1063 Depression Moderates the Association Between Posttraumatic Stress Disorder and Nightmare Severity in Nurses

Abstract Introduction Nurses report a higher prevalence of posttraumatic stress disorder (PTSD) than the general population, and approximately 18% of nurses report having depression. Nightmares are a common symptom of PTSD, and both nightmares and PTSD are correlated with depression. Nightmares may represent a possible clinical target for improving outcomes in both disorders. This study assessed associations between PTSD and depressive symptoms with nightmare severity, and whether depressive symptoms moderated associations between PTSD and nightmare severity. Methods Participants were 461 nurses (91% female; 77% white, mean age = 38.39 years) recruited from two hospitals for a parent study. Participants completed the Patient Health Questionnaire (PHQ-9), Post-traumatic Stress Disorder Checklist (PCL-5), and 14 days of sleep diaries to assess daily nightmare frequency and severity (on a scale of 0 = not at all severe to 3 = very severe). Results 22.1% of participants reported at least one nightmare across the 14 days, with a mean daily nightmare frequency of 1.17 (SD = 2.15) and a mean severity of 0.11 (SD = 0.18). PCL-5 and PHQ-9 scores were significantly correlated with nightmare severity (r = 0.27; r = 0.24, respectively) and each other (r = 0.69). PHQ-9 scores moderated the association between PCL-5 scores and nightmare severity (β = -.01, SE = <0.01, p = 0.015). For individuals 1 SD below the PHQ-9 mean, higher PCL-5 scores were associated with higher nightmare severity. For individuals 1 SD above the PHQ-9 mean, higher PCL-5 scores were associated with higher nightmare severity, but to a lesser degree. Conclusion Both depressive and PTSD symptoms were associated with more severe nightmares. Surprisingly, the association between PTSD symptoms and nightmare severity was stronger for those with lower depressive symptoms. Results suggest depression, PTSD, and nightmares may represent a partially overlapping symptom cluster. Research should investigate how nightmare treatment may reduce PTSD and depressive symptoms. Support NIAID R01AI128359-01

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Abstract 19204: Symptoms of Depression and Posttraumatic Stress Disorder are Associated with Differential Autonomic Influences to Standing

Circulation ◽

10.1161/circ.130.suppl_2.19204 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Amit J Shah ◽

Ayman Alkhoder ◽

Malik Obideen ◽

Ronnie Ramadan ◽

Kobina Wilmot ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Depressive Symptoms ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Beta Blockers ◽

Autonomic Response ◽

Ptsd Symptoms ◽

Symptoms Of Depression ◽

Autonomic Pathways ◽

The Mean

Introduction: Depression and posttraumatic stress disorder (PTSD) are associated with impaired baroreflex sensitivity, a risk factor for sudden death. Unlike depression, PTSD is associated with hyperarousal. We hypothesized that, in patients with CAD, depressive and PTSD symptoms associate with different autonomic responses to standing (baroreflex response). Methods: We examined 178 patients with CAD for autonomic dysfunction with the ANSAR test (ANX 3.0, ANSAR Inc. Philadelphia, PA) in which heart rate variability was measured in both sitting (5 minutes) and standing (5 minutes) positions. Sympathetic (SNS) and parasympathetic (PNS) nervous system activity was measured using continuous wavelet transform and log-transformed. PTSD symptoms were assessed using the PTSD checklist scale (PCL), and depressive symptoms were assessed using the Beck Depression Inventory-II (BDI). Both BDI and PCL were examined in multivariate models simultaneously, adjusting for CAD risk factors, beta blockers, and antidepressants. Results: The mean (SD) age, BDI, and PCL scores were 62.4 (9.1), 7.2 (7.6), and 26.2 (10.2), respectively. For the group as a whole, the mean baseline SNS and PNS tones were -0.49 and -0.60 log beats per minute squared (log BPM 2 ). In multivariable models, PCL score associated with higher baseline SNS tone (β=0.03, p=0.046). With standing, PCL score associated with decrease in the levels of SNS tone (β=-0.02, p=0.02) vs. sitting, and BDI associated with an increased PNS tone (β=0.03, p=0.03) vs. sitting. In both cases, these responses are the opposite of the expected autonomic response to standing, which is an increase in SNS tone and decrease in PNS tone vs. sitting. Conclusion: Depressive and PTSD symptoms have opposite autonomic pathologies in CAD patients. While PTSD symptoms are associated with higher SNS tone at baseline, they are also associated with lower sympathetic activation with standing. Depressive symptoms, on the other hand, are associated with reduced vagal withdrawal with standing. This suggests that both depressive and PTSD symptoms are associated with an abnormal baroreceptor function, but through different autonomic pathways.

