NoneMain Outcome Measure(s):Exposure to trauma during the Second Lebanon War, prior trauma exposure, PTSD symptom severity, perceived life threat, and peri-traumatic dissociation.Results:The residents directly affected by the bombardment (Kiryat Shmona; KS) endorsed more trauma exposure, (p <0.01); more prior trauma, (p <0.01); more life threat, (p <0.01); and greater PTSD symptomatology (12 % of KY participants and 38% of KS participants had probable PTSD), compared to residents in the comparison town (Kfar Yona; KY). Both groups reported a similar degree of peri-event dissociation (KS: M = 7.2 ±3.7; KY: M = 7.3 ±3.0). Perceived life threat mediated the relationship between exposure to bombardment and PTSD symptomatology. Time spent in bomb shelters was not associated with PTSD symptom severity. Prior shelling-related trauma negatively predicted PTSD.Conclusions:The terror of bombardment is a risk factor for PTSD among civil-ians. Although there is considerable resilience in chronically threatened commu-nities, it is prudent to develop and implement public health approaches to prevent those most distressed during and after attacks from developing PTSD. Because, to a small degree, prior trauma exposure buffers the response to bombardment, interventions should consider leveraging citizens' past successful coping.

Measures of PTSD Symptom Severity

2018 ◽  
Author(s):  
Kelly S. Parker-Guilbert ◽  
Samantha J. Moshier ◽  
Brian P. Marx ◽  
Terence M. Keane
Keyword(s):  
Traumatic Stress ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Categorical Diagnosis ◽  
Post Traumatic ◽  
Dsm Iv ◽  
Ptsd Symptom Severity ◽  
Symptom Criteria

Assessment of post-traumatic stress disorder (PTSD) symptom severity serves a variety of important clinical and research purposes and may be able to more accurately represent the nature of posttraumatic stress when compared with traditional categorical diagnosis. Numerous measures that assess PTSD symptom severity are available and choosing measures with strong psychometric properties that meet one’s clinical or research needs is essential to accurate assessment. This task is made more complex by the recent update to the PTSD symptom criteria from DSM-IV-TR to DSM-5. This chapter discusses available clinician-rated and self-report methods for evaluating PTSD symptom severity and makes recommendations for clinicians and researchers across a range of contexts and patient populations.

scholarly journals Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henrik Nilsson ◽  
Catharina Gustavsson ◽  
Maria Gottvall ◽  
Fredrik Saboonchi
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Symptom Severity ◽  
Asylum Seekers ◽  
Ptsd Symptom ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic ◽  
Ptsd Symptom Severity ◽  
Different Levels

Abstract Background Forced migrant populations have high rates of trauma-related ill health, including post-traumatic stress disorder (PTSD). Physical activity (PA) is well-established as an effective stress reliever, while insufficient PA is associated with adverse effects on both mental and physical health. The aim of this study was to examine the prevalence of different levels of PA and its association with PTSD symptom severity, controlled for exposure to torture, among asylum seekers in Sweden. Methods A cross-sectional survey study, with data from 455 asylum seekers, originating from Afghanistan, Eritrea, Iraq, Somalia, and Syria, residing at large housing facilities across Sweden. Level of PA was assessed by the Exercise Vital Sign and categorized as; Inactive, Insufficient PA, and Sufficient PA. Prevalence estimates for proportions of different levels of PA were calculated. Analysis of variance were conducted to determine the association between levels of PA and PTSD symptom severity, measured by the Harvard Trauma Questionnaire. Multivariable logistic regression analysis was performed to determine the contribution of PA on PTSD beyond sex, age, and exposure to torture. Results About half of the participants (53.3, 95% CI: 48.6–58.1) met the recommendations for Sufficient PA. One third of the participants (33.3, 95% CI: 28.7–37.8) were insufficiently engaged in PA, and 13.4% (95% CI: 10.1–16.7) were inactive. There was a significant difference in PTSD symptom severity between groups of asylum seekers with different levels of PA (F(2, 316) = 23.15, p < .001). When controlling for sex, age, and exposure to torture, Sufficient PA was found to be associated with less PTSD symptom severity compared to both Insufficient PA (B = 0.297, SE = 0.086, p < .001) and Inactive (B = 0.789, SE = 0.104, p < .001). Conclusions Insufficient PA was common among the asylum seekers and our findings suggest that more PA is highly associated with lower PTSD symptom severity. An increased focus on assessment and promotion of PA is justified and discussed as particularly pertinent considering the much extended time of asylum-seeking processes. The results support previous evidence of PA as a potentially important factor in the context of PTSD and forced migrants’ health.

