scholarly journals Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool

2021 ◽  
Vol 6 (1) ◽  
pp. e000623
Author(s):  
Saad Rahmat ◽  
Jessica Velez ◽  
Muhammad Farooqi ◽  
Abbas Smiley ◽  
Kartik Prabhakaran ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Multivariate Regression ◽  
Stress Disorder ◽  
Acute Stress ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Post Traumatic ◽  
Single Question ◽  
Ptsd Severity

BackgroundPost-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or screening tools at different time points in patients hospitalized after admission to the hospital after significant physical trauma, but with stable vitals (level II trauma).MethodsPatients completed the ‘initial question’ and the National Stressful Events Survey Acute Stress Disorder Scale (NSESSS) at 3 days to 5 days after trauma (NSESSS-1). The same scale was administered 2 weeks to 4 weeks after trauma (NSESSS-2). The Posttraumatic Stress Disorder Symptoms Scale Interview for DSM-5 (PSSI-5) was administered 2 months after trauma. PTSD diagnosis and PTSD severity were extracted from the PSSI-5. Linear multivariate regression analyses were used to establish whether scores for NSESSS-1 or NSESSS-2 predicted PTSD diagnosis/PTSD severity. Non-linear multivariate regression analyses were performed to better understand the relationship between NSESSS-1/NSESSS-2 and PTSD diagnosis/PTSD severity.ResultsA single question assessing the experience of fear, helplessness, or horror was not an effective tool for determining the diagnosis of PTSD (p=0.114) but can be a predictor of PTSD severity (p=0.039). We demonstrate that administering the NSESSS after either 3 days to 5 days (p=0.008, p<0.001) or 2 weeks to 4 weeks (p=0.039; p<0.001) can predict the diagnosis of PTSD and PTSD severity. Scoring an NSESSS above 14/28 (50%) increases the chance of experiencing a higher PTSD severity substantially and linearly.DiscussionOur initial question was not an effective predictor of PTSD diagnosis. However, using the NSESSS at both 3 days to 5 days and 2 weeks to 4 weeks after trauma is an effective method for predicting PTSD diagnosis and PTSD severity. Additionally, we show that patients who score higher than 14 on the NSESSS for acute stress symptoms may need closer follow-up.Level of evidenceLevel III, prognostic.

scholarly journals An epistasis between dopaminergic and oxytocinergic systems confers risk of post-traumatic stress disorder in a traumatized Chinese cohort

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kunlin Zhang ◽  
Gen Li ◽  
Li Wang ◽  
Chengqi Cao ◽  
Ruojiao Fang ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Trauma Exposure ◽  
Environment Interaction ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Psychiatric Syndrome ◽  
Chinese Cohort ◽  
Post Traumatic

AbstractPost-traumatic stress disorder (PTSD) is a psychiatric syndrome that occurs after trauma exposure. Neurotransmitters such as dopamine and oxytocin have been reported to be involved in neuropathology of PTSD. Previous studies indicated that the dopamine–oxytocin interaction may contribute to behavioral disorders. Thus, exploring the epistasis (gene–gene interaction) between oxytocinergic and dopaminergic systems might be useful to reveal the genetic basis of PTSD. In this study, we analyzed two functional single nucleotide polymorphisms (SNPs), rs2268498 for oxytocinergic gene OXTR and rs1801028 for dopaminergic gene DRD2 based on putative oxytocin receptor–dopamine receptor D2 (OTR–DR2) heterocomplex in a Chinese cohort exposed to the 2008 Wenchuan earthquake (156 PTSD cases and 978 controls). Statistical analyses did not find any single variant or gene–environment interaction (SNP × earthquake-related trauma exposure) associated with provisional PTSD diagnosis or symptoms. An OXTR–DRD2 interaction (rs2268498 × rs1801028) was identified to confer risk of provisional PTSD diagnosis (OR = 9.18, 95% CI = 3.07–27.46 and P = 7.37e-05) and further subset analysis indicated that rs2268498 genotypes controlled the association directions of rs1801028 and rs1801028 genotypes also controlled the association directions of rs2268498. Rs2268498 × rs1801028 is also associated with PTSD symptoms (P = 0.043). Our study uncovered a genetic and putative function-based contribution of dopaminergic–oxytocinergic system interaction to PTSD.

scholarly journals Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach

2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Expressive Writing ◽  
Stress Disorder ◽  
Post Treatment ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Severity

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.

scholarly journals Treating adults with acute stress disorder and post‐traumatic stress disorder in general practice: a clinical update

