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 Associations between posttraumatic stress disorder and substance use: a longitudinal investigation of individuals recently exposed to trauma

2021 ◽  
Author(s):  
Sonya G. Wanklyn
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Alcohol Use ◽  
Posttraumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Traumatic Event ◽  
Ptsd Symptoms ◽  
Ptsd Symptom Severity

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly cooccur following trauma, and their co-occurrence is associated with substantial costs; however, our understanding of the timing and sequencing of these posttrauma mental health conditions is limited. This study examined the trajectories of PTSD symptom severity and substance use among individuals recently exposed to a traumatic event, with a focus on the potential moderating roles of PTSD and SUD diagnoses at the final assessment. Additionally, in attempt to better understand the functional relationship between PTSD symptoms and substance use posttrauma, this study compared models reflecting the theories of self-medication, susceptibility, and mutual maintenance. Participants included 137 individuals who had experienced a traumatic event within 6 months prior to study enrollment. Participants completed four assessments over an approximate 1-year period that included clinician-administered measures for DSM-5 PTSD symptoms and SUD diagnosis and self-report measures of alcohol and drug use. Change over time in PTSD symptoms and substance use by diagnostic status were investigated using growth curve models. Temporal sequencing between PTSD symptom severity and substance use was investigated with bivariate latent difference score structural equation modeling. In line with the conceptualization of PTSD as a disorder of impeded recovery, having a diagnosis of PTSD at the final assessment moderated the trajectory of PTSD symptom severity such that symptom severity declined only among those without PTSD. In contrast, the influence of SUD appeared to be negligible. Both PTSD and SUD diagnoses were associated with initial drug use frequency. However, the relationship between alcohol use and diagnostic status did not reach statistical significance. Regarding temporal relationships between PTSD symptoms and substance use, significant and negative PTSD to change in substance use cross-lagged paths were found across most of the models, while only one significant substance use to change in PTSD severity crosslagged path emerged in the PTSD intrusion with alcohol use model. These results add to a growing body of research suggesting trauma-focused intervention is viable for individuals with PTSD/SUD. Further, examination of potential mediators and moderators of the relation between PTSD and SUD is recommended as a critical focus for future research.

scholarly journals Associations between posttraumatic stress disorder and substance use: a longitudinal investigation of individuals recently exposed to trauma

2021 ◽  
Author(s):  
Sonya G. Wanklyn
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Alcohol Use ◽  
Posttraumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Traumatic Event ◽  
Ptsd Symptoms ◽  
Ptsd Symptom Severity

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly cooccur following trauma, and their co-occurrence is associated with substantial costs; however, our understanding of the timing and sequencing of these posttrauma mental health conditions is limited. This study examined the trajectories of PTSD symptom severity and substance use among individuals recently exposed to a traumatic event, with a focus on the potential moderating roles of PTSD and SUD diagnoses at the final assessment. Additionally, in attempt to better understand the functional relationship between PTSD symptoms and substance use posttrauma, this study compared models reflecting the theories of self-medication, susceptibility, and mutual maintenance. Participants included 137 individuals who had experienced a traumatic event within 6 months prior to study enrollment. Participants completed four assessments over an approximate 1-year period that included clinician-administered measures for DSM-5 PTSD symptoms and SUD diagnosis and self-report measures of alcohol and drug use. Change over time in PTSD symptoms and substance use by diagnostic status were investigated using growth curve models. Temporal sequencing between PTSD symptom severity and substance use was investigated with bivariate latent difference score structural equation modeling. In line with the conceptualization of PTSD as a disorder of impeded recovery, having a diagnosis of PTSD at the final assessment moderated the trajectory of PTSD symptom severity such that symptom severity declined only among those without PTSD. In contrast, the influence of SUD appeared to be negligible. Both PTSD and SUD diagnoses were associated with initial drug use frequency. However, the relationship between alcohol use and diagnostic status did not reach statistical significance. Regarding temporal relationships between PTSD symptoms and substance use, significant and negative PTSD to change in substance use cross-lagged paths were found across most of the models, while only one significant substance use to change in PTSD severity crosslagged path emerged in the PTSD intrusion with alcohol use model. These results add to a growing body of research suggesting trauma-focused intervention is viable for individuals with PTSD/SUD. Further, examination of potential mediators and moderators of the relation between PTSD and SUD is recommended as a critical focus for future research.

