scholarly journals Prior sleep problems and adverse post-traumatic neuropsychiatric sequelae of motor vehicle collision in the AURORA study

SLEEP ◽  
2020 ◽  
Author(s):  
Thomas C Neylan ◽  
Ronald C Kessler ◽  
Kerry J Ressler ◽  
Gari Clifford ◽  
Francesca L Beaudoin ◽  
...  
Keyword(s):  
Stress Reactivity ◽  
Stress Disorder ◽  
Motor Vehicle ◽  
Acute Stress ◽  
Sleep Problems ◽  
Population Attributable Risk ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Peritraumatic Distress

Abstract Study Objectives Many patients in Emergency Departments (EDs) after motor vehicle collisions (MVCs) develop post-traumatic stress disorder (PTSD) or major depressive episode (MDE). This report from the AURORA study focuses on associations of pre-MVC sleep problems with these outcomes 8 weeks after MVC mediated through peritraumatic distress and dissociation and 2-week outcomes. Methods A total of 666 AURORA patients completed self-report assessments in the ED and at 2 and 8 weeks after MVC. Peritraumatic distress, peritraumatic dissociation, and pre-MVC sleep characteristics (insomnia, nightmares, daytime sleepiness, and sleep duration in the 30 days before the MVC, trait sleep stress reactivity) were assessed retrospectively in the ED. The survey assessed acute stress disorder (ASD) and MDE at 2 weeks and at 8 weeks assessed PTSD and MDE (past 30 days). Control variables included demographics, MVC characteristics, and retrospective reports about PTSD and MDE in the 30 days before the MVC. Results Prevalence estimates were 41.0% for 2-week ASD, 42.0% for 8-week PTSD, 30.5% for 2-week MDE, and 27.2% for 8-week MDE. Pre-MVC nightmares and sleep stress reactivity predicted 8-week PTSD (mediated through 2-week ASD) and MDE (mediated through the transition between 2-week and 8-week MDE). Pre-MVC insomnia predicted 8-week PTSD (mediated through 2-week ASD). Estimates of population attributable risk suggest that blocking effects of sleep disturbance might reduce prevalence of 8-week PTSD and MDE by as much as one-third. Conclusions Targeting disturbed sleep in the immediate aftermath of MVC might be one effective way of reducing MVC-related PTSD and MDE.

COGNITIVE BEHAVIOURAL TREATMENT OF POST TRAUMATIC STRESS DISORDER AFTER MOTOR VEHICLE ACCIDENT

1999 ◽  
Vol 27 (3) ◽  
pp. 201-214 ◽  
Author(s):  
Gary Fecteau ◽  
Richard Nicki
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Vehicle Accident ◽  
Cognitive Behavioural ◽  
Post Traumatic

Post traumatic stress disorder (PTSD) and other reactions including driving phobias and depression have in recent years been clearly identified as common motor vehicle accident (MVA) sequelae. To date, no treatment outcome data exist for PTSD following MVA beyond case study reports and one pilot investigation. The present study reports on the first randomized control trial for PTSD following MVA. Twenty volunteer participants who had motor vehicle accidents resulting in physical injury requiring medical attention and PTSD were recruited through rehabilitation service providers, other psychologists, community physicians, and lawyers. Assessments included a structured interview for diagnosis of post traumatic stress disorder (Clinician Administered PTSD Scale) by an independent rater, a range of self-report symptom questionnaires and a behavioural test wherein they had their heart rate and subjective distress measured in reaction to idiosyncratic audio descriptions of their accident. Participants were randomly assigned to eight to ten hours of individual cognitive-behavioural therapy (n=10) or to a wait list control group (n=10). Treatment included education about post-trauma reactions, relaxation training, exposure therapy with cognitive restructuring and instruction for self-directed graduated behaviour practice. Results demonstrated statistically and clinically significant treatment effects across structured interviews, self-report questionnaires and the behavioural test. Treatment gains were maintained over a 6 month follow-up using self-report questionnaires.