scholarly journals Physical activity, post-traumatic stress disorder, and exposure to torture among asylum seekers in Sweden: a cross-sectional study

2021 ◽  
Author(s):  
Henrik Nilsson ◽  
Catharina Gustavsson ◽  
Maria Gottvall ◽  
Fredrik Saboonchi
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Symptom Severity ◽  
Asylum Seekers ◽  
Ptsd Symptom ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic ◽  
Ptsd Symptom Severity ◽  
Different Levels

Abstract Background: Forced migrant populations have high rates of trauma-related ill health, including post-traumatic stress disorder (PTSD). Physical activity (PA) is well-established as an effective stress reliever, while insufficient PA is associated with adverse effects on both mental and physical health. The aim of this study was to examine the prevalence of different levels of PA and its association with PTSD symptom severity, controlled for exposure to torture, among asylum seekers in Sweden. Methods: A cross-sectional survey study, with data from 455 asylum seekers, originating from Afghanistan, Eritrea, Iraq, Somalia, and Syria, residing at large housing facilities across Sweden. Level of PA was assessed by the Exercise Vital Sign and categorized as; Inactive, Insufficient PA, and Sufficient PA. Prevalence estimates for proportions of different levels of PA were calculated. Analysis of variance were conducted to determine the association between levels of PA and PTSD symptom severity, measured by the Harvard Trauma Questionnaire. Multivariable logistic regression analysis was performed to determine the contribution of PA on PTSD beyond sex, age, and exposure to torture. Results: About half of the participants (53.3%, 95% CI: 48.6-58.1) met the recommendations for Sufficient PA. One third of the participants (33.3%, 95% CI: 28.7-37.8) were insufficiently engaged in PA, and 13.4% (95% CI: 10.1-16.7) were inactive. There was a significant difference in PTSD symptom severity between groups of asylum seekers with different levels of PA (F(2, 316) = 23.15, p < .001). When controlling for sex, age, and exposure to torture, Sufficient PA was found to be associated with less PTSD symptom severity compared to both Insufficient PA (B = 0.297, SE = 0.086, p < .001) and Inactive (B = 0.789, SE = 0.104, p < .001).Conclusions: Insufficient PA was common among the asylum seekers and our findings suggest that more PA is highly associated with better mental health in these populations. An increased focus on assessment and promotion of PA is justified during the extended time of asylum-seeking processes. The result support PA as a potentially viable treatment component in PTSD.

scholarly journals Post-traumatic stress disorder symptom severity, trauma load and sleeping difficulties in trauma-exposed, treatment-seeking adolescents

2018 ◽  
Vol 24 ◽  
Author(s):  
Carissa Van Aarde ◽  
Jani Nothling ◽  
Cherie Armour ◽  
Soraya Seedat
Keyword(s):  
Traumatic Stress ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Traumatic Event ◽  
Treatment Seeking ◽  
Post Traumatic Stress ◽  
Trauma Types ◽  
Post Traumatic ◽  
Ptsd Symptom Severity ◽  
Sleep Difficulties

