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Sample records for ptsd symptom scale

  1. The Child PTSD Symptom Scale: Psychometric Properties in Female Adolescent Sexual Assault Survivors

    Science.gov (United States)

    Gillihan, Seth J.; Aderka, Idan M.; Conklin, Phoebe H.; Capaldi, Sandra; Foa, Edna B.

    2013-01-01

    Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and…

  2. Bullying and PTSD Symptoms

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    Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

    2012-01-01

    PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

  3. Symptom structure of PTSD following breast cancer.

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    Cordova, M J; Studts, J L; Hann, D M; Jacobsen, P B; Andrykowski, M A

    2000-04-01

    Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.

  4. Toward an empirical definition of pediatric PTSD: the phenomenology of PTSD symptoms in youth.

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    Carrion, Victor G; Weems, Carl F; Ray, Rebecca; Reiss, Allan L

    2002-02-01

    To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages. Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents. Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty. Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.

  5. Symptom structure and severity: a comparison of responses to the positive and negative syndrome scale (PANSS) between patients with PTSD or schizophrenia.

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    Stefanovics, Elina A; Krystal, John H; Rosenheck, Robert A

    2014-05-01

    To describe and compare the structure and relative severity of symptoms in clinical trial patients diagnosed with Post Traumatic Stress Disorder (PTSD) or schizophrenia using the Positive and Negative Syndrome Scale (PANSS), developed originally to evaluate symptoms of schizophrenia. This secondary data analysis used baseline PANSS symptom ratings (n=267) from a six-month multicenter randomized placebo-controlled trial of adjunctive risperidone in patients with chronic military-related PTSD. First, using a split-half design, Exploratory Factor Analysis (EFA) was employed to identify independent factors which were then compared to published factor structures for schizophrenia. Next, Confirmatory Factor Analysis (CFA) was applied to the second half of the sample to compare the results of the EFA and published factor structures. Finally, T-tests were used to compare the severity of factor scores between the PTSD sample and the baseline PANSS ratings from the Clinical Antipsychotic Trial for Intervention Effectiveness (CATIE) schizophrenia sample (n=1460). EFA suggested five factors similar to those identified in a summary of 29 schizophrenia studies by Wallwork (Schizophrenia Research, 137:246-250). CFA showed that the five factor Wallwork model fit the data better than the EFA, although both had relatively high goodness of fit. T-tests showed that the PTSD sample had more severe symptoms on the Depressive factor, and the schizophrenia sample on the Positive, Negative, and Disorganized factors, with no significant difference on the Excited factor. Veterans with PTSD had similar symptom structure to patients with schizophrenia on the PANSS, but were less symptomatic on psychosis-related factors and more symptomatic on depression. Dimensional symptom factors can be virtually the same across diagnoses. Published by Elsevier Inc.

  6. Examining various subthreshold definitions of PTSD using the Clinician Administered PTSD Scale for DSM-5.

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    Franklin, C Laurel; Raines, Amanda M; Chambliss, Jessica L; Walton, Jessica L; Maieritsch, Kelly P

    2018-07-01

    The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychiatric Association [APA], 2013) includes Other- and Unspecified- Trauma and Stressor-Related Disorders to capture subthreshold Posttraumatic Stress Disorder (PTSD) symptoms. However, the DSM-5 does not specify the number or type of symptoms needed to assign them. The purpose of the current study was to extend our understanding of subthreshold PTSD by comparing four commonly used definitions adapted to the DSM-5 PTSD criteria in an outpatient treatment-seeking sample. Veterans (N = 193) presenting to PTSD clinics were assessed using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5). Participants reported a criterion A traumatic event, but did not meet criteria for threshold-PTSD. We hypothesized that the number of veterans captured would be highest when fewer specific criterion sets were required by the subthreshold definition. Our hypothesis was upheld in that the more criteria required by the subthreshold PTSD definition, the lower the number of veterans counted within the group. The study consisted primarily of trauma treatment-seeking male veterans, with chronic PTSD symptoms. In addition, the sample size was small and was collected as part of routine clinical care. These results support previous contentions around careful decision making when defining what constitutes subthreshold PTSD in research and clinical work. It also points to the need for continued research to better understand the diagnostic and treatment implications of subthreshold PTSD. Published by Elsevier B.V.

  7. Altered DNA Methylation Patterns Associated With Clinically Relevant Increases in PTSD Symptoms and PTSD Symptom Profiles in Military Personnel.

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    Martin, Christiana; Cho, Young-Eun; Kim, Hyungsuk; Yun, Sijung; Kanefsky, Rebekah; Lee, Hyunhwa; Mysliwiec, Vincent; Cashion, Ann; Gill, Jessica

    2018-05-01

    Military personnel experience posttraumatic stress disorder (PTSD), which is associated with differential DNA methylation across the whole genome. However, the relationship between these DNA methylation patterns and clinically relevant increases in PTSD severity is not yet clearly understood. The purpose of this study was to identify differences in DNA methylation associated with PTSD symptoms and investigate DNA methylation changes related to increases in the severity of PTSD in military personnel. In this pilot study, a cross-sectional comparison was made between military personnel with PTSD (n = 8) and combat-matched controls without PTSD (n = 6). Symptom measures were obtained, and genome-wide DNA methylation was measured using methylated DNA immunoprecipitation (MeDIP-seq) from whole blood samples at baseline and 3 months later. A longitudinal comparison measured DNA methylation changes in military personnel with clinically relevant increases in PTSD symptoms between time points (PTSD onset) and compared methylation patterns to controls with no clinical changes in PTSD. In military personnel with elevated PTSD symptoms 3 months following baseline, 119 genes exhibited reduced methylation and 8 genes exhibited increased methylation. Genes with reduced methylation in the PTSD-onset group relate to the canonical pathways of netrin signaling, Wnt/Ca + pathway, and axonal guidance signaling. These gene pathways relate to neurological disorders, and the current findings suggest that these epigenetic changes potentially relate to PTSD symptomology. This study provides some novel insights into the role of epigenetic changes in PTSD symptoms and the progression of PTSD symptoms in military personnel.

  8. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

    Science.gov (United States)

    2011-01-01

    Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i) purpose of instrument, (ii) construct measured, (iii) contents of construct, (iv) local idioms employed, (v) structure of response sets, and (vi) comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS) and Child PTSD Symptom Scale (CPSS) in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64) aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old). The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Global Assessment of Psychosocial Disability (GAPD) were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC) = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14); CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20). The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7), "feeling that life is not worth living" (DSRS.10), and "feeling

  9. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

    Directory of Open Access Journals (Sweden)

    Tol Wietse A

    2011-08-01

    Full Text Available Abstract Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i purpose of instrument, (ii construct measured, (iii contents of construct, (iv local idioms employed, (v structure of response sets, and (vi comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS and Child PTSD Symptom Scale (CPSS in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64 aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old. The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS and Global Assessment of Psychosocial Disability (GAPD were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14; CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20. The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7, "feeling that life is not worth living" (DSRS.10, and

  10. Posttraumatic stress disorder (PTSD) symptoms in PTSD patients' families of origin.

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    Watson, C G; Anderson, P E; Gearhart, L P

    1995-10-01

    Posttraumatic stress disorder (PTSD) patients, psychiatric controls, and hospital employee controls rated their father, mother, and oldest sibling of each sex on 14 PTSD Interview (PTSD-I) symptom ratings. The stress disorder patients assigned their relatives significantly higher PTSD-I ratings than the control group members did in 35 of 120 comparisons. The number of significant differences was nearly identical in the fathers, mothers, sisters, and brothers. Differences were particularly frequent on items pertaining to intrusive thoughts, impoverished relationships, and guilt. The results suggest that a trauma survivor's risk for PTSD may be related to his family's history for PTSD-like behaviors.

  11. PTSD, emotion dysregulation, and dissociative symptoms in a highly traumatized sample

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    Powers, Abigail; Cross, Dorthie; Fani, Negar; Bradley, Bekh

    2015-01-01

    Exposure to multiple traumas has been shown to result in many negative mental health outcomes, including posttraumatic stress disorder (PTSD). Dissociation, which involves disruptions in memory, identity, and perceptions, may be a component of PTSD, particularly among individuals who have experienced childhood trauma. Emotion regulation difficulties are also strongly associated with childhood trauma and emotion dysregulation may be a particularly important factor to consider in the development and maintenance of dissociative symptoms. The goal of the present study was to determine whether emotion dysregulation mediated the relationship between PTSD symptoms and dissociation in a sample of 154 (80% female, 97% African-American) adults recruited from a public, urban hospital. PTSD was measured using the Clinician Administered PTSD Scale, emotion dysregulation was measured using the Difficulties in Emotion Regulation Scale, and dissociation was measured using the Multiscale Dissociation Inventory. A linear regression analysis showed that both PTSD and emotion dysregulation were statistically significant predictors of dissociation even after controlling for trauma exposure. Alexithymia and an inability to use emotion regulation strategies in particular were predictive of dissociation above and beyond other predictor variables. Using bootstrapping techniques, we found that overall emotion dyregulation partially mediated the effect of PTSD symptoms on dissociative symptoms. Our results suggest that emotion dysregulation may be important in understanding the relation between PTSD and dissociative symptoms. Treatment approaches may consider a focus on training in emotional understanding and the development of adaptive regulation strategies as a way to address dissociative symptoms in PTSD patients. PMID:25573648

  12. Dysregulation in cortical reactivity to emotional faces in PTSD patients with high dissociation symptoms

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    Aleksandra Klimova

    2013-09-01

    Full Text Available Background: Predominant dissociation in posttraumatic stress disorder (PTSD is characterized by restricted affective responses to positive stimuli. To date, no studies have examined neural responses to a range of emotional expressions in PTSD with high dissociative symptoms. Objective: This study tested the hypothesis that PTSD patients with high dissociative symptoms will display increased event-related potential (ERP amplitudes in early components (N1, P1 to threatening faces (angry, fearful, and reduced later ERP amplitudes (Vertex Positive Potential (VPP, P3 to happy faces compared to PTSD patients with low dissociative symptoms. Methods: Thirty-nine civilians with PTSD were classified as high dissociative (n=16 or low dissociative (n=23 according to their responses on the Clinician Administered Dissociative States Scale. ERPs were recorded, whilst participants viewed emotional (happy, angry, fear and neutral facial expressions in a passive viewing task. Results: High dissociative PTSD patients displayed significantly increased N120 amplitude to the majority of facial expressions (neutral, happy, and angry compared to low dissociative PTSD patients under conscious and preconscious conditions. The high dissociative PTSD group had significantly reduced VPP amplitude to happy faces in the conscious condition. Conclusion: High dissociative PTSD patients displayed increased early (preconscious cortical responses to emotional stimuli, and specific reductions to happy facial expressions in later (conscious, face-specific components compared to low dissociative PTSD patients. Dissociation in PTSD may act to increase initial pre-attentive processing of affective stimuli, and specifically reduce cortical reactivity to happy faces when consciously processing these stimuli.

  13. Relationship between burnout and PTSD symptoms in firefighters: the moderating effects of a sense of calling to firefighting.

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    Jo, Insung; Lee, Songhee; Sung, Gyhye; Kim, Minkyoung; Lee, Sanghyuk; Park, Jooeon; Lee, Kangsoo

    2018-01-01

    Firefighting has been reported to lead to burnout and posttraumatic stress disorder (PTSD). However, burnout and PTSD symptoms may vary depending on personal characteristics, such as having a sense of calling. This study examined the role of calling in the association between burnout and PTSD symptoms. We hypothesized that burnout would be associated with more severe PTSD symptoms and calling would buffer the relationship between burnout and PTSD symptoms. The Korean version of the Maslach Burnout Inventory-General Survey, Sense of Calling Subscale of the Professionalism Scale, and the Impact of Event Scale-Revised-Korean version were used to measure burnout, calling, and PTSD symptoms. Data from 109 of 127 firefighters from Gyeonggi-do, South Korea were analyzed using hierarchical linear regression. Burnout was a significant predictor of PTSD symptoms. Furthermore, the interaction term between burnout and calling accounted for a significant variance in PTSD symptoms. Higher burnout was associated with severe PTSD symptoms, but this relationship differed by the level of calling. The increase in PTSD symptoms due to increased burnout in the high calling group was relatively higher than in the low and average calling groups. Calling, though perceived as a positive variable, can be hazardous to exhausted people. A sense of calling as part of one's job identity should not be encouraged until personal circumstances and characteristics, such burnout symptoms, are evaluated. Identifying context and variables associated with PTSD for interventions with firefighters and persons in other dangerous occupations should aid in their recovery from trauma exposure.

  14. PTSD symptom reports of patients evaluated for the New Mexico Medical Cannabis Program.

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    Greer, George R; Grob, Charles S; Halberstadt, Adam L

    2014-01-01

    New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, other than case reports, of the effects of cannabis on PTSD symptoms. The purpose of the study was to report and statistically analyze psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011. The Clinician Administered Posttraumatic Scale for DSM-IV (CAPS) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated. Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not. Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

  15. Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms.

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    Kuhn, Eric; Greene, Carolyn; Hoffman, Julia; Nguyen, Tam; Wald, Laura; Schmidt, Janet; Ramsey, Kelly M; Ruzek, Josef

    2014-01-01

    PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  16. Impulsivity interacts with momentary PTSD symptom worsening to predict alcohol use in male veterans.

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    Black, Anne C; Cooney, Ned L; Sartor, Carolyn E; Arias, Albert J; Rosen, Marc I

    2018-04-11

    Posttraumatic stress disorder (PTSD) is prevalent among veterans who served post-9/11, and co-occurs with problem alcohol and substance use. Studies using ecological momentary assessment have examined the temporal association between time-varying PTSD symptoms and alcohol use. Results suggest individual differences in these associations. We tested hypotheses that alcohol use measured by momentary assessment would be explained by acute increases in PTSD symptoms, and the PTSD-alcohol association would be moderated by trait impulsivity. A sample of 28 male post-9/11-era veterans who reported past-month PTSD symptoms and risky alcohol use were enrolled. On a quasi-random schedule, participants completed three electronic assessments daily for 28 days measuring past 2-h PTSD symptoms, alcohol, and substance use. At baseline, trait impulsivity was measured by the Barratt Impulsiveness Scale. Past-month PTSD symptoms and alcohol use were measured. Using three-level hierarchical models, number of drinks recorded by momentary assessment was modeled as a function of change in PTSD symptoms since last assessment, controlling for lag-1 alcohol and substance use and other covariates. A cross-level interaction tested moderation of the within-time PTSD-alcohol association by impulsivity. A total of 1,522 assessments were completed. A positive within-time association between PTSD symptom change and number of drinks was demonstrated. The association was significantly moderated by impulsivity. Results provide preliminary support for a unique temporal relationship between acute PTSD symptom change and alcohol use among veterans with trait impulsiveness. If replicated in a clinical sample, results may have implications for a targeted momentary intervention.

  17. Improving PTSD Symptoms and Preventing Progression of Subclinical PTSD to an Overt Disorder by Treating Comorbid OSA With CPAP.

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    Ullah, M I; Campbell, Douglas G; Bhagat, Rajesh; Lyons, Judith A; Tamanna, Sadeka

    2017-10-15

    Obstructive sleep apnea (OSA) and posttraumatic stress disorder (PTSD) are common in United States veterans. These conditions often coexist and symptoms overlap. Previous studies reported improvement in PTSD symptoms with continuous positive airway pressure (CPAP) therapy for comorbid OSA but its effect has not been assessed in a non-PTSD cohort. We have prospectively assessed the effect of CPAP therapy on clinical symptom improvement as a function of CPAP compliance levels among PTSD and non-PTSD veterans. Veterans in whom OSA was newly diagnosed were enrolled in our study (n = 192). Assignment to PTSD and non-PTSD cohorts was determined by chart review. Each patient completed the military version of the PTSD Checklist (PCL), Epworth Sleepiness Scale (ESS), and reported nightmare frequency (NMF) at baseline and 6 months after CPAP therapy. CPAP adherence was objectively documented from machine compliance data. We had complete data for 177 veterans (PTSD n = 59, non-PTSD n = 118) for analysis. The mean ages were 51.24 years in the PTSD cohort and 52.36 years in the non-PTSD cohort ( P = .30). In the PTSD cohort, the mean total PCL score (baseline = 66.06, post-CPAP = 61.27, P = .004, d = -0.34) and NMF (baseline = 4.61, post-CPAP = 1.49, P = .0001, d = -0.51) decreased after 6 months of CPAP treatment. Linear regression analysis showed that the CPAP compliance was the only significant predictor for these changes among veterans with PTSD (PCL score: P = .033, R 2 = .65; NMF; P = .03, R 2 = .61). Further analysis by CPAP compliance quartiles in this cohort (Q1 = 0% to 25%, Q2 = 26% to 50%, Q3 = 51% to 75%, Q4 > 75%) revealed that mean total PCL score declined in Q2 (change = -3.91, P = .045, d = 0.43), Q3 (change = -6.6, P = .002, d = 0.59), and Q4 (change = -7.94, P = .037, d = 0.49). In the non-PTSD cohort, the PCL score increased despite CPAP therapy in lower CPAP compliance quartiles Q1 (change = 8.71, P = .0001, d = 0.46) and Q2 (change = 4.51, P = .046, d = 0

  18. PTSD symptomics: network analyses in the field of psychotraumatology

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    Armour, Cherie; Fried, Eiko I.; Olff, Miranda

    2017-01-01

    ABSTRACT Recent years have seen increasing attention on posttraumatic stress disorder (PTSD) research. While research has largely focused on the dichotomy between patients diagnosed with mental disorders and healthy controls — in other words, investigations at the level of diagnoses — recent work has focused on psychopathology symptoms. Symptomics research in the area of PTSD has been scarce so far, although several studies have focused on investigating the network structures of PTSD symptoms. The present special issue of EJPT adds to the literature by curating additional PTSD network studies, each looking at a different aspect of PTSD. We hope that this special issue encourages researchers to conceptualize and model PTSD data from a network perspective, which arguably has the potential to inform and improve the efficacy of therapeutic interventions. PMID:29250305

  19. PTSD symptomics: network analyses in the field of psychotraumatology.

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    Armour, Cherie; Fried, Eiko I; Olff, Miranda

    2017-01-01

    Recent years have seen increasing attention on posttraumatic stress disorder (PTSD) research. While research has largely focused on the dichotomy between patients diagnosed with mental disorders and healthy controls - in other words, investigations at the level of diagnoses - recent work has focused on psychopathology symptoms. Symptomics research in the area of PTSD has been scarce so far, although several studies have focused on investigating the network structures of PTSD symptoms. The present special issue of EJPT adds to the literature by curating additional PTSD network studies, each looking at a different aspect of PTSD. We hope that this special issue encourages researchers to conceptualize and model PTSD data from a network perspective, which arguably has the potential to inform and improve the efficacy of therapeutic interventions.

  20. A cross-cultural validation of the Clinician Administered PTSD Scale for Children and Adolescents in a Dutch population

    NARCIS (Netherlands)

    Diehle, Julia; de Roos, Carlijn; Boer, Frits; Lindauer, Ramón J. L.

    2013-01-01

    Background: Trauma-focused interventions for children could be administered more efficiently and effectively if posttraumatic stress disorder (PTSD) and related symptoms were first investigated by a reliable and valid instrument. The Clinician Administered PTSD Scale for Children and Adolescents

  1. Depression and Dissociation as Predictors of Physical Health Symptoms Among Female Rape Survivors with PTSD

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    Scioli-Salter, Erica R.; Johnides, Benjamin D.; Mitchell, Karen S.; Smith, Brian N.; Resick, Patricia A.; Rasmusson, Ann M.

    2016-01-01

    Objective To investigate the relative contributions of depression and dissociation, as well as PTSD, to physical health symptoms and to examine the relationships among somatic symptoms, PTSD, depression, and dissociation in relation to childhood and adult trauma exposure. Method Cross-sectional data are from 132 female rape survivors with PTSD assessed prior to engaging in a study of trauma-focused cognitive therapy for PTSD. Measures included the Pennebaker Inventory of Limbic Languidness, Clinician Administered PTSD Scale, Beck Depression Inventory, Trauma Symptom Inventory-Dissociation Subscale, Childhood Sexual Abuse Exposure Questionnaire, and Assessing Environments-III-Physical Punishment Scale. Results Hierarchical regression analyses revealed that only dissociative and depression symptoms contributed significantly to physical health symptoms. Similarly, among the subsample of women with either childhood sexual or physical abuse, depression and dissociation were significant predictors of somatic symptoms. However, among women without childhood abuse, only dissociation significantly predicted somatic symptoms. Conclusion Understanding the psychological and biological mechanisms that link childhood versus adult trauma exposure, PTSD, and comorbid depression or dissociation to physical health symptoms may aid development of individualized treatments for the physical and psychological consequences of trauma. PMID:27149157

  2. Aggression inoculates against PTSD symptom severity—insights from armed groups in the eastern DR Congo

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    Tobias Hecker

    2013-05-01

    Full Text Available Background: In the ongoing conflict in the Democratic Republic of the Congo (DRC, combatants are exposed to massive forms of violence and other traumatic stressors. Nevertheless, many combatants do not suffer from trauma-related disorders, although they have experienced numerous traumatizing events. Perceiving aggressive behavior as fascinating and arousing might be a defense against trauma-related disorders in the violent environment of war and conflict. Objective: Thus, in this study we investigated the relationship between the exposure to traumatic stressors, appetitive aggression, and posttraumatic stress disorder (PTSD symptom severity. We hypothesized that cumulative traumatic experiences correlated positively and appetitive aggression negatively with PTSD symptom severity. Method: In total, 105 voluntary male combatants from different armed groups in the eastern DRC took part in this study. In a semistructured interview, respondents were questioned about their exposure to traumatic stressors, the extent of appetitive aggression (Appetitive Aggression Scale and their PTSD symptom severity (PTSD Symptom Scale - Interview. Results: A multiple sequential regression analysis showed that traumatic events were positively related to PTSD symptom severity. For participants with low to medium PTSD symptom severity, appetitive aggression correlated negatively with PTSD symptom severity. Conclusions: The results of this study provide further support for earlier findings that repeated exposure to traumatic stressors cumulatively heightens the risk of PTSD and revealed that appetitive aggression buffers the risk of developing PTSD symptoms under certain circumstances. Thus, the perception of aggressive behavior as fascinating and arousing seem to help combatants to adapt to violent environments but may also be one reason for recurrent failure of reintegration programs for excombatants.

  3. A Prospective Study of Trait Anger and PTSD Symptoms in Police

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    Meffert, Susan M.; Metzler, Thomas J.; Henn-Haase, Clare; McCaslin, Shannon; Inslicht, Sabra; Chemtob, Claude; Neylan, Thomas; Marmar, Charles R.

    2008-01-01

    It is unknown whether anger is a risk factor for the development of posttraumatic stress disorder (PTSD) symptoms, arises as a consequence of PTSD, or both. Two hypotheses were tested in 180 police recruits: Greater trait anger during training will predict greater PTSD symptoms at one year; greater PTSD symptoms at one year will predict greater state anger at one year. Both hypotheses were confirmed, suggesting that trait anger is a risk factor for PTSD symptoms, but that PTSD symptoms are al...

  4. COMT Val158Met polymorphism moderates the association between PTSD symptom severity and hippocampal volume.

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    Hayes, Jasmeet P; Logue, Mark W; Reagan, Andrew; Salat, David; Wolf, Erika J; Sadeh, Naomi; Spielberg, Jeffrey M; Sperbeck, Emily; Hayes, Scott M; McGlinchey, Regina E; Milberg, William P; Verfaellie, Mieke; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

    2017-03-01

    Memory-based alterations are among the hallmark symptoms of posttraumatic stress disorder (PTSD) and may be associated with the integrity of the hippocampus. However, neuroimaging studies of hippocampal volume in individuals with PTSD have yielded inconsistent results, raising the possibility that various moderators, such as genetic factors, may influence this association. We examined whether the catechol-O-methyltransferase (COMT) Val158Met polymorphism, which has previously been shown to be associated with hippocampal volume in healthy individuals, moderates the association between PTSD and hippocampal volume. Recent war veterans underwent structural MRI on a 3 T scanner. We extracted volumes of the right and left hippocampus using FreeSurfer and adjusted them for individual differences in intracranial volume. We assessed PTSD severity using the Clinician-Administered PTSD Scale. Hierarchical linear regression was used to model the genotype (Val158Met polymorphism) × PTSD severity interaction and its association with hippocampal volume. We included 146 white, non-Hispanic recent war veterans (90% male, 53% with diagnosed PTSD) in our analyses. A significant genotype × PTSD symptom severity interaction emerged such that individuals with greater current PTSD symptom severity who were homozygous for the Val allele showed significant reductions in left hippocampal volume. The direction of proposed effects is unknown, thus precluding definitive assessment of whether differences in hippocampal volume reflect a consequence of PTSD, a pre-existing characteristic, or both. Our findings suggest that the COMT polymorphism moderates the association between PTSD and hippocampal volume. These results highlight the role that the dopaminergic system has in brain structure and suggest a possible mechanism for memory disturbance in individuals with PTSD.

  5. Impulsivity facets’ predictive relations with DSM-5 PTSD symptom clusters

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    Roley, Michelle E.; Contractor, Ateka A.; Weiss, Nicole H.; Armour, Cherie; Elhai, Jon D.

    2017-01-01

    Objective Posttraumatic Stress Disorder (PTSD) has a well-established theoretical and empirical relation with impulsivity. Prior research has not used a multidimensional approach for measuring both PTSD and impulsivity constructs when assessing their relationship. Method The current study assessed the unique relationship of impulsivity facets on PTSD symptom clusters among a non-clinical sample of 412 trauma-exposed adults. Results Linear regression analyses revealed that impulsivity facets best accounted for PTSD’s arousal symptoms. The negative urgency facet of impulsivity was most predictive, as it was associated with all of PTSD’s symptom clusters. Sensation seeking did not predict PTSD’s intrusion symptoms, but did predict the other symptom clusters of PTSD. Lack of perseverance only predicted intrusion symptoms, while lack of premeditation only predicted PTSD’s mood/cognition symptoms. Conclusions Results extend theoretical and empirical research on the impulsivity-PTSD relationship, suggesting that impulsivity facets may serve as both risk and protective factors for PTSD symptoms. PMID:27243571

  6. Prevalence of traumatic events and PTSD symptoms among secondary school students in Baghdad

    Directory of Open Access Journals (Sweden)

    Ashraf Al-Hadethe

    2014-11-01

    Full Text Available Background: People in Iraq have been more or less continually exposed to war for more than three decades. Studies with Iraqi participants report high prevalence rates of posttraumatic stress disorder (PTSD and related problems. Methods: The aim of this study is to measure the prevalence of traumatic events and to screen the prevalence of PTSD symptoms among Iraqi secondary school students. Four self-report scales were administered to 403 secondary school students, aged 16–19 (61% male and 31% female. These scales were Baghdad Trauma History Screen, the Scale of Posttraumatic Stress Symptoms (SPTSS, Social Support Scale, and Scale of Religious Coping. Results: The results showed that 84% of participants experienced at least one traumatic event. Of these, 61% fully met the criteria for PTSD; 65% of the females and 58% of the males. PTSD symptoms were correlated with 20 positive religious coping but not with social support. Conclusions: It’s clear that traumatic events were speared widely among the participants and the result showed that the vast majority of participants were exposed to different types of traumatic events. In addition, many of the participants have met full PTSD criteria and others had partial PTSD.

  7. Validación Preliminar de la Escala Infantil de Síntomas del Trastorno de Estrés Postraumático (Child PTSD Symptom Scale, CPSS en Niños/as y Adolescentes Víctimas de Violencia Sexual Preliminary Validation of the Child PTSD Symptom Scale (CPSS in Children and Adolescent Victims of Sexual Violence

    Directory of Open Access Journals (Sweden)

    Patricia Bustos

    2009-11-01

    Full Text Available Se presenta la validación preliminar en Chile de la Escala Infantil de Síntomas del Trastorno de Estrés Postraumático, desarrollada por Foa, Johnson, Feeny y Treadwell (2001 para evaluar el trastorno en niños/as y adolescentes expuestos a situaciones traumáticas, con arreglo a criterios DSM-IV. La muestra fue de 75 niños y adolescentes chilenos de la región del Bío Bío que sufrieron abuso sexual o violación. Los resultados indican una alta consistencia interna, medida con alfa de Cronbach, de 0,916. Asimismo, la consistencia interna de cada subescala es alta. La validez convergente con el criterio de juicio experto es adecuada, con puntuaciones significativas en la escala y todas las subescalas.The preliminary validation in Chile of the Infantile Scale of Symptoms of Post Traumatic Stress Disorder (CPSS is presented. This instrument was developed by Johnson, Feeny, and Treadwell (2001 to evaluate PTSD in children and adolescents exposed to traumatic events, in accordance with DSM-IV criteria. The sample consisted of 75 Chilean children and adolescents of the Bio Bio region of Chile who suffered sexual abuse or rape. The results indicate high internal consistency, measured with Cronbach's alpha, of 0.916. The convergent validity with the criterion of expert judgment is also adequate, with significant punctuations in the scale and all the subscales.

  8. Predictors of PTSD symptoms in Brazilian police officers: the synergy of negative affect and peritraumatic dissociation

    Science.gov (United States)

    Maia, Deborah B.; Marmar, Charles R.; Henn-Haase, Clare; Nóbrega, Augusta; Fiszman, Adriana; Marques-Portella, Carla; Mendlowicz, Mauro V.; Coutinho, Evandro S.F.; Figueira, Ivan

    2013-01-01

    Background Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD). Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. Method In a cross-sectional sample of active duty officers (n = 212), participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. Results Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55% of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. Conclusions The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers. PMID:22189925

  9. PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.

    Science.gov (United States)

    Contractor, Ateka A; Weiss, Nicole H; Dranger, Paula; Ruggero, Camilo; Armour, Cherie

    2017-06-01

    A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder's (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD's symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  10. Evidence for a unique PTSD construct represented by PTSD's D1-D3 symptoms.

    Science.gov (United States)

    Elhai, Jon D; Biehn, Tracey L; Armour, Cherie; Klopper, Jessica J; Frueh, B Christopher; Palmieri, Patrick A

    2011-04-01

    Two models of posttraumatic stress disorder (PTSD) have received the most empirical support in confirmatory factor analytic studies: King, Leskin, King, and Weathers' (1998) Emotional Numbing model of reexperiencing, avoidance, emotional numbing and hyperarousal; and Simms, Watson, and Doebbeling's (2002) Dysphoria model of reexperiencing, avoidance, dysphoria and hyperarousal. These models only differ in placement of three PTSD symptoms: sleep problems (D1), irritability (D2), and concentration problems (D3). In the present study, we recruited 252 women victims of domestic violence and tested whether there is empirical support to separate these three PTSD symptoms into a fifth factor, while retaining the Emotional Numbing and Dysphoria models' remaining four factors. Confirmatory factor analytic findings demonstrated that separating the three symptoms into a separate factor significantly enhanced model fit for the Emotional Numbing and Dysphoria models. These three symptoms may represent a unique latent construct. Implications are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. The relationship between rumination, PTSD, and depression symptoms.

    Science.gov (United States)

    Roley, Michelle E; Claycomb, Meredith A; Contractor, Ateka A; Dranger, Paula; Armour, Cherie; Elhai, Jon D

    2015-07-15

    Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are highly comorbid (Elhai et al., 2008. J. Clin. Psychiatry, 69, (4), 597-602). Rumination is a cognitive mechanism found to exacerbate and maintain both PTSD and MDD (Elwood et al., 2009. Clin. Psychol. Rev. 29, (1), 87-100; Olatunji et al., 2013. Clin. Psychol.: Sci. Pract. 20, (3), 225-257). Assess whether four rumination subtypes moderate the relationship between comorbid PTSD and MDD symptoms. We consecutively sampled patients (N=45) presenting to a mental health clinic using self-report measures of PTSD and MDD symptoms, and rumination in a cross-sectional design. Repetitive rumination moderates the relationship between PTSD and MDD symptoms at one standard deviation above the mean (β=.044, p=.016), while anticipatory rumination moderates the relationship between PTSD and MDD symptoms at mean levels and higher levels of anticipatory rumination (mean β=.030, p=.042; higher β=.060, p=.008). Repetitive and anticipatory rumination should be assessed in the context of comorbid PTSD and MDD and interventions should focus on reducing these rumination subtypes. Results should be replicated with other trauma populations because the number and complexity of traumatic events may impact the assessed symptoms. Constructs should also be assessed longitudinally, in order to establish causality. We are unable to confirm why rumination styles moderated the relationship between PTSD and depression or why counterfactual thinking and problem-focused thinking did not moderate the relationship between the two constructs. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Network analysis of PTSD symptoms following mass violence.

    Science.gov (United States)

    Sullivan, Connor P; Smith, Andrew J; Lewis, Michael; Jones, Russell T

    2018-01-01

    Network analysis is a useful tool for understanding how symptoms interact with one another to influence psychopathology. However, this analytic strategy has not been fully utilized in the PTSD field. The current study utilized network analysis to examine connectedness and strength among PTSD symptoms (employing both partial correlation and regression network analyses) among a community sample of students exposed to the 2007 Virginia Tech shootings. Respondents (N = 4,639) completed online surveys 3-4 months postshootings, with PTSD symptom severity measured via the Trauma Symptom Questionnaire. Data were analyzed via adaptive least absolute shrinkage and selection operator (LASSO) and relative importance networks, as well as Dijkstra's algorithm to identify the shortest path from each symptom to all other symptoms. Relative importance network analysis revealed that intrusive thoughts had the strongest influence on other symptoms (i.e., had many strong connections [highest outdegree]) while computing Dijkstra's algorithm indicated that anger produced the shortest path to all other symptoms (i.e., the strongest connections to all other symptoms). Findings suggest that anger or intrusion likely play a crucial role in the development and maintenance of PTSD (i.e., are more influential within the network than are other symptoms). (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. PTSD and depressive symptoms are linked to DHEAS via personality.

    Science.gov (United States)

    Savic, Danka; Knezevic, Goran; Matic, Gordana; Damjanovic, Svetozar

    2018-06-01

    Research results on dehydroepiandrosterone sulfate ester (DHEAS) in post-traumatic stress disorder (PTSD) are inconsistent. We hypothesized that personality traits could be the confounders of DHEAS levels and disease symptoms, which could in part explain the discrepancy in findings. This study was a part of a broader project in which simultaneous psychological and biological investigations were carried out in hospital conditions. 380 male subjects were categorized in four groups: A) current PTSD (n = 132), B) lifetime PTSD (n = 66), C) trauma controls (n = 101), and D) healthy controls (n = 81), matched by age. The level of DHEAS is significantly lower in the current PTSD group than in trauma controls. All groups significantly differ in personality traits Disintegration and Neuroticism (current PTSD group having the highest scores). DHEAS is related to both PTSD and depressive symptoms; however, Structural Equation Model (SEM) shows that the relations are indirect, realized via their confounder - personality trait Disintegration. According to our project results, DHEAS is the second putative biomarker for trauma-related disorders that fails to fulfil this expectation. It appears to be more directly related to personality than to the disease symptoms (the first one being basal cortisol). Our data promote personality as a biologically based construct with seemingly important role in understanding the mental health status. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Relationships between soldiers' PTSD symptoms and spousal communication during deployment.

    Science.gov (United States)

    Carter, Sarah; Loew, Benjamin; Allen, Elizabeth; Stanley, Scott; Rhoades, Galena; Markman, Howard

    2011-06-01

    Social support, including support from spouses, may buffer against posttraumatic stress disorder (PTSD) symptoms. The current study assessed whether the frequency of spousal communication during a recent deployment, a potentially important source of support for soldiers, was related to postdeployment PTSD symptoms. Data came from 193 married male Army soldiers who returned from military deployment within the past year. For communication modalities conceptualized as delayed (i.e., letters, care packages, and e-mails), greater spousal communication frequency during deployment was associated with lower postdeployment PTSD symptom scores, but only at higher levels of marital satisfaction (p = .009). At lower marital satisfaction, more delayed spousal communication during deployment was associated with more PTSD symptoms (p = .042). For communication modalities conceptualized as interactive (i.e., phone calls, instant messaging, instant messaging with video), the same general direction of effects was seen, but the interaction between communication frequency and marital satisfaction predicting PTSD symptoms did not reach significance. Copyright © 2011 International Society for Traumatic Stress Studies.

  15. Police trauma and cardiovascular disease: association between PTSD symptoms and metabolic syndrome.

    Science.gov (United States)

    Violanti, John M; Fekedulegn, Desta; Hartley, Tara A; Andrew, Michael E; Charles, Luenda E; Mnatsakanova, Anna; Burchfiel, Cecil M

    2006-01-01

    Although prior evidence exists concerning the association between posttraumatic stress disorder (PTSD) and cardiovascular disease, few studies have examined associations of PTSD symptomatology and the metabolic syndrome in the high stress occupation of police work. The metabolic syndrome is a clustering of cardiovascular disease risk factors that have also been independently associated with psychological conditions. The aim of this study was to examine associations between the PTSD symptoms and metabolic syndrome in police officers. A stratified sample of 115 police officers was randomly selected from the Buffalo, NY Police Department. PTSD symptoms were measured with the Impact of Event scale (IES), divided into categories of subclinical, mild, moderate and severe symptom levels. The metabolic syndrome was considered present if three or more of its component parameters (obesity, elevated blood pressure, reduced high density lipoprotein (HDL) cholesterol, elevated triglycerides, and abnormal glucose levels) were present in each officer. Results indicated a significantly increased prevalence of the metabolic syndrome among those officers in the severe PTSD symptom category compared with the lowest PTSD severity category (prevalence ratio (PR) = 3.31, 95% C.I. = 1.19 - 9.22). Adjustment for age did not alter the association appreciably (PR = 3.12, 95% C.I. = 1.15 - 8.50). Adjustment for several demographic and lifestyle factors (age, education, smoking, alcohol intake) reduced the magnitude of the prevalence ratio slightly for the severe versus subclinical PTSD category (PR = 2.69, 95% C.I. = 0. 79 - 9.13), with adjustment for age and education accounting for most of the attenuation (PR = 2.71, 95% C.I. = 0.99 - 7.37). Thus, officers with severe PTSD symptoms were approximately three times more likely to have the metabolic syndrome and education may account for some of this association.

  16. The Association of PTSD Symptom Severity with Localized Hippocampus and Amygdala Abnormalities

    Science.gov (United States)

    Akiki, Teddy J.; Averill, Christopher L.; Wrocklage, Kristen M.; Schweinsburg, Brian; Scott, J. Cobb; Martini, Brenda; Averill, Lynnette A.; Southwick, Steven M.; Krystal, John H.; Abdallah, Chadi G.

    2017-01-01

    Background The hippocampus and amygdala have been repeatedly implicated in the psychopathology of posttraumatic stress disorder (PTSD). While numerous structural neuroimaging studies examined these two structures in PTSD, these analyses have largely been limited to volumetric measures. Recent advances in vertex-based neuroimaging methods have made it possible to identify specific locations of subtle morphometric changes within a structure of interest. Methods In this cross-sectional study, we used high-resolution magnetic resonance imaging to examine the relationship between PTSD symptomatology, as measured using the Clinician Administered PTSD Scale for the DSM-IV (CAPS), and structural shape of the hippocampus and amygdala using vertex-wise shape analyses in a group of combat-exposed US Veterans (N = 69). Results Following correction for multiple comparisons and controlling for age and cranial volume, we found that participants with more severe PTSD symptoms showed an indentation in the anterior half of the right hippocampus and an indentation in the dorsal region of the right amygdala (corresponding to the centromedial amygdala). Post hoc analysis using stepwise regression suggest that among PTSD symptom clusters, arousal symptoms explain most of the variance in the hippocampal abnormality, whereas re-experiencing symptoms explain most of the variance in the amygdala abnormality. Conclusion The results provide evidence of localized abnormalities in the anterior hippocampus and centromedial amygdala in combat-exposed US Veterans suffering from PTSD symptoms. This novel finding provides a more fine-grained analysis of structural abnormalities in PTSD and may be informative for understanding the neurobiology of the disorder. PMID:28825050

  17. The Utility and Comparative Incremental Validity of the MMPI-2 and Trauma Symptom Inventory Validity Scales in the Detection of Feigned PTSD

    Science.gov (United States)

    Efendov, Adele A.; Sellbom, Martin; Bagby, R. Michael

    2008-01-01

    The authors examined the comparative predictive capacity of the Trauma Symptom Inventory (TSI) Atypical Response Scale (ATR) and the standard set of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) fake-bad validity scales (i.e., F, F[subscript B[prime

  18. Parents bereaved by infant death: PTSD symptoms up to 18 years after the loss.

    Science.gov (United States)

    Christiansen, Dorte M; Elklit, Ask; Olff, Miranda

    2013-01-01

    Losing an infant or fetus late in pregnancy, during birth or in the first year of life is a potentially traumatic event for parents. However, little is known about the factors contributing to chronic posttraumatic stress reactions in this population. The present study examined chronic posttraumatic stress disorder (PTSD) symptoms and potential correlates in 634 mothers and fathers up to 18 years (M=3.4 years) after the death of their infant. Members of a private national support organization for parents bereaved by infant death were contacted and asked to participate in the study. Participants filled out a questionnaire package including measures of PTSD (the Harvard Trauma Questionnaire), coping (the Coping Style Questionnaire), perceived social support (the Crisis Support Scale) and attachment (the Revised Adult Attachment Scale). Associations between variables were examined through the use of analyses of variance, correlation analyses and a regression analysis. We found an estimated PTSD prevalence of 12.3%. Type of loss (pre-, peri- or postnatal) did not have any effect on PTSD severity, but lower gestational age was associated with more symptoms. Time since the loss, female sex, attachment avoidance, attachment anxiety, emotion-focused coping, rational coping, feeling let down and social support satisfaction accounted for 42% of the variance in PTSD severity. The study highlights the long-term impact of infant loss and points to attachment, coping and social support as important contributors to the development and maintenance of posttraumatic stress symptoms. © 2013.