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

scholarly journals Handgrip Strength of World Trade Center (WTC) Responders: The Role of Re-Experiencing Posttraumatic Stress Disorder (PTSD) Symptoms

2019 ◽  
Vol 16 (7) ◽  
pp. 1128 ◽  
Author(s):  
Soumyadeep Mukherjee ◽  
Sean Clouston ◽  
Roman Kotov ◽  
Evelyn Bromet ◽  
Benjamin Luft
Keyword(s):  
Depressive Symptoms ◽  
Symptom Severity ◽  
World Trade ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Handgrip Strength ◽  
World Trade Center ◽  
Ptsd Symptoms ◽  
Trade Center ◽  
Ptsd Symptom Severity

Background: This study sought to examine whether handgrip strength (HGS), a measure of muscle strength and a biomarker of aging, was associated with post-traumatic stress disorder (PTSD) in a cohort of World Trade Center (WTC) responders at midlife. Methods: HGS was assessed utilizing a computer-assisted hand dynamometer administered to a consecutive sample of men and women (n = 2016) who participated in rescue and recovery efforts following the World Trade Center (WTC) attacks and subsequently attended monitoring appointments in Long Island, NY. PTSD symptom severity and depressive symptoms were assessed using the PTSD specific-trauma checklist (PCL-S) and the Patient Health Questionnaire (PHQ-9). General linear models were used to examine the association of WTC-related PTSD with HGS after adjusting for confounders. Results: The sample was at midlife (mean age = 53.3) when assessed, and 91.3% were men. Nearly 10% of the sample had probable PTSD (PCL ≥ 44) with concomitant depression (PHQ ≥ 10), while 5.1% had probable PTSD without depression. Average HGS was 57.4 lbs. (95% confidence interval (95% CI): 56.6–58.1) among men and 36.1 lbs. (95% CI = 33.8–38.5) among women. Mean HGS of those with probable PTSD with concomitant depression was lower (45.9 lbs., 95% CI = 43.6–48.2) than responders with only PTSD (49.1 lbs., 95% CI = 46.0–52.4) and those without PTSD or depression (57.5 lbs., 95% CI = 56.2–57.8). Subdomain analyses of PTSD symptoms revealed that re-experiencing symptoms at enrollment (p = 0.003) was associated with lower HGS after adjusting for depressive symptoms and other confounders. Discussion: Results suggested that higher WTC-related PTSD symptom severity was associated with lower HGS. Results support ongoing work suggesting that PTSD may be associated with more rapid physical aging. The potential for developing interventions that might simultaneously improve physical and mental health in the aftermath of trauma may be considered.

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.

Physical Exercise as Treatment for PTSD: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Frida Björkman ◽  
Örjan Ekblom
Keyword(s):  
Subgroup Analysis ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Study Quality ◽  
Ptsd Symptoms ◽  
Military Trauma ◽  
Exercise Type ◽  
Ptsd Symptom Severity

ABSTRACT Introduction Post-traumatic stress disorder (PTSD) is a cluster of physical and psychiatric symptoms following military or civilian trauma. The effect of exercise on PTSD symptoms has previously been investigated in several studies. However, it has not been fully determined what type of exercise most impacts PTSD symptoms. The aim of the present study was to systematically review the effects of different types of exercise on PTSD symptom severity and symptoms of coexisting conditions in adults. Materials and Methods Electronic searches were conducted in the databases PubMed, APA PsycInfo, and SportDiscus, from database inception up until February 1, 2021. Inclusion criteria were randomized controlled trials published in English, participants having a PTSD diagnosis or clinically relevant symptoms, and participants randomly allocated to either a non-exercising control group or an exercise group. Data concerning the number of participants, age, exercise type and duration, PTSD symptom severity (primary outcome), and symptoms of coexisting conditions (secondary outcomes) were extracted. The subgroup analysis included high or low training dose, military trauma versus non-military trauma, the type of intervention (yoga versus other exercise), active or passive control condition, group training versus individual exercise, and study quality. The study quality and risk of bias were assessed using grading of recommendation assessment, development and evaluation (GRADE) guidelines. A meta-analysis was performed with a mixed-effects model and restricted maximum likelihood as model estimator, and effect size was calculated as the standardized difference in mean and 95% CI. Results Eleven studies were included in the present review. Results showed a main random effect of exercise intervention (0.46; 95% CI: 0.18 to 0.74) and a borderline significant interaction between more voluminous (&gt;20 hours in total) and less voluminous (≤20 hours in total) exercise interventions (P = .07). No significant findings from the subgroup analysis were reported. The secondary outcome analysis showed a small but significant effect of exercise on depressive symptoms (0.20, 95% CI: 0.01 to 0.38), and a larger effect on sleep (0.51, 95% CI: 0.29 to 0.73). For substance use (alcohol and drugs combined) and quality of life, we found significant effects of 0.52 (95% CI: 0.06 to 0.98) and 0.51 (95% CI: 0.34 to 0.69), respectively. No significant effect was found for anxiety (0.18, 95% CI: −0.15 to 0.51), and no sign of publication bias was found. Conclusions Exercise can be an effective addition to PTSD treatment, and greater amounts of exercise may provide more benefits. However, as there were no differences found between exercise type, possibly due to the inclusion of a low number of studies using different methodologies, further research should aim to investigate the optimal type, dose, and duration of activity that are most beneficial to persons with PTSD.