Psychological consequences of road traffic accidents for children and their mothers

2004 ◽  
Vol 34 (2) ◽  
pp. 335-346 ◽  
Author(s):  
B. BRYANT ◽  
R. MAYOU ◽  
L. WIGGS ◽  
A. EHLERS ◽  
G. STORES
Keyword(s):  
Traffic Accidents ◽  
Stress Disorder ◽  
Acute Stress ◽  
Road Traffic ◽  
Clinical Care ◽  
Self Report ◽  
Road Traffic Accidents ◽  
Post Traumatic Stress ◽  
Psychological Outcome ◽  
Post Traumatic

Background. Little is known about the psychological and behavioural consequences of road traffic accidents for children. The study aimed to determine the outcome of road traffic accidents on children and their mothers.Method. A 1-year cohort study of consecutive child attenders aged 5–16 years at an Accident and Emergency Department. Data were extracted from medical notes and from interview and self-report at baseline, 3 months and 6 months.Results. The children had an excellent physical outcome. Fifteen per cent suffered acute stress disorder; 25% suffered post-traumatic stress disorder at 3 months and 18% at 6 months. Travel anxiety was frequent. Post-traumatic consequences for mothers were common.Conclusion. Psychological outcome was poor for a minority of children and associated with disability, especially for travel. There were significant family consequences. There is a need for changes in clinical care to prevent, identify and treat distressing and disabling problems.

scholarly journals Two Rapid Screens for Detecting Probable Post-Traumatic Stress Disorder and Interpersonal Violence Exposure: Predictive Utility in a Juvenile Justice Sample

2018 ◽  
Vol 24 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Damion J. Grasso ◽  
Christine Doyle ◽  
Ron Koon
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Interpersonal Violence ◽  
Violence Exposure ◽  
Stress Disorder ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Predictive Utility ◽  
Risk Characteristics ◽  
Post Traumatic

The Trauma-Related Symptoms and Impairment Rapid Screen (TSIRS) and the Dimensions of Violence Exposure Rapid Screen (DVERS) are two new tools designed to detect traumatic stress symptoms and high-risk characteristics of trauma exposure. Each screen contains 10 yes-or-no questions and is estimated to take approximately 2 min to complete. The rapid screens were developed to address the demand for efficient, effective, and user-friendly tools for use in settings where universal screening of trauma and related symptoms is recommended, but training and expertise in clinical assessment are generally lacking or absent. The purpose of the current study was to examine the predictive utility of the TSIRS and DVERS in detecting probable post-traumatic stress disorder and poly-victimization assessed via a validated self-report instrument. Data were collected on a sample of 218 detained adolescents. Results provide initial support for the predictive utility of the TSIRS and DVERS in a justice-involved sample.

Treating post-traumatic stress disorder in the ‘real world’: evaluation of a specialist trauma service and adaptations to standard treatment approaches

2008 ◽  
Vol 32 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Damon Lab ◽  
Ines Santos ◽  
Felicity de Zulueta
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Treatment ◽  
Self Report ◽  
Trauma Survivors ◽  
Post Traumatic Stress ◽  
Trauma Service ◽  
Social Difficulties ◽  
Post Traumatic

Aims and MethodTo evaluate the effectiveness of treatment at the Traumatic Stress Service (TSS) by comparing pre- and post-treatment scores on patient self-report measures. Through a questionnaire survey, to explore therapists' views of problems presenting in addition to post-traumatic stress disorder (PTSD) and how, as a result, they adapted their approach to trauma work.ResultsTherapists reported that their patients present with a range of complex problems, and self-report measures show that patients suffer particularly high levels of psychopathology. Therapists identified a number of adaptations to trauma-focused work to deal with these additional problems. Of the 112 patients who completed therapy, 43% filled in pre- and post-treatment questionnaire measures. Analysis showed clinically and statistically significant improvements in levels of PTSD, depression and social functioning.Clinical ImplicationsThe typical presentation of trauma survivors is often not ‘simple’ PTSD, but PTSD resulting from chronic and multiple traumas and complicated by additional psychological and social difficulties. Adaptations to trauma-focused work can successfully treat such ‘complex’ PTSD.