Introduction: Sleep disturbances are associated with various anxiety- and trauma-related disorders, and specifically with post-traumatic stress disorder (PTSD). Two of the core symptoms of PTSD are recurrent distressing dreams about the traumatic event and difficulty in falling or staying asleep (insomnia). Sleep is essential for functioning, with poor sleep compromising cognitive, emotional and behavioural regulations. Sleep is also of particular importance for brain development and information processing in children and adolescents. The aim of this study was to determine if PTSD symptom severity and trauma load is associated with nightmares and insomnia in a sample of trauma-exposed, treatment-seeking adolescents.Methods: A total of 358 South African adolescents, between 12 and 18 years of age, exposed to at least one DSM-5 qualifying traumatic event, were assessed for PTSD-related sleep difficulties using the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS). Childhood exposure to 10 common trauma types was also recorded using the KSADS trauma checklist. PTSD symptom severity was measured using the child PTSD checklist (CPC).Results: Adolescents reporting current trauma-related nightmares (F[268.2] = 0.68, t = -8.16, p = 0.000) and current insomnia (F[265.2] = 0.16, t = -9.03, p = 0.000) had significantly higher PTSD symptom severity scores compared to those without current nightmares and insomnia. Adolescents with current trauma-related nightmares (F[355.2] = 0.15, t = -3.30, p = 0.001) and insomnia (F[353.2] = 0.15, t = -2.51, p = 0.013) were also exposed to a significantly greater number of different trauma types compared to those without current nightmares and insomnia.Conclusion: Assessing and treating sleep difficulties related to PTSD in trauma-exposed adolescents, in an effort to reduce the developmental impact of trauma on the brain and general functioning, should not be overlooked. Longitudinal studies may contribute to a better understanding of the long-term effects of trauma-related insomnia and nightmares on mental and physical health outcomes.

scholarly journals The DRD2 Taq1A polymorphism moderates the effect of PTSD symptom severity on the left hippocampal CA3 volume: a pilot study

2021 ◽  
Author(s):  
Minlan Yuan ◽  
Hongru Zhu ◽  
Yuchen Li ◽  
Fenfen Ge ◽  
Su Lui ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Imaging System ◽  
Dopamine D2 Receptor ◽  
Magnetic Resonance Imaging System ◽  
Hippocampal Function ◽  
Hippocampal Ca3 ◽  
Ptsd Symptom Severity ◽  
Ptsd Symptomatology ◽  
Ptsd Severity

Abstract Rationale and objectives The hippocampus, especially the CA1, CA3, and dentate gyrus (DG) subfields, is reported to be associated with post-traumatic stress disorder (PTSD) after trauma. However, neuroimaging studies of the associations between PTSD and hippocampal subfield volumes have failed to yield consistent findings. The aim of this study is to examine whether the dopamine D2 receptor (DRD2) Taq1A polymorphism, which is associated with both hippocampal function and PTSD, moderated the association between PTSD severity and hippocampal CA1, CA3 and DG volumes. Methods T1-weighted images were acquired from 142 trauma survivors from the 2008 Wenchuan earthquake using a 3.0-T magnetic resonance imaging system. Hippocampal subfield segmentations were performed with FreeSurfer v6.0. We used the simple moderation model from the PROCESS v3.4 tool for SPSS 23.0 to examine the association between the rs1800497 polymorphism, PTSD severity, and hippocampal CA3 and DG volumes. Results A significant genotype × PTSD symptom severity interaction was found for the left CA3 volume (ΔF = 5.01, p = 0.008, ΔR2 = 0.05). Post hoc, exploratory analyses deconstructing the interaction revealed that severe PTSD symptomatology were associated with reduced left CA3 volume among TC heterozygotes (t =  − 2.86, p = 0.005). Conclusions This study suggests that DRD2 Taq1A polymorphism moderates the association between PTSD symptomatology and left CA3 volume, which promotes an etiological understanding of the hippocampal atrophy at the subfield level. This highlights the complex effect of environmental stress, and provides possible mechanism for the relationship between the dopaminergic system and hippocampal function in PTSD.

scholarly journals Prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: task-shifting randomised controlled trial

2018 ◽  
Vol 213 (4) ◽  
pp. 587-594 ◽  
Author(s):  
Jaco Rossouw ◽  
Elna Yadin ◽  
Debra Alexander ◽  
Soraya Seedat
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Ptsd Symptom ◽  
Post Traumatic Stress ◽  
Supportive Counselling ◽  
Post Traumatic ◽  
Ptsd Symptom Severity

BackgroundEmpirical evidence on the effectiveness of evidence-based treatments for adolescents with post-traumatic stress disorder (PTSD) in low-resource settings is needed.AimsTo evaluate the comparative effectiveness of prolonged exposure and supportive counselling in adolescents with PTSD.MethodSixty-three adolescents (13–18 years) with PTSD were randomly assigned to receive either of the interventions comprising 7–14 sessions of treatment (trial registration in the Pan African Clinical Trials Registry: PACTR201511001345372). The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale at pre-treatment, post-treatment, and at 3- and 6-month follow-up.ResultsParticipants receiving prolonged exposure experienced greater improvement on the PTSD symptom severity scale than those receiving supportive counselling (between group differences at post-intervention, mean 12.49, 95% CI 6.82–18.17, P<0.001; d = 1.22). A similar effect size was maintained at 3-month (d = 0.85) and 6-month (d = 1.02) follow-up assessments.ConclusionsAdolescents with PTSD experienced greater benefit from prolonged exposure treatment when provided by non-specialist health workers (nurses) in a community setting.Declaration of interestNone.