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Learning and Consolidation of Verbal Declarative Memory in Patients with Posttraumatic Stress Disorder

Zeitschrift für Psychologie / Journal of Psychology ◽

10.1027/0044-3409/a000020 ◽

2010 ◽

Vol 218 (2) ◽

pp. 135-140 ◽

Cited By ~ 1

Author(s):

Slawomira J. Diener ◽

Herta Flor ◽

Michèle Wessa

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Verbal Memory ◽

Stress Disorder ◽

Declarative Memory ◽

Memory Performance ◽

Verbal Learning ◽

Depression Scale ◽

Learning Performance ◽

Ptsd Symptoms

Impairments in declarative memory have been reported in posttraumatic stress disorder (PTSD). Fragmentation of explicit trauma-related memory has been assumed to impede the formation of a coherent memorization of the traumatic event and the integration into autobiographic memory. Together with a strong non-declarative memory that connects trauma reminders with a fear response the impairment in declarative memory is thought to be involved in the maintenance of PTSD symptoms. Fourteen PTSD patients, 14 traumatized subjects without PTSD, and 13 non-traumatized healthy controls (HC) were tested with the California Verbal Learning Test (CVLT) to assess verbal declarative memory. PTSD symptoms were assessed with the Clinician Administered PTSD Scale and depression with the Center of Epidemiological Studies Depression Scale. Several indices of the CVLT pointed to an impairment in declarative memory performance in PTSD, but not in traumatized persons without PTSD or HC. No group differences were observed if recall of memory after a time delay was set in relation to initial learning performance. In the PTSD group verbal memory performance correlated significantly with hyperarousal symptoms, after concentration difficulties were accounted for. The present study confirmed previous reports of declarative verbal memory deficits in PTSD. Extending previous results, we propose that learning rather than memory consolidation is impaired in PTSD patients. Furthermore, arousal symptoms may interfere with successful memory formation in PTSD.

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Social Support, Emotional Intelligence, and Posttraumatic Stress Disorder Symptoms

Journal of Individual Differences ◽

10.1027/1614-0001/a000185 ◽

2016 ◽

Vol 37 (1) ◽

pp. 31-39 ◽

Cited By ~ 8

Author(s):

Nicole L. Hofman ◽

Austin M. Hahn ◽

Christine K. Tirabassi ◽

Raluca M. Gaher

Keyword(s):

Social Support ◽

Posttraumatic Stress Disorder ◽

Emotional Intelligence ◽

Protective Factors ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Traumatic Events ◽

Ptsd Symptoms ◽

The Relationship

Abstract. Exposure to traumatic events and the associated risk of developing Posttraumatic stress disorder (PTSD) symptoms is a significant and overlooked concern in the college population. It is important for current research to identify potential protective factors associated with the development and maintenance of PTSD symptoms unique to this population. Emotional intelligence and perceived social support are two identified protective factors that influence the association between exposure to traumatic events and PTSD symptomology. The current study examined the mediating role of social support in the relationship between emotional intelligence and PTSD symptoms. Participants included 443 trauma-exposed university students who completed online questionnaires. The results of this study indicated that social support mediates the relationship between emotional intelligence and reported PTSD symptoms. Thus, emotional intelligence is significantly associated with PTSD symptoms and social support may play an integral role in the relationship between emotional intelligence and PTSD. The current study is the first to investigate the role of social support in the relationship between emotional intelligence and PTSD symptoms. These findings have important treatment and prevention implications with regard to PTSD.