scholarly journals Investigation of relationship between post-traumatic stress disorder and quality of life among firefighters in Birjand City at 2018

2020 ◽  
Author(s):  
M Sadeghi khorashad ◽  
E Rezaieyan ◽  
A Abdolahnezhad
Keyword(s):  
Quality Of Life ◽  
Statistical Analysis ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Stress Disorders ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Post Traumatic

Introduction: Firefighters are at high risk of developing post-traumatic stress disorder (PTSD), and that Quality of Life (QoL) is seriously compromised in individuals who have PTSD. This study was designed to assess the relationship between post-traumatic stress disorders and quality of life among firefighters. Materials and Methods: In this analytical and cross-sectional study, all firefighters in Birjand city were selected by census method (N = 96) in 2018. PTSD and QoL status was assessed by the Persian version of the Mississippi (Eshel) and WHOQOL-BREF questionnaires, respectively. Using Cronbach's α, the Iranian version of these two scales' internal reliability has been reported to be 0.92 and more than 0.7, respectively. Data analysis using SPSS software version 21 and independent T-test, ANOVA, Tukey's test, and Pearson correlation coefficient were used for statistical analysis. Results: The results showed that most firefighters (70.5%) were suffered from moderate PTSD symptoms (79.2± 11.7). Based on the self-report scale, 53.7% of the firefighters rated their quality of life as Good, and 43.2% of the firefighters were satisfied with their health. Statistical analysis showed that there is a statistically significant inverse relationship between PTSD score and areas of mental health (P = 0.03), social relations (P = 0.002), and environmental health (P = 0.004). Between PTSD score and physical health, no statistically significant relationship was found (P = 0.08). Conclusion: This study has proven a high rate of PTSD among firefighters and its negative correlation with the quality of their life. However, most firefighters rated their health and quality of life as good. Implementing strategies to combat mental disorders among firefighters improves the quality of their life and increases their job productivity.

scholarly journals The spectral fingerprint of sleep problems in post-traumatic stress disorder

SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
M de Boer ◽  
M J Nijdam ◽  
R A Jongedijk ◽  
K A Bangel ◽  
M Olff ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Rem Sleep ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Sleep Problems ◽  
Nrem Sleep ◽  
Post Traumatic Stress ◽  
Oscillation Power ◽  
Post Traumatic

Abstract Study Objectives Sleep problems are a core feature of post-traumatic stress disorder (PTSD). The aim of this study was to find a robust objective measure for the sleep disturbance in patients having PTSD. Methods The current study assessed EEG power across a wide frequency range and multiple scalp locations, in matched trauma-exposed individuals with and without PTSD, during rapid eye movement (REM) and non-REM (NREM) sleep. In addition, a full polysomnographical evaluation was performed, including sleep staging and assessment of respiratory function, limb movements, and heart rate. The occurrence of sleep disorders was also assessed. Results In patients having PTSD, NREM sleep shows a substantial loss of slow oscillation power and increased higher frequency activity compared with controls. The change is most pronounced over right-frontal sensors and correlates with insomnia. PTSD REM sleep shows a large power shift in the opposite direction, with increased slow oscillation power over occipital areas, which is strongly related to nightmare activity and to a lesser extent with insomnia. These pronounced spectral changes occur in the context of severe subjective sleep problems, increased occurrence of various sleep disorders and modest changes in sleep macrostructure. Conclusions This is the first study to show pronounced changes in EEG spectral topologies during both NREM and REM sleep in PTSD. Importantly, the observed power changes reflect the hallmarks of PTSD sleep problems: insomnia and nightmares and may thus be specific for PTSD. A spectral index derived from these data distinguishes patients from controls with high effect size, bearing promise as a candidate biomarker.

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