  19. The Effects of a Short-term Cognitive Behavioral Group Intervention on Bam Earthquake Related PTSD Symptoms in Adolescents

    Directory of Open Access Journals (Sweden)

    Fatemeh Naderi

    2009-04-01

    Full Text Available "n "n "nObjective :Post traumatic stress disorder (PTSD may be the first reaction after disasters. Many studies have shown the efficacy of cognitive- behavioral therapy in treatment of post traumatic stress disorder. The main objective of this study is to evaluate the effect of group CBT in adolescent survivors of a large scale disaster (Bam earthquake. "n "nMethods: In a controlled trial, we evaluated the efficacy of a short term method of group cognitive-behavioral therapy in adolescent survivors of Bam earthquake who had PTSD symptoms and compared it with a control group. The adolescents who had severe PTSD or other psychiatric disorders that needed pharmacological interventions were excluded. We evaluated PTSD symptoms using Post traumatic Stress Scale (PSS pre and post intervention and compared them with a control group. "n "nResults: 100 adolescents were included in the study and 15 were excluded during the intervention. The mean age of the participants was 14.6±2.1 years. The mean score of total PTSD symptoms and the symptoms of avoidance was reduced after interventions, and was statistically significant. The mean change of re-experience and hyper arousal symptoms of PTSD were not significant. "n "nConclusion: Psychological debriefing and group cognitive behavioral therapy may be effective in reducing some of the PTSD symptoms.

  20. Symptoms of PTSD in Frontline Journalists: A Retrospective Examination of 18 Years of War and Conflict.

    Science.gov (United States)

    Feinstein, Anthony; Osmann, Jonas; Patel, Viral

    2018-01-01

    The objective of the current study was to determine the frequency and severity of symptoms of posttraumatic stress disorder (PTSD) in journalists covering conflict. PTSD data (Impact of Event Scale-Revised) collected over an 18-year period from 684 conflict journalists were analyzed retrospectively for frequency and severity of reexperiencing, avoidance, and arousal symptoms. Conflicts covered were civil wars in the Balkans ( n = 140 journalists), 9/11 attack in New York City ( n = 46), Iraq war ( n = 84), Mexico drug wars ( n = 104), civil war in Syria ( n = 59), Kenya election violence/Al-Shabab terror ( n = 57), state-sanctioned media intimidation in Iran ( n = 114), and the current migration crisis in Europe ( n = 80). The mean age of the sample was 38.59 (SD = 8.35) years, 461 (67%) journalists were men, and the mean duration of conflict work was 13.42 (SD = 7.74) years. The 5 most frequently endorsed symptoms were in the reexperiencing/intrusion category. Mean intrusion (1.31, SD = 0.97), avoidance (1.08, SD = 0.89), and arousal (1.07, SD = 0.96) scores for the entire sample were in the mild range. Being female and less educated independently predicted PTSD symptoms. PTSD phenomenology in a group of conflict journalists with well over a decade of frontline experience is dominated by reexperiencing symptoms. While symptom severity is for the most part mild, group means can obscure those individuals with significantly more severe difficulties.

  1. Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters.

    Science.gov (United States)

    Stanley, Ian H; Hom, Melanie A; Spencer-Thomas, Sally; Joiner, Thomas E

    2017-08-01

    Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model. Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Predictors of PTSD symptoms in caregivers of pediatric burn survivors

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    Lucía Del Carmen Quezada Berumen

    2015-11-01

    Full Text Available Facing a severe injury in the children is one of the most devastating experiences that parents may face. The aim of this study was to explore the role of resilience showed by fathers and mothers of children with burns, the TBSA burned, age at the time of the burn and time since the burn in PTSD symptoms in caregivers. It was a cross-sectional study where fathers, mothers and guardians of 51 burn patients were evaluated. Results showed that the higher strength and confidence in caregivers, less severity in PTSD symptoms. The post-burn reactions of parents and guardians can affect the responses and welfare of their children. Therefore, a better understanding of factors related to the adaptation in caregivers, better attention by health services.

  3. The structure of PTSD symptoms according to DSM-5 and IDC-11 proposal: A multi-sample analysis.

    Science.gov (United States)

    Cyniak-Cieciura, M; Staniaszek, K; Popiel, A; Pragłowska, E; Zawadzki, B

    2017-07-01

    Posttraumatic stress disorder (PTSD) symptoms structure is a subject of ongoing debate since its inclusion in DSM-III classification in 1980. Different research on PTSD symptoms structure proved the better fit of four-factor and five-factor models comparing to the one proposed by DSM-IV. With the publication of DSM-5 classification, which introduced significant changes to PTSD diagnosis, the question arises about the adequacy of the proposed criteria to the real structure of disorder symptoms. Recent analyses suggest that seven-factor hybrid model is the best reflection of symptoms structure proposed to date. At the same time, some researchers and ICD-11 classification postulate a simplification of PTSD diagnosis restricting it to only three core criteria and adding additional diagnostic unit of complex-PTSD. This research aimed at checking symptoms' structure according to well-known and supported four-, five-, six- and seven-factor models based on DSM-5 symptoms and the conceptualization proposed by the ICD-11 as well as examining the relation between PTSD symptoms categories with borderline personality disorder. Four different trauma populations were examined with self-reported Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) measure. The results suggest that six- and seven-factor hybrid model as well as three-factor ICD-11 concept fits the data better than other models. The core PTSD symptoms were less related to borderline personality disorder than other, broader, symptoms categories only in one sample. Combination of ICD-11 simplified PTSD diagnosis with the more complex approach (e.g. basing on a seven-factor model) may be an attractive proposal for both scientists and practitioners, however does not necessarily lower its comorbidity with borderline personality disorder. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Developing the PTSD Checklist-I/F for the DSM-IV (PCL-I/F: Assessing PTSD Symptom Frequency and Intensity in a Pilot Study of Male Veterans with Combat-Related PTSD

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    Ryan Holliday

    2015-02-01

    Full Text Available The widely used posttraumatic stress disorder (PTSD Checklist (PCL has established reliability and validity, but it does not differentiate posttraumatic symptom frequency from intensity as elements of posttraumatic symptom severity. Thus, the PCL in its existing form may not provide a comprehensive appraisal of posttraumatic symptomatology. Because of this, we modified the PCL to create the PCL-I/F that measures both frequency and intensity of PTSD symptoms via brief self-report. To establish validity and internal consistency of the PCL-I/F, we conducted a pilot study comparing PCL-I/F scores to structured diagnostic interview for PTSD (the Clinician Administered PTSD Scale [CAPS] in a male combat veteran sample of 92 participants. Statistically significant correlations between the PCL-I/F and the CAPS were found, suggesting initial validation of the PCL-I/F to screen and assess frequency and intensity of combat-related PTSD symptoms. Implications are discussed for screening and assessment of PTSD related to combat and non-combat trauma.

  5. Symptom structure of PTSD: support for a hierarchical model separating core PTSD symptoms from dysphoria

    NARCIS (Netherlands)

    Rademaker, Arthur R.; van Minnen, Agnes; Ebberink, Freek; van Zuiden, Mirjam; Hagenaars, Muriel A.; Geuze, Elbert

    2012-01-01

    As of yet, no collective agreement has been reached regarding the precise factor structure of posttraumatic stress disorder (PTSD). Several alternative factor-models have been proposed in the last decades. The current study examined the fit of a hierarchical adaptation of the Simms et al. (2002)

  6. Measuring Symptoms of Moral Injury in Veterans and Active Duty Military with PTSD

    Directory of Open Access Journals (Sweden)

    Harold G. Koenig

    2018-03-01

    Full Text Available The Moral Injury Symptom Scale-Military Version (MISS-M is a 45-item measure of moral injury (MI symptoms designed to use in Veterans and Active Duty Military with PTSD. This paper reviews the psychometric properties of the MISS-M identified in a previous report, discusses the rationale for the development of the scale, and explores its possible clinical and research applications. The MISS-M consists of 10 theoretically grounded subscales that assess the psychological and spiritual/religious symptoms of MI: guilt, shame, betrayal, moral concerns, loss of meaning/purpose, difficulty forgiving, loss of trust, self-condemnation, spiritual/religious struggles, and loss of religious faith/hope. The scale has high internal reliability, high test-retest reliability, and a factor structure that can be replicated. The MISS-M correlates strongly with PTSD severity, depressive symptoms, and anxiety symptoms, indicating convergent validity, and is relatively weakly correlated with social, spiritual, and physical health constructs, suggesting discriminant validity. The MISS-M is the first multidimensional scale that measures both the psychological and spiritual/religious symptoms of MI and is a reliable and valid measure for assessing symptom severity in clinical practice and in conducting research that examines the efficacy of treatments for MI in Veterans and Active Duty Military personnel.

  7. Veterans’ PTSD Symptoms and their Partners’ Desired Changes in Key Relationship Domains

    OpenAIRE

    LaMotte, Adam D.; Taft, Casey T.; Reardon, Annemarie F.; Miller, Mark W.

    2015-01-01

    There is a growing literature investigating the connection between veterans’ posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans’ PTSD symptoms and their partners’ perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners’ desired changes in the areas of intimacy, shared activities, and respon...

  8. PTSD symptoms associated with the experiences of psychosis and hospitalisation: a review of the literature.

    Science.gov (United States)

    Berry, Katherine; Ford, Sarah; Jellicoe-Jones, Lorna; Haddock, Gillian

    2013-06-01

    There is evidence of high rates of PTSD in people with psychosis, but the influence that symptoms or hospitalisation have on PTSD in individuals with psychosis is less clear. This paper reviewed studies investigating the prevalence of PTSD induced as a result of the experience of psychosis and hospitalisation and factors that might influence its development. The review included 24 studies, published between 1980 and 2011. Studies showed high levels of PTSD resulting from the trauma of symptoms and/or hospitalisation, with prevalence rates for actual PTSD resulting from these traumas varying from 11% to 67%. In line with studies of PTSD related to other traumatic events, there were inconsistent associations between PTSD and severity of positive and negative symptoms, but there were consistent associations between affective symptoms and PTSD. There were also inconsistent associations between hospital experiences and PTSD. Consistent with the general PTSD literature, there was some evidence that psychosis-related PTSD was associated with trauma history. There was also some emerging evidence that psychological variables, such as appraisals and coping style may influence psychosis-related PTSD. The review highlights the need for further research into psychological mechanisms that could increase vulnerability to psychosis-related PTSD and treatment approaches. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Validity of CBCL-derived PTSD and dissociation scales: further evidence in a sample of neglected children and adolescents.

    Science.gov (United States)

    Milot, Tristan; Plamondon, André; Ethier, Louise S; Lemelin, Jean-Pascal; St-Laurent, Diane; Rousseau, Michel

    2013-05-01

    There is growing evidence that child neglect is an important risk factor for posttraumatic stress disorder (PTSD) and dissociation. Considering that the Child Behavior Checklist (CBCL) is a widely used measure, the possibility of using validated CBCL-derived trauma symptoms scales could be particularly useful to better understand how trauma symptoms develop among neglected children and adolescents. This study examined the factor structure of three CBCL-derived measures of PTSD and dissociation (namely, PTSD scale, Dissociation scale, and PTSD/Dissociation scale) in a sample of 239 neglected children and adolescents aged 6 to 18 years using the latest version of CBCL (CBCL 6-18). Evidence of convergent validity of these scales was also examined for participants aged 12 and under using two well-validated measures of PTSD and Dissociation: the Trauma Symptoms Checklist for Young Children and the Child Dissociation Checklist. Findings suggest that CBCL-derived measures of trauma symptoms, especially PTSD and Dissociations scales, may be of heuristic value in the study of trauma symptomatology in neglected samples. Factor structure and evidence of convergent validity were supported for these two scales. Results also provide further support to the well-established assumption that PTSD and dissociation are two related but different constructs.

  10. Rape survivors' trauma-related beliefs before and after Cognitive processing therapy: associations with PTSD and depression symptoms.

    Science.gov (United States)

    Iverson, Katherine M; King, Matthew W; Cunningham, Katherine C; Resick, Patricia A

    2015-03-01

    This study examined whether cognitive distortions (i.e., assimilated and overaccommodated thoughts) and realistic (i.e., accommodated) thoughts assessed from impact statements written 5-10 years after completing cognitive processing therapy (CPT) accurately predicted posttreatment maintenance or decline in treatment gains during the same period. The sample included 50 women diagnosed with posttraumatic stress disorder (PTSD) secondary to rape who participated in a randomized clinical trial of CPT for PTSD. Cognitions were assessed via coding and analyses of participants' written impact statements at three time points: beginning of treatment, end of treatment, and at 5-10 years follow-up. Primary mental health outcomes were symptoms of PTSD (Clinician-Administered PTSD Scale) and depression (Beck Depression Inventory). Changes in trauma-related beliefs between the end of treatment and long-term follow-up were associated with concomitant changes in PTSD and depression symptoms (effect sizes ranging from r = .35-.54). Declines in accommodated thinking and increases in overaccommodated thinking were associated with elevations in symptomatology. Improvement in accommodated thinking and declines in overaccommodated thinking were associated with lower PTSD and depression symptoms during this same time period. Findings provided support for the role of changes in accommodated and overaccommodated thinking being associated with level of PTSD and depression many years after participating in CPT. Published by Elsevier Ltd.

  11. Negative Emotionality and Disconstraint Influence PTSD Symptom Course via Exposure to New Major Adverse Life Events

    Science.gov (United States)

    Sadeh, Naomi; Miller, Mark W.; Wolf, Erika J.; Harkness, Kate L.

    2015-01-01

    Identifying the factors that influence stability and change in chronic posttraumatic stress disorder (PTSD) is important for improving clinical outcomes. Using a cross-lagged design, we analyzed the reciprocal effects of personality and PTSD symptoms over time and their effects on stress exposure in a sample of 222 trauma-exposed veterans (ages 23 – 68; 90.5% male). Personality functioning and PTSD were measured approximately 4 years apart, and self-reported exposure to major adverse life events during the interim was also assessed. Negative emotionality positively predicted future PTSD symptoms, and this effect was partially mediated by exposure to new events. Constraint (negatively) indirectly affected PTSD via its association with exposure to new events. There were no significant effects of positive emotionality nor did PTSD symptom severity exert influences on personality over time. Results indicate that high negative affect and disconstraint influence the course of PTSD symptoms by increasing exposure to stressful life events. PMID:25659969

  12. Fear conditioned responses and PTSD symptoms in children: Sex differences in fear-related symptoms.

    Science.gov (United States)

    Gamwell, Kaitlyn; Nylocks, Maria; Cross, Dorthie; Bradley, Bekh; Norrholm, Seth D; Jovanovic, Tanja

    2015-11-01

    Fear conditioning studies in adults have found that posttraumatic stress disorder (PTSD) is associated with heightened fear responses and impaired discrimination. The objective of the current study was to examine the association between PTSD symptoms and fear conditioned responses in children from a highly traumatized urban population. Children between 8 and 13 years old participated in a fear conditioning study in addition to providing information about their trauma history and PTSD symptoms. Results showed that females showed less discrimination between danger and safety signals during conditioning compared to age-matched males. In boys, intrusive symptoms were predictive of fear responses, even after controlling for trauma exposure. However, in girls, conditioned fear to the danger cue was predictive of self-blame and fear of repeated trauma. This study suggests there are early sex differences in the patterns of fear conditioning and that these sex differences may translate to differential risk for trauma-related psychopathology. © 2015 Wiley Periodicals, Inc.

  13. Relations between Social Support, PTSD Symptoms, and Substance Use in Veterans

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    Gros, Daniel F.; Flanagan, Julianne C.; Korte, Kristina J.; Mills, Adam C.; Brady, Kathleen T.; Back, Sudie E.

    2016-01-01

    Social support plays a significant role in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). However, there has been little investigation of social support with PTSD and its frequent comorbid conditions and related symptoms. Substance use disorders (SUD) are one set of conditions that have yet to be investigated in combination with PTSD and social support. As compared to civilians, veterans are at increased risk for developing both PTSD and SUD. In this stud...

  14. Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms: a pilot study.

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    Rosaura Polak, A; Witteveen, Anke B; Denys, Damiaan; Olff, Miranda

    2015-03-01

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of PTSD symptoms. Patients (n = 8) with chronic PTSD were randomized to regular TF-CBT or TF-CBT with complementary breathing biofeedback to exposure. PTSD symptoms were measured before, during and after TF-CBT with the Impact of Event Scale-Revised. The results show that breathing biofeedback is feasible and can easily be complemented to TF-CBT. Although PTSD symptoms significantly decreased from pre to post treatment in both conditions, there was a clear trend towards a significantly faster (p = .051) symptom reduction in biofeedback compared to regular TF-CBT. The most important limitation was the small sample size. The hastened clinical improvement in the biofeedback condition supports the idea that breathing biofeedback may be an effective complementary component to exposure in PTSD patients. The mechanism of action of breathing biofeedback may relate to competing working memory resources decreasing vividness and emotionality, similar to eye movement desensitization and reprocessing. Future research is needed to examine this.

  15. Mismatch of Posttraumatic Stress Disorder (PTSD) Symptoms and DSM-IV Symptom Clusters in a Cancer Sample: Exploratory Factor Analysis of the PTSD Checklist-Civilian Version

    Science.gov (United States)

    Shelby, Rebecca A.; Golden-Kreutz, Deanna M.; Andersen, Barbara L.

    2007-01-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms. PMID:16281232

  16. Oxytocin is associated with PTSD's anxious arousal symptoms in Chinese male earthquake survivors

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    Chengqi Cao

    2014-12-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD is a complex and severe mental disorder triggered by exposure to an extraordinarily traumatic event. Human and animal studies have implied the functional role of the oxytocin system in the development of PTSD (Cochran, Fallon, Hill, & Frazier, 2013; Koch et al., 2014; Olff, 2012. Specification of the role of the oxytocin system in the emergence and progression of PTSD symptomatology would provide evidence to inform both theory and clinical practice. Methods: This study examined the association between oxytocin serum levels and PTSD symptoms. A total of 106 Chinese male adults who suffered from the deadly 2008 Wenchuan earthquake participated in this study. PTSD symptoms were measured with PTSD Checklist for DSM-5 (PCL-5, and serum oxytocin level was determined with ELISA oxytocin kits. Results: The mean score on the PCL-5 was 19.30 (SD=14.50, range: 1–65 in this sample. The mean oxytocin level was 101.59 pg/ml (SD=55.89, range: 31.50–286.71. The results indicated that although the oxytocin was not associated with total PTSD symptoms, it was associated with PTSD's anxious arousal symptoms. Conclusion: These findings support that the oxytocin may play an important functional role in the development of PTSD and contribute to the extant knowledge on the genetic basis of the PTSD symptoms.

  17. Event centrality in trauma and PTSD: relations between event relevance and posttraumatic symptoms

    Directory of Open Access Journals (Sweden)

    Thiago Loreto Garcia da Silva

    2016-01-01

    Full Text Available Abstract Recent investigations propose that cognitive characteristics of autobiographical memory significantly interact with Posttraumatic Stress Disorder (PTSD. A traumatic event becoming more or less central in a person’s identity and life story might influence development of the disorder. Studies show high correlations between event centrality (EC and PTSD. Participated in this study 68 treatment-seeking individuals referred to a specialized service for suspected trauma-related disorder: 39 matched criteria for PTSD and 29 were exposed to trauma without PTSD. Our aims were to explore how the groups differ regarding EC, depression, anxiety, posttraumatic cognitions, PTSD symptom severity, and peritraumatic dissociative experience; and how distinctively EC interacts with the measures in each group. The PTSD group had higher scores in all variables but dissociation. EC correlated with overall PTSD symptoms only in the PTSD group and with dissociation only in the no-PTSD group. Findings support a model emphasizing the role of memory processes in PTSD. People exposed to trauma who developed PTSD had the memory of the traumatic experience more intensively governing their sense of self and thus eliciting more negative cognitive reactions. As EC facilitates recollection of the traumatic event, it could also mediate a semantization process that reinforces and increases posttraumatic symptoms.

  18. Negative Trauma Appraisals and PTSD Symptoms in Sri Lankan Adolescents.

    Science.gov (United States)

    Ponnamperuma, Thyagi; Nicolson, Nancy A

    2016-02-01

    The cognitive model posits that negative appraisals play an important role in posttraumatic stress disorder, in children as well as in adults. This study examined correlates of negative appraisals in relation to trauma exposure and their relationship to posttraumatic stress symptoms (PTSS) in 414 Sri Lankan adolescents, aged 12 to 16, living in areas impacted in varying degrees by the 2004 tsunami. In 2008, participants completed measures of negative appraisals, lifetime traumatic events, posttraumatic stress symptoms, internalizing symptoms, ongoing adversity, and social support. The majority (70 %) of the participants reported multiple traumatic events; 25 % met DSM-IV criteria for full or partial PTSD. Adolescents who had experienced more severe events, abusive events, greater cumulative trauma, or greater current adversity reported more negative appraisals. In regression analyses controlling for known risk factors such as female gender, cumulative trauma, ongoing adversity, and low social support, negative appraisals were the best predictor of PTSS, explaining 22 % of the variance. This relationship appeared specific to PTSS, as negative appraisals did not predict internalizing symptoms. Findings confirm the link between negative cognitions concerning traumatic events and persistent PTSS in adolescents, but longitudinal studies are needed to determine whether appraisals contribute to symptom maintenance over time.

  19. Longitudinal Associations Between PTSD Symptoms and Dyadic Conflict Communication Following a Severe Motor Vehicle Accident.

    Science.gov (United States)

    Fredman, Steffany J; Beck, J Gayle; Shnaider, Philippe; Le, Yunying; Pukay-Martin, Nicole D; Pentel, Kimberly Z; Monson, Candice M; Simon, Naomi M; Marques, Luana

    2017-03-01

    There are well-documented associations between posttraumatic stress disorder (PTSD) symptoms and intimate relationship impairments, including dysfunctional communication at times of relationship conflict. To date, the extant research on the associations between PTSD symptom severity and conflict communication has been cross-sectional and focused on military and veteran couples. No published work has evaluated the extent to which PTSD symptom severity and communication at times of relationship conflict influence each other over time or in civilian samples. The current study examined the prospective bidirectional associations between PTSD symptom severity and dyadic conflict communication in a sample of 114 severe motor vehicle accident (MVA) survivors in a committed intimate relationship at the time of the accident. PTSD symptom severity and dyadic conflict communication were assessed at 4 and 16weeks post-MVA, and prospective associations were examined using path analysis. Total PTSD symptom severity at 4weeks prospectively predicted greater dysfunctional communication at 16weeks post-MVA but not vice versa. Examination at the level of PTSD symptom clusters revealed that effortful avoidance at 4weeks prospectively predicted greater dysfunctional communication at 16weeks, whereas dysfunctional communication 4weeks after the MVA predicted more severe emotional numbing at 16weeks. Findings highlight the role of PTSD symptoms in contributing to dysfunctional communication and the importance of considering PTSD symptom clusters separately when investigating the dynamic interplay between PTSD symptoms and relationship functioning over time, particularly during the early posttrauma period. Clinical implications for the prevention of chronic PTSD and associated relationship problems are discussed. Copyright © 2016. Published by Elsevier Ltd.

  20. PTSD symptom severity relates to cognitive and psycho-social dysfunctioning - a study with Congolese refugees in Uganda.

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    Ainamani, Herbert E; Elbert, Thomas; Olema, David K; Hecker, Tobias

    2017-01-01

    Background : In the ongoing conflict in the Democratic Republic of the Congo (DRC), civilians have been heavily exposed to traumatic stressors. Traumatizing experiences cumulatively heighten the risk for trauma-related disorders, and with it affect cognitive and psycho-social functioning. Objectives : We aimed at investigating the association between trauma-related disorders and cognitive and psycho-social functioning and hypothesized that PTSD symptom severity would negatively correlate with executive functioning, working memory and psycho-social functioning in everyday life. Method : In total, 323 Congolese refugees (mean age: 31.3 years) who arrived in the Ugandan Nakivale refugee settlement after January 2012 were assessed regarding their exposure to traumatic events, PTSD symptom severity (posttraumatic symptom scale interview), executive functioning (Tower of London), working memory performance (Corsi block tapping task) and psycho-social dysfunctioning (Luo functioning scale). Results : Hierarchical regression analyses indicated a significant negative association between PTSD symptom severity and working memory (β = -0.32, p  psycho-social functioning in everyday life was positively related with PTSD symptom severity (β = 0.70, p  psycho-social dysfunctioning (β = 0.09, p  > 0.05). Conclusion : Trauma survivors not only suffer from the core PTSD symptoms but also from impaired cognitive functioning. PTSD symptom severity seems furthermore to be related to impaired psycho-social functioning. Our findings suggest that trauma-related mental health problems may heighten the risk for poverty and lack of prospect and further aggravate the consequences of war and conflict.

  1. PTSD symptom severity relates to cognitive and psycho-social dysfunctioning – a study with Congolese refugees in Uganda

    Science.gov (United States)

    Ainamani, Herbert E.; Elbert, Thomas; Olema, David K.; Hecker, Tobias

    2017-01-01

    ABSTRACT Background: In the ongoing conflict in the Democratic Republic of the Congo (DRC), civilians have been heavily exposed to traumatic stressors. Traumatizing experiences cumulatively heighten the risk for trauma-related disorders, and with it affect cognitive and psycho-social functioning. Objectives: We aimed at investigating the association between trauma-related disorders and cognitive and psycho-social functioning and hypothesized that PTSD symptom severity would negatively correlate with executive functioning, working memory and psycho-social functioning in everyday life. Method: In total, 323 Congolese refugees (mean age: 31.3 years) who arrived in the Ugandan Nakivale refugee settlement after January 2012 were assessed regarding their exposure to traumatic events, PTSD symptom severity (posttraumatic symptom scale interview), executive functioning (Tower of London), working memory performance (Corsi block tapping task) and psycho-social dysfunctioning (Luo functioning scale). Results: Hierarchical regression analyses indicated a significant negative association between PTSD symptom severity and working memory (β = –0.32, p psycho-social functioning in everyday life was positively related with PTSD symptom severity (β = 0.70, p psycho-social dysfunctioning (β = 0.09, p > 0.05). Conclusion: Trauma survivors not only suffer from the core PTSD symptoms but also from impaired cognitive functioning. PTSD symptom severity seems furthermore to be related to impaired psycho-social functioning. Our findings suggest that trauma-related mental health problems may heighten the risk for poverty and lack of prospect and further aggravate the consequences of war and conflict. PMID:28326164

  2. PTSD symptom presentation among people with alcohol and drug use disorders: Comparisons by substance of abuse.

    Science.gov (United States)

    Dworkin, Emily R; Wanklyn, Sonya; Stasiewicz, Paul R; Coffey, Scott F

    2018-01-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) commonly co-occur, and there is some evidence to suggest that PTSD symptom clusters are differentially related to various substances of abuse. However, few studies to date have compared PTSD symptom patterns across people with different types of SUDs, and fewer still have accounted for the presence of comorbidity across types of SUDs in understanding symptom patterns. Thus, in the current study, we use a treatment-seeking sample of people with elevated symptoms of PTSD and problem alcohol use to explore differential associations between past-year SUDs with active use and PTSD symptoms, while accounting for the presence of multiple SUDs. When comparing alcohol and drug use disorders, avoidance symptoms were elevated in those with alcohol use disorder, and hyperarousal symptoms were elevated in those who had a drug use disorder. In the subsample with alcohol use disorder, hyperarousal symptoms were elevated in people with co-occurring cocaine use disorders and numbing symptoms were elevated in people with co-occurring sedative/hypnotic/anxiolytic use disorder. These findings provide evidence for different symptom cluster patterns between PTSD and various types of SUDs and highlight the importance of examining the functional relationship between specific substances of abuse when understanding the interplay between PTSD and SUDs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. The relationship between DSM-5 PTSD symptom clusters and alcohol misuse among military veterans.

    Science.gov (United States)

    Walton, Jessica L; Raines, Amanda M; Cuccurullo, Lisa-Ann J; Vidaurri, Desirae N; Villarosa-Hurlocker, Margo C; Franklin, C L

    2018-01-01

    Prior research has revealed a strong relationship between Posttraumatic Stress Disorder (PTSD) and alcohol misuse. However, previous attempts to understand nuanced associations between PTSD symptom clusters and alcohol misuse within military veteran samples have produced mixed results. In an attempt to better understand the associations between PTSD and alcohol misuse, the current study examined the unique relationships between the newly classified Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD symptom clusters and alcohol misuse in an outpatient sample of military veterans seeking treatment for PTSD and Substance Use Disorders. Veterans (N = 100) were administered a brief battery of self-report questionnaires prior to receiving psychological services to aid in diagnostic assessment and treatment planning. Hierarchical regression analyses revealed that PTSD intrusions (cluster B), negative alterations in cognition and mood (cluster D), and arousal/reactivity (cluster E) symptoms were associated with alcohol misuse. The positive association between alcohol misuse and PTSD symptom severity is consistent with a broader body of literature demonstrating the co-occurrence of these disorders, particularly in military samples. Increased alcohol consumption may interfere with current front-line treatments for PTSD, which encourages patients to experience a full range of emotions. As such, future research should explore the impact of substance use on the effectiveness of trauma focused treatments in the alleviation of DSM-5 PTSD symptoms. (Am J Addict 2018;27:23-28). © 2017 American Academy of Addiction Psychiatry.

  4. Social skills deficits as a mediator between PTSD symptoms and intimate partner aggression in returning veterans.

    Science.gov (United States)

    LaMotte, Adam D; Taft, Casey T; Weatherill, Robin P; Eckhardt, Christopher I

    2017-02-01

    This study examined social skills deficits as a mediator of the relationship between posttraumatic stress disorder (PTSD) symptoms and use of intimate partner aggression (IPA) among returning veterans. Prior research with veterans has focused on PTSD-related deficits at the decoding stage of McFall's (1982) social information processing model, and the current study adds to this literature by examining social skills deficits at the decision stage. Participants were 92 male veterans recruited from the greater Boston area. PTSD symptoms were assessed through clinician interview, IPA use was assessed through self- and partner report, and social skills deficits were assessed in a laboratory task in which veterans listened to a series of problematic marital situations and responded with what they would say or do in the situation. Responses were coded for social competency. Bivariate correlations revealed several significant associations among PTSD symptoms, social skills deficits, and use of IPA. When all PTSD symptom clusters were entered into a regression predicting social skills deficits, only emotional numbing emerged as a unique predictor. Finally, social skills deficits significantly mediated the relationship between veterans' PTSD symptoms and use of psychological (but not physical) IPA. Findings extend prior research on McFall's (1982) social information processing model as it relates to veterans' PTSD symptoms and use of IPA. More research is needed to understand the associations between PTSD symptoms and deficits at each individual step of this model. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Prevalence of Traumatic Events and Symptoms of PTSD Among South Africans Receiving an HIV Test.

    Science.gov (United States)

    Kagee, Ashraf; Bantjes, Jason; Saal, Wylene

    2017-11-01

    We studied posttraumatic stress disorder (PTSD) among a community sample of 500 persons seeking an HIV test. The majority of participants (62.2%) indicated that they had experienced at least one index event that qualified for PTSD, even though a small proportion (5%) actually met the diagnostic criteria for the disorder. Of those who reported an index event, 25 (8.04%) met the diagnostic criteria for PTSD while 286 (91.96%) did not. On average about one-third of participants who did not meet the criteria for PTSD endorsed PTSD symptoms whereas more than three quarters of those who met the full criteria did so. No demographic factors were associated with PTSD caseness, except number of traumatic events. These results are discussed in the context of the need to address traumatic events and PTSD among persons who undergo HIV testing.

  6. Peritraumatic tonic immobility is associated with PTSD symptom severity in Brazilian police officers: a prospective study

    Directory of Open Access Journals (Sweden)

    Deborah B. Maia

    2015-03-01

    Full Text Available Objective: Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD. Peritraumatic tonic immobility (PTI, a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132. Methods: Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C, Physical Reactions Subscale (PRS, Peritraumatic Dissociative Experiences Questionnaire (PDEQ, Tonic Immobility Scale (TIS, and Critical Incident History Questionnaire. Results: Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09, whereas for PRS, the increment was 7% (RM = 1.07. As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22. Conclusions: Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers.

  7. Peritraumatic tonic immobility is associated with PTSD symptom severity in Brazilian police officers: a prospective study.

    Science.gov (United States)

    Maia, Deborah B; Nóbrega, Augusta; Marques-Portella, Carla; Mendlowicz, Mauro V; Volchan, Eliane; Coutinho, Evandro S; Figueira, Ivan

    2015-01-01

    Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD). Peritraumatic tonic immobility (PTI), a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132). Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C), Physical Reactions Subscale (PRS), Peritraumatic Dissociative Experiences Questionnaire (PDEQ), Tonic Immobility Scale (TIS), and Critical Incident History Questionnaire. Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09), whereas for PRS, the increment was 7% (RM = 1.07). As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22). Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers.

  8. Impulsive responding in threat and reward contexts as a function of PTSD symptoms and trait disinhibition.

    Science.gov (United States)

    Sadeh, Naomi; Spielberg, Jeffrey M; Hayes, Jasmeet P

    2018-01-01

    We examined current posttraumatic stress disorder (PTSD) symptoms, trait disinhibition, and affective context as contributors to impulsive and self-destructive behavior in 94 trauma-exposed Veterans. Participants completed an affective Go/No-Go task (GNG) with different emotional contexts (threat, reward, and a multidimensional threat/reward condition) and current PTSD, trait disinhibition, and risky/self-destructive behavior measures. PTSD interacted with trait disinhibition to explain recent engagement in risky/self-destructive behavior, with Veterans scoring high on trait disinhibition and current PTSD symptoms reporting the highest levels of these behaviors. On the GNG task, commission errors were also associated with the interaction of PTSD symptoms and trait disinhibition. Specifically, PTSD symptoms were associated with greater commission errors in threat vs. reward contexts for individuals who were low on trait disinhibition. In contrast, veterans high on PTSD and trait disinhibition exhibited the greatest number of commission errors in the multidimensional affective context that involved both threat and reward processing. Results highlight the interactive effects of PTSD and disinhibited personality traits, as well as threat and reward systems, as risk factors for impulsive and self-destructive behavior in trauma-exposed groups. Findings have clinical implications for understanding heterogeneity in the expression of PTSD and its association with disinhibited behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The relation of PTSD symptoms to migraine and headache-related disability among substance dependent inpatients.

    Science.gov (United States)

    McDermott, Michael J; Fulwiler, Joshua C; Smitherman, Todd A; Gratz, Kim L; Connolly, Kevin M; Tull, Matthew T

    2016-04-01

    Despite emerging evidence for the comorbidity of posttraumatic stress disorder (PTSD) and migraine, few studies have examined the relation of PTSD and migraine, particularly among clinical populations at-risk for both conditions (e.g., substance-dependent patients). This study examined the role of PTSD symptoms in migraine and headache-related disability within a sample of 153 substance-dependent inpatients (37.25% female, Mean age 36.46). PTSD symptoms predicted both migraine and headache-related disability above and beyond gender, depression and anxiety symptoms, the experience of a Criterion A traumatic event, and current alcohol use disorder. Findings highlight the strong association between migraine and PTSD symptoms in a unique population at risk for both conditions.

  10. Unique relations between counterfactual thinking and DSM-5 PTSD symptom clusters.

    Science.gov (United States)

    Mitchell, Melissa A; Contractor, Ateka A; Dranger, Paula; Shea, M Tracie

    2016-05-01

    Cognitive models of posttraumatic stress disorder (PTSD) propose that rumination about a trauma may increase particular symptom clusters. One type of rumination, termed counterfactual thinking (CFT), refers to thinking of alternative outcomes for an event. CFT centered on a trauma is thought to increase intrusions, negative alterations in mood and cognitions (NAMC), and marked alterations in arousal and reactivity (AAR). The theorized relations between CFT and specific symptom clusters have not been thoroughly investigated. Also, past work has not evaluated whether the relation is confounded by depressive symptoms, age, gender, or number of traumatic events experienced. The current study examined the unique associations between CFT and PTSD symptom clusters according to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013) in 51 trauma-exposed treatment-seeking individuals. As predicted, CFT was associated with all PTSD symptom clusters. After controlling for common predictors of PTSD symptom severity (i.e., age, depressive symptoms, and number of traumatic life events endorsed), we found CFT to be significantly associated with the intrusion and avoidance symptom clusters but not the AAR or NAMC symptom clusters. Results from the present study provide further support for the role of rumination in specific PTSD symptom clusters above and beyond symptoms of depression, age, and number of traumatic life events endorsed. Future work may consider investigating interventions to reduce rumination in PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  11. Can Post mTBI Neurological Soft Signs Predict Postconcussive and PTSD Symptoms : A Pilot Study

    Science.gov (United States)

    2014-02-01

    disorders , including post - traumatic stress disorder ( PTSD ), but they have scarcely been studied in TBI. The present study measured NSS in the...including post - traumatic stress disorder ( PTSD ), but they have scarcely been studied in TBI. The present study measured NSS in the acute aftermath of...Can Post mTBI Neurological Soft Signs Predict Postconcussive and PTSD Symptoms?: A Pilot Study 5a. CONTRACT NUMBER E-Mail:

  12. Child abuse predicts adult PTSD symptoms among individuals diagnosed with intellectual disabilities

    Directory of Open Access Journals (Sweden)

    Claudia eCatani

    2015-10-01

    Full Text Available Prior research has shown that people with intellectual disabilities (ID are more likely to experience child abuse as well as other forms of traumatic events later in life compared to the general population. Little is known however, about the association of these experiences with adult mental health in individuals with ID. The present study aimed to assess whether child abuse in families and institutions as well as other types of adverse life events, were associated with current Posttraumatic Stress Disorder (PTSD and depression symptoms in individuals with ID. We conducted clinical interviews which included standardized self-report measures for childhood abuse, PTSD, and depression in an unselected sample of 56 persons with a medical diagnosis of intellectual disability who were attending a specialized welfare center. The frequency of traumatic experiences was very high, with physical and emotional child abuse being the most common trauma types. 87% of the persons reported at least one aversive experience on the family violence spectrum, and 50% of the sample reported a violent physical attack later in adulthood. 25% were diagnosed with PTSD and almost 27% had a critical score on the depression scale. Physical and emotional child abuse was positively correlated with the amount of institutional violence and the number of general traumatic events, whereas childhood sexual abuse was related to the experience of intimate partner violence in adult life. A linear regression revealed child abuse in the family to be the only significant independent predictor of PTSD symptom severity. The current findings underscore the central role of child maltreatment in the increased risk of further victimization and in the development of mental health problems in adulthood in individuals with ID. Our data have important clinical implications and demonstrate the need for targeted prevention and intervention programs that are tailored to the specific needs of children

  13. Beyond symptom self-report: use of a computer "avatar" to assess post-traumatic stress disorder (PTSD) symptoms.

    Science.gov (United States)

    Myers, Catherine E; Radell, Milen L; Shind, Christine; Ebanks-Williams, Yasheca; Beck, Kevin D; Gilbertson, Mark W

    2016-11-01

    Post-traumatic stress disorder (PTSD) can occur in the wake of exposure to a traumatic event. Currently, PTSD symptoms are assessed mainly through self-report in the form of questionnaire or clinical interview. Self-report has inherent limitations, particularly in psychiatric populations who may have limited awareness of deficit, reduced attention span, or poor vocabulary and/or literacy skills. Diagnosis and evaluation of treatment efficacy would be aided by behavioral measures. A viable alternative may be virtual environments, in which the participant guides an on-screen "avatar" through a series of onscreen events meant to simulate real-world situations. Here, a sample of 82 veterans, self-assessed for PTSD symptoms was administered such a task, in which the avatar was confronted with situations that might evoke avoidant behavior, a core feature of PTSD. Results showed a strong correlation between PTSD symptom burden and task performance; in fact, the ability to predict PTSD symptom burden based on simple demographic variables (age, sex, combat exposure) was significantly improved by adding task score as a predictor variable. The results therefore suggest that virtual environments may provide a new way to assess PTSD symptoms, while avoiding at least some of the limitations associated with symptom self-report, and thus might be a useful complement to questionnaire or clinical interview, potentially facilitating both diagnosis and evaluation of treatment efficacy.