2007 ◽  
Vol 187 (2) ◽  
pp. 120-123 ◽  
Author(s):  
David Forbes ◽  
Mark C Creamer ◽  
Andrea J Phelps ◽  
Anne‐Laure Couineau ◽  
John A Cooper ◽  
...  
Keyword(s):  
General Practice ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Acute Stress ◽  
Acute Stress Disorder ◽  
Post Traumatic Stress ◽  
Post Traumatic

Is plasma GABA level a biomarker of Post-Traumatic Stress Disorder (PTSD) severity? A preliminary study

2016 ◽  
Vol 241 ◽  
pp. 273-279 ◽  
Author(s):  
Marion Trousselard ◽  
Bertrand Lefebvre ◽  
Lionel Caillet ◽  
Yann Andruetan ◽  
Franck de Montleau ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Gaba Level ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Preliminary Study ◽  
Ptsd Severity

scholarly journals Perceptual processing advantages for trauma-related visual cues in post-traumatic stress disorder

2011 ◽  
Vol 42 (1) ◽  
pp. 173-181 ◽  
Author(s):  
B. Kleim ◽  
T. Ehring ◽  
A. Ehlers
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Visual Cues ◽  
Stress Disorder ◽  
Acute Stress ◽  
Perceptual Processing ◽  
Trauma Survivors ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic

BackgroundIntrusive re-experiencing in post-traumatic stress disorder (PTSD) comprises distressing sensory impressions from the trauma that seem to occur ‘out of the blue’. A key question is how intrusions are triggered. One possibility is that PTSD is characterized by a processing advantage for stimuli that resemble those that accompanied the trauma, which would lead to increased detection of such cues in the environment.MethodWe used a blurred picture identification task in a cross-sectional (n=99) and a prospective study (n=221) of trauma survivors.ResultsParticipants with acute stress disorder (ASD) or PTSD, but not trauma survivors without these disorders, identified trauma-related pictures, but not general threat pictures, better than neutral pictures. There were no group differences in the rate of trauma-related answers to other picture categories. The relative processing advantage for trauma-related pictures correlated with re-experiencing and dissociation, and predicted PTSD at follow-up.ConclusionsA perceptual processing bias for trauma-related stimuli may contribute to the involuntary triggering of intrusive trauma memories in PTSD.

Naturalistic Comparison of Models of Programmatic Interventions for Combat-Related Post-Traumatic Stress Disorder

2008 ◽  
Vol 42 (12) ◽  
pp. 1051-1059 ◽  
Author(s):  
David Forbes ◽  
Virginia Lewis ◽  
Ruth Parslow ◽  
Graeme Hawthorne ◽  
Mark Creamer
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
High Intensity ◽  
Stress Disorder ◽  
Moderate Intensity ◽  
Post Traumatic Stress ◽  
Low Intensity ◽  
Post Traumatic ◽  
Over Time ◽  
Ptsd Severity

Objectives: Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans’ psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment. Method: Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type. Results: Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes. Conclusion: Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments.

Fluoxetine in post-traumatic stress disorder

1999 ◽  
Vol 175 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Kathryn M. Connor ◽  
Suzanne M. Sutherland ◽  
Larry A. Tupler ◽  
Mary L. Malik ◽  
R. Jonathan ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
State Function ◽  
Global Rating ◽  
Post Traumatic Stress ◽  
Global Improvement ◽  
Stress Vulnerability ◽  
Post Traumatic ◽  
Ptsd Severity

BackgroundMost pharmacotherapy trials in post-traumatic stress disorder (PTSD) have been conducted upon male combat veterans. Outcome studies relating to civilians are therefore needed.AimsTo demonstrate that fluoxetine is more effective than placebo in treating PTSD.MethodCivilians with PTSD (n=53) were treated for 12 weeks with fluoxetine (up to 60 mg/day) or placebo. Assessments of PTSD severity, disability, stress vulnerability, and high end-state function were obtained.ResultsFluoxetine was more effective than placebo on most measures at week 12, including global improvement (much or very much improved: fluoxetine 85%, placebo 62%, difference 0.24, 95% CI 0.01–0.47; very much improved: fluoxetine 59%, placebo 19%, difference 0.40, 95% CI 0.16–0.64), and high end-state function (fluoxetine 41%, placebo 4%, difference 0.37, 95% CI 0.17–0.57)ConclusionsFluoxetine was superior for measures of PTSD severity, disability, stress vulnerability, and high end-state function. The placebo-group response was low when viewed as a broad outcome based on a portfolio of ratings, but was higher with a traditional global rating criterion.

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