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.

Polygenic prediction of PTSD trajectories in 9/11 responders

2020 ◽  
pp. 1-9
Author(s):  
Monika A. Waszczuk ◽  
Anna R. Docherty ◽  
Andrey A. Shabalin ◽  
Jiaju Miao ◽  
Xiaohua Yang ◽  
...  
Keyword(s):  
Symptom Severity ◽  
Multiple Testing ◽  
World Trade Center ◽  
Risk Scores ◽  
Generalized Anxiety ◽  
Targeted Prevention ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Growth Mixture Model ◽  
Prospective Longitudinal

Abstract Background Genetics hold promise of predicting long-term post-traumatic stress disorder (PTSD) outcomes following trauma. The aim of the current study was to test whether six hypothesized polygenic risk scores (PRSs) developed to capture genetic vulnerability to psychiatric conditions prospectively predict PTSD onset, severity, and 18-year course after trauma exposure. Methods Participants were 1490 responders to the World Trade Center (WTC) disaster (mean age at 9/11 = 38.81 years, s.d. = 8.20; 93.5% male; 23.8% lifetime WTC-related PTSD diagnosis). Prospective longitudinal data on WTC-related PTSD symptoms were obtained from electronic medical records and modelled as PTSD trajectories using growth mixture model analysis. Independent regression models tested whether six hypothesized psychiatric PRSs (PTSD-PRS, Re-experiencing-PRS, Generalized Anxiety-PRS, Schizophrenia-PRS, Depression-PRS, and Neuroticism-PRS) are predictive of WTC-PTSD outcomes: lifetime diagnoses, average symptom severity, and 18-year symptom trajectory. All analyses were adjusted for population stratification, 9/11 exposure severity, and multiple testing. Results Depression-PRS predicted PTSD diagnostic status (OR 1.37, CI 1.17–1.61, adjusted p = 0.001). All PRSs, except PTSD-PRS, significantly predicted average PTSD symptoms (β = 0.06–0.10, adjusted p < 0.05). Re-experiencing-PRS, Generalized Anxiety-PRS and Schizophrenia-PRS predicted the high severity PTSD trajectory class (ORs 1.21–1.28, adjusted p < 0.05). Finally, PRSs prediction was independent of 9/11 exposure severity and jointly accounted for 3.7 times more variance in PTSD symptoms than the exposure severity. Conclusions Psychiatric PRSs prospectively predicted WTC-related PTSD lifetime diagnosis, average symptom severity, and 18-year trajectory in responders to 9/11 disaster. Jointly, PRSs were more predictive of subsequent PTSD than the exposure severity. In the future, PRSs may help identify at-risk responders who might benefit from targeted prevention approaches.

Stress and Coping of Critical Care Nurses After Unsuccessful Cardiopulmonary Resuscitation

2017 ◽  
Vol 26 (2) ◽  
pp. 128-135 ◽  
Author(s):  
Dawn E. McMeekin ◽  
Ronald L. Hickman ◽  
Sara L. Douglas ◽  
Carol G. Kelley
Keyword(s):  
Critical Care ◽  
Symptom Severity ◽  
Ptsd Symptom ◽  
Institutional Support ◽  
Critical Care Nurses ◽  
Ptsd Symptoms ◽  
Coping Behaviors ◽  
Event Scale ◽  
Ptsd Symptom Severity ◽  
The Impact

Background Participation by a critical care nurse in an unsuccessful resuscitation can create a unique heightened level of psychological stress referred to as postcode stress, activation of coping behaviors, and symptoms of posttraumatic stress disorder (PTSD). Objectives To explore the relationships among postcode stress, coping behaviors, and PTSD symptom severity in critical care nurses after experiencing unsuccessful cardiopulmonary resuscitations and to see whether institutional support attenuates these repeated psychological traumas. Methods A national sample of 490 critical care nurses was recruited from the American Association of Critical-Care Nurses’ eNewsline and social media. Participants completed the Post-Code Stress Scale, the Brief COPE (abbreviated), and the Impact of Event Scale–Revised, which were administered through an online survey. Results Postcode stress and PTSD symptom severity were weakly associated (r = 0.20, P = .01). No significant associations between coping behaviors and postcode stress were found. Four coping behaviors (denial, self-distraction, self-blame, and behavioral disengagement) were significant predictors of PTSD symptom severity. Severity of postcode stress and PTSD symptoms varied with the availability of institutional support. Conclusions Critical care nurses show moderate levels of postcode stress and PTSD symptoms when asked to recall an unsuccessful resuscitation and the coping behaviors used. Identifying the critical care nurses most at risk for PTSD will inform the development of interventional research to promote critical care nurses’ psychological well-being and reduce their attrition from the profession.

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