PTSD in the Year Following Sexual Assault: A Meta-Analysis of Prospective Studies

Objective: Sexual assault is associated with higher rates of posttraumatic stress disorder (PTSD) than other traumas, and the course of PTSD may differ by trauma type. However, the course of PTSD after sexual assault has not been summarized. The aim of this meta-analysis was to identify the prevalence and severity of PTSD and changes to the average rate of recovery in the 12 months following sexual assault. Method: Authors searched four databases for prospective studies published before April 2020 and sought relevant unpublished data. Eligible studies assessed PTSD in at least 10 survivors of sexual assault in at least two time points, starting within 3 months postassault. Random effects linear-linear piecewise models were used to identify changes in average recovery rate and produce model-implied estimates of monthly point prevalence and mean symptom severity. Results: Meta-analysis of 22 unique samples ( N = 2,106) indicated that 74.58% (95% confidence interval [CI]: [67.21, 81.29]) and 41.49% (95% CI: [32.36, 50.92]) of individuals met diagnostic criteria for PTSD at the first and 12th month following sexual assault, respectively. PTSD symptom severity was 47.94% (95% CI: [41.27, 54.61]) and 29.91% (95% CI: [23.10, 36.73]) of scales’ maximum severity at the first and 12th month following sexual assault, respectively. Most symptom recovery occurred within the first 3 months following sexual assault, after which point the average rate of recovery slowed. Conclusions: Findings indicate that PTSD is common and severe following sexual assault, and the first 3 months postassault may be a critical period for natural recovery.

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

Military Medicine ◽

10.1093/milmed/usab497 ◽

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 (>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.

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PTSD Symptom Severity, but Not Trauma Type, Predicts Mental Health Help-seeking in the Military

Journal of Psychiatric Practice ◽

10.1097/pra.0000000000000331 ◽

2018 ◽

Vol 24 (5) ◽

pp. 310-316

Author(s):

JEFFREY GUINA ◽

RAMZI W. NAHHAS ◽

MINH-TRI NGUYEN ◽

SETH FARNSWORTH

Keyword(s):

Mental Health ◽

Symptom Severity ◽

Help Seeking ◽

Ptsd Symptom ◽

Ptsd Symptom Severity ◽

The Military ◽

Trauma Type

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Psychological Interventions for Healthcare Providers With PTSD in Life-Threatening Pandemic: Systematic Review and Meta-Analysis

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.697783 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zeyuan Sun ◽

Chuan Yu ◽

Yue Zhou ◽

Zhenmi Liu

Keyword(s):

Symptom Severity ◽

Ptsd Symptom ◽

Behavioral Therapy ◽

Meta Analysis ◽

Healthcare Providers ◽

Psychological Interventions ◽

Controlled Trials ◽

Randomized Controlled ◽

Life Threatening ◽

Ptsd Symptom Severity

Objective: This study aims to evaluate the effect of psychological interventions on healthcare providers (HCP) with post-traumatic stress disorder (PTSD) due to their necessary exposure in life-threatening pandemic.Methods: We performed a systematic research on Medline, Embase, Cochrane Central, PsycInfo, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, ProQuest PTSD Pubs ProQuest Dissertations & Theses Global, and other gray databases by January 2021. Randomized controlled trials involving therapeutic interventions for HCP with PTSD were included. The primary outcome was PTSD symptom severity. Summary standardized mean differences (SMDs) and 95% confidence intervals were estimated using inverse variance meta-analysis with fixed effects. Risks of bias were assessed using Cochrane methods.Results: Among 773 citations, this review includes six studies, randomizing 810 participants. A meta-analysis of the effect of interventions compared to placebo showed a significant reduction of PTSD symptom severity: Cognitive Behavioral Therapy-Brief (CBT-B) (M = 27.80, 95% CI: 17.12, 38.48), Cognitive Behavioral Therapy-Long (CBT-L) (M = 26.50, 95% CI: 15.75, 37.25), and Mindfulness-Based Stretching and Deep Breathing Exercise (MBX) (M = 17.2, 95% CI: 6.57, 27.83). CBT-L and CBT-B also showed a significant effect on depression severity.Conclusions: The most effective and feasible treatment option for HCP with PTSD is still unclear, but CBT and MBX have displayed the most significant effects based on current limited evidence. Future research in this area—preferably large robust randomized controlled trials—is much needed.

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Psychosocial correlates of PTSD symptom severity in sexual assault survivors

Journal of Traumatic Stress ◽

10.1002/jts.20290 ◽

2007 ◽

Vol 20 (5) ◽

pp. 821-831 ◽

Cited By ~ 125

Author(s):

Sarah E. Ullman ◽

Henrietta H. Filipas ◽

Stephanie M. Townsend ◽

Laura L. Starzynski

Keyword(s):

Sexual Assault ◽

Symptom Severity ◽

Ptsd Symptom ◽

Sexual Assault Survivors ◽

Psychosocial Correlates ◽

Ptsd Symptom Severity ◽

Assault Survivors

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Cognitive paths from trauma to posttraumatic stress disorder: a prospective study of Ehlers and Clark's model in survivors of assaults or road traffic collisions

Psychological Medicine ◽

10.1017/s0033291719002253 ◽

2019 ◽

Vol 50 (13) ◽

pp. 2172-2181 ◽

Cited By ~ 1

Author(s):

Esther T. Beierl ◽

Inga Böllinghaus ◽

David M. Clark ◽

Edward Glucksman ◽

Anke Ehlers

Keyword(s):

Cognitive Processing ◽

Symptom Severity ◽

Ptsd Symptom ◽

Road Traffic ◽

Cognitive Factors ◽

Persistent Symptom ◽

Ptsd Symptom Severity ◽

And Gender ◽

Trauma Type ◽

Negative Appraisals

AbstractBackgroundIndividual differences in cognitive responses to trauma may represent modifiable risk factors that could allow early identification, targeted early treatment and possibly prevention of chronic posttraumatic stress disorder (PTSD). Ehlers and Clark's cognitive model of PTSD suggests that negative appraisals, disjointed trauma memories, and unhelpful coping strategies maintain PTSD. These are thought to be influenced by cognitive processing during trauma. The aim of this study was to test this model prospectively with path analyses.MethodsParticipants (N = 828) were recruited from an emergency department following injury in a violent assault or road traffic collision and 700 participated in the 6-month assessments. Cognitive processing was assessed shortly after the event, negative appraisals, disjointed memories, and unhelpful coping strategies at 1 month, persistent PTSD symptom severity at 6 months, and early PTSD symptom severity at 2 weeks.ResultsCognitive variables, with trauma type and gender, explained 52% of the variance in PTSD symptom severity at 6 months. Including early symptom severity in the model did not explain more variance (53%). Early PTSD symptom severity, with trauma type and gender, only predicted 40%. Negative appraisals and disjointed memories predicted persistent symptom severity both directly and indirectly via unhelpful strategies. Peritraumatic processing predicted persistent symptom severity mainly indirectly. The effects of trauma type and gender were fully mediated by the cognitive factors.ConclusionsThe results are consistent with theoretically derived predictions and support cognitive factors as indicators of risk for chronic PTSD and as a target for the treatment and prevention of PTSD.

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