  14. Type D personality and the development of PTSD symptoms: a prospective study.

    Science.gov (United States)

    Rademaker, Arthur R; van Zuiden, Mirjam; Vermetten, Eric; Geuze, Elbert

    2011-05-01

    Psychological trauma and prolonged stress may cause mental disorders such as posttraumatic stress disorder (PTSD). Pretrauma personality is an important determinant of posttraumatic adjustment. Specifically, trait neuroticism has been identified as a risk factor for PTSD. Additionally, the combination of high negative affectivity or neuroticism with marked social inhibition or introversion, also called Type D personality (Denollet, 2000), may compose a risk factor for PTSD. There is no research available that examined pretrauma Type D personality in relation to PTSD. The present study examined the predictive validity of the Type D personality construct in a sample of Dutch soldiers. Data were collected prior to and 6 months after military deployment to Afghanistan. Separate multiple regression analyses were performed to examine the predictive validity of Type D personality. First, Type D personality was defined as the interaction between negative affect and social inhibition (Na × Si). In a second analysis, Type D was defined following cutoff criteria recommended by Denollet (2000). Results showed that negative affectivity was a significant predictor of PTSD symptoms. Social inhibition and the interaction Na × Si did not add to the amount of explained variance in postdeployment PTSD scores over the effects of childhood abuse, negative affectivity, and prior psychological symptoms. A second analysis showed that Type D personality (dichotomous) did not add to the amount of explained variance in postdeployment PTSD scores over the effects of childhood abuse, and prior psychological symptoms. Therefore, Type D personality appears to be of limited value to explain development of combat-related PTSD symptoms.

  15. Virtual Reality Exposure Therapy for PTSD Symptoms after a Road Accident: An Uncontrolled Case Series

    Science.gov (United States)

    Beck, J. Gayle; Palyo, Sarah A.; Winer, Eliot H.; Schwagler, Brad E.; Ang, Eu Jin

    2007-01-01

    This report examined whether Virtual Reality Exposure Therapy (VRET) could be used in the treatment of posttraumatic stress disorder (PTSD) symptoms in the aftermath of a serious motor vehicle accident. Six individuals reporting either full or severe subsyndromal PTSD completed 10 sessions of VRET, which was conducted using software designed to…

  16. PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash Injury.

    Science.gov (United States)

    Andersen, Tonny Elmose; Elklit, Ask; Brink, Ole

    2013-01-01

    The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury. The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury. Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation. A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation. Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.

  17. Negative appraisals and fear extinction are independently related to PTSD symptoms.

    Science.gov (United States)

    Zuj, Daniel V; Palmer, Matthew A; Gray, Kate E; Hsu, Chia-Ming K; Nicholson, Emma L; Malhi, Gin S; Bryant, Richard A; Felmingham, Kim L

    2017-08-01

    Considerable research has revealed impaired fear extinction to be a significant predictor of PTSD. Fear extinction is also considered the primary mechanism of exposure therapy, and a critical factor in PTSD recovery. The cognitive theory of PTSD proposes that symptoms persist due to excessive negative appraisals about the trauma and its sequelae. Research has not yet examined the relationship between fear extinction and negative appraisals in PTSD. A cross-sectional sample of participants with PTSD (n =21), and trauma-exposed controls (n =33) underwent a standardized differential fear conditioning and extinction paradigm, with skin conductance response (SCR) amplitude serving as the index of conditioned responses. The Posttraumatic Cognitions Inventory (PTCI) was used to index catastrophic negative appraisals. Participants with PTSD demonstrated a slower decrease in overall SCR responses during extinction and greater negative appraisals compared to the group. A moderation analysis revealed that both negative trauma-relevant appraisals and fear extinction learning were independently associated with PTSD symptoms, but there was no moderation interaction. The current study was limited by a modest sample size, leading to the inclusion of participants with subclinical PTSD symptoms. Further, the current study only assessed fear extinction learning; including a second day extinction recall task may show alternative effects. These findings indicate that negative appraisals and fear extinction did not interact, but had independent relationships with PTSD symptoms. Here we show for the first time in an experimental framework that negative appraisals and fear extinction play separate roles in PTSD symptoms. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Latent-level relations between DSM-5 PTSD symptom clusters and problematic smartphone use.

    Science.gov (United States)

    Contractor, Ateka A; Frankfurt, Sheila B; Weiss, Nicole H; Elhai, Jon D

    2017-07-01

    Common mental health consequences following the experience of potentially traumatic events include Posttraumatic Stress Disorder (PTSD) and addictive behaviors. Problematic smartphone use is a newer manifestation of addictive behaviors. People with anxiety severity (such as PTSD) may be at risk for problematic smartphone use as a means of coping with their symptoms. Unique to our knowledge, we assessed relations between PTSD symptom clusters and problematic smartphone use. Participants ( N = 347), recruited through Amazon's Mechanical Turk (MTurk), completed measures of PTSD and smartphone addiction. Results of the Wald tests of parameter constraints indicated that problematic smartphone use was more related to PTSD's negative alterations in cognitions and mood (NACM) than to PTSD's avoidance factor, Wald χ 2 (1, N = 347) = 12.51, p = 0.0004; and more to PTSD's arousal compared to PTSD's avoidance factor, Wald χ 2 (1, N = 347) = 14.89, p = 0.0001. Results indicate that problematic smartphone use is most associated with negative affect and arousal among trauma-exposed individuals. Implications include the need to clinically assess problematic smartphone use among trauma-exposed individuals presenting with higher NACM and arousal severity; and targeting NACM and arousal symptoms to mitigate the effects of problematic smartphone use.

  19. PTSD symptoms and perception of cognitive problems: The roles of posttraumatic cognitions and trauma coping self-efficacy.

    Science.gov (United States)

    Samuelson, Kristin W; Bartel, Alisa; Valadez, Racquel; Jordan, Joshua T

    2017-09-01

    Posttraumatic stress disorder (PTSD) is associated with mild neurocognitive deficits, yet clients often complain of cognitive problems that exceed what their objective performance demonstrates. In addition, PTSD is associated with negative appraisals about the self, traumatic event, and one's ability to cope. This study examined posttraumatic cognitions as a moderator, and trauma coping self-efficacy as a mediator, of the relationship between PTSD symptoms and self-report of cognitive problems. A sample of 268 trauma-exposed adults completed the PTSD Checklist for DSM-5, the Posttraumatic Cognitions Inventory, the Trauma Coping Self-Efficacy Scale, the Cognitive Self-Report Questionnaire, and the Quality of Life Scale. Negative self-appraisals was a significant moderator in the relationship between PTSD symptoms and perception of cognitive problems (β = -.252, p = .001). In participants with high levels of negative posttraumatic cognitions, perception of cognitive problems was high regardless of PTSD symptom level. In a mediator analysis, there was a significant indirect effect of trauma coping self-efficacy (b = .125, 95% CI [.088, .172]). Finally, there was evidence of moderated mediation, such that trauma coping self-efficacy was a mediator only when posttraumatic cognitions were low or average. Results indicate that posttraumatic appraisals and coping self-efficacy play significant roles in perception of cognitive problems following trauma. Clinically, in patients for which there is a perception of cognitive impairment that is not borne out in neuropsychological testing, cognitive-behavioral therapy focused on altering negative self-perceptions and appraisals may be beneficial. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  20. The role of perceived threat in the emergence of PTSD and depression symptoms during warzone deployment.

    Science.gov (United States)

    Lancaster, Cynthia L; Cobb, Adam R; Lee, Han-Joo; Telch, Michael J

    2016-07-01

    Numerous studies have shown that level of exposure to combat-related stressors is a robust risk factor for posttraumatic stress disorder (PTSD) and depression among military personnel deployed to a warzone. Threat perception of warzone experiences assessed retrospectively has been consistently linked to increased risk for PTSD and depression months or even years after returning from deployment. However, little is known about concurrent relations between perceived threat, deployment stress, and stress-related symptoms during deployment. Using a novel in-theater web-based assessment system, we investigated the unique and joint contribution of threat perception and deployment stressors in predicting the emergence of PTSD and depression symptoms during deployment. Soldiers (N = 150) completed assessments of deployment stressors, perceived threat, PTSD symptoms, and depression symptoms throughout deployment to Iraq. Results revealed that perceived threat potentiated the increase in PTSD symptoms as a result of increases in deployment stressors. In contrast, perceived threat, but not warzone stressors, uniquely predicted depression symptoms. Results highlight the important role of threat perception as a risk marker for the acute experience of depression and PTSD symptoms during deployment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  1. Association between facial expression and PTSD symptoms among young children exposed to the Great East Japan Earthquake: a pilot study.

    Science.gov (United States)

    Fujiwara, Takeo; Mizuki, Rie; Miki, Takahiro; Chemtob, Claude

    2015-01-01

    "Emotional numbing" is a symptom of post-traumatic stress disorder (PTSD) characterized by a loss of interest in usually enjoyable activities, feeling detached from others, and an inability to express a full range of emotions. Emotional numbing is usually assessed through self-report, and is particularly difficult to ascertain among young children. We conducted a pilot study to explore the use of facial expression ratings in response to a comedy video clip to assess emotional reactivity among preschool children directly exposed to the Great East Japan Earthquake. This study included 23 child participants. Child PTSD symptoms were measured using a modified version of the Parent's Report of the Child's Reaction to Stress scale. Children were filmed while watching a 2-min video compilation of natural scenes ('baseline video') followed by a 2-min video clip from a television comedy ('comedy video'). Children's facial expressions were processed the using Noldus FaceReader software, which implements the Facial Action Coding System (FACS). We investigated the association between PTSD symptom scores and facial emotion reactivity using linear regression analysis. Children with higher PTSD symptom scores showed a significantly greater proportion of neutral facial expressions, controlling for sex, age, and baseline facial expression (p software, has the potential to index emotional numbing in young children. This pilot study adds to the emerging literature on using experimental psychopathology methods to characterize children's reactions to disasters.

  2. Somatoform dissociation and posttraumatic stress syndrome - two sides of the same medal? A comparison of symptom profiles, trauma history and altered affect regulation between patients with functional neurological symptoms and patients with PTSD.

    Science.gov (United States)

    Kienle, Johanna; Rockstroh, Brigitte; Bohus, Martin; Fiess, Johanna; Huffziger, Silke; Steffen-Klatt, Astrid

    2017-07-11

    History of traumatic experience is common in dissociative disorder (DD), and similarity of symptoms and characteristics between DD and posttraumatic stress disorder (PTSD) encouraged to consider DD as trauma-related disorder. However, conceptualization of DD as a trauma-related syndrome would critically affect diagnosis and treatment strategies. The present study addressed overlap and disparity of DD and PTSD by directly comparing correspondence of symptoms, adverse/traumatic experience, and altered affect regulation between patients diagnosed with dissociative disorder (characterized by negative functional neurological symptoms) and patients diagnosed with PTSD. Somatoform and psychoform dissociation, symptoms of posttraumatic stress, general childhood adversities and lifetime traumata, and alexithymia as index of altered affect regulation were screened with standardized questionnaires and semi-structured interviews in 60 patients with DD (ICD-codes F44.4, F44.6, F44.7), 39 patients with PTSD (ICD-code F43.1), and 40 healthy comparison participants (HC). DD and PTSD patients scored higher than HC on somatoform and psychoform dissociative symptom scales and alexithymia, and reported more childhood adversities and higher trauma load. PTSD patients reported higher symptom severity and more traumata than DD patients. Those 20 DD patients who met criteria of co-occuring PTSD did not differ from PTSD patients in the amount of reported symptoms of somatoform dissociation, physical and emotional childhood adversities and lifetime traumata, while emotional neglect/abuse in childhood distinguished DD patients with and without co-occuring PTSD (DD patients with co-occuring PTSD reporting more emotional maltreatment). The pattern of distinctive somatoform and psychoform dissociative symptom severity, type of childhood and lifetime traumata, and amount of alexithymia suggests that DD and PTSD are distinctive syndromes and, therefore, challenges the conceptualization of DD as

  3. Neuroticism Increases PTSD Symptom Severity by Amplifying the Emotionality, Rehearsal, and Centrality of Trauma Memories.

    Science.gov (United States)

    Ogle, Christin M; Siegler, Ilene C; Beckham, Jean C; Rubin, David C

    2017-10-01

    Although it is well established that neuroticism increases the risk of posttraumatic stress disorder (PTSD), little is known about the mechanisms that promote PTSD in individuals with elevated levels of neuroticism. Across two studies, we examined the cognitive-affective processes through which neuroticism leads to greater PTSD symptom severity. Community-dwelling adults with trauma histories varying widely in severity (Study 1) and clinically diagnosed individuals exposed to DSM-IV-TR A1 criterion traumas (Study 2) completed measures of neuroticism, negative affectivity, trauma memory characteristics, and PTSD symptom severity. Longitudinal data in Study 1 showed that individuals with higher scores on two measures of neuroticism assessed approximately three decades apart in young adulthood and midlife reported trauma memories accompanied by more intense physiological reactions, more frequent involuntary rehearsal, and greater perceived centrality to identity in older adulthood. These properties of trauma memories were in turn associated with more severe PTSD symptoms. Study 2 replicated these findings using cross-sectional data from individuals with severe trauma histories and three additional measures of neuroticism. Results suggest that neuroticism leads to PTSD symptoms by magnifying the emotionality, availability, and centrality of trauma memories as proposed in mnemonic models of PTSD. © 2016 Wiley Periodicals, Inc.

  4. New DSM-5 PTSD guilt and shame symptoms among Italian earthquake survivors: Impact on maladaptive behaviors.

    Science.gov (United States)

    Carmassi, Claudia; Bertelloni, Carlo Antonio; Gesi, Camilla; Conversano, Ciro; Stratta, Paolo; Massimetti, Gabriele; Rossi, Alessandro; Dell'Osso, Liliana

    2017-05-01

    Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic symptoms among Italian survivors to a massive earthquake and their possible correlation with PTSD and maladaptive behaviors. 869 residents of the town of L'Aquila exposed to the earthquake of April 6th, 2009 were investigated by the Trauma and Loss Spectrum-Self Report (TALS-SR) with particular attention to guilt and shame feelings. DSM-5 symptomatological PTSD was reported by 41.7% of survivors, further 11.6% endorsed at least one guilt/shame symptoms, with significantly higher rates of endorsement were in PTSD respect to No-PTSD subjects, and in the subgroup with at least one maladaptive behavior respect to those with none. There was a significant main effects of PTSD and at least one guilt/shame symptom on TALS-SR symptomatological domains. Mean TALS-SR Maladaptive coping domain score appeared significantly higher in the subgroup with at least one guilt/shame symptom. Further study are needed to investigate guilt and shame feelings in survivors to a natural disaster. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. PTSD symptoms and onset of neurologic disease in elderly trauma survivors.

    Science.gov (United States)

    Grossman, A B; Levin, B E; Katzen, H L; Lechner, S

    2004-08-01

    In this case study, we present two Holocaust survivors who appeared to have adapted well post-trauma, but developed severe PTSD symptomatology following the onset of neurologic illness in later life. These individuals were referred fro neuropsychological evaluations by their treating neurologists to assess their levels of cognitive functioning. We present the neuropsychological findings, and discuss possible mechanisms for emergence of PTSD symptoms. These case studies demonstrate the need for systematic research to further investigate the potential relationship between aging, degenerative disease, and PTSD symptoms in elderly trauma survivors.

  6. The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.

    Science.gov (United States)

    Choi, Kristen R; Seng, Julia S; Briggs, Ernestine C; Munro-Kramer, Michelle L; Graham-Bermann, Sandra A; Lee, Robert C; Ford, Julian D

    2017-12-01

    The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broader set of dissociation symptoms. A sample of treatment-seeking, trauma-exposed adolescents 12 to 16 years old (N = 3,081) from the National Child Traumatic Stress Network Core Data Set was used to meet the study objectives. Two models of PTSD/dissociation co-occurrence were estimated using latent class analysis, one with 2 dissociation symptoms and the other with 10 dissociation symptoms. After model selection, groups within each model were compared on demographics, trauma characteristics, and psychopathology. Model A, the depersonalization/derealization model, had 5 classes: dissociative subtype/high PTSD; high PTSD; anxious arousal; dysphoric arousal; and a low symptom/reference class. Model B, the expanded dissociation model, identified an additional class characterized by dissociative amnesia and detached arousal. These 2 models provide new information about the specific ways PTSD and dissociation co-occur and illuminate some differences between adult and adolescent trauma symptom expression. A dissociative subtype of PTSD can be distinguished from PTSD alone in adolescents, but assessing a wider range of dissociative symptoms is needed to fully characterize adolescent traumatic stress responses. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Veterans’ PTSD Symptoms and their Partners’ Desired Changes in Key Relationship Domains

    Science.gov (United States)

    LaMotte, Adam D.; Taft, Casey T.; Reardon, Annemarie F.; Miller, Mark W.

    2015-01-01

    There is a growing literature investigating the connection between veterans’ posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans’ PTSD symptoms and their partners’ perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners’ desired changes in the areas of intimacy, shared activities, and responsibilities. The sample consisted of 249 male veterans of different service eras and their female partners. Results indicated that veterans’ PTSD symptoms were associated with greater desired changes from their partners in the veterans’ intimacy behaviors and participation in shared activities. When examining the contribution of each symptom cluster individually, only the veterans’ emotional numbing symptoms emerged as a significant unique predictor and were associated with partners’ desired changes in intimacy. The findings suggest that intimacy and shared activities may be relevant areas to address in PTSD treatment for veterans and their partners, and highlight the particular significance of emotional numbing symptoms to intimacy in veterans’ relationships. PMID:26010109

  8. Ten-Year Follow-Up Study of PTSD Diagnosis, Symptom Severity, and Psychosocial Indices in Aging Holocaust Survivors

    Science.gov (United States)

    Schmeidler, James; Labinsky, Ellen; Bell, Amanda; Morris, Adam; Zemelman, Shelly; Grossman, Robert A.

    2009-01-01

    Objective We performed a longitudinal study of Holocaust survivors with and without PTSD by assessing symptoms and other measures at two intervals, approximately 10 years apart. Method The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up. Results There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of Delayed Onset PTSD developed between the Time 1 and Time 2. Self-report ratings at both assessments revealed a worsening of trauma related symptoms over time in persons without PTSD at Time 1, but an improvement in those with PTSD at Time 1. Conclusion The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of Delayed Onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD. PMID:18785948

  9. Assessing PTSD in the military

    DEFF Research Database (Denmark)

    Karstoft, Karen-Inge; Andersen, Søren B.; Nielsen, Anni Brit Sternhagen

    2017-01-01

    Since 1998, soldiers deployed to war zones with the Danish Defense (≈31,000) have been invited to fill out a questionnaire on post-mission reactions. This provides a unique data source for studying the psychological toll of war. Here, we validate a measure of PTSD-symptoms from the questionnaire...... including symptoms of PTSD (PRIM-PTSD). They also filled out a validated measure of PTSD-symptoms in DSM-IV, the PTSD-checklist (PCL). We tested reliability of PRIM-PTSD by estimating Cronbach's alpha, and tested validity by correlating items, clusters, and overall scale with corresponding items in the PCL....... Furthermore, we conducted two confirmatory factor analytic models to test the factor structure of PRIM-PTSD, and tested measurement invariance of the selected model. Finally, we established a screening and a clinical cutoff score by application of ROC analysis. We found high internal consistency of the PRIM-PTSD...

  10. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2015-03-01

    Full Text Available Background: Three intrinsic connectivity networks in the brain, namely the central executive, salience, and default mode networks, have been identified as crucial to the understanding of higher cognitive functioning, and the functioning of these networks has been suggested to be impaired in psychopathology, including posttraumatic stress disorder (PTSD. Objective: 1 To describe three main large-scale networks of the human brain; 2 to discuss the functioning of these neural networks in PTSD and related symptoms; and 3 to offer hypotheses for neuroscientifically-informed interventions based on treating the abnormalities observed in these neural networks in PTSD and related disorders. Method: Literature relevant to this commentary was reviewed. Results: Increasing evidence for altered functioning of the central executive, salience, and default mode networks in PTSD has been demonstrated. We suggest that each network is associated with specific clinical symptoms observed in PTSD, including cognitive dysfunction (central executive network, increased and decreased arousal/interoception (salience network, and an altered sense of self (default mode network. Specific testable neuroscientifically-informed treatments aimed to restore each of these neural networks and related clinical dysfunction are proposed. Conclusions: Neuroscientifically-informed treatment interventions will be essential to future research agendas aimed at targeting specific PTSD and related symptoms.

  11. Self-Compassion as a prospective predictor of PTSD symptom severity among trauma-exposed U.S. Iraq and Afghanistan war veterans.

    Science.gov (United States)

    Hiraoka, Regina; Meyer, Eric C; Kimbrel, Nathan A; DeBeer, Bryann B; Gulliver, Suzy Bird; Morissette, Sandra B

    2015-04-01

    U.S. combat veterans of the Iraq and Afghanistan wars have elevated rates of posttraumatic stress disorder (PTSD) compared to the general population. Self-compassion, characterized by self-kindness, a sense of common humanity when faced with suffering, and mindful awareness of suffering, is a potentially modifiable factor implicated in the development and maintenance of PTSD. We examined the concurrent and prospective relationship between self-compassion and PTSD symptom severity after accounting for level of combat exposure and baseline PTSD severity in 115 Iraq and Afghanistan war veterans exposed to 1 or more traumatic events during deployment. PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-IV (CAPS-IV) at baseline and 12 months (n =101). Self-compassion and combat exposure were assessed at baseline via self-report. Self-compassion was associated with baseline PTSD symptoms after accounting for combat exposure (β = -.59; p Afghanistan war veterans. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

  12. Risk factors for DSM 5 PTSD symptoms in Israeli civilians during the Gaza war.

    Science.gov (United States)

    Gil, Sharon; Weinberg, Michael; Or-Chen, Keren; Harel, Hila

    2015-04-01

    In light of the current modifications presented in the diagnostic criteria of posttraumatic stress disorder (PTSD) in the DSM 5, this study aimed at revalidating well-known PTSD risk factors, including gender, peritraumatic dissociation, social support, level of threat, and trait tendency for forgiveness. Five hundred and one Israeli civilians were assessed during real-time exposure to missile and rocket fire at the eruption of the Gaza war. Assessments took place approximately one to 2 weeks after the beginning of this military operation, relying on web administration of the study, which allowed simultaneous data collection from respondents in the three regions in Israel that were under attack. A structural equation model design revealed that higher levels of forgiveness toward situations were associated with fewer PTSD symptoms, whereas peritraumatic dissociation and high levels of objective and subjective threat were positively associated with PTSD symptoms. Additionally, females were at higher risk for PTSD symptoms than males. The findings of this study provide further evidence for the importance of directing preventive attention to those vulnerable to the development of elevated levels of PTSD symptoms. Theoretical and clinical implications of the findings are discussed.

  13. Predicting symptom clusters of posttraumatic stress disorder (PTSD) in Croatian war veterans: the role of socio-demographics, war experiences and subjective quality of life.

    Science.gov (United States)

    Lončar, Mladen; Plašć, Ivana Dijanić; Bunjevac, Tomislav; Hrabač, Pero; Jakšić, Nenad; Kozina, Slavica; Henigsberg, Neven; Sagud, Marina; Marčinko, Darko

    2014-09-01

    Previous research has documented multiple chains of risk in the development of PTSD among war veterans. However, existing studies were mostly carried out in the West, while they also did not analyze specific symptom clusters of PTSD. The aim of this study was to examine the role of socio-demographic characteristics, war experiences and subjective quality of life in the prediction of three clusters of PTSD symptoms (i.e., avoidance, intrusion, hyperarousal). This study comprised 184 male participants who have survived war imprisonment during the Croatian Homeland War in the period from 1991 to 1995. The data was collected through several self-report measuring instruments: questionnaire on socio-demographic data, war experiences (Questionnaire on Traumatic Combat and War Experiences), subjective quality of life (WHO-Five Well-being Index), and PTSD symptoms (Impact of Events Scale - Revised). The level of three symptom clusters of PTSD was found to be moderate to high, as indicated by the scores on the IES-R. Results of the three hierarchical regression analyses showed the following: traumatic war experiences were significant predictors of avoidance symptoms; traumatic war experiences and subjective quality of life were significant predictors of hyperarousal symptoms; and traumatic war experiences, material status and subjective quality of life were significant predictors of intrusion symptoms. These findings support the widespread belief that the development of war-related PTSD is accounted for by multiple chains of risk, while traumatic war experiences seem to be the only predictor of all three symptom clusters. Future research should put more emphasis on specific PTSD symptom clusters when investigating the etiopathogenesis of this disorder among war-affected populations.

  14. Investigating Relationships Between PTSD Symptom Clusters Within Virtual Reality Exposure Therapy for OEF/OIF Veterans.

    Science.gov (United States)

    Maples-Keller, Jessica L; Price, Matthew; Rauch, Sheila; Gerardi, Maryrose; Rothbaum, Barbara O

    2017-03-01

    Several cognitive behavioral therapeutic approaches have been demonstrated to be effective in reducing post-traumatic stress disorder (PTSD) symptoms (Foa, Keane, Friedman, & Cohen, 2008). The bulk of PTSD treatment research has relied on pre-post designs, which are limited in their ability to investigate the therapeutic process over time. The present study investigated the relations between PTSD symptom clusters using symptom assessment at pretreatment, midtreatment, and posttreatment using cross-lagged panel design over the course of Virtual Reality Exposure (VRE) treatment. Participants were 156 Iraq and/or Afghanistan veterans who met DSM-IV criteria for PTSD due to military trauma. Using structural equation modeling, the final reexperiencing model demonstrated good fit, χ 2 (34)=39.95, p=.22; RMSEA=.034, 90% CI: [0.00, 0.07], CFI=.993, and results suggested that reexperiencing at pretreatment demonstrated a significant effect on numbing, avoidance, hyperarousal at midtreatment, and reexperiencing symptoms at midtreatment demonstrate a significant effect on each of the three symptom clusters at posttreatment. These findings suggest that reexperiencing symptoms are indeed a key aspect of the therapeutic process within exposure therapy for PTSD. Additional research examining the impact of reexperiencing-focused intervention strategies on treatment outcomes is warranted. Copyright © 2016. Published by Elsevier Ltd.

  15. Is ideology a risk factor for PTSD symptom severity among Israeli political evacuees?

    Science.gov (United States)

    Oren, Lior; Possick, Chaya

    2010-08-01

    To study the role of ideology in situations of extreme stress, a research questionnaire, measuring posttraumatic stress disorder (PTSD), settlement ideology (the importance of Jewish settlement in Gaza), and type of evacuation was administered to 326 Jewish residents who were evacuated from Gaza settlements by the Israeli government. Forty percent of the participants met the criteria of probable PTSD. Forcibly evicted individuals reported higher levels of settlement ideology and higher levels of PTSD symptom severity compared to voluntarily evacuated individuals. Contrary to previous studies, ideology was found to be positively associated with PTSD symptom severity. The results are explained by the conservation of resources and terror management theories. Theoretical and practical implications are discussed.

  16. Preventing PTSD with oxytoxin : Effects of oxytocin administration on fear neurocircuitry and PTSD symptom development in recently trauma-exposed individuals

    NARCIS (Netherlands)

    Frijling, J.L.

    2017-01-01

    The overall aim of the current PhD-thesis was to investigate the potential of intranasal oxytocin administration as early preventive intervention for PTSD, by assessing the effects of intranasal oxytocin early after trauma on functioning of the fear neurocircuitry and on PTSD symptom development in

  17. PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash Injury

    OpenAIRE

    Andersen, Tonny Elmose; Elklit, Ask; Brink, Ole

    2013-01-01

    Introduction: The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which...

  18. Predictors of PTSD Treatment Response Trajectories in a Sample of Childhood Sexual Abuse Survivors: The Roles of Social Support, Coping, and PTSD Symptom Clusters.

    Science.gov (United States)

    Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

    2017-11-01

    This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors.

  19. The unique associations between rape acknowledgment and the DSM-5 PTSD symptom clusters.

    Science.gov (United States)

    Wilson, Laura C; Scarpa, Angela

    2017-11-01

    It is well documented in the sexual assault literature that more than half of rape survivors do not label their experience as rape. This is called unacknowledged rape. Although this phenomenon is common and undoubtedly has huge implications for psychotherapy, the impact of acknowledgment status on psychological adjustment is unclear. The present study aimed to delineate the unique impact of rape acknowledgment on psychopathology by examining PTSD symptoms at the cluster level. To examine this, 178 female college students who reported rape completed an online survey, including an assessment of PTSD symptoms in the past month. The results suggested that, after accounting for several covariates, acknowledged rape survivors reported significantly greater levels of intrusion and avoidance symptoms compared to unacknowledged rape survivors. The findings suggest that examining PTSD symptoms at the cluster level may provide more insight into the process of recovery following rape and therefore may better inform treatment decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Treatment of OSA with CPAP Is Associated with Improvement in PTSD Symptoms among Veterans

    Science.gov (United States)

    Orr, Jeremy E.; Smales, Carolina; Alexander, Thomas H.; Stepnowsky, Carl; Pillar, Giora; Malhotra, Atul; Sarmiento, Kathleen F.

    2017-01-01

    Study Objectives: Posttraumatic stress disorder (PTSD) is common among veterans of the military, with sleep disturbance as a hallmark manifestation. A growing body of research has suggested a link between obstructive sleep apnea and PTSD, potentially due to obstructive sleep apnea (OSA) related sleep disruption, or via other mechanisms. We examined the hypothesis that treatment of OSA with positive airway pressure would reduce PTSD symptoms over 6 months. Methods: A prospective study of Veterans with confirmed PTSD and new diagnosis of OSA not yet using PAP therapy were recruited from a Veteran's Affairs sleep medicine clinic. All subjects were instructed to use PAP each night. Assessments were performed at 3 and 6 months. The primary outcome was a reduction in PTSD symptoms at 6 months. Results: Fifty-nine subjects were enrolled; 32 remained in the study at 6 months. A significant reduction in PTSD symptoms, measured by PCL-S score was observed over the course of the study (60.6 ± 2.7 versus 52.3 ± 3.2 points; p J Clin Sleep Med. 2017;13(1):57–63. PMID:27707436

  1. PTSD symptomics: network analyses in the field of psychotraumatology

    NARCIS (Netherlands)

    Armour, Cherie; Fried, Eiko I.; Olff, Miranda

    2017-01-01

    Recent years have seen increasing attention on posttraumatic stress disorder (PTSD) research. While research has largely focused on the dichotomy between patients diagnosed with mental disorders and healthy controls - in other words, investigations at the level of diagnoses - recent work has focused

  2. PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: a latent class analysis.

    Science.gov (United States)

    Hruska, Bryce; Irish, Leah A; Pacella, Maria L; Sledjeski, Eve M; Delahanty, Douglas L

    2014-10-01

    We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Psychotic symptoms in refugees diagnosed with PTSD: a series of case reports

    DEFF Research Database (Denmark)

    Nørredam, Marie Louise; Ekstrøm, Morten; Jensen, Mette

    2011-01-01

    BACKGROUND: In our clinical work, we treat refugees who have been exposed to trauma and who subsequently develop psychotic symptoms. However, the literature does not address the relationship between refugees with depression, post-traumatic stress disorder (PTSD) and psychotic symptoms. Therefore...

  4. Psychotic symptoms in refugees diagnosed with PTSD: a series of case reports

    DEFF Research Database (Denmark)

    Norredam, Marie; Jensen, Mette; Ekstrøm, Morten

    2011-01-01

    In our clinical work, we treat refugees who have been exposed to trauma and who subsequently develop psychotic symptoms. However, the literature does not address the relationship between refugees with depression, post-traumatic stress disorder (PTSD) and psychotic symptoms. Therefore the aim...

  5. Experiential Avoidance and the Relationship between Child Maltreatment and PTSD Symptoms: Preliminary Evidence

    Science.gov (United States)

    Shenk, Chad E.; Putnam, Frank W.; Noll, Jennie G.

    2012-01-01

    Objective: Not every adolescent exposed to child maltreatment develops symptoms of post-traumatic stress disorder (PTSD), emphasizing the need to identify variables that explain how some maltreated children come to develop these symptoms. This study tested whether a set of variables, respiratory sinus arrhythmia (RSA) and cortisol reactivity as…

  6. Perceived social support buffers the impact of PTSD symptoms on suicidal behavior: implications into suicide resilience research.

    Science.gov (United States)

    Panagioti, M; Gooding, P A; Taylor, P J; Tarrier, N

    2014-01-01

    A growing body of research has highlighted the importance of identifying resilience factors against suicidal behavior. However, no previous study has investigated potential resilience factors among individuals with Posttraumatic Stress Disorder (PTSD). The aim of this study was to examine whether perceived social support buffered the impact of PTSD symptoms on suicidal behavior. Fifty-six individuals who had previously been exposed to a traumatic event and reported PTSD symptoms in the past month (n = 34, 60.7% participants met the full criteria for a current PTSD diagnosis) completed a range of self-report measures assessing PTSD symptoms, perceived social support and suicidal behavior. Hierarchical regression analyses were conducted to examine whether perceived social support moderates the effects of PTSD symptoms on suicidal behavior. The results showed that perceived social support moderated the impact of the number and severity of PTSD symptoms on suicidal behavior. For those who perceived themselves as having high levels of social support, an increased number and severity of PTSD symptoms were less likely to lead to suicidal behavior. The current findings suggest that perceived social support might confer resilience to individuals with PTSD and counter the development of suicidal thoughts and behaviors. The milieu of social support potentially provides an area of further research and an important aspect to incorporate into clinical interventions for suicidal behavior in PTSD or trauma populations. © 2013.

  7. Trauma history characteristics and subsequent PTSD symptoms in motor vehicle accident victims.

    Science.gov (United States)

    Irish, Leah; Ostrowski, Sarah A; Fallon, William; Spoonster, Eileen; Dulmen, Manfred van; Sledjeski, Eve M; Delahanty, Douglas L

    2008-08-01

    The present study examined the relationship between trauma history characteristics (number and type of traumas, age at first trauma, and subjective responses to prior traumas) and the development of posttraumatic stress disorder (PTSD) symptoms following a motor vehicle accident (MVA). One hundred eighty-eight adult MVA victims provided information about prior traumatization and were evaluated for PTSD symptoms 6 weeks and one year following the MVA. Results indicated that after controlling for demographics and depression, prior trauma history characteristics accounted for a small, but significant amount of the variance in PTSD symptoms. Distress from prior trauma and number of types of prior traumas were the most meaningful trauma history predictors. Results encourage further evaluation of trauma history as a multifaceted construct.

  8. Self-worth mediates the effects of violent loss on PTSD symptoms.

    Science.gov (United States)

    Mancini, Anthony D; Prati, Gabriele; Black, Sarah

    2011-02-01

    Although research has confirmed that violent losses can exacerbate grief reactions, few investigations have explored underlying mechanisms. In this study, the authors used a dataset on bereaved spouses and bereaved parents at 4- and 18-months postloss to examine the mediating effects of self-worth and worldviews (benevolence and meaningfulness beliefs). Persons bereaved by violent causes had significantly more posttraumatic stress disorder (PTSD), grief, and depression symptoms at 4- and 18-months postloss than persons bereaved by natural causes. Moreover, self-worth but not worldviews mediated the effects of violent loss on PTSD and depression symptoms cross sectionally and PTSD symptoms longitudinally. Findings underscore that self-views are a critical component of problematic reactions to violent loss, but fail to support the role of "shattered" worldviews. Copyright © 2011 International Society for Traumatic Stress Studies.

  9. Anxiety, depression and PTSD-related symptoms in spouses and close relatives of burn survivors: When the supporter needs to be supported.

    Science.gov (United States)

    Bond, Suzie; Gourlay, Catherine; Desjardins, Alexandra; Bodson-Clermont, Paule; Boucher, Marie-Ève

    2017-05-01

    The aim of the study was to assess the prevalence of anxiety, depression and PTSD-related symptoms reported by spouses and close relatives of adult burn survivors. Potential associations between these symptoms and variables such as the severity of the burn were also explored. Participants were spouses (n=31) and close relatives (n=25) of hospitalized patients with acute burns. Anxiety and depression symptoms were assessed by the Hospital Distress Anxiety and Depression Scale and PTSD-related symptoms by the Modified PTSD Symptom Scale at both admission to and discharge from the burn unit. At admission, 77% of spouses and 56% of close relatives of burn patients reported anxiety, depression or PTSD-related symptoms in the clinical range. While spouses had higher scores than close relatives on symptom measures, significant differences were only established for anxiety symptoms (p<.02). A significant effect was found for gender, with women reporting more anxiety (p=.01) and depression (p=.02) symptoms than men. Results also showed a main effect for time, with anxiety (p<.0001), depression (p<.0001) and PTSD-related (p<.0001) symptoms being higher at admission than at discharge. Variables associated with the index patient, such as total body surface area burned, length of stay, number of ventilated days, facial burns, or level of care at admission, were not associated with outcome measures. Spouses and close relatives of burn survivors showed high levels of psychological distress in the first few days following admission, and more than a quarter still reported symptoms in the clinical range at discharge. Our analysis points to the need to offer psychological support and guidance to family members so that they can in turn provide effective support to the burn survivor. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  10. Factor Structure of the PTSD Checklist for DSM-5: Relationships Among Symptom Clusters, Anger, and Impulsivity.

    Science.gov (United States)

    Armour, Cherie; Contractor, Ateka; Shea, Tracie; Elhai, Jon D; Pietrzak, Robert H

    2016-02-01

    Scarce data are available regarding the dimensional structure of Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) posttraumatic stress disorder (PTSD) symptoms and how factors relate to external constructs. We evaluated six competing models of DSM-5 PTSD symptoms, including Anhedonia, Externalizing Behaviors, and Hybrid models, using confirmatory factor analyses in a sample of 412 trauma-exposed college students. We then examined whether PTSD symptom clusters were differentially related to measures of anger and impulsivity using Wald chi-square tests. The seven-factor Hybrid model was deemed optimal compared with the alternatives. All symptom clusters were associated with anger; the strongest association was between externalizing behaviors and anger (r = 0.54). All symptom clusters, except re-experiencing and avoidance, were associated with impulsivity, with the strongest association between externalizing behaviors and impulsivity (r = 0.49). A seven-factor Hybrid model provides superior fit to DSM-5 PTSD symptom data, with the externalizing behaviors factor being most strongly related to anger and impulsivity.

  11. A Dyadic Perspective on PTSD Symptoms' Associations with Couple Functioning and Parenting Stress in First-Time Parents.

    Science.gov (United States)

    Fredman, Steffany J; Le, Yunying; Marshall, Amy D; Brick, Timothy R; Feinberg, Mark E

    2017-06-01

    Posttraumatic stress disorder (PTSD) symptoms are associated with disruptions in both couple functioning and parenting, and limited research suggests that, among military couples, perceptions of couple functioning and parenting stress are a function of both one's own and one's partner's mental health symptoms. However, this work has not been generalized to civilian couples, and little is known about the associations between PTSD symptoms and family adjustment in specific family developmental contexts. We examined PTSD symptoms' associations with perceived couple functioning and parenting stress within a dyadic context in civilian couples who had participated in a randomized controlled trial of a universal, couple-based transition to parenthood program and at least one member of the couple reported having experienced a Criterion A1 traumatic event. Results of actor-partner interdependence models revealed that parents' own and partners' PTSD symptoms were negatively associated with perceived couple functioning; contrary to expectation, the association of partners' PTSD symptoms with perceived couple functioning was strongest among men who received the intervention. A parent's own PTSD symptoms were positively associated with parenting stress for both men and women and were unexpectedly strongest for men who received the intervention. Partner PTSD symptoms were also positively associated with increased parenting stress for both men and women. Findings support a dyadic conceptualization of the associations between spouses' PTSD symptoms and family outcomes during the transition to parenthood and suggest that participating in a couple-based, psychoeducational program during this phase in the family life cycle may be particularly salient for men.