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Factors Associated With Posttraumatic Stress Disorder Symptomology Among Women Who Have Experienced Sexual Assault in Canada

Journal of Interpersonal Violence ◽

10.1177/0886260519860084 ◽

2019 ◽

pp. 088626051986008

Author(s):

Janice Du Mont ◽

Holly Johnson ◽

Cassandra Hill

Keyword(s):

Posttraumatic Stress Disorder ◽

Sexual Assault ◽

Posttraumatic Stress ◽

Dating Violence ◽

Sexual Victimization ◽

Stress Disorder ◽

General Social Survey ◽

Future Research ◽

Ptsd Symptoms ◽

Sexually Assaulted

There is a dearth of information about the association of victim-related and assailant-related characteristics and posttraumatic stress disorder (PTSD) among sexually assaulted women. Recently, Statistics Canada included items measuring the possible presence of PTSD symptoms in their 2014 nationally representative General Social Survey on Victimization (GSS-V), for the purpose of improving the understanding of mental health impacts associated with sexual victimization. The present study used the GSS-V to examine the association of sociodemographic, health, and assailant characteristics and prior traumatic experiences in the form of physical or sexual dating violence, physical assault, stalking, childhood abuse, and witnessing of violence between parents with PTSD symptomology among sexually assaulted women. Among 319 women who reported experiencing at least one incident of sexual assault in the 12 months prior to the survey, 68.6% had experienced at least one negative emotional impact as a result, among whom, 43.6% reported past-month PTSD symptoms. Logistic regression modeling revealed that prior traumatic events in the form of physical or sexual dating violence, stalking, and having witnessed violence between parents were associated with higher odds of experiencing PTSD symptoms, as was having been sexually assaulted by a known assailant. In contrast, the odds of experiencing PTSD symptoms was lower for Aboriginal or visible minority women. The results suggest that PTSD symptoms in the near aftermath of sexual victimization are common, and there are a range of factors that contribute to the likelihood of developing these symptoms. Implications for future research are discussed.

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Standard EMDR Protocol for Alcohol and Substance Dependence Comorbid With Posttraumatic Stress Disorder: Four Cases With 12-Month Follow-Up

Journal of EMDR Practice and Research ◽

10.1891/1933-3196.10.1.33 ◽

2016 ◽

Vol 10 (1) ◽

pp. 33-46 ◽

Cited By ~ 9

Author(s):

Claire Kullack ◽

Jonathan Laugharne

Keyword(s):

Posttraumatic Stress Disorder ◽

Substance Use ◽

Alcohol Dependence ◽

Posttraumatic Stress ◽

Substance Use Disorders ◽

Substance Dependence ◽

Stress Disorder ◽

Case Series ◽

Post Traumatic Stress

This report begins with a summary of the literature regarding the theoretical models behind the comorbid relationship between posttraumatic stress disorder and substance use disorders and the various modified addiction protocols formulated to assist in treating these disorders. This case series outlines the effect that the standard eye movement desensitization and reprocessing (EMDR) protocol had on alcohol and substance dependence for 4 patients who attended our Post Traumatic Stress Clinic in Fremantle, Western Australia, primarily for treatment for posttraumatic stress disorder. Patients were assessed for substance use disorders using the Mini International Neuropsychiatric Interview Plus prior to, immediately after, and 12 months after completing EMDR therapy. Results indicate that the standard EMDR protocol was successful in reducing alcohol and substance use. Prior to treatment, 3 patients met criteria for alcohol dependence and 1 met criteria for substance dependence. At 12-month follow-up, 3 out of 4 clients did not meet the diagnostic criteria for current alcohol dependence or current substance dependence. The implications of these findings are discussed with reference to theories of comorbid posttraumatic stress disorder and substance use disorder and the modified EMDR protocols developed for patients with substance dependence.

