Depression in post-traumatic stress disorder

2020 ◽  
Vol 31 (7) ◽  
pp. 703-722
Author(s):  
Milen L. Radell ◽  
Eid Abo Hamza ◽  
Ahmed A. Moustafa
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Self Report ◽  
Response To Treatment ◽  
Post Traumatic Stress ◽  
Behavioral Measures ◽  
Computer Based ◽  
Post Traumatic

AbstractMajor depressive disorder (MDD) symptoms commonly occur after trauma-exposure, both alone and in combination with post-traumatic stress disorder (PTSD). This article reviews recent research on comorbidity between these disorders, including its implications for symptom severity and response to treatment. Despite considerable symptom overlap, the two disorders represent distinct constructs and depend, at least in part, on separate biological mechanisms. Both, however, are also clearly related to stress psychopathology. We recommend that more research focus specifically on the study of individual differences in symptom expression in order to identify distinct subgroups of individuals and develop targeted treatments. However, a barrier to this line of inquiry is the trend of excluding particular patients from clinical trials of new interventions based on symptom severity or comorbidity. Another obstacle is the overreliance on self-report measures in human research. We argue that developing computer-based behavioral measures in order to supplement self-report can help address this challenge. Furthermore, we propose that these measures can help tie findings from human and non-human animal research. A number of paradigms have been used to model MDD-and PTSD-like behavior in animals. These models remain valuable for understanding the biological basis of these disorders in humans and for identifying potential interventions, but they have been underused for the study of comorbidity. Although the interpretation of animal behavior remains a concern, we propose that this can also be overcome through the development of close human analogs to animal paradigms.

Challenges of post-traumatic stress disorder (PTSD) in Iraq: biochemical network and methodologies. A brief review

2020 ◽  
Vol 41 (4) ◽  
Author(s):  
Daniele Suzete Persike ◽  
Suad Yousif Al-Kass
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Structural Changes ◽  
Stress Disorder ◽  
Feedback Mechanism ◽  
Biochemical Network ◽  
Response To Treatment ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Biochemical Mechanisms

AbstractPost-traumatic stress disorder (PTSD) is a multifaceted syndrome due to its complex pathophysiology. Signals of illness include alterations in genes, proteins, cells, tissues, and organism-level physiological modifications. Specificity of sensitivity to PTSD suggests that response to trauma depend on gender and type of adverse event being experienced. Individuals diagnosed with PTSD represent a heterogeneous group, as evidenced by differences in symptoms, course, and response to treatment. It is clear that the biochemical mechanisms involved in PTSD need to be elucidated to identify specific biomarkers. A brief review of the recent literature in Pubmed was made to explore the major biochemical mechanisms involved in PTSD and the methodologies applied in the assessment of the disease. PTSD shows pre-exposure vulnerability factors in addition to trauma-induced alterations. The disease was found to be associated with dysfunctions of the hypothalamic–pituitary–adrenal axis (HPA) and hypothalamus–pituitary–thyroid axis. Sympathetic nervous system (SNS) activity play a role in PTSD by releasing norepinephrine and epinephrine. Cortisol release from the adrenal cortex amplifies the SNS response. Cortisol levels in PTSD patients, especially women, are later reduced by a negative feedback mechanism which contributes to neuroendocrine alterations and promotes structural changes in the brain leading to PTSD. Gender differences in normal HPA responsiveness may be due to an increased vulnerability in women to PTSD. Serotonin and dopamine levels were found to be abnormal in the presence of PTSD. Mechanisms such as the induction of neuroinflammation and alterations of mitochondrial energy processing were also associated with PTSD.

Prediction of Outcome for Veterans with Post-Traumatic Stress Disorder Using Constructs from the Transtheoretical Model of Behaviour Change

2007 ◽  
Vol 41 (7) ◽  
pp. 590-597 ◽  
Author(s):  
Kathleen Rooney ◽  
Caroline Hunt ◽  
Leanne Humphreys ◽  
David Harding ◽  
Miriam Mullen ◽  
...  
Keyword(s):  
Transtheoretical Model ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Readiness To Change ◽  
Processes Of Change ◽  
Post Traumatic Stress ◽  
Predictive Utility ◽  
Post Traumatic

Objective: Post-traumatic stress disorder (PTSD) is a disabling condition, sometimes unresponsive to treatment. The aim of the present study was to examine the predictive utility of constructs from the transtheoretical model of behaviour change (TTM) known to predict outcome for other disorders. Method: A sample of 50 veterans presenting for a PTSD treatment programme provided data for this longitudinal study. Variables were assessed at four time-points during the treatment programme. Multiple regression and mixed-effects regression were utilized to determine the predictive utility of variables from the TTM. Results: Allocated stage of change at the time of a 2 day introduction programme predicted follow-up symptom severity, but changes therein during treatment did not predict changes in symptom severity. However, changes in the continuous readiness-to-change variable and behavioural processes of change were predictive of such changes. Conclusions: Despite some difficulties in the application of the TTM to PTSD, the model does appear to predict treatment outcome. Veterans who have increased readiness to change and who make more use of behavioural processes of change are likely to have improved outcomes.

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 GEROFIT: IMPACT ON PTSD SYMPTOMS AMONG PARTICIPATING VETERANS WITH SELF-REPORTED PTSD

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S34-S34
Author(s):  
Cathy Lee ◽  
Rebecca Melrose ◽  
Erin Blanchard ◽  
Stacy Wilkins ◽  
Steven Castle ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Exercise Program ◽  
Self Report ◽  
Symptom Improvement ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Negative Feelings

Abstract Post-traumatic stress disorder (PTSD) increases risk of medical comorbidities in aging. The Gerofit Program is an exercise program for older Veterans that shows efficacy for physical health. We sought to determine its impact on PTSD. Veterans in Gerofit completed a self-report questionnaire at 3 and 6 months assessing effect of Gerofit on: PTSD symptoms generally, disturbing dreams, avoidance, negative feelings, and irritability. Two hundred twenty-nine Veterans completed the questionnaire. Of these, 56 (24.5%) reported PTSD. None reported worsened PTSD following Gerofit participation. At 3 months, >50% of Veterans reported symptom improvement and this was maintained over 6 months for all items (p>0.05 paired t-test). There was an increase between 3 and 6 months in the percentage who reported “improved a lot” for overall symptoms (16.7% to 22.2%), negative feelings (5.6% to 11.1%) and irritability (0% to 11.1%). Gerofit may offer an effective intervention to improve PTSD symptoms in older Veterans.

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.

scholarly journals A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression

2016 ◽  
Vol 46 (12) ◽  
pp. 2571-2582 ◽  
Author(s):  
J. Wild ◽  
K. V. Smith ◽  
E. Thompson ◽  
F. Béar ◽  
M. J. J. Lommen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Stressful Events ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Psychological Traits ◽  
Post Traumatic

BackgroundIt is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions.MethodNewly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews.ResultsIn all, 32 participants (8.3%) developed an episode of PTSD and 41 (10.6%) an episode of MD during follow-up. In all but nine cases (2.3%), episodes had remitted by the next assessment 4 months later. At 2 years, those with episodes of PTSD or MD during follow-up reported more days off work, poorer sleep, poorer quality of life, greater burn-out; and greater weight-gain for those with PTSD. In line with theories of PTSD and depression, analyses controlling for psychiatric and trauma history identified several pre-trauma predictors (cognitive styles, coping styles and psychological traits). Logistic regressions showed that rumination about memories of stressful events at the start of training uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.ConclusionsParticipants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training. Cognitive predictors of episodes of PTSD and MD are promising targets for resilience interventions.

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