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 Delayed-onset post-traumatic stress disorder among war veterans in primary care clinics

2009 ◽  
Vol 194 (6) ◽  
pp. 515-520 ◽  
Author(s):  
B. Christopher Frueh ◽  
Anouk L. Grubaugh ◽  
Derik E. Yeager ◽  
Kathryn M. Magruder
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Symptom Onset ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Trauma Exposure ◽  
Post Traumatic Stress ◽  
Delayed Onset ◽  
Post Traumatic ◽  
Current Ptsd

BackgroundOnly limited empirical data support the existence of delayed-onset post-traumatic stress disorder (PTSD).AimsTo expand our understanding of delayed-onset PTSD prevalence and phenomenology.MethodA cross-sectional, epidemiological design (n = 747) incorporating structured interviews to obtain relevant information for analyses in a multisite study of military veterans.ResultsA small percentage of veterans with identified current PTSD (8.3%, 7/84), current subthreshold PTSD (6.9%, 2/29), and lifetime PTSD only (5.4%, 2/37) met criteria for delayed onset with PTSD symptoms initiating more than 6 months after the index trauma. Altogether only 0.4% (3/747) of the entire sample had current PTSD with delayed-onset symptoms developing more than 1 year after trauma exposure, and no PTSD symptom onset was reported more than 6 years posttrauma.ConclusionsRetrospective reports of veterans reveal that delayed-onset PTSD (current, subthreshold or lifetime) is extremely rare 1 year post-trauma, and there was no evidence of PTSD symptom onset 6 or more years after trauma exposure.

Salience and central executive networks track overgeneralization of conditioned-fear in post-traumatic stress disorder

2020 ◽  
pp. 1-10
Author(s):  
Hannah Berg ◽  
Yizhou Ma ◽  
Amanda Rueter ◽  
Antonia Kaczkurkin ◽  
Philip C. Burton ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Large Scale ◽  
Ptsd Symptom ◽  
Conditioned Fear ◽  
Neural Substrates ◽  
Post Traumatic Stress ◽  
Generalization Gradients ◽  
Post Traumatic ◽  
Ptsd Symptom Severity

Abstract Background Generalization of conditioned-fear, a core feature of post-traumatic stress disorder (PTSD), has been the focus of several recent neuroimaging studies. A striking outcome of these studies is the frequency with which neural correlates of generalization fall within hubs of well-established functional networks including salience (SN), central executive (CEN), and default networks (DN). Neural substrates of generalization found to date may thus reflect traces of large-scale brain networks that form more expansive neural representations of generalization. The present study includes the first network-based analysis of generalization and PTSD-related abnormalities therein. Methods fMRI responses in established intrinsic connectivity networks (ICNs) representing SN, CEN, and DN were assessed during a generalized conditioned-fear task in male combat veterans (N = 58) with wide-ranging PTSD symptom severity. The task included five rings of graded size. Extreme sizes served as conditioned danger-cues (CS+: paired with shock) and safety-cues (CS−), and the three intermediate sizes served as generalization stimuli (GSs) forming a continuum-of-size between CS+ and CS–. Generalization-gradients were assessed as behavioral and ICN response slopes from CS+, through GSs, to CS–. Increasing PTSD symptomatology was predicted to relate to less-steep slopes indicative of stronger generalization. Results SN, CEN, and DN responses fell along generalization-gradients with levels of generalization within and between SN and CEN scaling with PTSD symptom severity. Conclusions Neural substrates of generalized conditioned-fear include large-scale networks that adhere to the functional organization of the brain. Current findings implicate levels of generalization in SN and CEN as promising neural markers of PTSD.

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