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Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries

Child and Adolescent Psychiatry and Mental Health ◽

10.1186/s13034-021-00378-2 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Dusko Stupar ◽

Dejan Stevanovic ◽

Panos Vostanis ◽

Olayinka Atilola ◽

Paulo Moreira ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Traumatic Events ◽

Ptsd Symptoms ◽

Middle Income ◽

Palestinian Territories ◽

Middle Income Countries ◽

Dsm 5 ◽

Low And Middle Income

Abstract Background Exposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs). Methods Data were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12–18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms. Results The most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2–8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2–10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria. Conclusions Nearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.

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Symptoms of Posttraumatic Stress Disorder and Associated Risk Factors in Patients With Lung Cancer: A Longitudinal Observational Study

Integrative Cancer Therapies ◽

10.1177/1534735418807970 ◽

2018 ◽

Vol 17 (4) ◽

pp. 1195-1203 ◽

Cited By ~ 3

Author(s):

Jun Ni ◽

Jian Feng ◽

Linda Denehy ◽

Yi Wu ◽

Liqin Xu ◽

...

Keyword(s):

Lung Cancer ◽

Posttraumatic Stress Disorder ◽

Observational Study ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Ptsd Symptoms ◽

Newly Diagnosed ◽

Cancer Symptoms ◽

Longitudinal Observational Study ◽

Prospective Longitudinal

Purpose. This study aimed to measure symptoms of posttraumatic stress disorder (PTSD) in Chinese patients following a new diagnosis of lung cancer. Secondary aims were to explore factors at diagnosis that may predict PTSD symptoms at 6 months. Methods. This was a prospective longitudinal observational study that included 93 patients with newly diagnosed lung cancer. PTSD symptomology was assessed using the PTSD Checklist Civilian Version (PCL-C) and health-related quality of life (HRQoL) was assessed with the European Organisation for the Research and Treatment of Cancer questionnaire. Measures were completed at diagnosis and 6 months. Results. No patient had PTSD at baseline or 6 months as measured by a score of ⩾50 in the PCL-C. However, at diagnosis, 44% of patients had “mild” symptoms of PTSD. At 6 months, 64% of patients had “mild” and 8% had “moderate” PTSD symptoms. PTSD symptom scores significantly worsened over 6 months (mean difference [95% CI] = 7.2 [5.4 to 9.0]). Six months after diagnosis, higher PTSD scores were seen in people who at diagnosis were younger ( P = .003), had a lower smoking pack history ( P = .012), displayed less sedentary behavior ( P < .005), or initially had worse cancer symptoms, including fatigue ( P = .001) and poorer HRQoL ( P = .004). Conclusions. Mild PTSD symptoms are common in patients with lung cancer 6 months after treatment; however, a full diagnosis of PTSD is uncommon. Screening for PTSD symptoms may be considered for at-risk patients with newly diagnosed lung cancer.

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The exposure to traumatic events and symptoms of posttraumatic stress disorder among Korean journalists

Journalism ◽

10.1177/1464884917707596 ◽

2017 ◽

Vol 19 (9-10) ◽

pp. 1308-1325 ◽

Cited By ~ 4

Author(s):

Mina Lee ◽

Eun Hye Ha ◽

Jung Kun Pae

Keyword(s):

Social Support ◽

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Coping Strategy ◽

Stress Disorder ◽

Traumatic Event ◽

Traumatic Events ◽

Ptsd Symptoms ◽

Negative Beliefs ◽

Traumatic Event Exposure

This study investigated posttraumatic stress disorder (PTSD) symptoms on Korean journalists and the contributing variables. Predicting variables included the exposure to traumatic events, coping strategy, social support, optimism, negative beliefs, and the journalists’ occupational perspectives. A total of 367 Korean journalists participated in the survey. The findings revealed that, first, Korean journalists had suffered severely from PTSD symptoms according to the prevalence rate. Second, the extent of traumatic event exposure, the length of career, the use of dysfunctional coping strategy, a lack of social support, and negative beliefs were identified as significantly related variables. Finally, occupational perspectives showed meaningful associations with development of the symptoms. This study provided an empirical analysis of Korean journalists’ experiences of traumatic events and psychological stress for the first time.