  12. Couples Facing the Birth of a Newborn with a Congenital Anomaly: PTSD Symptoms in the First Year.

    Science.gov (United States)

    Bevilacqua, Francesca; Morini, Francesco; Zaccara, Antonio; De Marchis, Chiara; Braguglia, Annabella; Gentile, Simonetta; Bagolan, Pietro; Aite, Lucia

    2018-04-18

     The objective of this study was to assess the presence of posttraumatic stress disorder (PTSD) symptoms in parental couples of newborn requiring early surgery at 6 and 12 months after birth.  A longitudinal study was set up from January 2014 to June 2015. As a measure of PTSD, we used the Italian version of the Impact of Event Scale-Revised (IES-R).  Thirty-four couples form the object of the study. At 6 months, half of mothers (52.9%) and fathers (44.1%) reported traumatic stress symptoms above the clinical cutoff. Percentages remained stable at 12 months. When parental gender and length of follow-up were compared with two-factor analysis of variance, none had an impact on IES-R score, nor an interaction between these factors was found. A significant correlation of IES-R total score was present within the couple both at 6 and 12 months (6 months- r : 0.6842, p  stressful situation with persistent burden for both parents who are at high risk of developing PTSD symptoms. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Association between facial expression and PTSD symptoms among young children exposed to the Great East Japan Earthquake: A pilot study

    Directory of Open Access Journals (Sweden)

    Takeo eFujiwara

    2015-10-01

    Full Text Available Emotional numbing is a symptom of post-traumatic stress disorder (PTSD characterized by a loss of interest in usually enjoyable activities, feeling detached from others, and an inability to express a full range of emotions. Emotional numbing is usually assessed through self-report, and is particularly difficult to ascertain among young children. We conducted a pilot study to explore the use of facial expression ratings in response to a comedy video clip, and to assess emotional reactivity among preschool children directly exposed to the Great East Japan Earthquake. This study included 23 child participants. Child PTSD symptoms were measured using a modified version of the Parent’s Report of the Child’s Reaction to Stress scale. Children were filmed while watching a 2-minute video compilation of natural scenes (‘baseline video’ followed by a 2-minute video clip from a television comedy (‘comedy video’. Children’s facial expressions were processed using Noldus FaceReader software, which implements the Facial Action Coding System (FACS. We investigated the association between PTSD symptom scores and facial emotion reactivity using linear regression analysis. Children with higher PTSD symptom scores showed a significantly greater proportion of neutral facial expressions, controlling for sex, age and baseline facial expression (p < .05. This pilot study suggests that facial emotion reactivity could provide an index against which emotional numbing could be measured in young children, using facial expression recognition software. This pilot study adds to the emerging literature on using experimental psychopathology methods to characterize children’s reactions to disasters.

  14. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART(®)).

    Science.gov (United States)

    Kip, Kevin E; Elk, Carrie A; Sullivan, Kelly L; Kadel, Rajendra; Lengacher, Cecile A; Long, Christopher J; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F; Street, Jennifer D; Girling, Sue Ann; Diamond, David M

    2012-06-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART(®)) that incorporates the use of eye movements administered in a brief treatment period (1-5 one-hour sessions within three weeks). Eighty adults aged 21-60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants' mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD.

  15. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®)

    Science.gov (United States)

    Kip, Kevin E.; Elk, Carrie A.; Sullivan, Kelly L.; Kadel, Rajendra; Lengacher, Cecile A.; Long, Christopher J.; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F.; Street, Jennifer D.; Girling, Sue Ann; Diamond, David M.

    2012-01-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART®) that incorporates the use of eye movements administered in a brief treatment period (1–5 one-hour sessions within three weeks). Eighty adults aged 21–60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants’ mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD. PMID:25379218

  16. PTSD Symptoms, Emotion Dysregulation, and Alcohol-Related Consequences Among College Students With a Trauma History.

    Science.gov (United States)

    Tripp, Jessica C; McDevitt-Murphy, Meghan E; Avery, Megan L; Bracken, Katherine L

    2015-01-01

    Posttraumatic stress disorder (PTSD), alcohol use, and alcohol-related consequences have been linked to emotion dysregulation. Sex differences exist in both emotion regulation dimensions and alcohol use patterns. This investigation examined facets of emotion dysregulation as potential mediators of the relationship between PTSD symptoms and alcohol-related consequences and whether differences may exist across sexes. Participants were 240 college students with a trauma history who reported using alcohol within the past three months and completed measures of PTSD symptoms, emotion dysregulation, alcohol consumption, alcohol-related consequences, and negative affect. The six facets of emotion dysregulation were examined as mediators of the relationship between PTSD symptoms and alcohol-related consequences in the full sample and by sex. There were differences in sexes on several variables, with women reporting higher PTSD scores and lack of emotional awareness. Men reported significantly more drinks per week in a typical week and a heavy week. There were significant associations between the variables for the full sample, with PTSD showing associations with five facets of emotion dysregulation subscales: impulse control difficulties when upset, difficulties engaging in goal-directed behavior, nonacceptance of emotional responses, lack of emotional clarity, and limited access to emotion regulation strategies. Alcohol-related consequences were associated with four aspects of emotion dysregulation: impulse control difficulties when upset, difficulties engaging in goal-directed behavior, nonacceptance of emotional responses, and limited access to emotion regulation strategies. Two aspects of emotion regulation, impulse control difficulties and difficulties engaging in goal directed behavior, mediated the relationship between PTSD symptoms and alcohol-related consequences in the full sample, even after adjusting for the effects of negative affect. When examined separately by

  17. Resource Loss Moderates the Association Between Child Abuse and Current PTSD Symptoms Among Women in Primary-Care Settings.

    Science.gov (United States)

    Costa, Eleonora C V; Guimarães, Sara; Ferreira, Domingos; Pereira, M Graça

    2016-09-01

    This study examined if abuse during childhood, rape in adulthood, and loss of resources predict a woman's probability of reporting symptoms of posttraumatic stress disorder (PTSD), and whether resource loss moderates the association between reporting childhood abuse and PTSD symptoms. The sample included 767 women and was collected in publicly funded primary-care settings. Women who reported having been abused during childhood also reported more resource loss, more acute PTSD symptoms, and having suffered more adult rape than those who reported no childhood abuse. Hierarchical logistic regression yielded a two-variable additive model in which child abuse and adult rape predict the probability of reporting or not any PTSD symptoms, explaining 59.7% of the variance. Women abused as children were 1 to 2 times more likely to report PTSD symptoms, with sexual abuse during childhood contributing most strongly to this result. Similarly, women reporting adult rape were almost twice as likely to report symptoms of PTSD as those not reporting it. Resource loss was unexpectedly not among the predictors but a moderation analysis showed that such loss moderated the association between child abuse and current PTSD symptoms, with resource loss increasing the number and severity of PTSD symptoms in women who also reported childhood abuse. The findings highlight the importance of early assessment and intervention in providing mental health care to abused, neglected, and impoverished women to help them prevent and reverse resource loss and revictimization.

  18. Cognitive-Behavioral Therapy for PTSD and Depression Symptoms Reduces Risk for Future Intimate Partner Violence among Interpersonal Trauma Survivors

    Science.gov (United States)

    Iverson, Katherine M.; Gradus, Jaimie L.; Resick, Patricia A.; Suvak, Michael K.; Smith, Kamala F.; Monson, Candice M.

    2011-01-01

    Objective: Women who develop symptoms of posttraumatic stress disorder (PTSD) and depression subsequent to interpersonal trauma are at heightened risk for future intimate partner violence (IPV) victimization. Cognitive-behavioral therapy (CBT) is effective in reducing PTSD and depression symptoms, yet limited research has investigated the…

  19. The Influence of Exposure to Natural Disasters on Depression and PTSD Symptoms among Firefighters.

    Science.gov (United States)

    Pennington, Michelle L; Carpenter, Thomas P; Synett, Samantha J; Torres, Victoria A; Teague, Jennifer; Morissette, Sandra B; Knight, Jeffrey; Kamholz, Barbara W; Keane, Terence M; Zimering, Rose T; Gulliver, Suzy B

    2018-02-01

    Introduction Firefighters represent an important population for understanding the consequences of exposure to potentially traumatic stressors. Hypothesis/Problem The researchers were interested in the effects of pre-employment disaster exposure on firefighter recruits' depression and posttraumatic stress disorder (PTSD) symptoms during the first three years of fire service and hypothesized that: (1) disaster-exposed firefighters would have greater depression and PTSD symptoms than non-exposed overall; and (2) depression and PTSD symptoms would worsen over years in fire service in exposed firefighters, but not in their unexposed counterparts. In a baseline interview, 35 male firefighter recruits from seven US cities reported lifetime exposure to natural disaster. These disaster-exposed male firefighter recruits were matched on age, city, and education with non-exposed recruits. A generalized linear mixed model revealed a significant exposure×time interaction (e coef =1.04; Pdisaster exposure only. This pattern persisted after controlling for social support from colleagues (e coefficient=1.05; Pdisaster exposure only, even after controlling for social support. Posttraumatic stress disorder symptoms did not vary between exposure groups. Pennington ML , Carpenter TP , Synett SJ , Torres VA , Teague J , Morissette SB , Knight J , Kamholz BW , Keane TM , Zimering RT , Gulliver SB . The influence of exposure to natural disasters on depression and PTSD symptoms among firefighters. Prehosp Disaster Med. 2018;33(1):102-108.

  20. Examining the diagnostic utility of the DSM-5 PTSD symptoms among male and female returning veterans.

    Science.gov (United States)

    Green, Jonathan D; Annunziata, Anthony; Kleiman, Sarah E; Bovin, Michelle J; Harwell, Aaron M; Fox, Annie M L; Black, Shimrit K; Schnurr, Paula P; Holowka, Darren W; Rosen, Raymond C; Keane, Terence M; Marx, Brian P

    2017-08-01

    Posttraumatic stress disorder (PTSD) diagnostic criteria have been criticized for including symptoms that overlap with commonly comorbid disorders, which critics argue undermines the validity of the diagnosis and inflates psychiatric comorbidity rates. In response, the upcoming 11th edition of the International Classification of Diseases (ICD-11) will offer PTSD diagnostic criteria that are intended to promote diagnostic accuracy. However, diagnostic utility analyses have not yet assessed whether these criteria minimize diagnostic errors. The present study examined the diagnostic utility of each PTSD symptom in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) for males and females. Participants were 1,347 individuals enrolled in a longitudinal national registry of returning veterans receiving care at a Department of Veterans Affairs (VA) facility. Doctoral level clinicians assessed all participants using the PTSD module of the Structured Clinical Interview for DSM. Of the 20 symptoms examined, the majority performed in the fair to poor range on test quality indices. Although a few items did perform in the good (or better) range, only half were ICD-11 symptoms. None of the 20 symptoms demonstrated good quality of efficiency. Results demonstrated few sex differences across indices. There were no differences in the proportion of comorbid psychiatric disorders or functional impairment between DSM-5 and ICD-11 criteria. ICD-11 PTSD criteria demonstrate neither greater diagnostic specificity nor reduced rates of comorbidity relative to DSM-5 criteria and, as such, do not perform as intended. Modifications to existing symptoms or new symptoms may improve differential diagnosis. © 2017 Wiley Periodicals, Inc.

  1. Shame versus trauma-related guilt as mediators of the relationship between PTSD symptoms and aggression among returning veterans.

    Science.gov (United States)

    Crocker, Laura D; Haller, Moira; Norman, Sonya B; Angkaw, Abigail C

    2016-07-01

    It is well established that posttraumatic stress disorder (PTSD) is associated with various forms of aggression, though the mechanisms by which PTSD is related to aggression are not fully understood. Some research suggests that the tendency to experience shame, but not guilt, contributes to aggression in individuals with a history of interpersonal trauma. This study tested the hypothesis that trait shame but not trauma-related guilt would mediate the relationship between PTSD symptoms and verbal and physical aggression in veterans with combat/military-related trauma seeking PTSD treatment. In a sample of 127 returning veterans (95% male, mean age = 32.93), negative binomial path analyses tested multiple mediational models in which shame versus trauma-related guilt (separate models entered the effects of global guilt, guilt cognitions, and guilt distress) were examined as mediators of PTSD symptoms on verbal and physical aggression separately. Results indicated that shame partially mediated the association of PTSD symptoms with verbal aggression but not physical aggression when accounting for trauma-related guilt. Although PTSD symptoms were associated with higher scores on all aspects of trauma-related guilt, guilt did not significantly mediate relations between PTSD symptoms and verbal or physical aggression when accounting for shame. These results indicate that it is worthwhile to examine whether addressing shame in PTSD treatment may also reduce verbal aggression in returning veterans. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Preliminary findings on lifetime trauma prevalence and PTSD symptoms among adolescents in Sarawak Malaysia.

    Science.gov (United States)

    Ghazali, Siti Raudzah; Elklit, Ask; Balang, Rekaya Vincent; Sultan, M Ameenudeen; Kana, Kamarudin

    2014-10-01

    The objective of this study is to determine the prevalence of lifetime exposure to traumatic events and its relation to PTSD symptoms. Participants were randomly selected from several schools located in the city of Kuching. There were 85 adolescents participating in this study, with ages ranging from 13 to 14 years old, of whom 31% (n=26) were males and 69% (n=59) females. The Child Posttraumatic Stress Index-Revised, The Harvard Trauma Questionnaire and a lifetime trauma checklist were used in this study. Results showed that 77.6% of participants were exposed to at least one lifetime trauma. The most frequently reported traumas were road accident (20.1%), death of a family member (19.7%), and almost drowning (10%). There was more indirect trauma than direct trauma exposure. Males were more likely to be involved in traumatic events than females. Results showed that 7.1% (6) exhibited PTSD symptoms. There was no significant difference in the mean score of CPTS-RI between genders and among ethnic groups. Total exposure to traumatic events was significantly correlated with PTSD symptoms. Findings suggest that number of lifetime traumatic events was quite high and multiple exposures to traumatic events were significantly related to PTSD symptoms. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Trauma-focused treatment in PTSD patients with psychosis : symptom exacerbation, adverse events, and revictimization

    NARCIS (Netherlands)

    van den Berg, D.P.G.; de Bont, P.A.J.M.; van der Vleugel, B.M.; de Roos, C.; de Jongh, A.; van Minnen, A.; van der Gaag, M.

    2016-01-01

    Objectives: Most clinicians refrain from trauma treatment for patients with psychosis because they fear symptom exacerbation and relapse. This study examined the negative side effects of trauma-focused (TF) treatment in patients with psychosis and posttraumatic stress disorder (PTSD). Methods:

  4. PTSD Symptoms and Sexual Harassment: The Role of Attributions and Perceived Control

    Science.gov (United States)

    Larsen, Sadie E.; Fitzgerald, Louise F.

    2011-01-01

    Researchers have compiled significant evidence demonstrating that sexual harassment leads to psychological harm, including the full symptom picture of PTSD, but few have examined the psychological processes involved. Research on attributions among trauma victims would suggest that causal attributions and perceptions of control may be important…

  5. Longitudinal Examination of PTSD Symptoms and Problematic Alcohol Use as Risk Factors for Adolescent Victimization

    Science.gov (United States)

    McCart, Michael R.; Zajac, Kristyn; Kofler, Michael J.; Smith, Daniel W.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2012-01-01

    The current study examined associations between posttraumatic stress disorder (PTSD) symptoms and future interpersonal victimization among adolescents, after accounting for the impact of early victimization exposure, gender, ethnicity, and household income. In addition, problematic alcohol use was tested as a mediator of the relation between PTSD…

  6. Assessing impact of differential symptom functioning on post-traumatic stress disorder (PTSD) diagnosis

    NARCIS (Netherlands)

    He, Qiwei; Glas, Cornelis A.W.; Veldkamp, Bernard P.

    2014-01-01

    This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as

  7. Food addiction as a proxy for eating disorder and obesity severity, trauma history, PTSD symptoms, and comorbidity.

    Science.gov (United States)

    Brewerton, Timothy D

    2017-06-01

    Food addiction (FA) is a newly defined yet still controversial condition that has important etiological, developmental, treatment, prevention, and social policy implications. In this review, the case is made that FA (or high scores on the Yale Food Addiction Scale) may be used as a proxy measure for a matrix of interrelated clinical features, including greater eating disorder severity, greater obesity severity, more severe trauma histories, greater symptoms of posttraumatic stress disorder (PTSD), greater psychiatric comorbidity, as well as greater medical morbidity and mortality. A Medline search was undertaken using the following terms: food addiction cross-referenced with eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and binge eating), obesity, trauma, posttraumatic stress disorder, and comorbidity. The thesis is that the identification and acknowledgment of the concept of FA, when integrated into an overall, trauma-focused and transdiagnostic treatment approach, are supported and can be useful in understanding clinically the "big picture." Food addiction (FA) may be used as a proxy for (1) bulimic eating disorder severity, (2) complex trauma histories, (3) severity of PTSD and PTSD symptoms, (4) intensity of psychiatric comorbidity, (5) severity of obesity, as well as (6) their combination. Implications for developing treatment strategies are discussed. The case for a comprehensive management that requires careful attention to medical and psychiatric assessment and integrated care that incorporates trauma-focused treatment is made.

  8. PTSD symptom severity is associated with increased recruitment of top-down attentional control in a trauma-exposed sample

    Directory of Open Access Journals (Sweden)

    Stuart F. White

    2015-01-01

    Conclusions: We suggest that these data may reflect two phenomena associated with increased PTSD symptomatology in combat-exposed, but PTSD negative, armed services members. First, these data indicate increased emotional responsiveness by: (i the positive relationship between PTSD symptom severity and amygdala responsiveness to emotional relative to neutral stimuli; (ii greater BOLD response as a function of PTSD symptom severity in regions implicated in emotion (striatum and representation (occipital and temporal cortices during emotional relative to neutral conditions; and (iii increased connectivity between the amygdala and regions implicated in emotion (insula/caudate and representation (middle temporal cortex as a function of PTSD symptom severity during emotional relative to neutral trials. Second, these data indicate a greater need for the recruitment of regions implicated in top down attention as indicated by (i greater BOLD response in superior/middle frontal gyrus as a function of PTSD symptom severity in task relative to view conditions; (ii greater BOLD response in dmFC/dACC, lateral frontal and inferior parietal cortices as a function of PTSD symptom severity in emotional relative to neutral conditions and (iii greater functional connectivity between the amygdala and inferior parietal cortex as a function of PTSD symptom severity during emotional relative to neutral conditions.

  9. Relationship of early-life trauma, war-related trauma, personality traits, and PTSD symptom severity: a retrospective study on female civilian victims of war

    Directory of Open Access Journals (Sweden)

    Aleksandra Stevanović

    2016-04-01

    Full Text Available Background: Consequences of war-related traumatisation have mostly been investigated in military and predominant male populations, while research on female civilian victims of war has been neglected. Furthermore, research of post-war posttraumatic stress disorder (PTSD in women has rarely included early-life trauma in their prediction models, so the contribution of trauma in childhood and early youth is still unexplored. Objective: To examine the relationship of early-life trauma, war-related trauma, personality traits, and symptoms of posttraumatic stress among female civilian victims of the recent war in Croatia. Method: The cross-sectional study included 394 participants, 293 war-traumatised adult women civilians, and 101 women without war-related trauma. Participants were recruited using the snowball sampling method. The applied instruments included the Clinician-Administrated PTSD Scale (CAPS, the NEO Personality Inventory-Revised (NEO-PI-R, the War Stressors Assessment Questionnaire (WSAQ, and the Early Trauma Inventory Self Report-Short Form (ETISR-SF. A hierarchical multiple regression analysis was performed to assess the prediction model of PTSD symptom severity measured by CAPS score for current PTSD. Results: The prevalence of current PTSD (CAPS cut-off score=65 in this cohort was 20.7%. The regression model that included age, early-life trauma, war-related trauma, neuroticism, and extraversion as statistically significant predictors explained 45.8% of variance in PTSD symptoms. Conclusions: Older age, exposure to early-life trauma, exposure to war-related traumatic events, high neuroticism, and low extraversion are independent factors associated with higher level of PTSD symptoms among women civilian victims of war.

  10. PTSD symptoms and pain in Canadian military veterans: the mediating roles of anxiety, depression, and alcohol use.

    Science.gov (United States)

    Irwin, Kara C; Konnert, Candace; Wong, May; O'Neill, Thomas A

    2014-04-01

    Symptoms of posttraumatic stress disorder (PTSD) and pain are often comorbid among veterans. The purpose of this study was to investigate to what extent symptoms of anxiety, depression, and alcohol use mediated the relationship between PTSD symptoms and pain among 113 treated male Canadian veterans. Measures of PTSD, pain, anxiety symptoms, depression symptoms, and alcohol use were collected as part of the initial assessment. The bootstrapped resampling analyses were consistent with the hypothesis of mediation for anxiety and depression, but not alcohol use. The confidence intervals did not include zero and the indirect effect of PTSD on pain through anxiety was .04, CI [.03, .07]. The indirect effect of PTSD on pain through depression was .04, CI [.02, .07]. These findings suggest that PTSD and pain symptoms among veterans may be related through the underlying symptoms of anxiety and depression, thus emphasizing the importance of targeting anxiety and depression symptoms when treating comorbid PTSD and pain patients. © 2014 International Society for Traumatic Stress Studies.

  11. PTSD symptoms and family versus stranger violence in Iraq and Afghanistan veterans.

    Science.gov (United States)

    Sullivan, Connor P; Elbogen, Eric B

    2014-02-01

    As a diagnosis, posttraumatic stress disorder (PTSD) has been associated with violence committed by veterans in many studies; however, a potential link to specific PTSD symptoms has received relatively less attention. This paper examines the relationship between PTSD symptoms and different types of violent behavior in Iraq and Afghanistan veterans. Participants were randomly sampled from a roster of all separated U.S. military service members or national guard/reservists who served after September 11, 2001. Data were collected at baseline and 1-year follow-up from a national sample of N = 1,090 veterans, from 50 states and all military branches. Of these veterans, 13% reported aggression toward a family member and 9% toward a stranger during the 1-year study period. Anger symptoms at baseline predicted higher odds of family violence at follow-up, both severe (OR = 1.30, CI [1.13, 1.48], p violence at follow-up, both severe (OR = 1.26, CI [1.11, 1.42], p violence, whereas females were more likely to endorse aggression in the family context. The results provide limited support to the hypothesis that PTSD "flashbacks" in veterans are linked to violence. The differing multivariate models illustrate distinct veteran characteristics associated with specific types of violence.

  12. PTSD Symptoms and Family vs. Stranger Violence in Iraq and Afghanistan Veterans

    Science.gov (United States)

    Sullivan, Connor P.; Elbogen, Eric B.

    2015-01-01

    As a diagnosis, posttraumatic stress disorder (PTSD) has been associated with violence committed by veterans in many studies; however, a potential link to specific PTSD symptoms has received relatively less attention. This paper examines the relationship between PTSD symptoms and different types of violent behavior in Iraq and Afghanistan veterans. Participants were randomly sampled from a roster of all separated U.S. military service members or national guard/reservists who served after September 11, 2001. Data were collected at baseline and 1-year follow-up from a national sample of N = 1,090 veterans, from 50 states and all military branches. Of these veterans, 13% reported aggression toward a family member and 9% toward a stranger during the 1-year study period. Anger symptoms at baseline predicted higher odds of family violence at follow-up, both severe (OR = 1.30, CI [1.13, 1.48], p violence at follow-up, both severe (OR = 1.26, CI [1.11, 1.42], p violence, whereas females were more likely to endorse aggression in the family context. The results provide limited support to the hypothesis that PTSD “flashbacks” in veterans are linked to violence. The differing multivariate models illustrate distinct veteran characteristics associated with specific types of violence. PMID:23646917

  13. A Latent Growth Mixture Modeling Approach to PTSD Symptoms in Rape Victims.

    Science.gov (United States)

    Armour, Cherie; Shevlin, Mark; Elklit, Ask; Mroczek, Dan

    2012-03-01

    The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (intercept) and rate of change (slope) being negligible. However, not everyone who has experienced a trauma is diagnosed with PTSD, and symptom severity levels differ between individuals exposed to similar traumas. The current study employed the latent growth mixture modeling technique to test for multiple trajectories using data from a sample of Danish rape victims (N = 255). In addition, the analysis aimed to determine whether a number of explanatory variables could differentiate between the trajectories (age, acute stress disorder [ASD], and perceived social support). Results concluded the existence of two PTSD trajectories. ASD was found to be the only significant predictor of one trajectory characterized by high initial levels of PTSD symptomatology. The present findings confirmed the existence of multiple trajectories with regard to PTSD symptomatology in a way that may be useful to clinicians working with this population.

  14. A Latent Growth Mixture Modeling Approach to PTSD Symptoms in Rape Victims

    Science.gov (United States)

    Armour, Cherie; Shevlin, Mark; Elklit, Ask; Mroczek, Dan

    2012-01-01

    The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (intercept) and rate of change (slope) being negligible. However, not everyone who has experienced a trauma is diagnosed with PTSD, and symptom severity levels differ between individuals exposed to similar traumas. The current study employed the latent growth mixture modeling technique to test for multiple trajectories using data from a sample of Danish rape victims (N = 255). In addition, the analysis aimed to determine whether a number of explanatory variables could differentiate between the trajectories (age, acute stress disorder [ASD], and perceived social support). Results concluded the existence of two PTSD trajectories. ASD was found to be the only significant predictor of one trajectory characterized by high initial levels of PTSD symptomatology. The present findings confirmed the existence of multiple trajectories with regard to PTSD symptomatology in a way that may be useful to clinicians working with this population. PMID:22661909

  15. The relationship of PTSD to key somatic complaints and cultural syndromes among Cambodian refugees attending a psychiatric clinic: the Cambodian Somatic Symptom and Syndrome Inventory (CSSI).

    Science.gov (United States)

    Hinton, Devon E; Kredlow, M Alexandra; Pich, Vuth; Bui, Eric; Hofmann, Stefan G

    2013-06-01

    This article describes a culturally sensitive questionnaire for the assessment of the effects of trauma in the Cambodian refugee population, the Cambodian Somatic Symptom and Syndrome Inventory (CSSI), and gives the results of a survey with the instrument. The survey examined the relationship of the CSSI, the two CSSI subscales, and the CSSI items to posttraumatic stress disorder (PTSD) severity and self-perceived functioning. A total of 226 traumatized Cambodian refugees were assessed at a psychiatric clinic in Lowell, MA, USA. There was a high correlation of the CSSI, the CSSI somatic and syndrome scales, and all the CSSI items to the PTSD Checklist (PCL), a measure of PTSD severity. All the CSSI items varied greatly across three levels of PTSD severity, and patients with higher levels of PTSD had very high scores on certain CSSI-assessed somatic items such as dizziness, orthostatic dizziness (upon standing), and headache, and on certain CSSI-assessed cultural syndromes such as khyâl attacks, "fear of fainting and dying upon standing up," and "thinking a lot." The CSSI was more highly correlated than the PCL to self-perceived disability assessed by the Short Form-12 Health Survey (SF-12). The study demonstrates that the somatic symptoms and cultural syndromes described by the CSSI form a central part of the Cambodian refugee trauma ontology. The survey indicates that locally salient somatic symptoms and cultural syndromes need be profiled to adequately assess the effects of trauma.

  16. The underlying dimensions of DSM-5 PTSD symptoms and their relations with anxiety and depression in a sample of adolescents exposed to an explosion accident.

    Science.gov (United States)

    Yang, Haibo; Wang, Li; Cao, Chengqi; Cao, Xing; Fang, Ruojiao; Zhang, Jianxin; Elhai, Jon D

    2017-01-01

    Background: A large number of empirical studies pertaining to the latent dimensions of DSM-5 PTSD symptoms have accumulated. However, there is still a lack of studies specific to youths. Objective: This study sought to investigate the latent dimensions of DSM-5 PTSD symptoms in a sample of adolescents exposed to an explosion accident. Method: Participants were 836 students (407 females and 428 males). Self-reported measures including the PTSD Checklist for DSM-5 and the anxiety and depression subscales of the 21-item Depression Anxiety Stress Scale were administered to participants. Confirmatory factor analysis (CFA) was implemented to test competing factor models. Results: A seven-factor model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, anxious arousal and dysphoric arousal factors emerged as the best fitting model, and PTSD's factors displayed distinguishable correlations with external measures of anxiety and depression. Conclusions: The findings provide and extend empirical evidence supporting the newly refined seven-factor hybrid model of DSM-5 PTSD symptoms, and have implications for further trauma-related clinical practice and research.

  17. The structure of PTSD symptoms: a test of alternative models using confirmatory factor analysis.

    Science.gov (United States)

    Elklit, Ask; Shevlin, Mark

    2007-09-01

    This study aimed to examine the structure of self-reported post-traumatic stress disorder (PTSD) symptoms. Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters. The analyses were based on responses from 1116 participants who had suffered whiplash injuries and screened for full or subclinical PTSD using the Harvard Trauma Questionnaire. A correlated four-factor model with re-experiencing, avoidance, dysphoria and arousal factors fitted the data very well. Correlations with criteria measures showed that these factors were associated with other trauma related variables in a theoretically predictable way and showed evidence of unique predictive utility. These results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings.

  18. DSM-5 PTSD's symptom dimensions and relations with major depression's symptom dimensions in a primary care sample

    DEFF Research Database (Denmark)

    Contractor, A. A.; Durham, T. A.; Brennan, J. A.

    2014-01-01

    Existing literature indicates significant comorbidity between posttraumatic stress disorder (PTSD) and major depression. We examined whether PTSD's dysphoria and mood/cognitions factors, conceptualized by the empirically supported four-factor DSM-5 PTSD models, account for PTSD's inherent relatio...

  19. Vets prevail online intervention reduces PTSD and depression in veterans with mild-to-moderate symptoms.

    Science.gov (United States)

    Hobfoll, Stevan E; Blais, Rebecca K; Stevens, Natalie R; Walt, Lisa; Gengler, Richard

    2016-01-01

    Despite heightened rates of depression and posttraumatic stress disorder (PTSD) among in Iraq/Afghanistan veterans, the majority of distressed veterans will not receive mental health care. Overcoming barriers to mental health services requires innovative approaches to broaden the reach of evidence-based treatment. The current study examined the efficacy and acceptability of an innovative and dynamic online cognitive-behavioral therapy intervention for PTSD and depression called Vets Prevail. A randomized clinical trial conducted between 2011 and 2013 assessed changes in PTSD and depression in veterans with mild-to-moderate distress. Veterans randomized to Vets Prevail (n = 209) were aged 34.2 ± 7.6 years, mostly male (81.3%), and nonminority (73.7%). Veterans randomized to adjustment as usual (n = 94) were aged 34.7 ± 8.9, mostly male (81.9%), and White (67.0%). Veterans completed the PTSD Checklist-Military Version and the Center for Epidemiological Studies Depression scale (10-item version) postintervention and at 12-week follow-up. Veterans in the Vets Prevail condition reported significantly greater reductions in PTSD, t(250) = 3.24, p = .001 (Mreduction = 5.51, SD = 9.63), and depression, t(252) = 4.37, p = .001 (Mreduction = 2.31, SD = 5.34), at 12-week follow-up compared with veterans in the adjustment as usual condition (PTSD Mreduction = 1.00, SD = 7.32; depression Mreduction = 0.48, SD = 4.95), with moderate effect sizes for PTSD (Cohen's d = 0.42) and depression (Cohen's d = 0.56). Exploratory analysis shows that Vets Prevail may be effective regardless of combat trauma exposure, gender, and ethnic minority status. Vets Prevail circumvents many barriers to care and effectively addresses the dire mental health needs of veterans. (c) 2015 APA, all rights reserved).

  20. Understanding Combat-Related PTSD Symptom Expression Through Index Trauma and Military Culture: Case Studies of Filipino Soldiers.

    Science.gov (United States)

    Dela Cruz Fajarito, Cariñez; De Guzman, Rosalito G

    2017-05-01

    Few studies demonstrate how the index trauma may influence subsequent post-traumatic stress disorder (PTSD) symptoms, especially among soldiers. There is still no consensus on specific trauma types and their corresponding PTSD symptom profiles. Furthermore, varied PTSD symptom manifestations that may yield to PTSD trauma subtypes are yet to be known. Importantly, the significance of the military culture's possible influence on soldiers' PTSD has also been underexplored. And the dominant PTSD construct may possibly be unable to capture the essential aspects of the military context in understanding combat-related PTSD. Hence, this study aims to reach an understanding into how index trauma and military culture may possibly shape participants' PTSD expressions. Case study design was used, wherein multiple sources of data-such as PTSD assessments, and interviews with the participants and key informants-enabled data triangulation. The three case reports are the outcomes of the corroboration of evidences that reveal an enriched and holistic understanding of the phenomenon under study. The Ethics Review Board Committee of the Armed Forces of the Philippines Medical Center approved the study. The participants were three Filipino active duty combat soldiers. Although all participants had similar index traumas, their PTSD symptom expressions are unique from one another, in that they differ in terms of their most incapacitating PTSD symptoms and other symptoms that have been potentially shaped by military culture. Their most incapacitating symptoms: hypervigilance (case 1), negative belief in oneself and negative emotions (case 2), prolonged distress, and marked physiological reactions to trauma-related cues (case 3), may be understood in the light of how they personally experienced different circumstances of their index traumas. The way participants have anchored specific components of their sworn soldier's creed (i.e., not leaving a fallen comrade) into some of their PTSD

  1. Assessing the underlying dimensionality of DSM-5 PTSD symptoms in Chinese adolescents surviving the 2008 Wenchuan earthquake.

    Science.gov (United States)

    Wang, Li; Zhang, Lingmin; Armour, Cherie; Cao, Chengqi; Qing, Yulan; Zhang, Jianxin; Liu, Ping; Zhang, Biao; Wu, Qi; Zhao, Zhihong; Fan, Gaolin

    2015-04-01

    By analyzing data yielded from a sample of Chinese adolescents surviving a high-intensity earthquake, this study investigated the underlying dimensionality of DSM-5 PTSD symptoms. The sample included 743 traumatized middle school students (396 females and 332 males) aged 11-17 years (mean=13.6, SD=1.0). Results of confirmatory factor analysis showed that an intercorrelated seven-factor model comprised of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided a significant better representation of DSM-5 PTSD symptoms than other alternative models. Further analyses indicated that external measures of major depression disorder and panic disorder symptoms displayed unique associations with four PTSD factors. The findings provide further support for the newly proposed seven-factor model of DSM-5 PTSD symptoms, add to very limited empirical knowledge on the latent structure of DSM-5 PTSD symptoms among adolescents, and carry implications for further refinement of the current classifications of PTSD symptoms and further clinical practice and research on posttraumatic stress symptomatology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Evaluating the stability of DSM-5 PTSD symptom network structure in a national sample of U.S. military veterans.

    Science.gov (United States)

    von Stockert, Sophia H H; Fried, Eiko I; Armour, Cherie; Pietrzak, Robert H

    2018-03-15

    Previous studies have used network models to investigate how PTSD symptoms associate with each other. However, analyses examining the degree to which these networks are stable over time, which are critical to identifying symptoms that may contribute to the chronicity of this disorder, are scarce. In the current study, we evaluated the temporal stability of DSM-5 PTSD symptom networks over a three-year period in a nationally representative sample of trauma-exposed U.S. military veterans. Data were analyzed from 611 trauma-exposed U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). We estimated regularized partial correlation networks of DSM-5 PTSD symptoms at baseline (Time 1) and at three-year follow-up (Time 2), and examined their temporal stability. Evaluation of the network structure of PTSD symptoms at Time 1 and Time 2 using a formal network comparison indicated that the Time 1 network did not differ significantly from the Time 2 network with regard to network structure (p = 0.12) or global strength (sum of all absolute associations, i.e. connectivity; p = 0.25). Centrality estimates of both networks (r = 0.86) and adjacency matrices (r = 0.69) were highly correlated. In both networks, avoidance, intrusive, and negative cognition and mood symptoms were among the more central nodes. This study is limited by the use of a self-report instrument to assess PTSD symptoms and recruitment of a relatively homogeneous sample of predominantly older, Caucasian veterans. Results of this study demonstrate the three-year stability of DSM-5 PTSD symptom network structure in a nationally representative sample of trauma-exposed U.S. military veterans. They further suggest that trauma-related avoidance, intrusive, and dysphoric symptoms may contribute to the chronicity of PTSD symptoms in this population. Published by Elsevier B.V.

  3. 50 How can informal support impact child PTSD symptoms following a psychological trauma?

    Science.gov (United States)

    Halligan, Sarah

    2017-12-01

    An estimated 20% of children who present to hospital emergency departments following potentially traumatic events (e.g., serious injuries, road traffic accidents, assaults) will develop post-traumatic stress disorder as a consequence. The development of PTSD can have a substantial impact on a child's developmental trajectory, including their emotional, social and educational wellbeing. Despite this, only a small proportion will access mental health services, with the majority relying on informal sources of support. Parents, in particular, are often the primary source of support. However, it remains unclear what types of parental responses may be effective, and parents themselves report experiencing uncertainty about the best approach. To address this gap in knowledge, we examined the capacity for specific aspects of parental responding in the aftermath of child trauma to facilitate or hinder children's psychological recovery. We conducted a longitudinal study of 132 parent-child pairs, recruited following the child's experience of trauma and subsequent attendance at one of four regional emergency departments. At an initial assessment, within 1 month post-trauma, we examined how parents appraised and responded to their child following the event, using both questionnaires and direct observations. Child-report questionnaires were used to assess PTSD symptom severity at 1 month, and at a follow up 6 months later. Children also reported on their own appraisals of the trauma and their coping behaviours, which were considered as potential mediators between parental support and later child symptoms. Controlling for relevant covariates and initial PTSD symptoms, parent negative appraisals of the trauma and encouragement of avoidant coping in children were associated with higher child-reported PTSD symptoms at 6 month follow-up. There was some evidence that children's own trauma related appraisals and coping styles mediated these effects. Findings indicate that

  4. Brain activation to facial expressions in youth with PTSD symptoms.

    Science.gov (United States)

    Garrett, Amy S; Carrion, Victor; Kletter, Hilit; Karchemskiy, Asya; Weems, Carl F; Reiss, Allan

    2012-05-01

    This study examined activation to facial expressions in youth with a history of interpersonal trauma and current posttraumatic stress symptoms (PTSS) compared to healthy controls (HC). Twenty-three medication-naive youth with PTSS and 23 age- and gender-matched HC underwent functional magnetic resonance imaging (fMRI) while viewing fearful, angry, sad, happy, and neutral faces. Data were analyzed for group differences in location of activation, as well as timing of activation during the early versus late phase of the block. Using SPM5, significant activation (P effect of group was identified. Activation from selected clusters was extracted to SPSS software for further analysis of specific facial expressions and temporal patterns of activation. The PTSS group showed significantly greater activation than controls in several regions, including the amygdala/hippocampus, medial prefrontal cortex, insula, and ventrolateral prefrontal cortex, and less activation than controls in the dorsolateral prefrontal cortex (DLPFC). These group differences in activation were greatest during angry, happy, and neutral faces, and predominantly during the early phase of the block. Post hoc analyses showed significant Group × Phase interactions in the right amygdala and left hippocampus. Traumatic stress may impact development of brain regions important for emotion processing. Timing of activation may be altered in youth with PTSS. © 2012 Wiley Periodicals, Inc.

  5. Assessing impact of differential symptom functioning on post-traumatic stress disorder (PTSD) diagnosis.

    Science.gov (United States)

    He, Qiwei; Glas, Cees A W; Veldkamp, Bernard P

    2014-06-01

    This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as differential item functioning [DIF]) related to various background variables such as gender, marital status and educational level, this study emphasizes the importance of evaluating the impact of DIF on population inferences as made in health surveys and clinical trials, and on the diagnosis of individual patients. Using a sample from the National Comorbidity Study-Replication (NCS-R), four symptoms for gender, one symptom for marital status, and three symptoms for educational level were significantly flagged as DIF, but their impact on diagnosis was fairly small. We conclude that the DSM-IV diagnostic criteria for PTSD do not produce substantially biased results in the investigated subpopulations, and there should be few reservations regarding their use. Further, although the impact of DIF (i.e. the influence of differential symptom functioning on diagnostic results) was found to be quite small in the current study, we recommend that diagnosticians always perform a DIF analysis of various subpopulations using the methodology presented here to ensure the diagnostic criteria is valid in their own studies. Copyright © 2014 John Wiley & Sons, Ltd.

  6. Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms.

    Science.gov (United States)

    Di Blasio, Paola; Miragoli, Sarah; Camisasca, Elena; Di Vita, Angela Maria; Pizzo, Rosalia; Pipitone, Laura

    2015-05-01

    Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58) were assessed for depression and PTSD in the prenatal phase (T1). In about 96 hours after childbirth they were randomly assigned to either "Making Sense condition" (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth) or "Control-Neutral condition" (NC: in which they wrote about the daily events in behavioural terms) and then reassessed for depression and PTSD (T2). A follow up was conducted 3 months later (T3) to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth.

  7. Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms

    Directory of Open Access Journals (Sweden)

    Paola Di Blasio

    2015-05-01

    Full Text Available Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58 were assessed for depression and PTSD in the prenatal phase (T1. In about 96 hours after childbirth they were randomly assigned to either “Making Sense condition” (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth or “Control-Neutral condition” (NC: in which they wrote about the daily events in behavioural terms and then reassessed for depression and PTSD (T2. A follow up was conducted 3 months later (T3 to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth.

