Anger and predictors of drop-out from PTSD treatment of veterans and first responders

2021 ◽  
pp. 1-15
Author(s):  
Emily Hinton ◽  
Zachary Steel ◽  
Dominic Hilbrink ◽  
David Berle
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Military Veterans ◽  
First Responders ◽  
Female Gender ◽  
Drop Out ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Ptsd Symptom Severity ◽  
Pre Treatment

Abstract Background: Drop-out is an important barrier in treating post-traumatic stress disorder (PTSD) with consequences that negatively impact clients, clinicians and mental health services as a whole. Anger is a common experience in people with PTSD and is more prevalent in military veterans. To date, no research has examined if anger may predict drop-out in military veterans or first responders. Aims: The present study aimed to determine the variables that predict drop-out among individuals receiving residential treatment for PTSD. Method: Ninety-five military veterans and first responders completed pre-treatment measures of PTSD symptom severity, depression, anxiety, anger, and demographic variables. Logistic regression analyses were used to determine if these variables predicted drop-out from treatment or patterns of attendance. Results: Female gender was predictive of drop-out. However, when analysed by occupation female gender was predictive of drop-out among first responders and younger age was predictive of drop-out in military participants. Anger, depression, anxiety and PTSD symptom severity were not predictive of drop-out in any of the analyses. No variables were found to predict attendance patterns (consistent or inconsistent) or early versus late drop-out from the programme. Conclusion: These results suggest that although anger is a relevant issue for treating PTSD, other factors may be more pertinent to drop-out, particularly in this sample. In contrast with other findings, female gender was predictive of drop-out in this study. This may indicate that in this sample, there are unique characteristics and possible interacting variables that warrant exploration in future research.

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.

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 The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0246990
Author(s):  
Marcel O. Bonn-Miller ◽  
Sue Sisley ◽  
Paula Riggs ◽  
Berra Yazar-Klosinski ◽  
Julie B. Wang ◽  
...  
Keyword(s):  
Active Treatment ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Controlled Trial ◽  
Military Veterans ◽  
Ptsd Symptoms ◽  
Significant Difference ◽  
Ptsd Symptom Severity ◽  
Stage 1 ◽  
To Receive

Importance There is a pressing need for development of novel pharmacology for the treatment of Posttraumatic Stress Disorder (PTSD). Given increasing use of medical cannabis among US military veterans to self-treat PTSD, there is strong public interest in whether cannabis may be a safe and effective treatment for PTSD. Objective The aim of the present study was to collect preliminary data on the safety and potential efficacy of three active concentrations of smoked cannabis (i.e., High THC = approximately 12% THC and < 0.05% CBD; High CBD = 11% CBD and 0.50% THC; THC+CBD = approximately 7.9% THC and 8.1% CBD, and placebo = < 0.03% THC and < 0.01% CBD) compared to placebo in the treatment of PTSD among military veterans. Methods The study used a double-blind, cross-over design, where participants were randomly assigned to receive three weeks of either active treatment or placebo in Stage 1 (N = 80), and then were re-randomized after a 2-week washout period to receive one of the other three active treatments in Stage 2 (N = 74). The primary outcome measure was change in PTSD symptom severity from baseline to end of treatment in Stage 1. Results The study did not find a significant difference in change in PTSD symptom severity between the active cannabis concentrations and placebo by the end of Stage 1. All three active concentrations of smoked cannabis were generally well tolerated. Conclusions and relevance The present study is the first randomized placebo-controlled trial of smoked cannabis for PTSD. All treatment groups, including placebo, showed good tolerability and significant improvements in PTSD symptoms during three weeks of treatment, but no active treatment statistically outperformed placebo in this brief, preliminary trial. Additional well-controlled and adequately powered studies with cannabis suitable for FDA drug development are needed to determine whether smoked cannabis improves symptoms of PTSD. Trial registration Identifier: NCT02759185; ClinicalTrials.gov.

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 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

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.

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.

The association between daily PTSD symptom severity and alcohol-related outcomes in recent traumatic injury victims.

2017 ◽  
Vol 31 (3) ◽  
pp. 326-335 ◽  
Author(s):  
Bryce Hruska ◽  
Maria L. Pacella ◽  
Richard L. George ◽  
Douglas L. Delahanty
Keyword(s):  
Symptom Severity ◽  
Ptsd Symptom ◽  
Traumatic Injury ◽  
Ptsd Symptom Severity
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