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Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Veterans With Posttraumatic Stress Disorder: A Pilot Study

Behavior Modification ◽

10.1177/0145445517724539 ◽

2017 ◽

Vol 42 (2) ◽

pp. 210-230 ◽

Cited By ~ 7

Author(s):

Ruth L. Varkovitzky ◽

Andrew M. Sherrill ◽

Greg M. Reger

Keyword(s):

Posttraumatic Stress Disorder ◽

Emotion Regulation ◽

Depressive Symptoms ◽

Pilot Study ◽

Posttraumatic Stress ◽

Emotional Disorders ◽

Symptom Severity ◽

Stress Disorder ◽

Transdiagnostic Treatment ◽

Unified Protocol

Effective treatment options are needed for veterans who do not participate in trauma-focused psychotherapy. Research has yet to examine the effectiveness of transdiagnostic psychotherapy in veterans with posttraumatic stress disorder (PTSD) and co-occurring psychological disorders. This pilot study examined the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a 16-week group format. We examined treatment outcomes in male and female veterans ( n = 52) in an outpatient specialty PTSD clinic at a large Veterans Affairs (VA) medical center. We hypothesized significant decreases in emotion regulation difficulty (Difficulties in Emotion Regulation Scale), PTSD symptom severity (PTSD Checklist for DSM-5), and depressive symptom severity (Patient Health Questionnaire–9). In addition, we hypothesized that reductions in emotion regulation difficulty across treatment would negatively predict PTSD and depressive symptoms at posttreatment. PTSD symptoms, depressive symptoms, and emotion regulation difficulty all evidenced significant improvements at the end of treatment relative to baseline ( ps < .001). In addition, reductions in emotion regulation across treatment were associated with lower PTSD and depressive symptoms at posttreatment ( ps < .001). This pilot study provides preliminary evidence supporting use of UP among veterans with PTSD and co-occurring disorders. Well-designed clinical trials evaluating efficacy of UP among veterans are needed.

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Authenticity as a Resilience Factor Against CV-19 Threat Among Those With Chronic Pain and Posttraumatic Stress Disorder

Frontiers in Psychology ◽

10.3389/fpsyg.2021.643869 ◽

2021 ◽

Vol 12 ◽

Author(s):

David E. Reed ◽

Elizabeth Lehinger ◽

Briana Cobos ◽

Kenneth E. Vail ◽

Paul S. Nabity ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Chronic Pain ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Brief Pain Inventory ◽

The Novel ◽

Ptsd Symptoms ◽

Physical Conditions ◽

Resilience Factors ◽

Novel Coronavirus

ObjectiveThe novel coronavirus (2019; CV-19) is linked to increases in emotional distress and may be particularly problematic for those with pre-existing mental and physical conditions, such as chronic pain and posttraumatic stress disorder (PTSD). However, little empirical research has been published on resilience factors in these individuals. The present study aims to examine authenticity as a resilience factor among those with chronic pain and/or PTSD.MethodsPrior to the national response to the pandemic (January 10-24, 2020), participants were screened for pain-related disability (Oswestry Disability Index; ODI) and PTSD symptoms (Posttraumatic Checklist for DSM-5; PCL-5), and on the basis of those responses were categorized into one of four groups: healthy, chronic pain only, PTSD only, or comorbid chronic pain and PTSD. During the CV-19 pandemic (May 5-May 13, 2020), participants responded again to the ODI and PCL-5, in addition to the Wood Authenticity Scale, Brief Pain Inventory, and items related to the CV-19 pandemic.ResultsA total of 110 participants (54.55% women), aged 42.19 (SD = 13.16), completed the survey during the pandemic. The comorbid group endorsed higher levels of CV-19 Threat and Impact compared to all other groups. Authenticity moderated this relationship relevant to CV-19 Threat among those in the chronic pain only group, and not in any other group.ConclusionThe comorbid group endorsed higher levels of CV-19 Threat and Impact compared to all other groups. Importantly, greater authenticity was associated with less CV-19 Threat in the chronic pain only group, and not in any other group. The present study also highlights the importance of engaging authentically for those with chronic pain during the pandemic.

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