  8. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans.

    Science.gov (United States)

    Weathers, Frank W; Bovin, Michelle J; Lee, Daniel J; Sloan, Denise M; Schnurr, Paula P; Kaloupek, Danny G; Keane, Terence M; Marx, Brian P

    2018-03-01

    The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  9. A Meta-Analysis for the Efficacy of Hypnotherapy in Alleviating PTSD Symptoms.

    Science.gov (United States)

    Rotaru, Tudor-Ștefan; Rusu, Andrei

    2016-01-01

    A systematic review and meta-analysis of the efficacy of hypnotherapy in the treatment of PTSD used literature searches to obtain 47 articles. However, only 6 were experiments testing the efficacy of hypnosis-based treatments. A fixed-effects meta-analysis was applied to postintervention assessment results and 4-week follow-ups. A large effect in favor of hypnosis-based (especially manualized abreactive hypnosis) treatment was found for the studies that reported the posttest results (d = 1.17). The temporal stability of the effect remains strong, as reflected by the 4-week follow-up assessments (d = 1.58) and also by long-term evaluations (e.g., 12 months). Hypnosis appears to be effective in alleviating PTSD symptoms.

  10. Utility of the Mild Brain Injury Atypical Symptoms Scale to detect symptom exaggeration: an analogue simulation study.

    Science.gov (United States)

    Lange, Rael T; Edmed, Shannon L; Sullivan, Karen A; French, Louis M; Cooper, Douglas B

    2013-01-01

    Brief self-report symptom checklists are often used to screen for postconcussional disorder (PCD) and posttraumatic stress disorder (PTSD) and are highly susceptible to symptom exaggeration. This study examined the utility of the five-item Mild Brain Injury Atypical Symptoms Scale (mBIAS) designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist-Civilian (PCL-C). Participants were 85 Australian undergraduate students who completed a battery of self-report measures under one of three experimental conditions: control (i.e., honest responding, n = 24), feign PCD (n = 29), and feign PTSD (n = 32). Measures were the mBIAS, NSI, PCL-C, Minnesota Multiphasic Personality Inventory-2, Restructured Form (MMPI-2-RF), and the Structured Inventory of Malingered Symptomatology (SIMS). Participants instructed to feign PTSD and PCD had significantly higher scores on the mBIAS, NSI, PCL-C, and MMPI-2-RF than did controls. Few differences were found between the feign PCD and feign PTSD groups, with the exception of scores on the NSI (feign PCD > feign PTSD) and PCL-C (feign PTSD > feign PCD). Optimal cutoff scores on the mBIAS of ≥8 and ≥6 were found to reflect "probable exaggeration" (sensitivity = .34; specificity = 1.0; positive predictive power, PPP = 1.0; negative predictive power, NPP = .74) and "possible exaggeration" (sensitivity = .72; specificity = .88; PPP = .76; NPP = .85), respectively. Findings provide preliminary support for the use of the mBIAS as a tool to detect symptom exaggeration when administering the NSI and PCL-C.

  11. Latent profiles of DSM-5 PTSD symptoms and the "Big Five" personality traits.

    Science.gov (United States)

    Contractor, Ateka A; Armour, Cherie; Shea, M Tracie; Mota, Natalie; Pietrzak, Robert H

    2016-01-01

    Typologies of DSM-5 PTSD symptoms and personality traits were evaluated in regard to coping styles and treatment preferences using data from 1266 trauma-exposed military veterans of which the majority were male (n=1097; weighted 89.6%). Latent profile analyses indicated a best-fitting 5-class solution; PTSD asymptomatic and emotionally stable (C1); predominant re-experiencing and avoidance symptoms and less emotionally stable (C2); subsyndromal PTSD (C3); predominant negative alterations in mood/cognitions and combined internalizing-externalizing traits (C4); and high PTSD severity and combined internalizing-externalizing traits (C5). Compared to C5, C1 members were less likely to use self-distraction, denial, and substance use and more likely to use active coping; C2 and C4 members were less likely to use denial and more likely to use behavioral disengagement; C3 members were less likely to use denial and instrumental coping and more likely to use active coping; most classes were less likely to seek mental health treatment. Compared to C1, C2 members were more likely to use self-distraction, substance use, behavioral disengagement and less likely to use active coping; C3 members were more likely to use self-distraction, and substance use, and less likely to use positive reframing, and acceptance; and C4 members were more likely to use denial, substance use, emotional support, and behavioral disengagement, and less likely to use active coping, positive reframing, and acceptance; all classes were more likely to seek mental health treatment. Emotional stability was most distinguishing of the typologies. Other implications are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Reliability and Validity of the Korean Version of the Symptom Checklist-Post-Traumatic Stress Disorder Scale

    Science.gov (United States)

    2016-01-01

    The Symptom Checklist - Post-Traumatic Stress Disorder Scale (SCL-PTSD), also known as Crime-Related PTSD Scale has been validated in survivors of interpersonal trauma in the general population. However, the psychometric properties have not been investigated in a clinical setting for patients with PTSD from diverse traumatic events. This study investigates the reliability and validity of the Korean version of the SCL-PTSD among 104 psychiatric outpatients with PTSD, caused by interpersonal (n = 50) or non-interpersonal trauma (n = 54). Self-report data of the SCL-PTSD, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Impact of Events Scale-Revised (IES-R) were gathered. The Korean version of the SCL-PTSD showed excellent internal consistency and moderate-to-good four-week temporal stability in both the interpersonal and non-interpersonal trauma groups. In comparison with other diagnostic groups, the scores of the SCL-PTSD were significantly higher compared to those of adjustment disorder, depression, other anxiety disorders, and schizophrenia, demonstrating its criteria-related validity. Convergent validity was confirmed because the scores of the SCL-PTSD were significantly correlated with BDI, SAI and TAI scores. Concurrent validity was demonstrated by significant correlation with the IES-R score. This study demonstrated the favorable psychometric prosperities of the Korean version of the SCL-PTSD, supporting its use in clinical research and practice. PMID:27134501

  13. PTSD symptom severity is associated with increased recruitment of top-down attentional control in a trauma-exposed sample.

    Science.gov (United States)

    White, Stuart F; Costanzo, Michelle E; Blair, James R; Roy, Michael J

    2015-01-01

    Recent neuroimaging work suggests that increased amygdala responses to emotional stimuli and dysfunction within regions mediating top down attentional control (dorsomedial frontal, lateral frontal and parietal cortices) may be associated with the emergence of anxiety disorders, including posttraumatic stress disorder (PTSD). This report examines amygdala responsiveness to emotional stimuli and the recruitment of top down attention systems as a function of task demands in a population of U.S. military service members who had recently returned from combat deployment in Afghanistan/Iraq. Given current interest in dimensional aspects of pathophysiology, it is worthwhile examining patients who, while not meeting full PTSD criteria, show clinically significant functional impairment. Fifty-seven participants with sub-threshold levels of PTSD symptoms completed the affective Stroop task while undergoing fMRI. Participants with PTSD or depression at baseline were excluded. Greater PTSD symptom severity scores were associated with increased amygdala activation to emotional, particularly positive, stimuli relative to neutral stimuli. Furthermore, greater PTSD symptom severity was associated with increased superior/middle frontal cortex response during task conditions relative to passive viewing conditions. In addition, greater PTSD symptom severity scores were associated with: (i) increased activation in the dorsolateral prefrontal, lateral frontal, inferior parietal cortices and dorsomedial frontal cortex/dorsal anterior cingulate cortex (dmFC/dACC) in response to emotional relative to neutral stimuli; and (ii) increased functional connectivity during emotional trials, particularly positive trials, relative to neutral trials between the right amygdala and dmFC/dACC, left caudate/anterior insula cortex, right lentiform nucleus/caudate, bilateral inferior parietal cortex and left middle temporal cortex. We suggest that these data may reflect two phenomena associated with

  14. Trajectories of depressive symptoms in foster youth transitioning into adulthood: the roles of emotion dysregulation and PTSD.

    Science.gov (United States)

    Valdez, Christine E; Bailey, Brenda E; Santuzzi, Alecia M; Lilly, Michelle M

    2014-01-01

    Foster youth often experience considerable adversity both in and out of foster care, including histories of abuse and/or neglect, and further stressors within the foster system. These adverse experiences often occur at key developmental periods that can compromise emotional functioning and lead to posttraumatic symptomatology, including posttraumatic stress disorder (PTSD) and emotion dysregulation. In the face of difficult histories and ongoing mental health challenges, youth transitioning into adulthood may be particularly vulnerable to increases in depressive symptoms. We explored the trajectory of depressive symptoms in foster youth from age 17 to 19 using a piecewise linear growth model, examining the effects of PTSD and emotion dysregulation on youth's depressive symptoms over time. Results revealed depressive symptoms decreased from age 17 to 18 but increased from 18 to 19. PTSD and emotion dysregulation predicted greater baseline depressive symptoms and decreases in symptoms from age 17 to 18, whereas only PTSD predicted increases in depressive symptoms from 18 to 19. Females reported higher levels of depressive symptoms compared to males. Additionally, emotion dysregulation was a stronger predictor of depressive symptoms for females than males. Implications for service delivery for foster youth transitioning into adulthood are discussed. © The Author(s) 2014.

  15. Maternal Factors as Moderators or Mediators of PTSD Symptoms in Very Young Children: A Two-Year Prospective Study

    OpenAIRE

    Scheeringa, Michael S.; Myers, Leann; Putnam, Frank W.; Zeanah, Charles H.

    2015-01-01

    Research has suggested that parenting behaviors and other parental factors impact the long-term outcome of children’s posttraumatic stress disorder (PTSD) symptoms. In a sample of 62 children between the ages of one and six who experienced life-threatening traumas, PTSD was measured prospectively two years apart. Seven maternal factors were measured in a multi-method, multi-informant design. Both moderation and mediation models, with different theoretical and mechanism implications, were test...

  16. Maternal Factors as Moderators or Mediators of PTSD Symptoms in Very Young Children: A Two-Year Prospective Study.

    Science.gov (United States)

    Scheeringa, Michael S; Myers, Leann; Putnam, Frank W; Zeanah, Charles H

    2015-07-01

    Research has suggested that parenting behaviors and other parental factors impact the long-term outcome of children's posttraumatic stress disorder (PTSD) symptoms. In a sample of 62 children between the ages of one and six who experienced life-threatening traumas, PTSD was measured prospectively two years apart. Seven maternal factors were measured in a multi-method, multi-informant design. Both moderation and mediation models, with different theoretical and mechanism implications, were tested. Moderation models were not significant. Mediation models were significant when the mediator variable was maternal symptoms of PTSD or depression (measured at Time 1), self-report of maternal escape/avoidance coping (measured at Time 2), or self-report emotional sensitivity (measured at Time 2). Greater maternal emotional sensitivity was associated with greater Time 2 PTSD symptoms among children. Observational measures of emotional sensitivity as the mediator were not supported. Correlation of parents' and children's symptoms is a robust finding, however caution is warranted in attributing children's PTSD symptoms to insensitive parenting.

  17. Changes in negative cognitions mediate PTSD symptom reductions during client-centered therapy and prolonged exposure for adolescents.

    Science.gov (United States)

    McLean, Carmen P; Yeh, Rebecca; Rosenfield, David; Foa, Edna B

    2015-05-01

    To assess whether changes in negative trauma-related cognitions play an important role in reducing symptoms of posttraumatic stress disorder (PTSD) and depression during prolonged exposure therapy for adolescents (PE-A). Secondary analysis of data from a randomized controlled trial comparing PE-A with client-centered therapy (CCT) for PTSD. Participants were 61 adolescent female sexual assault survivors ages 13-18 who received 8-14 weekly sessions of PE-A or CCT at a community rape crisis center. PTSD severity was assessed at baseline, mid-treatment, post-treatment, and 3-months post-treatment. Participants also completed self-report measures of negative posttraumatic cognitions and depressive symptoms at the same assessment points. Cross lag panel mediation analyses showed that change in negative trauma-related cognitions mediated change in PTSD symptoms and depressive symptoms whereas change in PTSD and depressive symptoms did not mediate change in negative cognitions. Our findings support EPT and suggest that change in negative trauma-related cognitions is a mechanism of both PE-A and CCT. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Cortisol at the emergency room rape visit as a predictor of PTSD and depression symptoms over time.

    Science.gov (United States)

    Walsh, Kate; Nugent, Nicole R; Kotte, Amelia; Amstadter, Ananda B; Wang, Sheila; Guille, Constance; Acierno, Ron; Kilpatrick, Dean G; Resnick, Heidi S

    2013-11-01

    Dysregulation of the hypothalamic-pituitary-adrenal axis, typically reflected by alterations in cortisol responsivity, has been associated with exposure to traumatic events and the development of stress-related disorders such as posttraumatic stress disorder (PTSD) and depression. Serum cortisol was measured at the time of a post sexual assault medical exam among a sample of 323 female victims of recent sexual assault. Analyses were conducted among 235 participants who provided data regarding history of previous assault as well as PTSD and depression symptoms during at least one of the three follow-ups. Growth curve models suggested that prior history of assault and serum cortisol were positively associated with the intercept and negatively associated with the slope of PTSD and depression symptoms after controlling for covariates. Prior history of assault and serum cortisol also interacted to predict the intercept and slope of PTSD and depression symptoms such that women with a prior history of assault and lower ER cortisol had higher initial symptoms that decreased at a slower rate relative to women without a prior history and those with higher ER cortisol. Prior history of assault was associated with diminished acute cortisol responsivity at the emergency room visit. Prior assault history and cortisol both independently and interactively predicted PTSD and depression symptoms at first follow-up and over the course a 6-month follow-up. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Emotional distress and positive and negative memories from military deployment: The influence of PTSD symptoms and time

    DEFF Research Database (Denmark)

    Niziurski, Julie Ann; Johannessen, Kim Berg; Berntsen, Dorthe

    2017-01-01

    positive deployment memories from a company of 337 soldiers who were deployed together to Afghanistan. We examined how the level of emotional distress of the soldiers and the valence of the memory were related to the emotional intensity, experience of reliving, rehearsal and coherence of the memories......, and how the perceived impact of these memories changed over time. We found that soldiers with higher levels of post-traumatic stress disorder (PTSD) symptoms were more affected by both their negative and positive memories, compared with soldiers with lower levels of PTSD symptoms. Emotional intensity...... of the most negative memory increased over time in the group with highest levels of PTSD symptoms, but dropped in the other groups. The present study adds to the literature on emotion and autobiographical memory and how this relationship interacts with an individual’s present level of emotional distress...

  20. Khat use, PTSD and psychotic symptoms among Somali refugees in Nairobi - a pilot study

    Directory of Open Access Journals (Sweden)

    Marina eWidmann

    2014-06-01

    Full Text Available In East-African and Arab countries, khat leaves are traditionally chewed in social settings. They contain the amphetamine-like alkaloid cathinone. Especially among Somali refugees khat use has been associated with psychiatric symptoms. We assessed khat use patterns and psychiatric symptoms among male Somali refugees living in a disadvantaged urban settlement area in Kenya, a large group that has not yet received scientific attention. We wanted to explore consume patterns and study the associations between khat use, traumatic experiences and psychotic symptoms.Using privileged access sampling we recruited 33 healthy male khat chewers and 15 comparable non-chewers. Based on extensive preparatory work, we assessed khat use, khat dependence according to DSM-IV, traumatic experiences, Posttraumatic Stress Disorder and psychotic symptoms using standardized diagnostic instruments that had been adapted to the Somali language and culture.Hazardous use patterns like chewing for more than 24 hours without interruption were frequently reported. All khat users fulfilled the DSM-IV-criteria for dependence and eighty-five percent reported functional khat-use, i.e. that khat helps them to forget painful experiences. We found that the studied group was heavily burdened by traumatic events and posttraumatic symptoms. Khat users had experienced more traumatic events and had more often PTSD than non-users. Most khat users experience khat-related psychotic symptoms and in a quarter of them we found true psychotic symptoms. In contrast, among control group members no psychotic symptoms could be detected.We found first evidence for the existence and high prevalence of severely hazardous use patterns, comorbid psychiatric symptoms and khat use as a self-medication of trauma-consequences among male Somali refugees in urban Kenyan refugee settlements. There is a high burden by psychopathology and adequate community-based interventions urgently need to be developed.

  1. Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of Posttraumatic Stress Disorder (PTSD) Symptoms Among Active Duty Military Members

    Science.gov (United States)

    2016-03-01

    you were manic-depressive or had bipolar disorder ?* ○ No ○ Yes 9. Have you received therapy for PTS/PTSD in the past month?* ○ No [Go to Question...Posttraumatic Stress Disorder (PTSD) Symptoms among Active Duty Military Members PRINCIPAL INVESTIGATOR: Bradford B. Walters, MD, PhD CONTRACTING...of Posttraumatic Stress Disorder (PTSD) Symptoms among Active Duty Military Members 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

  2. The Association Between Peritraumatic Dissociation and PTSD Symptoms: The Mediating Role of Negative Beliefs About the Self.

    Science.gov (United States)

    Thompson-Hollands, Johanna; Jun, Janie J; Sloan, Denise M

    2017-04-01

    Peritraumatic dissociation, a term used to describe a complex array of reactions to trauma, including depersonalization, derealization, and emotional numbness, has been associated with posttraumatic stress disorder (PTSD) symptoms across a number of studies. Cognitive theory suggests that interpretations of traumatic events and reactions underlie the persistence of PTSD. The present study examined the associations among peritraumatic dissociation, posttraumatic cognitions, and PTSD symptoms in a group of trauma-exposed adults (N = 169). Results indicated that, after accounting for overall symptom severity and current dissociative tendencies, peritraumatic dissociation was significantly predictive of negative beliefs about the self (R 2 = .06, p < .001). Other categories of maladaptive posttraumatic cognitions did not show a similar relationship (R 2 = .01 to .02, nonsignificant). Negative thoughts about the self partially mediated the association between peritraumatic dissociation and PTSD severity (completely standardized indirect effect = .25). These findings lend support to cognitive theories of PTSD and point to an important area for clinical intervention. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  3. Coping Self-Efficacy Moderates the Association Between Severity of Partner Violence and PTSD Symptoms Among Incarcerated Women.

    Science.gov (United States)

    DeCou, Christopher R; Lynch, Shannon M; Cole, Trevor T; Kaplan, Stephanie P

    2015-10-01

    Previous research indicates self-efficacy may function as a protective factor for survivors of partner violence (PV), including coping self-efficacy specific to domestic violence. We hypothesized that domestic violence coping self-efficacy would moderate the association between recent PV and posttraumatic stress disorder (PTSD) symptoms in a sample of incarcerated women, such that the association between PV and PTSD would be strongest at low levels of domestic violence coping self-efficacy. Participants (N = 102) were incarcerated women who reported PV in the year prior to incarceration. They were aged 19-55 years (M = 33.57, SD = 9.32), identified predominantly as European American (84.3%), American Indian (15.7%), and Hispanic (14.7%), with 80.4% completing high school or more in terms of education. Participants responded to self-report measures of PV, trauma history, domestic violence coping self-efficacy, and current PTSD symptoms. In a series of sequential regression analyses, PV (β = .65, sr(2) = .06, p = .017) was significantly associated with current PTSD symptoms above and beyond past trauma history (β = .37, sr(2) = .14, p violence coping self-efficacy (Domestic Violence Coping Self-Efficacy × Partner Violence; β = -.54, sr(2) = .03, p = .044). The relationship between PV and PTSD symptoms was greatest at low and average levels of domestic violence coping self-efficacy and nonsignificant at high levels of domestic violence coping self-efficacy. These findings highlight the importance of assessing domestic violence coping self-efficacy in incarcerated women with recent PV, given that domestic violence coping self-efficacy appeared to be protective against symptoms of PTSD. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

  4. Type D personality and the development of PTSD symptoms: a prospective study

    NARCIS (Netherlands)

    Rademaker, Arthur R.; van Zuiden, Mirjam; Vermetten, Eric; Geuze, Elbert

    2011-01-01

    Psychological trauma and prolonged stress may cause mental disorders such as posttraumatic stress disorder (PTSD). Pretrauma personality is an important determinant of posttraumatic adjustment. Specifically, trait neuroticism has been identified as a risk factor for PTSD. Additionally, the

  5. Variation in post-traumatic response: the role of trauma type in predicting ICD-11 PTSD and CPTSD symptoms.

    Science.gov (United States)

    Hyland, Philip; Murphy, Jamie; Shevlin, Mark; Vallières, Frédérique; McElroy, Eoin; Elklit, Ask; Christoffersen, Mogens; Cloitre, Marylène

    2017-06-01

    The World Health Organization's 11th revision to the International Classification of Diseases manual (ICD-11) will differentiate between two stress-related disorders: PTSD and Complex PTSD (CPTSD). ICD-11 proposals suggest that trauma exposure which is prolonged and/or repeated, or consists of multiple forms, that also occurs under circumstances where escape from the trauma is difficult or impossible (e.g., childhood abuse) will confer greater risk for CPTSD as compared to PTSD. The primary objective of the current study was to provide an empirical assessment of this proposal. A stratified, random probability sample of a Danish birth cohort (aged 24) was interviewed by the Danish National Centre for Social Research (N = 2980) in 2008-2009. Data from this interview were used to generate an ICD-11 symptom-based classification of PTSD and CPTSD. The majority of the sample (87.1%) experienced at least one of eight traumatic events spanning childhood and early adulthood. There was some indication that being female increased the risk for both PTSD and CPTSD classification. Multinomial logistic regression results found that childhood sexual abuse (OR = 4.98) and unemployment status (OR = 4.20) significantly increased risk of CPTSD classification as compared to PTSD. A dose-response relationship was observed between exposure to multiple forms of childhood interpersonal trauma and risk of CPTSD classification, as compared to PTSD. Results provide empirical support for the ICD-11 proposals that childhood interpersonal traumatic exposure increases risk of CPTSD symptom development.

  6. Factor structure of DSM-5 PTSD symptoms in trauma-exposed adolescents: Examining stability across time.

    Science.gov (United States)

    Wang, Li; Cao, Xing; Cao, Chengqi; Fang, Ruojiao; Yang, Haibo; Elhai, Jon D

    2017-12-01

    This study investigated the latent structure of DSM-5 PTSD symptoms using two-wave longitudinal data collected from a sample of adolescents exposed to an explosion accident. Two waves of surveys were conducted approximately 3 and 8 months after the accident, respectively. A total of 836 students completed the baseline survey, and 762 students completed the follow-up survey. The results of confirmatory factor analyses(CFA) indicated that a seven-factor hybrid model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal and dysphoric arousal factors yielded significantly better data fit at both waves than the other models including the DSM-5 four-factor model, the six-factor anhedonia and externalizing behaviors models. Furthermore, the results of CFA invariance tests supported the longitudinal invariance of the model. Implications and limitations in terms of these results are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Effects of acculturative stress on PTSD, depressive, and anxiety symptoms among refugees resettled in Australia and Austria

    Directory of Open Access Journals (Sweden)

    Dzenana Kartal

    2016-02-01

    Full Text Available Background: Research indicates that exposure to war-related traumatic events impacts on the mental health of refugees and leads to higher rates of posttraumatic stress disorder (PTSD, depression, and anxiety symptoms. Furthermore, stress associated with the migration process has also been shown to impact negatively on refugees’ mental health, but the extent of these experiences is highly debatable as the relationships between traumatic events, migration, and mental health outcomes are complex and poorly understood. Objective: This study aimed to examine the influence of trauma-related and post-migratory factors on symptoms of PTSD, depression, and anxiety in two samples of Bosnian refugees that have resettled in two different host nations—Austria and Australia. Method: Using multiple recruitment methods, 138 participants were recruited to complete self-report measures assessing acculturative stress, PTSD, depressive, and anxiety symptoms. Results: Hierarchical regressions indicated that after controlling for age, sex, and exposure to traumatic events, acculturative stress associated with post-migratory experiences predicted severity of PTSD and anxiety symptoms, while depressive symptoms were only predicted by exposure to traumatic events. This model, however, was only significant for Bosnian refugees resettled in Austria, as PTSD, depressive, and anxiety symptoms were only predicted by traumatic exposure in the Bosnian refugees resettled in Australia. Conclusion: These findings point toward the importance of assessing both psychological and social stressors when assessing mental health of refugees. Furthermore, these results draw attention to the influence of the host society on post-migratory adaptation and mental health of refugees. Further research is needed to replicate these findings among other refugee samples in other host nations.

  8. Effects of acculturative stress on PTSD, depressive, and anxiety symptoms among refugees resettled in Australia and Austria.

    Science.gov (United States)

    Kartal, Dzenana; Kiropoulos, Litza

    2016-01-01

    Research indicates that exposure to war-related traumatic events impacts on the mental health of refugees and leads to higher rates of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Furthermore, stress associated with the migration process has also been shown to impact negatively on refugees' mental health, but the extent of these experiences is highly debatable as the relationships between traumatic events, migration, and mental health outcomes are complex and poorly understood. This study aimed to examine the influence of trauma-related and post-migratory factors on symptoms of PTSD, depression, and anxiety in two samples of Bosnian refugees that have resettled in two different host nations-Austria and Australia. Using multiple recruitment methods, 138 participants were recruited to complete self-report measures assessing acculturative stress, PTSD, depressive, and anxiety symptoms. Hierarchical regressions indicated that after controlling for age, sex, and exposure to traumatic events, acculturative stress associated with post-migratory experiences predicted severity of PTSD and anxiety symptoms, while depressive symptoms were only predicted by exposure to traumatic events. This model, however, was only significant for Bosnian refugees resettled in Austria, as PTSD, depressive, and anxiety symptoms were only predicted by traumatic exposure in the Bosnian refugees resettled in Australia. These findings point toward the importance of assessing both psychological and social stressors when assessing mental health of refugees. Furthermore, these results draw attention to the influence of the host society on post-migratory adaptation and mental health of refugees. Further research is needed to replicate these findings among other refugee samples in other host nations.

  9. Relationships among Adult Attachment, Social Support, and PTSD Symptoms in Trauma-Exposed College Students

    Science.gov (United States)

    Pruneau, Genevieve Mary Catherine

    2010-01-01

    Although many people are exposed to trauma, substantially fewer develop posttraumatic stress disorder (PTSD). Given this, studies have examined risk and protective factors for developing PTSD. This literature has established that there is a robust negative correlation between social support and PTSD. Attachment insecurity may be an informative…

  10. Preventing PTSD with oxytocin: effects of oxytocin administration on fear neurocircuitry and PTSD symptom development in recently trauma-exposed individuals

    NARCIS (Netherlands)

    Frijling, Jessie L.

    2017-01-01

    Background: Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder which develops in approximately 10% of trauma-exposed individuals. Currently, there are few early preventive interventions available for PTSD. Intranasal oxytocin administration early posttrauma may prevent PTSD

  11. Positive Traits versus Previous Trauma: Racially Different Correlates with PTSD Symptoms among Hurricane Katrina-Rita Volunteers

    Science.gov (United States)

    Ai, Amy L.; Plummer, Carol; Kanno, Hanae; Heo, Grace; Appel, Hoa B.; Simon, Cassandra E.; Spigner, Clarence

    2011-01-01

    This study compared risks and protective factors for acquiring symptoms of posttraumatic stress disorder (PTSD) between African-American (n = 299) and European-American (n = 206) student volunteers 3 months after Hurricanes Katrina and Rita (H-KR). Respondents retrospectively provided information on peritraumatic emotional reactions and previous…

  12. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

    -Revised (SCL-90-R). At the 5 year follow-up, the PTSD Checklist-Civilian (PCL-C) was also administered to confirm the findings from CR-PTSD and to determine whether the women met the DSM-IV symptom criteria of PTSD. ANOVA was performed using treatment group as a between factor and the four time points...... follow-up by the total symptom severity score on the PCL-C (r = 0.929). Of the women participating in the 5-years follow-up, 18 (28%) met the DSM-IV symptom criteria as measured by PCL-C (analytic: 36%, systemic: 21%, χ2 NS). Conclusion: Symptoms of PTSD and general psychiatric distress were reduced...... and general psychiatric distress (GSI from SCL-90-R) five years after discharge among adult women suffering from sequelae from childhood sexual abuse. Materials and method: This 5-year follow-up study of a randomized controlled trial included 106 women: 52 assigned to analytic group psychotherapy and 54...

  13. Web intervention for OEF/OIF veterans with problem drinking and PTSD symptoms: a randomized clinical trial.

    Science.gov (United States)

    Brief, Deborah J; Rubin, Amy; Keane, Terence M; Enggasser, Justin L; Roy, Monica; Helmuth, Eric; Hermos, John; Lachowicz, Mark; Rybin, Denis; Rosenbloom, David

    2013-10-01

    Veterans who served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) commonly experience alcohol misuse and symptoms of posttraumatic stress disorder (PTSD) following their return from deployment to a war zone. We conducted a randomized clinical trial to evaluate the efficacy of a newly developed, 8-module, self-management web intervention (VetChange) based on motivational and cognitive-behavioral principles to reduce alcohol consumption, alcohol-related problems, and PTSD symptoms in returning combat veterans. Six hundred participants, recruited through targeted Facebook ads, were randomized to either an Initial Intervention Group (IIG; n = 404) or a Delayed Intervention Group (DIG; n = 196) that waited 8 weeks for access to VetChange. Primary outcome measures were Drinks per Drinking Day, Average Weekly Drinks, Percent Heavy Drinking Days, and PTSD symptoms. Intent-to-treat analyses compared changes in outcome measures over time between IIG and DIG as well as within-group changes. IIG participants demonstrated greater reductions in drinking (p < .001 for each measure) and PTSD symptoms (p = .009) between baseline and end-of-intervention than did DIG participants between baseline and the end of the waiting period. DIG participants showed similar improvements to those in IIG following participation in VetChange. Alcohol problems were also reduced within each group between baseline and 3-month follow-up. Results indicate that VetChange is effective in reducing drinking and PTSD symptoms in OIF/OEF veterans. Further studies of VetChange are needed to assess web-based recruitment and retention methods and to determine VetChange's effectiveness in demographic and clinical sub-populations of returning veterans. (c) 2013 APA, all rights reserved.

  14. Effect of Prolonged Exposure Therapy Delivered Over 2 Weeks vs 8 Weeks vs Present-Centered Therapy on PTSD Symptom Severity in Military Personnel: A Randomized Clinical Trial.

    Science.gov (United States)

    Foa, Edna B; McLean, Carmen P; Zang, Yinyin; Rosenfield, David; Yadin, Elna; Yarvis, Jeffrey S; Mintz, Jim; Young-McCaughan, Stacey; Borah, Elisa V; Dondanville, Katherine A; Fina, Brooke A; Hall-Clark, Brittany N; Lichner, Tracey; Litz, Brett T; Roache, John; Wright, Edward C; Peterson, Alan L

    2018-01-23

    Effective and efficient treatment is needed for posttraumatic stress disorder (PTSD) in active duty military personnel. To examine the effects of massed prolonged exposure therapy (massed therapy), spaced prolonged exposure therapy (spaced therapy), present-centered therapy (PCT), and a minimal-contact control (MCC) on PTSD severity. Randomized clinical trial conducted at Fort Hood, Texas, from January 2011 through July 2016 and enrolling 370 military personnel with PTSD who had returned from Iraq, Afghanistan, or both. Final follow-up was July 11, 2016. Prolonged exposure therapy, cognitive behavioral therapy involving exposure to trauma memories/reminders, administered as massed therapy (n = 110; 10 sessions over 2 weeks) or spaced therapy (n = 109; 10 sessions over 8 weeks); PCT, a non-trauma-focused therapy involving identifying/discussing daily stressors (n = 107; 10 sessions over 8 weeks); or MCC, telephone calls from therapists (n = 40; once weekly for 4 weeks). Outcomes were assessed before and after treatment and at 2-week, 12-week, and 6-month follow-up. Primary outcome was interviewer-assessed PTSD symptom severity, measured by the PTSD Symptom Scale-Interview (PSS-I; range, 0-51; higher scores indicate greater PTSD severity; MCID, 3.18), used to assess efficacy of massed therapy at 2 weeks posttreatment vs MCC at week 4; noninferiority of massed therapy vs spaced therapy at 2 weeks and 12 weeks posttreatment (noninferiority margin, 50% [2.3 points on PSS-I, with 1-sided α = .05]); and efficacy of spaced therapy vs PCT at posttreatment. Among 370 randomized participants, data were analyzed for 366 (mean age, 32.7 [SD, 7.3] years; 44 women [12.0%]; mean baseline PSS-I score, 25.49 [6.36]), and 216 (59.0%) completed the study. At 2 weeks posttreatment, mean PSS-I score was 17.62 (mean decrease from baseline, 7.13) for massed therapy and 21.41 (mean decrease, 3.43) for MCC (difference in decrease, 3.70 [95% CI,0.72 to 6.68]; P = .02

  15. Parenting in the Wake of Abuse: Exploring the Mediating Role of PTSD Symptoms on the Relationship Between Parenting and Child Functioning.

    Science.gov (United States)

    Symes, Lene; McFarlane, Judith; Fredland, Nina; Maddoux, John; Zhou, Weiden

    2016-02-01

    Children whose mothers report partner violence and symptoms of posttraumatic stress disorder (PTSD) are at risk for behavior dysfunctions. To examine the mediating effects of maternal PTSD symptoms on the relationship of parenting behaviors to child internalizing and externalizing behavior dysfunctions. Maternal PTSD symptoms have a partial mediating effect on the relationship between inconsistent discipline and child internalizing and externalizing behaviors. Maternal PTSD symptoms have a fully mediating effect on the relationship between poor supervision and child internalizing behaviors. There is a need to identify women who report partner violence and are at high risk for PTSD and intervene early to prevent problematic parenting and resulting child behavior problems. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Sleep diaries of Vietnam War veterans with chronic PTSD: the relationships among insomnia symptoms, psychosocial stress, and nightmares.

    Science.gov (United States)

    Gehrman, Philip R; Harb, Gerlinde C; Cook, Joan M; Barilla, Holly; Ross, Richard J

    2015-01-01

    Impaired sleep and nightmares are known symptoms of posttraumatic stress disorder (PTSD) in the veteran population. In order to assess prospectively the sleep disturbances in this population, sleep diaries are an effective way to obtain information over an extended period of time. In this investigation, a sample of veterans (N = 105) completed daily sleep diaries for a 6-week period. Greater PTSD severity and nightmare-related distress were correlated with more awakenings, shorter duration of sleep, longer sleep latency, and greater frequency of nightmares. Perceived frequency of daytime stressors was associated with an increased number of nightmares, nightmare-related distress, and longer sleep latency. The use of sleep diaries in future investigations may allow targeted treatments for veteran populations with PTSD and sleep disturbances.

  17. Hair cortisol concentrations and cortisol stress reactivity predict PTSD symptom increase after trauma exposure during military deployment.

    Science.gov (United States)

    Steudte-Schmiedgen, Susann; Stalder, Tobias; Schönfeld, Sabine; Wittchen, Hans-Ulrich; Trautmann, Sebastian; Alexander, Nina; Miller, Robert; Kirschbaum, Clemens

    2015-09-01

    Previous evidence on endocrine risk markers for posttraumatic stress disorder (PTSD) has been inconclusive. Here, we report results of the first prospective study to investigate whether long-term hair cortisol levels and experimentally-induced cortisol stress reactivity are predictive of the development of PTSD symptomatology in response to trauma during military deployment. Male soldiers were examined before deployment to Afghanistan and at a 12-month post-deployment follow-up using dimensional measures for psychopathological symptoms. The predictive value of baseline (i) hair cortisol concentrations (HCC, N=90) and (ii) salivary cortisol stress reactivity (measured by the Trier Social Stress Test, N=80) for the development of PTSD symptomatology after being exposed to new-onset traumatic events was analyzed. Baseline cortisol activity significantly predicted PTSD symptom change from baseline to follow-up upon trauma exposure. Specifically, our results consistently revealed that lower HCC and lower cortisol stress reactivity were predictive of a greater increase in PTSD symptomatology in soldiers who had experienced new-onset traumatic events (explaining 5% and 10.3% of variance, respectively). Longitudinal analyses revealed an increase in HCC from baseline to follow-up and a trend for a negative relationship between HCC changes and the number of new-onset traumatic events. Additional pre-deployment analyses revealed that trauma history was reflected in lower HCC (at trend level) and that HCC were negatively related to stressful load. Our data indicate that attenuated cortisol secretion is a risk marker for subsequent development of PTSD symptomatology upon trauma exposure. Future studies are needed to confirm our findings in other samples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Oxytocin is associated with PTSD's anxious arousal symptoms in Chinese male earthquake survivors

    OpenAIRE

    Chengqi Cao; Li Wang; Richu Wang; Yulan Qing; Jianxin Zhang

    2014-01-01

    Background: Posttraumatic stress disorder (PTSD) is a complex and severe mental disorder triggered by exposure to an extraordinarily traumatic event. Human and animal studies have implied the functional role of the oxytocin system in the development of PTSD (Cochran, Fallon, Hill, & Frazier, 2013; Koch et al., 2014; Olff, 2012). Specification of the role of the oxytocin system in the emergence and progression of PTSD symptomatology would provide evidence to inform both theory and clinical pra...

  19. Prevalence and correlates of posttrauma distorted beliefs: evaluating DSM-5 PTSD expanded cognitive symptoms in a national sample.

    Science.gov (United States)

    Cox, Keith S; Resnick, Heidi S; Kilpatrick, Dean G

    2014-06-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013) modified the diagnostic criteria for posttraumatic stress disorder (PTSD), including expanding the scope of dysfunctional, posttrauma changes in belief (symptoms D2-persistent negative beliefs and expectations about oneself or the world, and D3-persistent distorted blame of self or others for the cause or consequences of the traumatic event). D2 and D3 were investigated using a national sample of U.S. adults (N = 2,498) recruited from an online panel. The prevalence of D2 and D3 was substantially higher among those with lifetime PTSD than among trauma-exposed individuals without lifetime PTSD (D2: 74.6% vs 23.9%; D3: 80.6% vs 35.7%). In multivariate analyses, the strongest associates of D2 were interpersonal assault (OR = 2.39), witnessing interpersonal assault (OR = 1.63), gender (female, OR = 2.11), and number of reported traumatic events (OR = 1.88). The strongest correlates of D3 were interpersonal assault (OR = 3.08), witnessing interpersonal assault (OR = 1.57), gender (female, OR = 2.30), and number of reported traumatic events (OR = 1.91). The findings suggested the expanded cognitive symptoms in the DSM-5 diagnostic criteria better capture the cognitive complexity of PTSD than those of the DSM-IV. Copyright © 2014 International Society for Traumatic Stress Studies.

  20. Development and Validation of a PTSD-Related Impairment Scale

    Science.gov (United States)

    2012-06-01

    Social Adjustment Scale (SAS-SR) (58] Dyadic Adjustment Scale (DAS) [59] Life Stressors and Social Resources Inventory ( LISRES ) [60] 3...measure that gauges on- 200 Social Resources lnven- 2. Spouse/partner going life stressors and social resources tory ( LISRES ; Moos & 3. Finances as well...measures (e.g., ICF checklist, LISRES ; Moos, Penn, & Billings, 1988) may nor be practical or desirable in many healthcare settings or in large-scale

  1. Differences in Cortisol Response to Trauma Activation in Individuals with and without Comorbid PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Sharon Dekel

    2017-05-01

    Full Text Available Background: Although depression symptoms are often experienced by individuals who develop posttraumatic stress disorder (PTSD following trauma exposure, little is know about the biological correlates associated with PTSD and depression co-morbidity vs. those associated with PTSD symptoms alone.Methods: Here we examined salivary cortisol responses to trauma activation in a sample of 60 survivors of the World Trade Center attacks on September 11, 2001. Participants recalled the escape from the attacks 7 months post 9/11. Salivary cortisol levels were measured before and after their recollection of the trauma. PTSD, depression, and somatic symptoms were also assessed. From the behavioral assessment scales, the participants were grouped into three conditions: those with comorbid PTSD and depressive symptoms, PTSD alone symptoms, or no-pathology.Results: Baseline and cortisol response levels differed between the comorbid, PTSD alone, and no-pathology groups. Individuals endorsing co-morbid symptoms had higher PTSD and somatic symptom severity and their cortisol response decreased following their trauma reminder while a trend of an elevated response to the trauma was found in the PTSD alone group. Our findings show distinct psychological and biological correlates related to the endorsement of PTSD with and without depression comorbidity.Conclusions: The findings suggest that comorbidity symptoms manifestation entails a separate trauma induced condition from PTSD. Future research on biological correlates of comorbid PTSD and depression is warranted.

  2. Self-stigma in PTSD: Prevalence and correlates.

    Science.gov (United States)

    Bonfils, Kelsey A; Lysaker, Paul H; Yanos, Philip T; Siegel, Alysia; Leonhardt, Bethany L; James, Alison V; Brustuen, Beth; Luedtke, Brandi; Davis, Louanne W

    2018-04-03

    Self-stigma is the internalization of negative societal stereotypes about those with mental illnesses. While self-stigma has been carefully characterized in severe mental disorders, like schizophrenia, the field has yet to examine the prevalence and correlates of self-stigma in post-traumatic stress disorder (PTSD). Thus, we assessed self-stigma in veterans diagnosed with PTSD and compared with veterans with schizophrenia. We further examined associations between PTSD, depressive symptoms and self-stigma in the PTSD sample. Data came from two larger studies of people with PTSD (n = 46) and schizophrenia-spectrum disorders (n = 82). All participants completed the Internalized Stigma of Mental Illness Scale (ISMIS). Results revealed that people with schizophrenia report more experiences of discrimination as a result of stigma than do those with PTSD, but these diagnostic groups did not differ for other subscales. In the PTSD group, feelings of alienation positively correlated with PTSD and depressive symptoms; other subscales positively correlated with depressive symptoms only. Taken together, results suggest a significant level of self-stigma exists among veterans with PTSD, and that self-stigma has an effect on PTSD and commonly comorbid symptoms, like depression. Future work should investigate whether current self-stigma interventions for other groups could be applicable for those with PTSD. Published by Elsevier B.V.

  3. Serotonin transporter 5-HTTLPR genotype is associated with intrusion and avoidance symptoms of DSM-5 posttraumatic stress disorder (PTSD) in Chinese earthquake survivors.

    Science.gov (United States)

    Liu, Luobing; Wang, Li; Cao, Chengqi; Cao, Xing; Zhu, Ye; Liu, Ping; Luo, Shu; Zhang, Jianxin

    2018-05-01

    Prior studies have found that the serotonin transporter gene-linked polymorphic region (5-HTTLPR) interacts with trauma exposure to increase general risk for Posttraumatic Stress Disorder (PTSD). However, there is little knowledge about the effects of the interaction on distinct symptom clusters of PTSD. This study aimed to investigate the relation between the interaction of 5-HTTLPR and earthquake-related exposures and a contemporary phenotypic model of DSM-5 PTSD symptoms in a traumatised adult sample from China. A cross-sectional design with gene-environment interaction (G × E) approach was adopted. Participants were 1131 survivors who experienced 2008 Wenchuan earthquake. PTSD symptoms were assessed with the PTSD Checklist for DSM-5 (PCL-5). The 5-HTTLPR polymorphism was genotyped with capillary electrophoresis (CE) in ABI 3730xl genetic Analyzer. Although there was no significant interaction between 5-HTTLPR and traumatic exposure on total PTSD symptoms, respondents with the LL genotype of 5-HTTLPR who were highly exposed to the earthquake experienced lower intrusion and avoidance symptoms than those with the S-allele carriers. The findings suggest that the 5-HTTLPR may have an important impact on the development of PTSD and add to the extant knowledge on understanding and treating of posttraumatic psychopathology.

  4. The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning Among Older Adults

    OpenAIRE

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2013-01-01

    The present study examined the impact of the developmental timing of trauma exposure on post-traumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (n = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas experienced during childhood, adolescence, young adulthood, midlife, or older adulthood. Each of these developmental periods is characterized by a...

  5. Examining the broader psychosocial effects of mass conflict on PTSD symptoms and functional impairment amongst West Papuan refugees resettled in Papua New Guinea (PNG).

    Science.gov (United States)

    Tay, Alvin Kuowei; Rees, Susan; Chan, Jack; Kareth, Moses; Silove, Derrick

    2015-05-01

    Mass conflict and displacement erode the core psychosocial foundations of society, but there is a dearth of quantitative data examining the long-term mental health effects of these macrocosmic changes, particularly in relation to posttraumatic stress disorder (PTSD) symptoms. In 2013, we conducted a cross-sectional community study (n = 230) of West Papuan refugees residing in Port Moresby, Papua New Guinea, testing a moderated-mediation structural equation model of PTSD symptoms in which we examined relationships involving the psychosocial effects of mass conflict and displacement based on the Adaptation and Development after Persecution and Trauma (ADAPT) model, a trauma count (TC) of traumatic events (TEs) related to mass conflict, and a count index of current adversity (AC). A direct and an indirect path via AC led to PTSD symptoms. The ADAPT index exerted two effects on PTSD symptoms, an indirect effect via AC, and a moderating effect on TC. PTSD symptoms were directly associated with functional impairment. Although based on cross-sectional data, our findings provide support for a core prediction of the ADAPT model, that is, that undermining of the core psychosocial foundations of society brought about by mass conflict and displacement exerts an indirect and moderating influence on PTSD symptoms. The path model supports the importance of repairing the psychosocial pillars of society as a foundation for addressing trauma-related symptoms and promoting the functioning of refugees. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Examining cumulative victimization, community violence exposure, and stigma as contributors to PTSD symptoms among high-risk young women.

    Science.gov (United States)

    Kennedy, Angie C; Bybee, Deborah; Greeson, Megan R

    2014-05-01

    This study examines patterns of lifetime victimization within the family, community violence exposure, and stigma as contributors to posttraumatic stress disorder (PTSD) symptoms within a sample of 198 high-risk young women who are pregnant or parenting. We used cluster analysis to identify 5 profiles of cumulative victimization, based on participants' levels of witnessing intimate partner violence (IPV), physical abuse by an adult caregiver, and sexual victimization, all beginning by age 12. Hierarchical regression was used to examine these 5 clusters (ranging from a High All Victimization cluster characterized by high levels of all 3 forms of violence, to a Low All Victimization cluster characterized by low levels of all 3 forms), along with community violence exposure and stigma, as predictors of PTSD symptoms. We found that 3 of the cumulative victimization clusters, in comparison with Low All Victimization, were significant predictors of PTSD symptoms, as was stigma, while community violence exposure was not a significant predictor. PsycINFO Database Record (c) 2014 APA, all rights reserved

  7. Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: A study of within-person processes

    Directory of Open Access Journals (Sweden)

    Asle eHoffart

    2015-08-01

    Full Text Available AbstractAlthough self-compassion is considered a promising change agent in the treatment of PTSD, no studies of this hypothesis exist. This study examined the within-person relationship of self-compassion components (self-kindness, common humanity, mindfulness, self-judgment, isolation, over-identification and subsequent PTSD symptoms over the course of therapy. Method: PTSD patients (n = 65 were randomized to either standard prolonged exposure, which includes imaginal exposure (IE to the traumatic memory, or modified prolonged exposure, where imagery re-scripting (IR of the memory replaced IE as the imagery component of prolonged exposure in a 10 week residential program. They were assessed weekly on self-compassion and PTSD symptom measures. The centering method of detrending was used to separate the variance related to the within-person process of change over the course of treatment from between-person variance. Results: The self-compassion components self-kindness, self-judgment, isolation, and over-identification had a within-person effect on subsequent PTSD symptoms. These relationships were independent of therapy form. The within-person relationship between self-judgment and subsequent PTSD symptoms was stronger in patients with higher initial self-judgment. By contrast, there were few indications that within-person variations in PTSD symptoms predict subsequent self-compassion components. Conclusion: The results support the role of self-compassion components in maintaining PTSD and imply the recommendation to facilitate decrease of self-judgment, isolation, and over-identification and increase of self-kindness in the treatment of PTSD patients. The reduction of self-judgment appears to be most important, especially for patients with a high initial level of self-judgment.

  8. A Longitudinal Examination of Mothers' Depression and PTSD Symptoms as Impacted by Partner-Abusive Men's Harm to Their Children.

    Science.gov (United States)

    Rivera, Echo A; Sullivan, Cris M; Zeoli, April M; Bybee, Deborah

    2016-02-12

    Intimate partner violence (IPV) is a serious and widespread form of gender-based violence that disproportionately affects women. It is well established that IPV victimization contributes to depression and posttraumatic stress disorder (PTSD), and that many partner-abusive men continue to perpetuate abuse even after their relationship with the victim ends. In addition, when men harm their partners, they are more likely to harm their children, and evidence suggests that this harm continues post-separation. However, scant research has been conducted on men's harm to their children as an extension of IPV perpetration, with even less known about the mental health impact this form of abuse has on mothers. For this longitudinal cohort study, 40 partner-abused mothers who had separated, or were planning to separate, from an abusive partner with whom they shared children were recruited. Women were interviewed 4 times over 1 year. Results confirmed that, in addition to men's physical abuse perpetration relating to subsequent increases in mothers' depression and PTSD symptoms over time, their harm to the children predicted both mothers' depression and PTSD symptoms as well. © The Author(s) 2016.

  9. PTSD: National Center for PTSD

    Science.gov (United States)

    ... Care » PTSD: National Center for PTSD » Public » Videos PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" ( ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Care » PTSD: National Center for PTSD » Public » Videos PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" ( ...

  11. The 7-factor hybrid model of DSM-5 PTSD symptoms and alcohol consumption and consequences in a national sample of trauma-exposed veterans.

    Science.gov (United States)

    Claycomb Erwin, Meredith; Charak, Ruby; Durham, Tory A; Armour, Cherie; Lv, Xin; Southwick, Steven M; Elhai, Jon D; Pietrzak, Robert H

    2017-10-01

    The purpose of the present study was to investigate associations between the 7-factor hybrid model of DSM-5 posttraumatic stress disorder (PTSD) symptoms, which includes intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal symptoms, and alcohol consumption and consequences. A nationally representative sample of 916 trauma-exposed U.S. military veterans were administered the Trauma History Screen, PTSD Checklist-5, and Alcohol Use Disorders Identification Test. Confirmatory factor analyses were conducted to determine associations between the 7-factor hybrid model of PTSD symptoms, and alcohol consumption and consequences. Results revealed that lifetime dysphoric arousal (r=0.31), negative affect (r=0.30), and anhedonia (r=0.29) symptom clusters were most strongly associated with past-year alcohol consequences. No significant associations were observed for alcohol consumption. While the cross-sectional study design does not allow one to ascertain causative associations between PTSD factors and alcohol consumption and consequences, results generally align with the self-medication hypothesis, as PTSD factors reflecting internalizing were most strongly related to alcohol-related consequences. These results underscore the importance of assessing for alcohol use problems in veterans who score highly on PTSD symptoms reflecting internalizing symptomatology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study.

    Science.gov (United States)

    Gökçe İsbir, Gözde; İnci, Figen; Önal, Hatice; Yıldız, Pelin Dıkmen

    2016-11-01

    Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Quasi-experimental study. The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared-an antenatal education intervention group (n=44), and a routine prenatal care control group (n=46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale-Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Compared to the control group, women who attended antenatal education had greater childbirth self-efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, ppost-traumatic stress disorder symptoms after childbirth. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Potentially traumatic events have negative and positive effects on loneliness, depending on PTSD-symptom levels: evidence from a population-based prospective comparative study.

    Science.gov (United States)

    van der Velden, Peter G; Pijnappel, Bas; van der Meulen, Erik

    2018-02-01

    Examine to what extent adults affected by recent potentially traumatic events (PTE) with different PTSD-symptom levels are more at risk for post-event loneliness than non-affected adults are in the same study period. We extracted data from the Dutch longitudinal LISS panel to measure pre-event loneliness (2011) and post-event loneliness (2013 and 2014), pre-event mental health problems (2011), PTE and PTSD symptoms (2012). This panel is based on a traditional random sample drawn from the population register by Statistics Netherlands. Results of the multinomial logistic regression analyses showed that affected adults with high levels of PTSD symptoms were more at risk for high levels of post-event loneliness than affected adults with very low PTSD-symptom levels and non-affected adults, while controlling for pre-event loneliness, pre-event mental health problems and demographics. However, affected adults with very low levels of PTSD symptoms compared to non-affected adults were less at risk for medium and high levels of post-event loneliness while controlling for the same variables. Yet, pre-event loneliness appeared to be the strongest independent predictor of loneliness at later stages: more than 80% with high pre-event levels had high post-event levels at both follow-ups. Remarkably, potentially traumatic events have depending on PTSD-symptom levels both negative and positive effects on post-event loneliness in favor of affected adults with very low PTSD symptoms levels. However, post-event levels at later stages are predominantly determined by pre-event loneliness levels.

  14. The Impact of PTSD on Functioning in Patients Seeking Treatment for Chronic Pain and Validation of the Posttraumatic Diagnostic Scale.

    Science.gov (United States)

    Åkerblom, Sophia; Perrin, Sean; Rivano Fischer, Marcelo; McCracken, Lance M

    2017-04-01

    The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status. Participants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital. The translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events with 28.9% fulfilling criteria for a current PTSD diagnosis. The patients with PTSD also reported significantly higher levels of pain interference, kinesiophobia, anxiety, and depression and significantly lower levels of life control, compared to patients exposed to trauma and not fulfilling criteria for PTSD and patients with no history of traumatic exposure. Consistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for PTSD according to a standardized self-report measure. The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted. Self-report measures like the PDS appear to be valid for use in chronic pain samples and offer a relative low-cost method for screening for PTSD.

  15. Resonance Frequency Breathing Biofeedback to Reduce Symptoms of Subthreshold PTSD with an Air Force Special Tactics Operator: A Case Study.

    Science.gov (United States)

    Petta, Lorene M

    2017-06-01

    The prevalence rates of post-traumatic stress disorder (PTSD) have been estimated to be several times higher in military populations compared to the national average. Special Tactics operators are a group that is more likely to avoid seeking psychological care due to the stigma and other consequences the diagnosis may have on their military careers. There is a need for more effective and less stigmatizing interventions to treat this population. Psychophysiological methods have been proven to be efficacious in treating PTSD, yet have received less attention as an adjunctive intervention. Resonance frequency (RF) biofeedback is a form of cardiorespiratory intervention that has shown promise as an effective treatment. The current case study examined the use of RF biofeedback in combination with other physiological and evidence-based methods as part of a comprehensive treatment approach. The client showed a significant drop from his initial scores on a screening assessment by the end of treatment, and demonstrated continued progress despite a 3-month break from the therapy. This author proposed that the synergistic effects of the multi-phased treatment approach contributed to the client's progress. Furthermore, a case was made for using multiple techniques when treating subthreshold PTSD and related symptoms within a treatment resistant population.

  16. The brief negative symptom scale: psychometric properties.

    Science.gov (United States)

    Kirkpatrick, Brian; Strauss, Gregory P; Nguyen, Linh; Fischer, Bernard A; Daniel, David G; Cienfuegos, Angel; Marder, Stephen R

    2011-03-01

    The participants in the NIMH-MATRICS Consensus Development Conference on Negative Symptoms recommended that an instrument be developed that measured blunted affect, alogia, asociality, anhedonia, and avolition. The Brief Negative Symptom Scale (BNSS) is a 13-item instrument designed for clinical trials and other studies that measures these 5 domains. The interrater, test-retest, and internal consistency of the instrument were strong, with respective intraclass correlation coefficients of 0.93 for the BNSS total score and values of 0.89-0.95 for individual subscales. Comparisons with positive symptoms and other negative symptom instruments supported the discriminant and concurrent validity of the instrument.

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here to download "PTSD Treatment: Know Your ...

  18. The Relationship Between Post Traumatic Stress Disorder (PTSD) Symptoms and Career Outcomes of Army Enlisted Servicemembers

    Science.gov (United States)

    2015-01-01

    genetic analysis on the serotonin transporter gene 5-HTTLPR. Researchers found evidence to suggest that servicemembers with low-transcription...after exposure to trauma, suggesting a servicemember’s likelihood for developing PTSD may change throughout time regardless of genetic ...Training Requirements and Resources System (ATRRS), this automated promotion system generates a final promotion score. Table 3.2 presents the rubric

  19. The Mediating Role of Anger in the Relationship Between PTSD Symptoms and Impulsivity

    DEFF Research Database (Denmark)

    Contractor, A. A.; Armour, C.; Wang, X.

    2015-01-01

    Research indicates a significant relationship between posttraumatic stress disorder (PTSD) and anger (Olatunji, Ciesielski, & Tolin, 2010; Orth & Wieland, 2006). Individuals may seek urgent coping to deal with the distress of anger, which is a mobilizing and action-oriented emotion (Novaco & Chem...

  20. Functional significance of a novel 7-factor model of DSM-5 PTSD symptoms: results from the National Health and Resilience in Veterans study.

    Science.gov (United States)

    Pietrzak, Robert H; Tsai, Jack; Armour, Cherie; Mota, Natalie; Harpaz-Rotem, Ilan; Southwick, Steven M

    2015-03-15

    While posttraumatic stress disorder (PTSD) symptoms in the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) are clustered into four factors, emerging confirmatory factor analytic studies suggest that this disorder is best characterized by seven symptom clusters, including re-experiencing, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms. To date, however, data are lacking regarding the relation between this novel model of DSM-5 PTSD symptoms and measures of clinical significance in this population (e.g., functioning). Using data from the National Health and Resilience in Veterans Study (NHRVS), a contemporary, nationally representative sample of 1484 U.S. veterans, we evaluated clinical and functional correlates of a novel 7-factor model of DSM-5 PTSD symptoms. Differential patterns of associations were observed between DSM-5 PTSD symptom clusters, and psychiatric comorbidities, suicidal ideation, hostility, and functioning and quality of life. Anhedonia symptoms, in particular, were strongly related to current depression, as well as reduced mental functioning and quality of life. Externalizing behaviors were most strongly related to hostility, supporting the convergent validity of this construct. Cross-sectional design and employment of self-report measures. These results suggest that a more refined 7-factor model of DSM-5 PTSD symptoms may provide greater specificity in understanding associations with comorbid psychopathology, suicidal ideation, and functioning and quality of life in U.S. veterans. They further suggest that prevention and treatment efforts that target distinct aspects of the PTSD phenotype may be more effective in mitigating key clinical and functional outcomes in this population. Published by Elsevier B.V.

  1. Early PTSD Symptom Trajectories: Persistence, Recovery, and Response to Treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS)

    Science.gov (United States)

    Galatzer-Levy, Isaac R.; Ankri, Yael; Freedman, Sara; Israeli-Shalev, Yossi; Roitman, Pablo; Gilad, Moran; Shalev, Arieh Y.

    2013-01-01

    Context Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis. Objectives To describe discrete symptom trajectories and examine their relevance for preventive interventions. Design Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data. Setting Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity. Participants Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months. Approach We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample. Main Outcome Measure Latent trajectories of PTSD symptoms; effects of CBT on these trajectories. Results Three trajectories were identified: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes. Conclusions The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder

  2. The impact of the developmental timing of trauma exposure on PTSD symptoms and psychosocial functioning among older adults.

    Science.gov (United States)

    Ogle, Christin M; Rubin, David C; Siegler, Ilene C

    2013-11-01

    The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas experienced during childhood, adolescence, young adulthood, midlife, or older adulthood. Each of these developmental periods is characterized by age-related changes in cognitive and social processes that may influence psychological adjustment following trauma exposure. Results revealed that older adults who experienced their currently most distressing traumatic event during childhood exhibited more severe symptoms of PTSD and lower subjective happiness compared with older adults who experienced their most distressing trauma after the transition to adulthood. Similar findings emerged for measures of social support and coping ability. The differential effects of childhood compared with later life traumas were not fully explained by differences in cumulative trauma exposure or by differences in the objective and subjective characteristics of the events. Our findings demonstrate the enduring nature of traumatic events encountered early in the life course and underscore the importance of examining the developmental context of trauma exposure in investigations of the long-term consequences of traumatic experiences.

  3. Supporting the education goals of post-9/11 veterans with self-reported PTSD symptoms: a needs assessment.

    Science.gov (United States)

    Ellison, Marsha Langer; Mueller, Lisa; Smelson, David; Corrigan, Patrick W; Torres Stone, Rosalie A; Bokhour, Barbara G; Najavits, Lisa M; Vessella, Jennifer M; Drebing, Charles

    2012-01-01

    The influx of young adult veterans with mental health challenges from recent wars combined with newly expanded veteran education benefits has highlighted the need for a supported education service within the Veterans Administration. However, it is unknown how such a service should be designed to best respond to these needs. This study undertook a qualitative needs assessment for education supports among veterans with post-9/11 service with self-reported PTSD symptoms. Focus groups were held with 31 veterans, 54% of whom were under age 30. Transcripts were analyzed and interpreted using a thematic approach and a Participatory Action Research team. Findings indicate a need for age relevant services that assist with: education planning and access, counseling for the G.I. Bill, accommodations for PTSD symptoms, community and family re-integration, and outreach and support. The veterans recommended that supported education be integrated with the delivery of mental health services, that services have varied intensity, and there be linkages between colleges and the Veterans Health Administration.

  4. Examining the effects of a novel training program and use of psychiatric service dogs for military-related PTSD and associated symptoms.

    Science.gov (United States)

    Kloep, Megan L; Hunter, Richard H; Kertz, Sarah J

    2017-01-01

    This study explored an intensive 3-week training program and use of psychiatric service dogs for military-related posttraumatic stress disorder (PTSD) and associated symptoms. The sample included 2 separate cohorts of military veterans (n = 7 and n = 5) with prior diagnoses of PTSD. Participants completed self-report measures assessing PTSD, depression, perception of social support, anger, and overall quality of life 1 month prior to the training (baseline), at arrival to the training site, and 6-month follow-up. Results indicated that, for this sample, there was a statistically significant decrease in PTSD and depression symptoms from pre- to posttreatment, as well as 6-month follow-up. For most participants decreases were both clinically significant and reliable changes. Further, participants reported significant reductions in anger and improvement in perceived social support and quality of life. Limitations of the study include a lack of control group, a limitation of most naturalistic studies, as well as small sample size. Despite this, the findings indicate that utilizing psychiatric service dogs, coupled with an intensive trauma resilience training program for veterans with ongoing symptoms, is feasible as a complementary treatment for PTSD that could yield beneficial results in terms of symptom amelioration and improvement to overall quality of life. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. The Brief Negative Symptom Scale: Psychometric Properties

    OpenAIRE

    Kirkpatrick, Brian; Strauss, Gregory P.; Nguyen, Linh; Fischer, Bernard A.; Daniel, David G.; Cienfuegos, Angel; Marder, Stephen R.

    2010-01-01

    The participants in the NIMH-MATRICS Consensus Development Conference on Negative Symptoms recommended that an instrument be developed that measured blunted affect, alogia, asociality, anhedonia, and avolition. The Brief Negative Symptom Scale (BNSS) is a 13-item instrument designed for clinical trials and other studies that measures these 5 domains. The interrater, test–retest, and internal consistency of the instrument were strong, with respective intraclass correlation coefficients of 0.93...

  6. A multi-level modeling approach examining PTSD symptom reduction during prolonged exposure therapy: moderating effects of number of trauma types experienced, having an HIV-related index trauma, and years since HIV diagnosis among HIV-positive adults.

    Science.gov (United States)

    Junglen, Angela G; Smith, Brian C; Coleman, Jennifer A; Pacella, Maria L; Boarts, Jessica M; Jones, Tracy; Feeny, Norah C; Ciesla, Jeffrey A; Delahanty, Douglas L

    2017-11-01

    People living with HIV (PLWH) have extensive interpersonal trauma histories and higher rates of posttraumatic stress disorder (PTSD) than the general population. Prolonged exposure (PE) therapy is efficacious in reducing PTSD across a variety of trauma samples; however, research has not examined factors that influence how PTSD symptoms change during PE for PLWH. Using multi-level modeling, we examined the potential moderating effect of number of previous trauma types experienced, whether the index trauma was HIV-related or not, and years since HIV diagnosis on PTSD symptom reduction during a 10-session PE protocol in a sample of 51 PLWH. In general, PTSD symptoms decreased linearly throughout the PE sessions. Experiencing more previous types of traumatic events was associated with a slower rate of PTSD symptom change. In addition, LOCF analyses found that participants with a non-HIV-related versus HIV-related index trauma had a slower rate of change for PTSD symptoms over the course of PE. However, analyses of raw data decreased this finding to marginal. Years since HIV diagnosis did not impact PTSD symptom change. These results provide a better understanding of how to tailor PE to individual clients and aid clinicians in approximating the rate of symptom alleviation. Specifically, these findings underscore the importance of accounting for trauma history and index trauma type when implementing a treatment plan for PTSD in PLWH.

  7. Surveying treatment preferences in U.S. Iraq-Afghanistan Veterans with PTSD symptoms: a step toward veteran-centered care.

    Science.gov (United States)

    Crawford, Eric F; Elbogen, Eric B; Wagner, H Ryan; Kudler, Harold; Calhoun, Patrick S; Brancu, Mira; Straits-Troster, Kristy A

    2015-04-01

    This study examined health care barriers and preferences among a self-selected sample of returning U.S. veterans drawn from a representative, randomly selected frame surveyed about posttraumatic stress disorder (PTSD) symptomatology and mental health utilization in the prior year. Comparisons between treated (n = 160) and untreated (n = 119) veterans reporting PTSD symptoms were conducted for measures of barriers and preferences, along with logistic models regressing mental health utilization on clusters derived from these measures. Reported barriers corroborated prior research findings as negative beliefs about treatment and stigma were strongly endorsed, but only privacy concerns were associated with lower service utilization (B = -0.408, SE = 0.142; p = .004). The most endorsed preference (91.0%) was for assistance with benefits, trailed by help for physical problems, and particular PTSD symptoms. Help-seeking veterans reported stronger preferences for multiple interventions, and desire for services for families (B = 0.468, SE = 0.219; p = .033) and specific PTSD symptoms (B = 0.659, SE = 0.302; p = .029) were associated with increased utilization. Outcomes of the study suggested PTSD severity drove help-seeking in this cohort. Results also support the integration of medical and mental health services, as well as coordination of health and benefits services. Finally, the study suggested that outreach about privacy protections and treatment options could well improve engagement in treatment. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

  8. Effect of asthma and PTSD on persistence and onset of gastroesophageal reflux symptoms among adults exposed to the September 11, 2001, terrorist attacks.

    Science.gov (United States)

    Li, Jiehui; Brackbill, Robert M; Jordan, Hannah T; Cone, James E; Farfel, Mark R; Stellman, Steven D

    2016-09-01

    Little is known about the direction of causality among asthma, posttraumatic stress disorder (PTSD), and onset of gastroesophageal reflux symptoms (GERS) after exposure to the 9/11/2001 World Trade Center (WTC) disaster. Using data from the WTC Health Registry, we investigated the effects of early diagnosed post-9/11 asthma and PTSD on the late onset and persistence of GERS using log-binomial regression, and examined whether PTSD mediated the asthma-GERS association using structural equation modeling. Of 29,406 enrollees, 23% reported GERS at follow-up in 2011-2012. Early post-9/11 asthma and PTSD were each independently associated with both the persistence of GERS that was present at baseline and the development of GERS in persons without a prior history. PTSD mediated the association between early post-9/11 asthma and late-onset GERS. Clinicians should assess patients with post-9/11 GERS for comorbid asthma and PTSD, and plan medical care for these conditions in an integrated fashion. Am. J. Ind. Med. 59:805-814, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  9. 5-HTTLPR genotype potentiates the effects of war zone stressors on the emergence of PTSD, depressive and anxiety symptoms in soldiers deployed to iraq.

    Science.gov (United States)

    Telch, Michael J; Beevers, Christopher G; Rosenfield, David; Lee, Han-Joo; Reijntjes, Albert; Ferrell, Robert E; Hariri, Ahmad R

    2015-06-01

    Exposure to war zone stressors is common, yet only a minority of soldiers experience clinically meaningful disturbance in psychological function. Identification of biomarkers that predict vulnerability to war zone stressors is critical for developing more effective treatment and prevention strategies not only in soldiers but also in civilians who are exposed to trauma. We investigated the role of the serotonin transporter linked polymorphic region (5-HTTLPR) genotype in predicting the emergence of post-traumatic stress disorder (PTSD), depressive and anxiety symptoms as a function of war zone stressors. A prospective cohort of 133 U.S. Army soldiers with no prior history of deployment to a war zone, who were scheduled to deploy to Iraq, was recruited. Multilevel regression models were used to investigate associations between 5-HTTLPR genotype, level of war zone stressors, and reported symptoms of PTSD, depression and anxiety while deployed to Iraq. Level of war zone stressors was associated with symptoms of PTSD, depression and anxiety. Consistent with its effects on stress responsiveness, 5-HTTLPR genotype moderated the relationship between level of war zone stressors and symptoms of emotional disturbance. Specifically, soldiers carrying one or two low functioning alleles (S or LG ) reported heightened symptoms of PTSD, depression and anxiety in response to increased levels of exposure to war zone stressors, relative to soldiers homozygous for the high functioning allele (LA ). These data suggest that 5-HTTLPR genotype moderates individual sensitivity to war zone stressors and the expression of emotional disturbance including PTSD symptoms. Replication of this association along with identification of other genetic moderators of risk can inform the development of biomarkers that can predict relative resilience vs. vulnerability to stress. © 2015 World Psychiatric Association.

  10. Gender differences in the effects of deployment-related stressors and pre-deployment risk factors on the development of PTSD symptoms in National Guard Soldiers deployed to Iraq and Afghanistan.

    Science.gov (United States)

    Polusny, Melissa A; Kumpula, Mandy J; Meis, Laura A; Erbes, Christopher R; Arbisi, Paul A; Murdoch, Maureen; Thuras, Paul; Kehle-Forbes, Shannon M; Johnson, Alexandria K

    2014-02-01

    Although women in the military are exposed to combat and its aftermath, little is known about whether combat as well as pre-deployment risk/protective factors differentially predict post-deployment PTSD symptoms among women compared to men. The current study assesses the influence of combat-related stressors and pre-deployment risk/protective factors on women's risk of developing PTSD symptoms following deployment relative to men's risk. Participants were 801 US National Guard Soldiers (712 men, 89 women) deployed to Iraq or Afghanistan who completed measures of potential risk/protective factors and PTSD symptoms one month before deployment (Time 1) and measures of deployment-related stressors and PTSD symptoms about 2-3 months after returning from deployment (Time 2). Men reported greater exposure to combat situations than women, while women reported greater sexual stressors during deployment than men. Exposure to the aftermath of combat (e.g., witnessing injured/dying people) did not differ by gender. At Time 2, women reported more severe PTSD symptoms and higher rates of probable PTSD than did men. Gender remained a predictor of higher PTSD symptoms after accounting for pre-deployment symptoms, prior interpersonal victimization, and combat related stressors. Gender moderated the association between several risk factors (combat-related stressors, prior interpersonal victimization, lack of unit support and pre-deployment concerns about life/family disruptions) and post-deployment PTSD symptoms. Elevated PTSD symptoms among female service members were not explained simply by gender differences in pre-deployment or deployment-related risk factors. Combat related stressors, prior interpersonal victimization, and pre-deployment concerns about life and family disruptions during deployment were differentially associated with greater post-deployment PTSD symptoms for women than men. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. PTSD Symptoms and Self-Rated Recovery among Adult Sexual Assault Survivors: The Effects of Traumatic Life Events and Psychosocial Variables

    Science.gov (United States)

    Najdowski, Cynthia J.; Ullman, Sarah E.

    2009-01-01

    Prior research has demonstrated that self-blame is predictive of more posttraumatic stress disorder (PTSD) symptoms and poorer recovery (Frazier, 2003; Koss, Figueredo, & Prince, 2002), and perceived control over recovery is associated with less distress (Frazier, 2003) in adult sexual assault (ASA) survivors. A structural equation model was…

  12. One-year follow-up of basic body awareness therapy in patients with posttraumatic stress disorder. A small intervention study of effects on movement quality, PTSD symptoms, and movement experiences.

    Science.gov (United States)

    Blaauwendraat, Conny; Levy Berg, Adrienne; Gyllensten, Amanda Lundvik

    2017-07-01

    The present study with mixed methods design evaluated the long-term effects of Basic Body Awareness Therapy (BBAT) for patients with posttraumatic stress disorder (PTSD). Fifteen patients received 12 individual sessions of BBAT treatment as usual (TAU) when needed. The patients were assessed at baseline (T0), directly after treatment (T1) and at one-year follow-up (T2), using the Body Awareness Scale Movement Quality and Experience (BAS MQ-E), the Visual Analog Scale (VAS), and the Impact of Event Scale-Revised (IES-R). The results at T1 showed significant improvement in the quality of movement (p = 0.001), body experience (p = 0.007), and symptoms (p = 0.001). At T2, the improvements were sustained. Pain in stillness (p = 0.017) and during movement (p = 0.007) had decreased. The verbal ability to describe the body experiences in words was poor at T0, but became more detailed at T1 and even more so at T2. Our findings suggest that BBAT in addition to TAU can be a viable physiotherapeutic treatment for patients with PTSD. This knowledge may influence future treatment strategies for patients with PTSD and be of guidance to physiotherapists working with persons with trauma experiences in the community or psychiatry/mental healthcare areas.

  13. Symptom rating scale for assessing hyperthyroidism.

    Science.gov (United States)

    Klein, I; Trzepacz, P T; Roberts, M; Levey, G S

    1988-02-01

    A hyperthyroid symptom scale (HSS) was designed and administered to ten subjects with untreated Graves' disease. All subjects had clinical and chemical evidence of hyperthyroidism and reproducible HSS scores of 20 or more points. During sequential treatments with propranolol hydrochloride (phase 2) followed by propylthiouracil (phase 3) there was a significant decline in the HSS scores at each phase. Accompanying the decrease in HSS scores was a decrease in heart rate, but there was no change in thyroid function test results at phase 2 and a decrease in heart rate, thyroid function test results, and goiter size at phase 3. This new scale includes ten categories of symptoms, it is sensitive to changes in both the adrenergic and metabolic components of hyperthyroidism, and it is useful in the clinical assessment and management of patients with thyrotoxicosis.

  14. THE ATTENUATING EFFECT OF EMPOWERMENT ON IPV-RELATED PTSD SYMPTOMS IN BATTERED WOMEN LIVING IN DOMESTIC VIOLENCE SHELTERS

    Science.gov (United States)

    Perez, Sara; Johnson, Dawn M.; Wright, Caroline Vaile

    2010-01-01

    Intimate partner violence (IPV) is associated with significant psychological distress, including posttraumatic stress disorder (PTSD). However, factors that attenuate the impact of IPV on PTSD remain largely unknown. Using hierarchical regression, this investigation explored the impact of resource acquisition and empowerment on the relationship between IPV and PTSD. Empowerment demonstrated greater relative importance over resource acquisition. Specifically, empowerment was found to attenuate the impact of IPV severity on PTSD at low and moderate levels of violence. The importance of fostering empowerment and addressing PTSD in addition to provision of resources in battered women is discussed. PMID:22411301

  15. Validation of two screening instruments for PTSD in Dutch substance use disorder inpatients.

    Science.gov (United States)

    Kok, Tim; de Haan, Hein A; van der Velden, Helena J W; van der Meer, Margreet; Najavits, Lisa M; de Jong, Cor A J

    2013-03-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in substance use disorder (SUD) populations. Because resources for extensive and thorough diagnostic assessment are often limited, reliable screening instruments for PTSD are needed. The aim of the current study was to test two short PTSD measures for diagnostic efficiency in predicting PTSD compared to the Clinician-Administered PTSD Scale (CAPS). The sample consisted of 197 SUD patients receiving residential substance use treatment who completed questionnaires regarding substance use and trauma-related symptoms, all abstinent from substance for 4weeks. The PTSD section of the Mini International Neuropsychiatric Interview plus (MINIplus) and the Self-Report Inventory for PTSD (SRIP) are compared to the CAPS. Results showed low sensitivity (.58) and high specificity (.91) for the PTSD section of the MINIplus. The SRIP showed high sensitivity (.80) and moderately high specificity (.73) at a cut-off score of 48. The prevalence of PTSD as measured with the CAPS was 25.4% current and 46.2% lifetime. Results indicate that the MINIplus, a short clinical interview, has insufficient quality as a screener for PTSD. The SRIP, however, is a reliable instrument in detecting PTSD in a SUD inpatient population in The Netherlands. Screening for PTSD is time efficient and increases detection of PTSD in SUD treatment settings. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Validation of a Brief PTSD Scale for Clients with Severe Mental Illnesses

    Science.gov (United States)

    O'Hare, Thomas; Shen, Ce; Sherrer, Margaret

    2012-01-01

    Trauma and Posttraumatic Stress Disorder (PTSD) are more common in severe mental illnesses (SMI) clients than in the general population, yet brief screens for detecting probable PTSD in SMI clients are nonexistent. In a two-part study, the authors used correlation analysis and receiver operating characteristics (ROC) analysis to develop and…

  17. Psychometric Properties and Factor Structure of the German Version of the Clinician-Administered PTSD Scale for DSM-5.

    Science.gov (United States)

    Müller-Engelmann, Meike; Schnyder, Ulrich; Dittmann, Clara; Priebe, Kathlen; Bohus, Martin; Thome, Janine; Fydrich, Thomas; Pfaltz, Monique C; Steil, Regina

    2018-05-01

    The Clinician-Administered PTSD Scale (CAPS) is a widely used diagnostic interview for posttraumatic stress disorder (PTSD). Following fundamental modifications in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5), the CAPS had to be revised. This study examined the psychometric properties (internal consistency, interrater reliability, convergent and discriminant validity, and structural validity) of the German version of the CAPS-5 in a trauma-exposed sample ( n = 223 with PTSD; n =51 without PTSD). The results demonstrated high internal consistency (αs = .65-.93) and high interrater reliability (ICCs = .81-.89). With regard to convergent and discriminant validity, we found high correlations between the CAPS severity score and both the Posttraumatic Diagnostic Scale sum score ( r = .87) and the Beck Depression Inventory total score ( r = .72). Regarding the underlying factor structure, the hybrid model demonstrated the best fit, followed by the anhedonia model. However, we encountered some nonpositive estimates for the correlations of the latent variables (factors) for both models. The model with the best fit without methodological problems was the externalizing behaviors model, but the results also supported the DSM-5 model. Overall, the results demonstrate that the German version of the CAPS-5 is a psychometrically sound measure.

  18. Examination of the Mild Brain Injury Atypical Symptom Scale and the Validity-10 Scale to detect symptom exaggeration in US military service members.

    Science.gov (United States)

    Lange, Rael T; Brickell, Tracey A; French, Louis M

    2015-01-01

    The purpose of this study was to examine the clinical utility of two validity scales designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist-Civilian Version (PCL-C); the Mild Brain Injury Atypical Symptoms Scale (mBIAS) and Validity-10 scale. Participants were 63 U.S. military service members (age: M = 31.9 years, SD = 12.5; 90.5% male) who sustained a mild traumatic brain injury (MTBI) and were prospectively enrolled from Walter Reed National Military Medical Center. Participants were divided into two groups based on the validity scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF): (a) symptom validity test (SVT)-Fail (n = 24) and (b) SVT-Pass (n = 39). Participants were evaluated on average 19.4 months postinjury (SD = 27.6). Participants in the SVT-Fail group had significantly higher scores (p scales (d = 0.69 to d = 2.47). Sensitivity, specificity, and predictive power values were calculated across the range of mBIAS and Validity-10 scores to determine the optimal cutoff to detect symptom exaggeration. For the mBIAS, a cutoff score of ≥8 was considered optimal, which resulted in low sensitivity (.17), high specificity (1.0), high positive predictive power (1.0), and moderate negative predictive power (.69). For the Validity-10 scale, a cutoff score of ≥13 was considered optimal, which resulted in moderate-high sensitivity (.63), high specificity (.97), and high positive (.93) and negative predictive power (.83). These findings provide strong support for the use of the Validity-10 as a tool to screen for symptom exaggeration when administering the NSI and PCL-C. The mBIAS, however, was not a reliable tool for this purpose and failed to identify the vast majority of people who exaggerated symptoms.

  19. Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms

    OpenAIRE

    Paola Di Blasio; Sarah Miragoli; Elena Camisasca; Angela Maria Di Vita; Rosalia Pizzo; Laura Pipitone

    2015-01-01

    Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thou...

  20. PTSD: National Center for PTSD

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    Full Text Available ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ...

  1. Injured civilian survivors of suicide bomb attacks: from partial PTSD to recovery or to traumatisation. Where is the turning point?

    Science.gov (United States)

    Dolberg, Ornah T; Barkai, Gabriel; Leor, Agnes; Rapoport, Helena; Bloch, Miki; Schreiber, Shaul

    2010-03-01

    To assess the short- (3-9 months) and medium-term (30 months) occurrence and severity of post-traumatic stress disorder (PTSD) in civilian survivors of suicide bombing terrorist attacks. We evaluated 129 injured survivors of nine attacks in Israel who were treated in our emergency room between June 2000 and September 2002. Data on demographics, physical injuries and psychiatric symptoms were collected by both a structured clinical interview and standard assessment scales for depression, anxiety, and sleep quality. Diagnosis of PTSD was based on a Hebrew-validated DSM-IV SCID-PTSD rating scale. At the first assessment (short-term), 20 survivors (15.5%) met the criteria for full-blown PTSD and 54 (42%) for sub-clinical PTSD, while 55 (42.5%) evidenced no symptoms of PTSD. Two years later, only 54 patients could be located: 19 (35%) of them had either persistent or de novo PTSD and none had residual sub-clinical PTSD. Relatively few survivors of suicide bomb attacks had full-blown PTSD, while a substantial number of survivors had short-term sub-clinical PTSD. Two-year follow-up evaluations revealed that a significant a number of the patients available for testing (35%) had full-blown PTSD. These findings imply that medium-term follow-up of survivors is needed in order to establish the actual prevalence of PTSD.

  2. Screening for HIV-related PTSD: sensitivity and specificity of the 17-item Posttraumatic Stress Diagnostic Scale (PDS) in identifying HIV-related PTSD among a South African sample.

    Science.gov (United States)

    Martin, L; Fincham, D; Kagee, A

    2009-11-01

    The identification of HIV-positive patients who exhibit criteria for Posttraumatic Stress Disorder (PTSD) and related trauma symptomatology is of clinical importance in the maintenance of their overall wellbeing. This study assessed the sensitivity and specificity of the 17-item Posttraumatic Stress Diagnostic Scale (PDS), a self-report instrument, in the detection of HIV-related PTSD. An adapted version of the PTSD module of the Composite International Diagnostic Interview (CIDI) served as the gold standard. 85 HIV-positive patients diagnosed with HIV within the year preceding data collection were recruited by means of convenience sampling from three HIV clinics within primary health care facilities in the Boland region of South Africa. A significant association was found between the 17-item PDS and the adapted PTSD module of the CIDI. A ROC curve analysis indicated that the 17-item PDS correctly discriminated between PTSD caseness and non-caseness 74.9% of the time. Moreover, a PDS cut-off point of > or = 15 yielded adequate sensitivity (68%) and 1-specificity (65%). The 17-item PDS demonstrated a PPV of 76.0% and a NPV of 56.7%. The 17-item PDS can be used as a brief screening measure for the detection of HIV-related PTSD among HIV-positive patients in South Africa.

  3. PTSD: National Center for PTSD

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    Full Text Available ... Apps Videos Web Links PTSD Site Search For Professionals Professional Section Home PTSD Overview Types of Trauma Trauma ... Watch our whiteboard video for clinicians in the Professional Section: Prescribing for PTSD, Know Your Options . × What ...

  4. PTSD: National Center for PTSD

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  5. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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    Full Text Available ... Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request ... Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right ...

  7. PTSD: National Center for PTSD

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    Full Text Available ... the Public Public Section Home PTSD Overview PTSD Basics Return from War Specific to Women Types of ... Section Home PTSD Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma ...

  8. PTSD: National Center for PTSD

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    Full Text Available ... Locations Contact Us FAQs Ask a Question Toll Free Numbers ... it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ...

  9. PTSD: National Center for PTSD

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    Full Text Available ... VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ... Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers VA Providers and ...

  10. PTSD: National Center for PTSD

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    Full Text Available ... PTSD or Get Help with VA PTSD Care, Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 ... Complete Directory EMAIL UPDATES Email Address Required Button ...

  11. PTSD: National Center for PTSD

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    Full Text Available ... Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site Map Content Inventory Accessibility ... Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health Care Veterans Health Administration ...

  12. Late-Onset PTSD in Unaccompanied Refugee Minors: Exploring the Predictive Utility of Depression and Anxiety Symptoms

    Science.gov (United States)

    Smid, Geert E.; Lensvelt-Mulders, Gerty J. L. M.; Knipscheer, Jeroen W.; Gersons, Berthold P. R.; Kleber, Rolf J.

    2011-01-01

    Following resettlement in Western countries, unaccompanied refugee minors (URM) are at risk of developing posttraumatic stress disorder (PTSD). It is unclear to what extent PTSD in this group may become manifest at later stages following resettlement and which factors are associated with late onset. We examined data from URM collected 1 (T1) and 2…

  13. PTSD Symptom Severities, Interpersonal Traumas, and Benzodiazepines Are Associated with Substance-Related Problems in Trauma Patients

    Science.gov (United States)

    Guina, Jeffrey; Nahhas, Ramzi W.; Goldberg, Adam J.; Farnsworth, Seth

    2016-01-01

    Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs), DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs), most PTSSs (especially negative beliefs, recklessness, and avoidance), and interpersonal traumas (e.g., assaults and child abuse). Conclusion: In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment. PMID:27517964

  14. PTSD Symptom Severities, Interpersonal Traumas, and Benzodiazepines Are Associated with Substance-Related Problems in Trauma Patients

    Directory of Open Access Journals (Sweden)

    Jeffrey Guina

    2016-08-01

    Full Text Available Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472, we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis, as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs, DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs, most PTSSs (especially negative beliefs, recklessness, and avoidance, and interpersonal traumas (e.g., assaults and child abuse. Conclusion: In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment.

  15. In search of the trauma memory: a meta-analysis of functional neuroimaging studies of symptom provocation in posttraumatic stress disorder (PTSD.

    Directory of Open Access Journals (Sweden)

    Gudrun Sartory

    Full Text Available Notwithstanding some discrepancy between results from neuroimaging studies of symptom provocation in posttraumatic stress disorder (PTSD, there is broad agreement as to the neural circuit underlying this disorder. It is thought to be characterized by an exaggerated amygdalar and decreased medial prefrontal activation to which the elevated anxiety state and concomitant inadequate emotional regulation are attributed. However, the proposed circuit falls short of accounting for the main symptom, unique among anxiety disorders to PTSD, namely, reexperiencing the precipitating event in the form of recurrent, distressing images and recollections. Owing to the technical demands, neuroimaging studies are usually carried out with small sample sizes. A meta-analysis of their findings is more likely to cast light on the involved cortical areas. Coordinate-based meta-analyses employing ES-SDM (Effect Size Signed Differential Mapping were carried out on 19 studies with 274 PTSD patients. Thirteen of the studies included 145 trauma-exposed control participants. Comparisons between reactions to trauma-related stimuli and a control condition and group comparison of reactions to the trauma-related stimuli were submitted to meta-analysis. Compared to controls and the neutral condition, PTSD patients showed significant activation of the mid-line retrosplenial cortex and precuneus in response to trauma-related stimuli. These midline areas have been implicated in self-referential processing and salient autobiographical memory. PTSD patients also evidenced hyperactivation of the pregenual/anterior cingulate gyrus and bilateral amygdala to trauma-relevant, compared to neutral, stimuli. Patients showed significantly less activation than controls in sensory association areas such as the bilateral temporal gyri and extrastriate area which may indicate that the patients' attention was diverted from the presented stimuli by being focused on the elicited trauma memory. Being

  16. Psychological Intimate Partner Violence and Sexual Risk Behavior: Examining the Role of Distinct PTSD Symptoms in the Partner Violence-sexual Risk Link

    Science.gov (United States)

    Overstreet, Nicole M.; Willie, Tiara C.; Hellmuth, Julianne C.; Sullivan, Tami P.

    2014-01-01

    BACKGROUND Research has examined how physical and sexual intimate partner violence (IPV) victimization increases sexual risk behavior, yet research is lacking on 1) the effect of psychological IPV on sexual risk behavior and 2) factors through which psychological IPV may be linked to sexual risk behavior. METHODS The current study examined the relationship between psychological IPV and sexual risk behavior controlling for other forms of IPV (i.e., physical and sexual) in a sample of 186 HIV-negative community women currently experiencing IPV. Further, this study examined the potential mediating effects of four posttraumatic stress disorder (PTSD) symptom severity clusters (i.e., re-experiencing, avoidance, numbing, and hyperarousal) on this relationship. FINDINGS Results revealed that greater severity of psychological IPV was uniquely and directly related to greater sexual risk behavior. Additionally, of the four PTSD symptom severity clusters, only avoidance symptom severity mediated the relationship between psychological IPV and sexual risk behavior. CONCLUSION Implications for addressing psychological IPV and PTSD to improve women’s sexual health outcomes are discussed. PMID:25498762

  17. Trauma exposure, resilience, social support, and PTSD construct validity among former prisoners of war.

    Science.gov (United States)

    Gold, P B; Engdahl, B E; Eberly, R E; Blake, R J; Page, W F; Frueh, B C

    2000-01-01

    The aim of this study was to investigate predictors of persistent symptoms of posttraumatic stress disorder (PTSD) and to examine the construct validity of PTSD in a national sample of 270 World War II and Korean Conflict prisoners of war (POWs). POWs were interviewed at two points in time (1965 and 1990). Predictors included PTSD symptomatology measured in 1965 by items from the Cornell Medical Index (CMI), severity of captivity trauma, resilience factors, and post-trauma social support. The criterion, symptomatology in the early 1990s, was evaluated with the PTSD module of the Structured Clinical Interview for DSM (SCID). The CMI provided only partial coverage of PTSD criteria and appeared to provide only a general index of distress. Clustering of SCID items in two-dimensional space via multidimensional scaling analysis offers some construct validation for the DSM's differentiation of PTSD symptoms into criterion groups, although there was not a perfect match. Trauma severity is best related to PTSD symptomatology experienced in 1990, mitigated in part by greater education level and age at the time of trauma exposure. Surprisingly, 1965 distress added only a modest amount to the prediction of current distress, while post-trauma social support added none. These findings support previous work showing the severe psychological sequelae of POW status 40-50 years after captivity, and indicate that trauma severity during captivity is the best predictor of current PTSD symptomatology. Results also add to our understanding of the conceptual differentiation of PTSD symptoms into separate and distinct symptom clusters.

  18. Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2014-09-01

    Full Text Available Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD is distinct from Borderline Personality Disorder (BPD when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.

  19. A psychometric assessment of Disturbances in Self-Organization symptom indicators for ICD-11 Complex PTSD using the International Trauma Questionnaire.

    Science.gov (United States)

    Shevlin, Mark; Hyland, Philip; Roberts, Neil P; Bisson, Jonathan I; Brewin, Chris R; Cloitre, Marylene

    2018-01-01

    Background : Two 'sibling disorders' have been proposed for the 11 th version of the International Classification of Diseases (ICD-11): Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). To date, no research has attempted to identify the optimal symptom indicators for the 'Disturbances in Self-Organization' (DSO) symptom cluster. Objective : The aim of the current study was to assess the psychometric performance of scores of 16 potential DSO symptom indicators from the International Trauma Questionnaire (ITQ). Criteria relating to score variability and their ability to discriminate were employed. Method : Participants ( N  = 1839) were a nationally representative household sample of non-institutionalized adults currently residing in the US. Item scores from the ITQ were examined in relation to basic criteria associated with interpretability, variability, homogeneity, and association with functional impairment. The performance of the DSO symptoms was also assessed using 1- and 2-parameter item response theory (IRT) models. Results : The distribution of responses for all DSO indicators met the criteria associated with interpretability, variability, homogeneity, and association with functional impairment. The 1-parameter graded response model was considered the best model and indicated that each set of indictors performed very similarly. Conclusions : The ITQ contains 16 DSO symptom indicators and they perform well in measuring their respective symptom cluster. There was no evidence that particular indicators were 'better' than others, and it was concluded that the indicators are essentially interchangeable.

  20. How Common Is PTSD?

    Science.gov (United States)

    ... Center for PTSD » Public » How Common Is PTSD? PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... here Enter ZIP code here How Common Is PTSD? Public This section is for Veterans, General Public, ...

  1. How Is PTSD Measured?

    Science.gov (United States)

    ... Public » Is it PTSD? » How is PTSD Measured? PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... code here Enter ZIP code here How is PTSD Measured? Public This section is for Veterans, General ...

  2. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD.

    Science.gov (United States)

    Armour, Cherie; Karstoft, Karen-Inge; Richardson, J Don

    2014-08-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD. The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group. In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.

  3. Avoidance symptoms and delayed verbal memory are associated with post-traumatic stress symptoms in female victims of sexual violence.

    Science.gov (United States)

    Shin, Kyoung Min; Chang, Hyoung Yoon; Cho, Sun-Mi; Kim, Nam Hee; Kim, Kyoung Ah; Chung, Young Ki

    2015-09-15

    Victimization by sexual violence is strongly associated with the development of posttraumatic stress disorder (PTSD). While several psychological and cognitive factors are known to be associated with PTSD prognosis, multivariable analysis is scarce. This study examined factors affecting the severity of PTSD symptoms in early stage of traumatic experience of sexual violence, including initial post-traumatic symptoms and cognitive characteristics. Participants were recruited from the center for women and children victims of violence in a university hospital. Thirty-four sexual assault victims were assessed at the baseline and the second visit one to five months after the baseline. At the baseline, an array of posttraumatic symptoms and cognitive functions were measured: at follow-up, PTSD symptoms were determined by Clinician Administered PTSD Scale. Stepwise multiple regression showed that avoidance symptoms (β = 0.551, P PTSD symptoms one to five month later. The regression model, factoring in avoidance and delayed verbal memory, showed a 34.9% explanatory power regarding the PTSD symptom severity. This study suggests that avoidance symptoms and verbal memory at the early stage of trauma are associated with later PTSD symptoms. It is also suggested that early intervention targeting avoidance symptoms may be beneficial in decreasing PTSD symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. PTSD: National Center for PTSD

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    Full Text Available ... to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here ... PTSD Treatment: Know Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here ...

  5. Biomarkers of PTSD: military applications and considerations

    OpenAIRE

    Amy Lehrner; Rachel Yehuda

    2014-01-01

    Background: Although there are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk fo...

  6. Prevalence and psychosocial risk factors of PTSD: 18 months after Kashmir earthquake in Pakistan.

    Science.gov (United States)

    Naeem, Farooq; Ayub, Muhammad; Masood, Khadija; Gul, Huma; Khalid, Mahwish; Farrukh, Ammara; Shaheen, Aisha; Waheed, Waquas; Chaudhry, Haroon Rasheed

    2011-04-01

    On average in a year 939 earthquakes of a magnitude between 5 and 8 on the Richter scale occur around the world. In earthquakes developing countries are prone to large-scale destruction because of poor structural quality of buildings, and preparedness for earthquakes. On 8th October 2005, a major earthquake hit the remote and mountainous region of northern Pakistan and Kashmir. We wanted to find out the rate of PTSD in a randomly selected sample of participants living in earthquake area and the correlates of the PTSD. The study was conducted 18 months after the earthquake. We selected a sample of men and women living in the houses and tents for interviews. Using well established instruments for PTSD and general psychiatric morbidity we gathered information from over 1200 people in face to face interviews. We gathered information about trauma exposure and loss as well. 55.2% women and 33.4% men suffered from PTSD. Living in a joint family was protective against the symptoms of PTSD. Dose of exposure to trauma was associated with the symptoms of PTSD. Living in a tent was associated with general psychiatric morbidity but not with PTSD. We used questionnaire instead of interviews to detect the symptoms of psychiatric disorders. The symptoms of PTSD are common 18 months after the earthquake and they are specifically associated with the dose of trauma exposure. This may have implications for rehabilitation of this population. Copyright © 2010 Elsevier B.V. All rights reserved.

  7. Can we combine symptom scales for collaborative research projects?

    LENUS (Irish Health Repository)

    Lyne, John P

    2012-02-01

    Collaborative research projects have the potential to answer important research questions, which may otherwise require huge resources, funding, and time to complete. There are several scales for measuring psychotic symptoms in schizophrenia and other psychotic disorders, with the Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS), Positive and Negative Symptom Scale (PANSS), and the Brief Psychiatric Rating Scale (BPRS) being among the most commonly used. High quality research efforts have used these three scales in different projects, and in order to merge study efforts, some means of combining data from these scales may be necessary. We reviewed correlations in published studies for these three scales, finding them to be highly correlated, however on comparison of the three scales there were considerable clinical differences between them. The paper discusses potential methods for combining the scales in collaborative research, including use of the recently developed standardised remission criteria for schizophrenia.

  8. Biomarkers for PTSD

    Science.gov (United States)

    2011-07-01

    Intern Med 167, 476-82 (2007). 5 P. B. Watson and B. Daniels, Follow up of post - traumatic stress disorder symptoms in Australian servicemen...for DOD and VA as objective indicators of PTSD for use in post - deployment medical screening, treatment selection, treatment outcome monitoring...mitigating the associations between war zone-related PTSD and physical health problems, including cardiovascular and metabolic disorders 6-10. In

  9. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD

    DEFF Research Database (Denmark)

    Armour, C.; Karstoft, K. I.; Richardson, J. D.

    2014-01-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD....... The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants...... were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity...

  10. PTSD: National Center for PTSD

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    Full Text Available ... Overview PTSD Basics Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse ... Treatment Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation ...

  11. PTSD: National Center for PTSD

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  1. PTSD: National Center for PTSD

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  2. Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms : a pilot study

    NARCIS (Netherlands)

    Rosaura Polak, A; Witteveen, Anke B; Denys, D.; Olff, Miranda

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of

  3. Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms: a pilot study

    NARCIS (Netherlands)

    Rosaura Polak, A.; Witteveen, Anke B.; Denys, Damiaan; Olff, Miranda

    2015-01-01

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of

  4. Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

    Directory of Open Access Journals (Sweden)

    Sara A. Freedman

    2015-12-01

    Full Text Available Background: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD, but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD. Objective: This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT on the association between the two. Method: Consecutive emergency department trauma admissions with qualifying PTSD symptoms (n=501 were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms. Results: The cross-lagged effect of SRS on PTSD was statistically significant (β=−0.12, p=0.01 among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (β=−0.02, p=0.67. Both relationships were non-significant among survivors who received CBT. Discussion: SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention.

  5. Validation of a self-reported HIV symptoms list: the ISS-HIV symptoms scale.

    Science.gov (United States)

    Bucciardini, Raffaella; Pugliese, Katherina; Francisci, Daniela; Costantini, Andrea; Schiaroli, Elisabetta; Cognigni, Miriam; Tontini, Chiara; Lucattini, Stefano; Fucili, Luca; Di Gregorio, Massimiliano; Mirra, Marco; Fragola, Vincenzo; Pompili, Sara; Murri, Rita; Vella, Stefano

    2016-01-01

    To describe the development and the psychometric properties of the Istituto Superiore di Sanità-HIV symptoms scale (lSS-HIV symptoms scale). The ISS-HIV symptom scale was developed by an Italian working team including researchers, physicians and people living with HIV. The development process went through the following steps: (1) review of HIV/AIDS literature; (2) focus group; (3) pre-test analysis; (4) scale validation. The 22 symptoms of HIV-ISS symptoms scale were clustered in five factors: pain/general discomfort (7 items); depression/anxiety (4 items); emotional reaction/psychological distress (5 items); gastrointestinal discomfort (4 items); sexual discomfort (2 items). The internal consistence reliability was for all factors within the minimum accepted standard of 0.70. The results of this study provide a preliminary evidence of the reliability and validity of the ISS-HIV symptoms scale. In the new era where HIV infection has been transformed into a chronic diseases and patients are experiencing a complex range of symptoms, the ISS-HIV symptoms scale may represent an useful tool for a comprehensive symptom assessment with the advantage of being easy to fill out by patients and potentially attractive to physicians mainly because it is easy to understand and requires short time to interpret the results.

  6. Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors.

    Science.gov (United States)

    Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

    2013-03-01

    Childbirth might be a traumatic event for some women. This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 women who were 6-8 weeks postpartum and had been undergone to this center for postpartum and child care. One hundred and three (17. 2%) women had symptoms of PTSD following childbirth based on the PTSD Symptom Scale (PSS). The results of logistic regression analysis revealed a significant correlation between maternal occupation (P = 0.01), depression level (P childbirth. PTSD from childbirth occurs in some women. Early identification of risk factors should lead to early therapeutic intervention in the mothers at risk of PTSD.

  7. PTSD-8: A Short PTSD Inventory.

    Science.gov (United States)

    Hansen, Maj; Andersen, Tonny Elmose; Armour, Cherie; Elklit, Ask; Palic, Sabina; Mackrill, Thomas

    2010-09-28

    Traumatic events pose great challenges on mental health services in scarcity of specialist trauma clinicians and services. Simple short screening instruments for detecting adverse psychological responses are needed. Several brief screening instruments have been developed. However, some are limited, especially in relation to reflecting the posttraumatic stress disorder (PTSD) diagnosis. Recently, several studies have challenged pre-existing ideas about PTSD's latent structure. Factor analytic research currently supports two four factor models. One particular model contains a dysphoria factor which has been associated with depression and anxiety. The symptoms in this factor have been hailed as less specific to PTSD. The scope of this article is therefore to present a short screening instrument, based on this research; Posttraumatic Stress Disorder (PTSD) - 8 items. The PTSD-8 is shown to have good psychometric properties in three independent samples of whiplash patients (n=1710), rape victims (n=305), and disaster victims (n=516). Good test-rest reliability is also shown in a pilot study of young adults from families with alcohol problems (n=56).

  8. An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2013-12-01

    Full Text Available Background : The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11 that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD, also define a new diagnosis termed “complex posttraumatic stress disorder” (CPTSD. Objective : We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision] PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. Methods : To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C and the Brief Symptom Inventory (BSI scales, to a sample of adult survivors (N=229 of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA. Results : More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8% than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD. The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively. Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. Conclusion : CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects.

  9. POST TRAUMATIC STRESS DISORDERS (PTSD WITH SEVERE DEPRESSION SYMPTOMS WITH ACUTE PSYCHOTIC IN PATIENT WITH HISTORY AS A PEDOPHILE VICTIMS AND DOMESTIC VIOLENCE IN 22 YEARS OLD MAN : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    I Ketut Agus Indra Adhiputra

    2014-02-01

    Full Text Available Post traumatic stress disorders (PTSD is a disorder that is fairly common in thecommunity. Every event in the life will have its own meaning in later, especially eventsthat occur in childhood. Data in the U.S. showed 60% men and 50% women have atraumatic experience, which develops into PTSD approximately 6.7% of the entirepopulation. While data from the Indonesian National Commission of Women, since 20072010there has been 91311 cases of sexual violence against women, as well as cases ofchild sexual abuse reported to reach 250 cases. Presenting symptoms can range fromanxiety disorders, depression, until psychotic. The severity of symptoms depends on eachself-defense mechanism thus the PTSD symptoms are very diverse.

  10. PTSD symptom severity is associated with increased recruitment of top-down attentional control in a trauma-exposed sample

    OpenAIRE

    White, Stuart F.; Costanzo, Michelle E.; Blair, James R.; Roy, Michael J.

    2015-01-01

    Background: Recent neuroimaging work suggests that increased amygdala responses to emotional stimuli and dysfunction within regions mediating top down attentional control (dorsomedial frontal, lateral frontal and parietal cortices) may be associated with the emergence of anxiety disorders, including posttraumatic stress disorder (PTSD). This report examines amygdala responsiveness to emotional stimuli and the recruitment of top down attention systems as a function of task demands in a populat...

  11. Validation of Turkish version of brief negative symptom scale.

    Science.gov (United States)

    Polat Nazlı, Irmak; Ergül, Ceylan; Aydemir, Ömer; Chandhoke, Swati; Üçok, Alp; Gönül, Ali Saffet

    2016-11-01

    Negative symptoms in schizophrenia have been assessed by many instruments. However, a current consensus on these symptoms has been built and new tools, such as the Brief Negative Symptom Scale (BNSS), are generated. This study aimed to evaluate reliability and validity of the Turkish version of BNSS. The scale was translated to Turkish and backtranslated to English. After the approval of the translation, 75 schizophrenia patients were interviewed with BNSS, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS) and Extrapyramidal Symptom Rating Scale (ESRS). Reliability and validity analyses were then calculated. In the reliability analysis, the Cronbach's alpha coefficient was 0.96 and item-total score correlation coefficients were between 0.655-0.884. The intraclass correlation coefficient was 0.665. The inter-rater reliability was 0.982 (p Symptoms Subscale, Negative Symptoms Subscale, and General Psychopathology Subscale. CDSS and ESRS were not correlated with BNSS-TR. The factor structure of the scale was consisting the same items as in the original version. Our study confirms that the Turkish version of BNSS is an applicable tool for the evaluation of negative symptoms in schizophrenia.

  12. Anger, hostility, and aggression among Iraq and Afghanistan War veterans reporting PTSD and subthreshold PTSD.

    Science.gov (United States)

    Jakupcak, Matthew; Conybeare, Daniel; Phelps, Lori; Hunt, Stephen; Holmes, Hollie A; Felker, Bradford; Klevens, Michele; McFall, Miles E

    2007-12-01

    Iraq and Afghanistan War veterans were grouped by level of posttraumatic stress disorder (PTSD) symptomatology and compared on self-report measures of trait anger, hostility, and aggression. Veterans who screened positive for PTSD reported significantly greater anger and hostility than those in the subthreshold-PTSD and non-PTSD groups. Veterans in the subthreshold-PTSD group reported significantly greater anger and hostility than those in the non-PTSD group. The PTSD and subthreshold-PTSD groups did not differ with respect to aggression, though both groups were significantly more likely to have endorsed aggression than the non-PTSD group. These findings suggest that providers should screen for anger and aggression among Iraq and Afghanistan War veterans who exhibit symptoms of PTSD and incorporate relevant anger treatments into early intervention strategies.

  13. FACTOR STRUCTURE OF THE BRIEF NEGATIVE SYMPTOM SCALE

    OpenAIRE

    Strauss, Gregory P.; Hong, L. Elliot; Gold, James M.; Buchanan, Robert W.; McMahon, Robert P.; Keller, William R.; Fischer, Bernard A.; Catalano, Lauren T.; Culbreth, Adam J.; Carpenter, William T.; Kirkpatrick, Brian

    2012-01-01

    The current study examined the factor structure of the Brief Negative Symptom Scale (BNSS), a next-generation negative symptom rating instrument developed in response to the NIMH-sponsored Consensus Development Conference on Negative Symptoms. Participants included 146 individuals with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Principal axis factoring indicated two distinct factors explaining 68.7% of the variance. Similar to previous findings, the factors reflected mot...

  14. Interdisciplinary Residential Treatment of Posttraumatic Stress Disorder and Traumatic Brain Injury: Effects on Symptom Severity and Occupational Performance and Satisfaction

    Science.gov (United States)

    Speicher, Sarah M.; Walter, Kristen H.

    2014-01-01

    OBJECTIVE. This study examined outcomes of an 8-wk residential treatment program for veterans with posttraumatic stress disorder (PTSD) and a history of traumatic brain injury (TBI). METHOD. Twenty-six veterans completed the Canadian Occupational Performance Measure, Clinician-Administered PTSD Scale, Beck Depression Inventory–2nd Edition, and PTSD Checklist before and after treatment. RESULTS. Veterans demonstrated significant improvements in occupational performance and satisfaction with their performance, as well as in PTSD and depression symptom severity after residential PTSD/TBI treatment. Additionally, improvements in occupational performance and satisfaction were associated with decreases in depression symptom severity. CONCLUSION. Although preliminary, results suggest that veterans with PTSD and a history of TBI experienced significant decreases in PTSD and depression symptom severity and improvement in self-perception of performance and satisfaction in problematic occupational areas. Changes in occupational areas and depression symptom severity were related, highlighting the importance of interdisciplinary treatment. PMID:25005504

  15. PTSD: National Center for PTSD

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  19. PTSD: National Center for PTSD

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  1. Factor structure of the Brief Negative Symptom Scale.

    Science.gov (United States)

    Strauss, Gregory P; Hong, L Elliot; Gold, James M; Buchanan, Robert W; McMahon, Robert P; Keller, William R; Fischer, Bernard A; Catalano, Lauren T; Culbreth, Adam J; Carpenter, William T; Kirkpatrick, Brian

    2012-12-01

    The current study examined the factor structure of the Brief Negative Symptom Scale (BNSS), a next-generation negative symptom rating instrument developed in response to the NIMH-sponsored Consensus Development Conference on Negative Symptoms. Participants included 146 individuals with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Principal axis factoring indicated two distinct factors explaining 68.7% of the variance. Similar to previous findings, the factors reflected motivation and pleasure and emotional expressivity. These findings provide further support for the construct validity of the BNSS, and for the existence of these two negative symptom factors. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Factor analysis of the scale of prodromal symptoms: differentiating between negative and depression symptoms

    NARCIS (Netherlands)

    Klaassen, Rianne M. C.; Velthorst, Eva; Nieman, Dorien H.; de Haan, Lieuwe; Becker, Hiske E.; Dingemans, Peter M.; van de Fliert, J. Reinaud; van der Gaag, Mark; Linszen, Don H.

    2011-01-01

    This study examines the ability of the Scale of Prodromal Symptoms (SOPS) to differentiate between negative and depression symptoms in a young help-seeking ultrahigh risk (UHR) group. SOPS data of 77 help-seeking patients at UHR for psychosis were analyzed with an exploratory factor analysis. The

  3. Assessing ADHD Symptoms in Preschool Children: Use of the ADHD Symptoms Rating Scale.

    Science.gov (United States)

    Phillips, Penny L.; Greenson, Jessica N.; Collett, Brent R.; Gimpel, Gretchen A.

    2002-01-01

    This study examined the psychometric and normative properties of the ADHD-Symptoms Rating Scale with preschool children. Results shed light on normative levels of ADHD behaviors and preschool children and suggested that preschoolers may present with a somewhat different symptom pattern than school-age children. Parents were more likely to endorse…

  4. Validation of the Adult ADHD Investigator Symptom Rating Scale (AISRS)

    Science.gov (United States)

    Spencer, Thomas J.; Adler, Lenard A.; Qiao, Meihua; Saylor, Keith E.; Brown, Thomas E.; Holdnack, James A.; Schuh, Kory J.; Trzepacz, Paula T.; Kelsey, Douglas K.

    2010-01-01

    Objective: Validation of the Adult ADHD Investigator Symptom Rating Scale (AISRS) that measures aspects of ADHD in adults. Method: Psychometric properties of the AISRS total and AISRS subscales are analyzed and compared to the Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV)…

  5. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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  8. PTSD: National Center for PTSD

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  9. Prevalence rate of post-traumatic stress disorders (PTSD and other psychological disorders among Saudi firefighters

    Directory of Open Access Journals (Sweden)

    Mohammed Alghamd

    2013-08-01

    Full Text Available Background: Firefighters have a high probability of being exposed to a variety of traumatic events. Potentially traumatic events can occur during a single rescue such as: providing aid to seriously injured or helpless victims. Moreover, firefighters who are injured in the line of duty may have to retire as a consequence of their injury. The psychological cost of this exposure may increase the risk of long-term problems, such as post-traumatic stress disorder (PTSD symptoms, depression, and anxiety. Objective: The purpose of this study was to investigate the prevalence of PTSD symptoms, depression, anxiety, and assess related variables such as coping strategies and social support among Saudi firefighters. Method: Two hundred firefighters completed the Fire-fighter Trauma History Screen (FTHS to measure the number of traumatic events, Screen for Post-traumatic Stress Symptoms (SPTSS scale to assess the prevalence of PTSD symptoms, Hospital Anxiety and Depression Scales (HADS to assess depression and anxiety, Brief Cope (BC scale to measure coping strategies used, and Social Support scale was used to evaluate the firefighter's support received. Results: The results showed that 84% (169/200 of firefighters were exposed to at least one traumatic event. The result presented that 57% (96/169 of exposure firefighters fully met the DSM-IV criteria for PTSD with high levels of depression and anxiety; 39% (66/169 partially met the PTSD criteria. However, only 4% participants have not met the PTSD criteria. The results also revealed that adaptive coping strategies and higher perceived social support was associated with lower levels of PTSD. Conclusion: The high prevalence rate of PTSD related to the type and severity of the traumatic events and years of experience in the job. Accordingly, many firefighters were severely affected by their experiences, and we should be developing methods to help them.

  10. The Body Dysmorphic Disorder Symptom Scale: Development and preliminary validation of a self-report scale of symptom specific dysfunction.

    Science.gov (United States)

    Wilhelm, Sabine; Greenberg, Jennifer L; Rosenfield, Elizabeth; Kasarskis, Irina; Blashill, Aaron J

    2016-06-01

    The Body Dysmorphic Disorder Symptom Scale (BDD-SS) is a new self-report measure used to examine the severity of a wide variety of symptoms associated with body dysmorphic disorder (BDD). The BDD-SS was designed to differentiate, for each group of symptoms, the number of symptoms endorsed and their severity. This report evaluates and compares the psychometric characteristics of the BDD-SS in relation to other measures of BDD, body image, and depression in 99 adult participants diagnosed with BDD. Total scores of the BDD-SS showed good reliability and convergent validity and moderate discriminant validity. Analyses of the individual BDD-SS symptom groups confirmed the reliability of the checking, grooming, weight/shape, and cognition groups. The current findings indicate that the BDD-SS can be quickly administered and used to examine the severity of heterogeneous BDD symptoms for research and clinical purposes. Copyright © 2016. Published by Elsevier Ltd.

  11. Differences in relationship conflict, attachment, and depression in treatment-seeking veterans with hazardous substance use, PTSD, or PTSD and hazardous substance use.

    Science.gov (United States)

    Owens, Gina P; Held, Philip; Blackburn, Laura; Auerbach, John S; Clark, Allison A; Herrera, Catherine J; Cook, Jerome; Stuart, Gregory L

    2014-05-01

    Veterans (N = 133) who were seeking treatment in either the Posttraumatic Stress Program or Substance Use Disorders Program at a Veterans Affairs Medical Center (VAMC) and, based on self-report of symptoms, met clinical norms for posttraumatic stress disorder (PTSD) or hazardous substance use (HSU) completed a survey related to relationship conflict behaviors, attachment styles, and depression severity. Participants were grouped into one of three categories on the basis of clinical norm criteria: PTSD only, HSU only, and PTSD + HSU. Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, Center for Epidemiologic Studies-Depression scale, Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test, and Psychological Aggression and Physical Violence subscales of the Conflict Tactics Scale. Most participants were male and Caucasian. Significant differences were found between groups on depression, avoidant attachment, psychological aggression perpetration and victimization, and physical violence perpetration and victimization. Post hoc analyses revealed that the PTSD + HSU group had significantly higher levels of depression, avoidant attachment, and psychological aggression than the HSU only group. The PTSD + HSU group had significantly higher levels of physical violence than did the PTSD only group, but both groups had similar mean scores on all other variables. Potential treatment implications are discussed.

  12. Mother's IPV, Child Maltreatment Type and the Presence of PTSD in Children and Adolescents.

    Science.gov (United States)

    Castro, Maravillas; Alcántara-López, Mavi; Martínez, Antonia; Fernández, Visitación; Sánchez-Meca, Julio; López-Soler, Concepción

    2017-09-17

    This correlational cross-sectional study was designed to investigate whether the intimate partner violence (IPV) suffered by mothers (physical and psychological maltreatment), child eyewitness of psychological and physical maltreatment suffered by the mother, the neglect suffered by children, and the maltreatment (physical and psychological) directly suffered by children are statistically associated to post-traumatic stress disorder (PTSD) symptoms exhibited by the child. In addition, the prevalence of child PTSD was estimated, as well as the concordance between the PTSD symptoms assessed by the Child PTSD Symptom Scale (CPSS) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for child PTSD. The sample consisted of 152 Spanish children aged 8 to 17 and their mothers, who were recruited from Centers of Specialized Assistance for Women Victims of IPV. PTSD prevalence was 20.4%. The results of a canonical correlation analysis showed that the two types of maltreatment with the largest contribution to the canonical variable were physical maltreatment directly suffered by the child, and child eyewitness of physical maltreatment suffered by the mother. The potential developmental pathway of PTSD when both children and mothers suffer severe maltreatment needs to be examined, and this will contribute to the choice of the most effective type of specialized intervention.

  13. Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2013-05-01

    Full Text Available Background: The WHO International Classification of Diseases, 11th version (ICD-11, has proposed two related diagnoses, posttraumatic stress disorder (PTSD and complex PTSD within the spectrum of trauma and stress-related disorders. Objective: To use latent profile analysis (LPA to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile. Method: An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse to single-incident events (e.g., exposure to 9/11 attacks. Results: The LPA revealed three classes of individuals: (1 a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2 a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3 a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity. Conclusion: Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  14. Development and validation of an instrument for rapidly assessing symptoms: the general symptom distress scale.

    Science.gov (United States)

    Badger, Terry A; Segrin, Chris; Meek, Paula

    2011-03-01

    Symptom assessment has increasingly focused on the evaluation of total symptom distress or burden rather than assessing only individual symptoms. The challenge for clinicians and researchers alike is to assess symptoms, and to determine the symptom distress associated with the symptoms and the patient's ability for symptom management without a lengthy and burdensome assessment process. The objective of this article was to discuss the psychometric evaluation of a brief general symptom distress scale (GSDS) developed to assess specific symptoms and how they rank in relation to each other, the overall symptom distress associated with the symptom schema, and provide an assessment of how well or poorly that symptom schema is managed. Results from a pilot study about the initial development of the GSDS with 76 hospitalized patients are presented, followed by a more complete psychometric evaluation of the GSDS using three samples of cancer patients (n=190) and their social network members, called partners in these studies (n=94). Descriptive statistics were used to describe the GSDS symptoms, symptom distress, and symptom management. Point biserial correlations indexed the associations between dichotomous symptoms and continuous measures, and conditional probabilities were used to illustrate the substantial comorbidities of this sample. Internal consistency was examined using the KR-20 coefficient, and test-retest reliability was examined. Construct validity and predictive validity also were examined. The GSDS demonstrated satisfactory internal consistency and test-retest reliability, and good construct validity and predictive validity. The total score on the GSDS, symptom distress, and symptom management correlated significantly with related constructs of depression, positive and negative affect, and general health. The GSDS was able to demonstrate its ability to distinguish between those with or without chronic illness, and was able to significantly predict scores on

  15. PTSD in Children and Teens

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    ... for PTSD » Public » PTSD in Children and Teens PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Enter ZIP code here Enter ZIP code here PTSD in Children and Teens Public This section is ...

  16. Effects of PTSD on Family

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    ... for PTSD » Public » Effects of PTSD on Family PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... code here Enter ZIP code here Effects of PTSD on Family Public This section is for Veterans, ...

  17. Posttraumatic stress disorder symptoms and food addiction in women by timing and type of trauma exposure.

    Science.gov (United States)

    Mason, Susan M; Flint, Alan J; Roberts, Andrea L; Agnew-Blais, Jessica; Koenen, Karestan C; Rich-Edwards, Janet W

    2014-11-01

    Posttraumatic stress disorder (PTSD) appears to increase obesity risk but the pathways by which PTSD leads to weight gain are not known. Identification of the links between PTSD and obesogenic eating behaviors is necessary to clarify this pathway and inform development of obesity prevention strategies in PTSD-affected populations. To determine whether women with PTSD symptoms are more likely to report food addiction, a measure of perceived dependence on food, than women without PTSD symptoms. Also, to determine whether age at PTSD symptom onset and type of trauma influence the PTSD-food addiction association. Cross-sectional analysis of 49,408 participants in the Nurses' Health Study II, a cohort comprising women nurses who were aged 25 to 42 years at the 1989 recruitment from 14 US states. The Nurses' Health Study II ascertained lifetime trauma exposure and PTSD symptoms in 2008 and current food addiction in 2009. Food addiction was defined as 3 or more clinically significant symptoms on a modified version of the Yale Food Addiction Scale. Confounder-adjusted prevalence ratios and 95% CIs were estimated using modified Poisson regression. Approximately 80% of the study sample reported some type of trauma exposure, with 66% of the trauma-exposed participants reporting at least 1 lifetime PTSD symptom. Eight percent of the cohort met the criteria for food addiction. The prevalence of food addiction increased with the number of lifetime PTSD symptoms, and women with the greatest number of PTSD symptoms (6-7 symptoms) had more than twice the prevalence of food addiction as women with neither PTSD symptoms nor trauma histories (prevalence ratio, 2.68; 95% CI, 2.41-2.97). Symptoms of PTSD were more strongly related to food addiction when symptom onset occurred at an earlier age. The PTSD-food addiction association did not differ substantially by trauma type. Symptoms of PTSD were associated with increased food addiction prevalence in this cohort of women. Strategies to

  18. French version validation of the psychotic symptom rating scales (PSYRATS for outpatients with persistent psychotic symptoms

    Directory of Open Access Journals (Sweden)

    Favrod Jerome

    2012-09-01

    Full Text Available Abstract Background Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. Methods A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS. Results ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. Conclusions The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience.

  19. Detecting feigned postconcussional and posttraumatic stress symptoms with the structured inventory of malingered symptomatology (SIMS).

    Science.gov (United States)

    Parks, Adam C; Gfeller, Jeffrey; Emmert, Natalie; Lammert, Hannah

    2017-01-01

    The Structured Inventory of Malingered Symptomatology (SIMS) is a standalone symptom validity test (SVT) designed as a screening measure to detect a variety of exaggerated psychological symptoms. A number of studies have explored the accuracy of the SIMS in litigious and clinical populations, yet few have examined the validity of the SIMS in detecting feigned symptoms of postconcussional disorder (PCD) and posttraumatic stress disorder (PTSD). The present study examined the sensitivity of the SIMS in detecting undergraduate simulators (N = 78) feigning symptoms of PCD, PTSD, and the comorbid presentation of both PCD and PTSD symptomatologies. Overall, the SIMS Total score produced the highest sensitivities for the PCD symptoms and PCD+PTSD symptoms groups (.89 and .85, respectively), and to a lesser extent, the PTSD symptoms group (.69). The Affective Disorders (AF) subscale was most sensitive to the PTSD symptoms group compared to the PCD and PCD+PTSD symptoms groups. Additional sensitivity values are presented and examined at multiple scale cutoff scores. These findings support the use of the SIMS as a SVT screening measure for PCD and PTSD symptom exaggeration in neuropsychological assessment.

  20. Next-generation negative symptom assessment for clinical trials: validation of the Brief Negative Symptom Scale.

    Science.gov (United States)

    Strauss, Gregory P; Keller, William R; Buchanan, Robert W; Gold, James M; Fischer, Bernard A; McMahon, Robert P; Catalano, Lauren T; Culbreth, Adam J; Carpenter, William T; Kirkpatrick, Brian

    2012-12-01

    The current study examined the psychometric properties of the Brief Negative Symptom Scale (BNSS), a next-generation rating instrument developed in response to the NIMH sponsored consensus development conference on negative symptoms. Participants included 100 individuals with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who completed a clinical interview designed to assess negative, positive, disorganized, and general psychiatric symptoms, as well as functional outcome. A battery of anhedonia questionnaires and neuropsychological tests were also administered. Results indicated that the BNSS has excellent internal consistency and temporal stability, as well as good convergent and discriminant validity in its relationships with other symptom rating scales, functional outcome, self-reported anhedonia, and neuropsychological test scores. Given its brevity (13-items, 15-minute interview) and good psychometric characteristics, the BNSS can be considered a promising new instrument for use in clinical trials. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Identifying PTSD personality subtypes in a workplace trauma sample.

    Science.gov (United States)

    Sellbom, Martin; Bagby, R Michael

    2009-10-01

    The authors sought to identify personality clusters derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology Five Scales in a sample of workplace claimants with posttraumatic stress disorder (PTSD). Three clusters--low pathology, internalizing, and externalizing were recovered similar to those obtained by M. W. Miller and colleagues (2003, 2004, 2007) in samples of combat veterans and sexual assault victims. Internalizers and externalizers scored comparably on measures of PTSD symptom severity, general distress, and negative affect. Internalizers were uniquely characterized by anhedonia and depressed mood; externalizers by antisocial behavior, substance abuse, and anger/aggression.

  2. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  3. Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members.

    Science.gov (United States)

    Wortmann, Jennifer H; Jordan, Alexander H; Weathers, Frank W; Resick, Patricia A; Dondanville, Katherine A; Hall-Clark, Brittany; Foa, Edna B; Young-McCaughan, Stacey; Yarvis, Jeffrey S; Hembree, Elizabeth A; Mintz, Jim; Peterson, Alan L; Litz, Brett T

    2016-11-01

    The Posttraumatic Stress Disorder Checklist (PCL-5; Weathers et al., 2013) was recently revised to reflect the changed diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). We investigated the psychometric properties of PCL-5 scores in a large cohort (N = 912) of military service members seeking PTSD treatment while stationed in garrison. We examined the internal consistency, convergent and discriminant validity, and DSM-5 factor structure of PCL-5 scores, their sensitivity to clinical change relative to PTSD Symptom Scale-Interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) scores, and their diagnostic utility for predicting a PTSD diagnosis based on various measures and scoring rules. PCL-5 scores exhibited high internal consistency. There was strong agreement between the order of hypothesized and observed correlations among PCL-5 and criterion measure scores. The best-fitting structural model was a 7-factor hybrid model (Armour et al., 2015), which demonstrated closer fit than all other models evaluated, including the DSM-5 model. The PCL-5's sensitivity to clinical change, pre- to posttreatment, was comparable with that of the PSS-I. Optimally efficient cut scores for predicting PTSD diagnosis were consistent with prior research with service members (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014). The results indicate that the PCL-5 is a psychometrically sound measure of DSM-5 PTSD symptoms that is useful for identifying provisional PTSD diagnostic status, quantifying PTSD symptom severity, and detecting clinical change over time in PTSD symptoms among service members seeking treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  4. Efficacy of Adjunctive Sleep Interventions for PTSD

    Science.gov (United States)

    2009-03-01

    MURI; BAA 08-019: Topic #1; PI: M. Hall, University of Pittsburgh). This multidisciplinary translational project focuses on investigating sleep...rate variability (high & low frequency) CAPS Part 2 PTSD symptom checklist (civilian version) Beck Depression Inventory Beck Anxiety...be completed by a CNRC RN) PTSD symptom checklist (civilian version) Beck Depression Inventory Beck Anxiety Inventory Inventory of

  5. Psychometric properties of the child PTSD checklist in a community sample of South African children and adolescents.

    Directory of Open Access Journals (Sweden)

    Mark E Boyes

    Full Text Available OBJECTIVE: The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD in a large sample of South African youth. METHODOLOGY: The checklist was completed by 1025 (540 male; 485 female South African youth (aged between 10 and 19 years. The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach's alpha and McDonald's omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD. RESULTS: Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues' Dysphoria Model of PTSD symptoms which provided a better fit to the observed data. CONCLUSION: Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made.

  6. Psychometric Properties of the Child PTSD Checklist in a Community Sample of South African Children and Adolescents

    Science.gov (United States)

    Boyes, Mark E.; Cluver, Lucie D.; Gardner, Frances

    2012-01-01

    Objective The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD) in a large sample of South African youth. Methodology The checklist was completed by 1025 (540 male; 485 female) South African youth (aged between 10 and 19 years). The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach’s alpha and McDonald’s omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD. Results Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales) were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues’ Dysphoria Model of PTSD symptoms) which provided a better fit to the observed data. Conclusion Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made. PMID:23056523

  7. Common paths to ASD and PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

    Numerous studies have investigated the prediction of acute and long term posttraumatic symptoms following traumatic exposure. As a result several factors have been shown to be predictive of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) respectively. Furthermore, research...... suggests a strong relationship between ASD severity and subsequent PTSD severity. However, little is known in relation to whether there are common pathways to the development of ASD and PTSD. Peritraumatic responses to trauma are found to be associated with both the development of ASD and PTSD. Although...... of peritraumatic factors such as symptoms of tonic immobility, panic, and dissociation on the development of ASD (N = 458) and PTSD (n = 378) symptoms in a national study of Danish bank robbery victims. The estimated ASD rate was 11.1 % (n = 41) and the estimated PTSD rate was 6.2 % (n = 23). The results...

  8. PTSD: National Center for PTSD

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  18. Psychometric evaluation of the HIV symptom distress scale

    Science.gov (United States)

    Marc, Linda G.; Wang, Ming-Mei; Testa, Marcia A.

    2012-01-01

    The objective of this paper is to psychometrically validate the HIV Symptom Distress Scale (SDS), an instrument that can be used to measure overall HIV symptom distress or clinically relevant groups of HIV symptoms. A secondary data analysis was conducted using the Collaborations in HIV Outcomes Research U.S. Cohort (CHORUS). Inclusion criteria required study participants (N=5,521) to have a valid baseline measure of the AIDS Clinical Trial Group Symptom Distress Module, with an SF-12 or SF-36 completed on the same day. Psychometric testing assessed unidimensionality, internal consistency and factor structure using exploratory and confirmatory factor analysis, and structural equation modeling (SEM). Construct validity examined whether the new measure discriminates across clinical significance (CD4 and HIV viral load). Findings show that the SDS has high reliability (α=0.92), and SEM supports a correlated second-order factor model (physical and mental distress) with acceptable fit (GFI=0.88, AGFI=0.85, NFI=0.99, NNFI=0.99; RMSEA=0.06, [90% CI 0.06 – 0.06]; Satorra Bentler Scaled, C2 =3274.20; p=0.0). Construct validity shows significant differences across categories for HIV-1 viral load (p< 0.001) and CD4 (p< 0.001). Differences in mean SDS scores exist across gender (p< 0.001), race/ethnicity (p< 0.05) and educational attainment (p < 0.001). Hence, the HIV Symptom Distress Scale is a reliable and valid instrument, which measures overall HIV symptoms or clinically relevant groups of symptoms. PMID:22409246

  19. Identification of Risk Factors for Chronic Posttraumatic Stress Disorder (PTSD)

    National Research Council Canada - National Science Library

    Shea, M. T; Hebert, Norman J

    2007-01-01

    The primary research aims are to examine the early longitudinal course of PTSD symptoms and test hypotheses regarding risk factors for chronic PTSD in military personnel returning from Iraq or Afghanistan...

  20. Auditory hallucinations and PTSD in ex-POWS

    DEFF Research Database (Denmark)

    Crompton, Laura; Lahav, Yael; Solomon, Zahava

    2017-01-01

    (PTSD) symptoms, over time. Former prisoners of war (ex-POWs) from the 1973 Yom Kippur War (n = 99) with and without PTSD and comparable veterans (n = 103) were assessed twice, in 1991 (T1) and 2003 (T2) in regard to auditory hallucinations and PTSD symptoms. Findings indicated that ex-POWs who suffered...... from PTSD reported higher levels of auditory hallucinations at T2 as well as increased hallucinations over time, compared to ex-POWs without PTSD and combatants who did not endure captivity. The relation between PTSD and auditory hallucinations was unidirectional, so that the PTSD overall score at T1...... predicted an increase in auditory hallucinations between T1 and T2, but not vice versa. Assessing the role of PTSD clusters in predicting hallucinations revealed that intrusion symptoms had a unique contribution, compared to avoidance and hyperarousal symptoms. The findings suggest that auditory...

  1. One-year follow up of PTSD and depression in elderly aboriginal people in Taiwan after Typhoon Morakot.

    Science.gov (United States)

    Chen, Yi-Lung; Hsu, Wen-Yau; Lai, Chung-Sheng; Tang, Tze-Chun; Wang, Peng-Wei; Yeh, Yi-Chung; Huang, Mei-Feng; Yen, Cheng-Fang; Chen, Cheng-Sheng

    2015-01-01

    This paper describes a 1-year follow-up of post-traumatic stress disorder (PTSD) symptomatology and depression in an elderly minority population who experienced Typhoon Morakot in Taiwan. The PTSD Symptom Scale--Interview and the 10-item short form Center for Epidemiological Studies Depression Scale were used to examine PTSD symptomatology and depression in 120 victims at 3-6 months and in 88 victims (73.3% reinterview rate) at 11-12 months after the disaster. Further, we looked for associations between stress, prognosis, and development of PTSD symptomatology and depression. The prevalence of PTSD symptomatology decreased from 29.2% (35/120) at 3-6 months to 15.9% (14/88) at 11-12 months. The prevalence of depression, however, increased from 43.3% (52/120) to 46.6% (41/88). No factor was associated with follow-up PTSD symptomatology, and only the level of education was related to follow-up depression. Generally, the risk factors of age, sex, symptomatology of PTSD and depression at baseline, and stressor of unemployment predicted new-onset or chronic PTSD symptomatology and depression. Delayed-onset depression 48.0% (24/50) was more common than delayed-onset PTSD symptomatology 11.3% (7/62). Chronic and delayed-onset PTSD symptomatology were more easily developed with depression. Although PTSD and depression were separate consequences of trauma, they emerged and affected mental health together. We documented the courses of PTSD and depression among elderly aboriginal people, and the possible effects of demographic, symptomatology, and adverse life stressors were discussed. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  2. Does the Association between Workplace Bullying and Post-Traumatic Stress Symptoms differ across Educational Groups?

    Directory of Open Access Journals (Sweden)

    Sabrina Islamoska

    2018-01-01

    Full Text Available The aim of this study was to investigate whether the level of reported post-traumatic stress (PTSD symptoms among targets of workplace bullying differ depending on their educational level. Exposure to workplace bullying was assessed by the behavioural experience method and the self-labelling method among 563 Danish employees. PTSD symptoms were assessed by the Impact of Event Scale – Revised. Educational level was measured as years of education. The results showed that workplace bullying was significantly associated with the reporting of PTSD symptoms. However, PTSD symptoms were not reported differently among those with experience of work-place bullying. Implementing bullying policies is an important step in promoting a healthy psychosocial working environment. All targets of workplace bullying would benefit from interventions aiming to reduce progression of PTSD symptoms.

  3. Does the Association between Workplace Bullying and Post-Traumatic Stress Symptoms differ across Educational Groups?

    DEFF Research Database (Denmark)

    Islamoska, Sabrina; Grynderup, Matias Brødsgaard; Nabe-Nielsen, Kirsten

    2018-01-01

    not reported differently among those with experience of workplace bullying. Implementing bullying policies is an important step in promoting a healthy psychosocial working environment. All targets of workplace bullying would benefit from interventions aiming to reduce progression of PTSD symptoms.The aim...... with experience of workplace bullying. Implementing bullying policies is an important step in promoting a healthy psychosocial working environment. All targets of workplace bullying would benefit from interventions aiming to reduce progression of PTSD symptoms.......-labelling method among 563 Danish employees. PTSD symptoms were assessed by the Impact of Event Scale – Revised. Educational level was measured as years of education. The results showed that workplace bullying was significantly associated with the reporting of PTSD symptoms. However, PTSD symptoms were...

  4. The somatic symptom scale-8 (SSS-8): a brief measure of somatic symptom burden.

    Science.gov (United States)

    Gierk, Benjamin; Kohlmann, Sebastian; Kroenke, Kurt; Spangenberg, Lena; Zenger, Markus; Brähler, Elmar; Löwe, Bernd

    2014-03-01

    Somatic symptoms are the core features of many medical diseases, and they are used to evaluate the severity and course of illness. The 8-item Somatic Symptom Scale (SSS-8) was recently developed as a brief, patient-reported outcome measure of somatic symptom burden, but its reliability, validity, and usefulness have not yet been tested. To investigate the reliability, validity, and severity categories as well as the reference scores of the SSS-8. A national, representative general-population survey was performed between June 15, 2012, and July 15, 2012, in Germany, including 2510 individuals older than 13 years. The SSS-8 mean (SD), item-total correlations, Cronbach α, factor structure, associations with measures of construct validity (Patient Health Questionnaire-2 depression scale, Generalized Anxiety Disorder-2 scale, visual analog scale for general health status, 12-month health care use), severity categories, and percentile rank reference scores. The SSS-8 had excellent item characteristics and good reliability (Cronbach α = 0.81). The factor structure reflects gastrointestinal, pain, fatigue, and cardiopulmonary aspects of the general somatic symptom burden. Somatic symptom burden as measured by the SSS-8 was significantly associated with depression (r = 0.57 [95% CI, 0.54 to 0.60]), anxiety (r = 0.55 [95% CI, 0.52 to 0.58]), general health status (r = -0.24 [95% CI, -0.28 to -0.20]), and health care use (incidence rate ratio, 1.12 [95% CI, 1.10 to 1.14]). The SSS-8 severity categories were calculated in accordance with percentile ranks: no to minimal (0-3 points), low (4-7 points), medium (8-11 points), high (12-15 points), and very high (16-32 points) somatic symptom burden. For every SSS-8 severity category increase, there was a 53% (95% CI, 44% to 63%) increase in health care visits. The SSS-8 is a reliable and valid self-report measure of somatic symptom burden. Cutoff scores identify individuals with low, medium, high, and very high somatic

  5. The brief negative symptom scale (BNSS): Sensitivity to treatment effects.

    Science.gov (United States)

    Kirkpatrick, Brian; Saoud, Jay B; Strauss, Gregory P; Ahmed, Anthony O; Tatsumi, Kazunori; Opler, Mark; Luthringer, Remy; Davidson, Michael

    2017-12-21

    The Brief Negative Symptom Scale (BNSS) grew out of a recommendation by the NIMH-sponsored Consensus Development Conference on Negative Symptoms that a scale based on contemporary concepts be developed. We assessed sensitivity to change of the BNSS in a trial of MIN-101, which showed efficacy for negative symptoms (PANSS pentagonal model) at daily doses of 32 and 64mg/day. Using mixed-effects model for repeated measures, we examined change in BNSS total score and in the BNSS factors of anhedonia/avolition/asociality (AAA), and expressivity (EXP). Compared to placebo, the 64mg group (N=83) showed a significant decrease in BNSS total score (effect size d [ES] 0.56, psymptom scores; covarying for disorganization, positive symptoms, or anxiety/depression did not cause a meaningful change in the significance of the BNSS total or factor scores in this group. The 32mg group (N=78) did not differ significantly from placebo (N=83) on BNSS total score (ES=0.33, p<0.09), AAA (ES=0.25, p<0.20) or EXP (ES=0.30, p<0.12) scores. These results demonstrate the BNSS is sensitive to change. Copyright © 2017. Published by Elsevier B.V.

  6. Biomarkers of PTSD: military applications and considerations

    Directory of Open Access Journals (Sweden)

    Amy Lehrner

    2014-08-01

    Full Text Available Background: Although there are no established biomarkers for posttraumatic stress disorder (PTSD as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk for PTSD following trauma exposure, and predict or identify recovery. While there has been much interest in PTSD biomarkers, there has been less discussion of their potential clinical applications, and of the social, legal, and ethical implications of such biomarkers. Objective: This article will discuss possible applications of PTSD biomarkers, including the social, legal, and ethical implications of such biomarkers, with an emphasis on military applications. Method: Literature on applications of PTSD biomarkers and on potential ethical and legal implications will be reviewed. Results: Biologically informed research findings hold promise for prevention, assessment, treatment planning, and the development of prophylactic and treatment interventions. As with any biological indicator of disorder, there are potentially positive and negative clinical, social, legal, and ethical consequences of using such biomarkers. Conclusions: Potential clinical applications of PTSD biomarkers hold promise for clinicians, patients, and employers. The search for biomarkers of PTSD should occur in tandem with an interdisciplinary discussion regarding the potential implications of applying biological findings in clinical and employment settings.

  7. Biomarkers of PTSD: military applications and considerations.

    Science.gov (United States)

    Lehrner, Amy; Yehuda, Rachel

    2014-01-01

    Although there are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk for PTSD following trauma exposure, and predict or identify recovery. While there has been much interest in PTSD biomarkers, there has been less discussion of their potential clinical applications, and of the social, legal, and ethical implications of such biomarkers. This article will discuss possible applications of PTSD biomarkers, including the social, legal, and ethical implications of such biomarkers, with an emphasis on military applications. Literature on applications of PTSD biomarkers and on potential ethical and legal implications will be reviewed. Biologically informed research findings hold promise for prevention, assessment, treatment planning, and the development of prophylactic and treatment interventions. As with any biological indicator of disorder, there are potentially positive and negative clinical, social, legal, and ethical consequences of using such biomarkers. Potential clinical applications of PTSD biomarkers hold promise for clinicians, patients, and employers. The search for biomarkers of PTSD should occur in tandem with an interdisciplinary discussion regarding the potential implications of applying biological findings in clinical and employment settings.

  8. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD.

    Science.gov (United States)

    Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

    2018-01-01

    Background : It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective : To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method : PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results : Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d  = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions : The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD.

  9. Measurement of narcolepsy symptoms: The Narcolepsy Severity Scale.

    Science.gov (United States)

    Dauvilliers, Yves; Beziat, Severine; Pesenti, Carole; Lopez, Regis; Barateau, Lucie; Carlander, Bertrand; Luca, Gianina; Tafti, Mehdi; Morin, Charles M; Billiard, Michel; Jaussent, Isabelle

    2017-04-04

    To validate the Narcolepsy Severity Scale (NSS), a brief clinical instrument to evaluate the severity and consequences of symptoms in patients with narcolepsy type 1 (NT1). A 15-item scale to assess the frequency and severity of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, and disrupted nighttime sleep was developed and validated by sleep experts with patients' feedback. Seventy untreated and 146 treated adult patients with NT1 were evaluated and completed the NSS in a single reference sleep center. The NSS psychometric properties, score changes with treatment, and convergent validity with other clinical parameters were assessed. The NSS showed good psychometric properties with significant item-total score correlations. The factor analysis indicated a 3-factor solution with good reliability, expressed by satisfactory Cronbach α values. The NSS total score temporal stability was good. Significant NSS score differences were observed between untreated and treated patients (dependent sample, 41 patients before and after sleep therapy; independent sample, 29 drug-free and 105 treated patients). Scores were lower in the treated populations (10-point difference between groups), without ceiling effect. Significant correlations were found among NSS total score and daytime sleepiness (Epworth Sleepiness Scale, Mean Sleep Latency Test), depressive symptoms, and health-related quality of life. The NSS can be considered a reliable and valid clinical tool for the quantification of narcolepsy symptoms to monitor and optimize narcolepsy management. © 2017 American Academy of Neurology.

  10. Impact of terrorism on the development of posttraumatic stress disorder (PTSD) among the residents of Khyber Bazaar and its immediate surrounding areas in Peshawar, Khyber Pakhtunkhwa, Pakistan.

    Science.gov (United States)

    Abbas, Syed Asad; Hassan, Asad; Ali, Shahid

    2017-01-01

    This study evaluated the prevalence of posttraumatic stress disorder (PTSD) and the severity of PTSD symptoms in survivors, rescuers and witnesses of terrorist attacks on Khyber bazaar, Qissa Khawani bazaar, and All Saints Church in Peshawar city area. Cross-sectional survey is carried out on a sample of one hundred survivors, rescuers and witness of terrorist attacks using structured interviews to assess the severity of posttraumatic stress, five months after the attacks. The study period extended from January 24, 2014 to March 24, 2014 which constitutes a total of period of 8 weeks. PTSD symptoms are measured using Posttraumatic Symptom Scale Interview (PSSI) and conferred to a diagnosis of PTSD at 5 months. Additionally, the severity of PTSD symptoms were determined using PSSI scores, severity ranged from 0-51. Of the one hundred survey respondents, 88% were males and 12% were females. Forty percent (40%) had attained 10 years of education, matriculation, but irrespective of the gender or educational status, all had some degree of PTSD. Sixty-six (66%) percent respondents are diagnosed as having moderate PTSD while 11% of the sample suffered from severe PTSD level. Age, gender, occupation and education level did not have any correlation with PTSD development. The contemporary findings indicate that any person who has witnessed or survived catastrophes of terrorist activities like bomb blast or being exposed to suicide attacks is at risk for developing PTSD, and there is necessity to deliver specialized post-disaster mental health facilities to the people having substantial levels of PTSD after calamities of such great intensity.

  11. Assessment of Plasma C-Reactive Protein as a Biomarker of PTSD Risk

    Science.gov (United States)

    Eraly, Satish A.; Nievergelt, Caroline M.; Maihofer, Adam X.; Barkauskas, Donald A.; Biswas, Nilima; Agorastos, Agorastos; O’Connor, Daniel T.; Baker, Dewleen G.; Team, MRS

    2014-01-01

    Importance Post-traumatic stress disorder (PTSD) has been associated in cross-sectional studies with peripheral inflammation. It is not known whether this observed association is due to PTSD predisposing to inflammation (as sometimes postulated) or to inflammation predisposing to PTSD. Objective To determine whether plasma concentration of the inflammatory marker, C-reactive protein (CRP), helps predict future PTSD symptoms. Design and Setting The Marine Resiliency Study (MRS), a prospective study of ~2,600 war zone-deployed Marines, during which PTSD symptomatology and various physiological and psychological parameters were determined pre-deployment and at approximately three and six months following a seven month deployment. Participants Subjects were recruited from four all-male infantry battalions imminently deploying to a war zone. Participation was requested of 2,978 subjects, of whom 2,610 (87.6%) consented and 2,555 (85.8%) were included in the current analysis. Post-deployment data on combat exposure were included from 2,215 subjects (86.7% of the 2,555 included subjects), and on PTSD symptomatology from 1,861 (72.8%) and 1,609 subjects (63.0%) at three and six months following deployment, respectively. Main Outcome Measure(s) PTSD symptoms three months after deployment, assessed by the Clinician Administered PTSD Scale (CAPS). Results We determined the effects of baseline plasma CRP concentration on post-deployment CAPS using Zero-inflated negative binomial regression (ZINBR), a procedure designed for distributions, such as CAPS in this study, which have an excess of zeros in addition to being positively skewed. Adjusting for baseline CAPS, trauma exposure, and other relevant covariates, we found baseline plasma CRP concentration to be a highly significant overall predictor of post-deployment CAPS scores (p=0.002): each 10-fold increment in CRP concentration was associated with an odds ratio of non-zero outcome (presence vs. absence of any PTSD symptoms

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available skip to page content Attention A T users. To access the menus on this page please perform the following steps. 1. Please switch auto forms ... Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Community Providers and Clergy Co-Occurring Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What is PILOTS? Quick Search Tips Modify ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Care, Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 Contact Us: ncptsd@va.gov Also see: VA Mental Health Connect with us return to top ... Notices Privacy FOIA Regulations Web Policies No FEAR Act Whistleblower Rights & Protections Site ...

  15. Dissociative, depressive, and PTSD symptom severity as correlates of nonsuicidal self-injury and suicidality in dissociative disorder patients.

    Science.gov (United States)

    Webermann, Aliya R; Myrick, Amie C; Taylor, Christina L; Chasson, Gregory S; Brand, Bethany L

    2016-01-01

    The present study investigates whether symptom severity can distinguish patients diagnosed with dissociative identity disorder and dissociative disorder not otherwise specified with a recent history of nonsuicidal self-injury (NSSI) and suicide attempts from those patients without recent self-harm. A total of 241 clinicians reported on recent history of patient NSSI and suicide attempts. Of these clinicians' patients, 221 completed dissociative, depressive, and posttraumatic stress disorder symptomatology measures. Baseline cross-sectional data from a naturalistic and prospective study of dissociative disorder patients receiving community treatment were utilized. Analyses evaluated dissociative, depressive, and posttraumatic stress disorder symptom severity as methods of classifying patients into NSSI and suicide attempt groupings. Results indicated that dissociation severity accurately classified patients into NSSI and suicidality groups, whereas depression severity accurately classified patients into NSSI groups. These findings point to dissociation and depression severity as important correlates of NSSI and suicidality in patients with dissociative disorders and have implications for self-harm prevention and treatment.

  16. Traumatic severity and trait resilience as predictors of posttraumatic stress disorder and depressive symptoms among adolescent survivors of the Wenchuan earthquake.

    Directory of Open Access Journals (Sweden)

    Liuhua Ying

    Full Text Available PURPOSE: To examine the associations between trauma severity, trait resilience, and posttraumatic stress disorder (PTSD and depressive symptoms among adolescent survivors of the Wenchuan earthquake, China. METHODS: 788 participants were randomly selected from secondary schools in the counties of Wenchuan and Maoxian, the two areas most severely affected by the earthquake. Participants completed four main questionnaires including the Child PTSD Symptom Scale, the Center for Epidemiologic Studies Depression Scale for Children, the Connor and Davidson's Resilience Scale, and the Severity of Exposure to Earthquake Scale. RESULTS: After adjusting for the effect of age and gender, four aspects of trauma severity (i.e., direct exposure, indirect exposure, worry about others, and house damage were positively associated with the severity of PTSD and depressive symptoms, whereas trait resilience was negatively associated with PTSD and depressive symptoms and moderated the relationship between subjective experience (i.e., worry about others and PTSD and depressive symptoms. CONCLUSIONS: Several aspects (i.e., direct exposure, indirect exposure, worry about others, and house damage of earthquake experiences may be important risk factors for the development and maintenance of PTSD and depression. Additionally, trait resilience exhibits the beneficial impact on PTSD and depressive symptoms and buffers the effect of subjective experience (i.e., worry about others on PTSD and depressive symptoms.

  17. A model comparison approach to trauma-related guilt as a mediator of the relationship between PTSD symptoms and suicidal ideation among veterans.

    Science.gov (United States)

    Cunningham, Katherine C; Farmer, Chloe; LoSavio, Stefanie T; Dennis, Paul A; Clancy, Carolina P; Hertzberg, Michael A; Collie, Claire F; Calhoun, Patrick S; Beckham, Jean C

    2017-10-15

    Suicidal ideation (SI) is a serious issue affecting U.S. veterans, and those with posttraumatic stress disorder (PTSD) are at an especially high risk of SI. Guilt has been associated with both PTSD and SI and may therefore be an important link between these constructs. The present study compared models of trauma-related guilt and used path analysis to examine the direct and indirect effects of PTSD and trauma-related guilt on SI among a sample of 988 veterans receiving outpatient PTSD treatment at a Veterans Affairs (VA) specialty clinic. Results showed that a model of trauma-related guilt including guilt-cognitions and global guilt (but not distress) provided the best model fit for the data. PTSD and trauma-related guilt had direct effects on SI, and PTSD exhibited indirect effects on SI via trauma-related guilt. The use of cross-sectional data limits the ability to make causal inferences. A treatment-seeking sample composed primarily of Vietnam veterans limits generalizability to other populations. Trauma-related guilt, particularly guilt cognitions, may be an effective point of intervention to help reduce SI among veterans with PTSD. This is an important area of inquiry, and suggestions for future research are discussed. Published by Elsevier B.V.

  18. Posttraumatic stress disorder following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity: the impact of alexithymia and coping.

    Science.gov (United States)

    Chung, Man Cheung; Rudd, Hannah; Wall, Natalie

    2012-05-30

    This study investigated the prevalence of post-asthma attack posttraumatic stress disorder (PTSD) and the severity of psychiatric co-morbidity among a group of college students and whether alexithymia and coping strategies would relate to health outcomes. This is a cross-sectional study in which 156 college students who had previously experienced asthma attack were recruited. They completed a demographic page, Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28, Toronto Alexithymia Scale and the COPE. They were also matched with 141 students without asthma. The results showed that 3% met the criteria for full-PTSD, 44% for partial and 53% for no-PTSD. There were no significant differences between the asthma and control groups in severity of psychiatric co-morbid symptoms. Path analyses showed that asthma severity was significantly correlated with PTSD and psychiatric co-morbidity. It was also correlated with alexithymia which was in turn associated with psychiatric co-morbidity but not PTSD. Coping strategies were not correlated with health outcomes. To conclude, people can develop PTSD symptoms and degrees of psychiatric co-morbid symptoms after suffering asthma attack. The severity of these symptoms relates to people's perceptions of asthma severity and alexithymia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Predictors of PTSD symptoms in brazilian police officers: the synergy of negative affect and peritraumatic dissociation Preditores de sintomas de transtorno de estresse pós-traumático em policiais brasileiros: a interação entre afeto negativo e dissociação peritraumática

    Directory of Open Access Journals (Sweden)

    Deborah B Maia

    2011-12-01

    Full Text Available BACKGROUND: Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD. Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. METHOD: In a cross-sectional sample of active duty officers (n = 212, participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. RESULTS: Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55% of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. CONCLUSIONS: The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers.INTRODUÇÃO: A exposição a eventos traumáticos é uma condição necessária, porém não única, para o desenvolvimento de transtorno de estresse pós-traumático (TEPT. Fatores individuais pré, peri e pós-trauma exercem impacto sobre a gravidade dos sintomas. O objetivo do presente estudo é determinar os fatores de risco para o desenvolvimento de sintomas de TEPT em policiais brasileiros. MÉTODO: Uma amostra transversal de policiais em atividade (n = 212 foi convidada a responder um questionário sóciodemográfico e escalas autoaplicáveis sobre afeto positivo e

  20. A Double-Blind Randomized Controlled Pilot Trial of N-Acetylcysteine in Veterans with PTSD and Substance Use Disorders

    Science.gov (United States)

    Back, Sudie E.; McCauley, Jenna L.; Korte, Kristina J.; Gros, Daniel F.; Leavitt, Virginia; Gray, Kevin M.; Hamner, Mark B.; DeSantis, Stacia M.; Malcolm, Robert; Brady, Kathleen T.; Kalivas, Peter W.

    2016-01-01

    Objective The antioxidant N-Acetylcysteine (NAC) is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders. Preclinical and clinical findings suggest that NAC normalizes extracellular glutamate by restoring the activity of glutamate transporters and antiporters in the nucleus accumbens. This study explored the efficacy of NAC in the treatment of post-traumatic stress disorder (PTSD), which frequently co-occurs with substance use disorders (SUD) and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. Method Veterans with current PTSD and SUD (N=35) were randomly assigned to receive a double-blind, 8-week course of NAC (2400 mg/day) or placebo plus outpatient group cognitive-behavioral therapy for SUD. Primary outcome measures included PTSD symptoms (Clinician Administered PTSD Scale, PTSD Checklist-Military) and craving (Visual Analogue Scale). Depression (Beck Depression Inventory-II) and substance use (Timeline Follow Back, urine drug screens) were also assessed. Results Participants treated with NAC, as compared to placebo, evidenced significant improvements in PTSD symptoms, craving, and depression. Substance use at the start of treatment was low for both the NAC and placebo groups and no significant between-group differences were observed. NAC was well tolerated and retention was high. Conclusions This is the first randomized controlled trial to investigate NAC as a pharmacological treatment for PTSD. The findings show a significant treatment effect on symptoms of PTSD and drug craving, and provide initial support for the use of NAC in combination with cognitive-behavioral therapy among individuals with co-occurring PTSD and SUD. PMID:27736051

  1. ASD and PTSD in Rape Victims

    DEFF Research Database (Denmark)

    Elklit, Ask; Christiansen, Dorte M

    2010-01-01

    In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims...... shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A2 and F criteria was best identified by classifying...... on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found....

  2. Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse

    Directory of Open Access Journals (Sweden)

    Antje Krüger

    2014-09-01

    Full Text Available Background: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD. However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD. Objective: The goal of the present study was to explore the frequency of sudden losses and sudden gains in the course of an exposure-based treatment programme for female patients suffering from PTSD related to childhood sexual abuse who also show severe comorbidity. In addition, the relationship between sudden changes and treatment outcome was examined. Methods: Female participants (N=74 were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. The pattern of symptom change was assessed via weekly assessments using the Posttraumatic Diagnostic Scale (PDS. Sudden changes were computed as suggested by the literature on sudden gains. Results: During treatment, only one participant (3% experienced a sudden loss, whereas 25% of participants experienced sudden gains. In the waiting condition, 8% of the participants experienced sudden losses and 5% experienced sudden gains during the same time period. No symptom worsening was observed in response to exposure sessions. However, sudden gains occurred during exposure and non-exposure treatment weeks. Patients with sudden gains showed better treatment outcome in the post-treatment and follow-up assessments. Conclusions: Exposure-based treatment did not lead to PTSD symptom worsening in the study sample. Results show that sudden gains occur frequently during PTSD treatment and have a prognostic value for treatment outcome.

  3. Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model

    Science.gov (United States)

    Liu, Chunli; Zhang, Yi; Jiang, Hong; Wu, Hui

    2017-01-01

    Post-traumatic stress disorder (PTSD) symptoms can develop after person experiences one or more traumatic events. Little research, however, has been done on PTSD symptoms of patients with ovarian cancer. The present study aimed to estimate the prevalence of PTSD symptoms in patients with ovarian cancer in China; the effects of demographic and clinical variables on PTSD symptoms; multiple mediation roles in the association between social support and PTSD symptoms in patients with ovarian cancer in China. We collected demographic and clinical information of patients with ovarian cancer in the first and second hospitals of China Medical University between January 1, 2014 and December 31, 2015. Qualified patients were asked to complete the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Duke-UNC Functional Social Support Questionnaire, Herth Hope Index (HHI), and Resilience Scale-14 (RS-14). 201 patients provided responses. We performed hierarchical linear regression to assess the correlation between social support and PTSD symptoms and bootstrapping to test the mediating role of hope and resilience as potential mediators. After controlling demographic and clinical characteristics, social support negatively correlated with PTSD symptoms (β = -0.406, P Social support explained 14.7% of the variance in PTSD symptoms. Hope and resilience explained 17.0% of the variance in PTSD symptoms. The proportion of the hope mediating effect was 43.37% for social support and the proportion of the resilience mediating effect was 10.64% for social support. Hope and resilience partly mediated the correlation between social support and PTSD symptoms despite accounting for different proportions of the mediating effect. Future intervention plans should pay more attention to social support as well as hope and resilience to prevent, relieve and treat PTSD symptoms. PMID:28475593

  4. Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model.

    Directory of Open Access Journals (Sweden)

    Chunli Liu

    Full Text Available Post-traumatic stress disorder (PTSD symptoms can develop after person experiences one or more traumatic events. Little research, however, has been done on PTSD symptoms of patients with ovarian cancer. The present study aimed to estimate the prevalence of PTSD symptoms in patients with ovarian cancer in China; the effects of demographic and clinical variables on PTSD symptoms; multiple mediation roles in the association between social support and PTSD symptoms in patients with ovarian cancer in China. We collected demographic and clinical information of patients with ovarian cancer in the first and second hospitals of China Medical University between January 1, 2014 and December 31, 2015. Qualified patients were asked to complete the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C, Duke-UNC Functional Social Support Questionnaire, Herth Hope Index (HHI, and Resilience Scale-14 (RS-14. 201 patients provided responses. We performed hierarchical linear regression to assess the correlation between social support and PTSD symptoms and bootstrapping to test the mediating role of hope and resilience as potential mediators. After controlling demographic and clinical characteristics, social support negatively correlated with PTSD symptoms (β = -0.406, P < 0.01. Social support explained 14.7% of the variance in PTSD symptoms. Hope and resilience explained 17.0% of the variance in PTSD symptoms. The proportion of the hope mediating effect was 43.37% for social support and the proportion of the resilience mediating effect was 10.64% for social support. Hope and resilience partly mediated the correlation between social support and PTSD symptoms despite accounting for different proportions of the mediating effect. Future intervention plans should pay more attention to social support as well as hope and resilience to prevent, relieve and treat PTSD symptoms.

  5. Post-traumatic stress symptom clusters in acute whiplash associated disorder and their prediction of chronic pain-related disability

    OpenAIRE

    Annick Maujean; Matthew J. Gullo; Tonny Elmose Andersen; Sophie Lykkegaard Ravn; Michele Sterling

    2017-01-01

    Abstract. Introduction:. The presence of post-traumatic stress disorder (PTSD) symptoms has been found to be associated with an increased risk of persisting neck pain and disability in motor vehicle crash (MVC) survivors with whiplash injuries. The findings are mixed as to which PTSD symptom(s) best predicts recovery in this population. Objectives:. The aims were (1) to explore the factor structure of the Post-traumatic Stress Diagnostic Scale (PDS) in a sample of acute whiplash-injured in...

  6. PTSD following childbirth: a prospective study of incidence and risk factors in Canadian women.

    Science.gov (United States)

    Verreault, Nancy; Da Costa, Deborah; Marchand, André; Ireland, Kierla; Banack, Hailey; Dritsa, Maria; Khalifé, Samir

    2012-10-01

    The goals of the present study were to estimate the incidence and course of full and partial Post-Traumatic Stress Disorder (PTSD) following childbirth and to prospectively identify factors associated with the development of PTSD symptoms at 1month following childbirth. The sample comprised 308 women, with assessments at four time points: 25-40weeks gestation, 4-6weeks postpartum, 3 and 6months postpartum. Current and prior PTSD were assessed by the Structured Clinical Interview for DSM-IV (SCID-I) and the Modified PTSD Symptom Scale Self-Report (MPSS-SR). Incidence rates of PTSD varied according to time of measurement and instrument used, with higher rates of full and partial PTSD using the MPSS-SR at 1month postpartum (7.6% and 16.6%, respectively). Multivariate logistic regression showed that higher anxiety sensitivity (OR=1.75; 95% CI=1.19‒2.57, p=.005), history of sexual trauma (OR=2.81; 95% CI=1.07‒7.37, p=.036), a more negative childbirth experience than expected (OR=0.96; 95% CI=0.94‒0.98, p=.001), and less available social support at 1month postpartum (OR=0.40; 95% CI=0.17‒0.96, p=.041) independently predicted full or partial PTSD at 1month following childbirth. Our results indicate that a history of sexual trauma and anxiety sensitivity can increase the probability of developing PTSD after childbirth. The findings highlight the importance of screening and providing more tailored services for women at high risk. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  7. Measurement and documentation of complex PTSD in treatment seeking traumatized refugees

    DEFF Research Database (Denmark)

    Palic, Sabina

    The aim of the thesis is to study complex traumatization and its measurement in treatment seeking traumatized refugees. Historically there have been repeated attempts to create a diagnosis for complex posttraumatic stress disorder (complex PTSD) to capture the more diverse, trauma related symptoms...... to measuring symptoms of PTSD, anxiety, and depression. This renders documentation, measurement, and treatment of possible complex traumatic adaptations in traumatized refugees very difficult. The thesis comprises two studies using different measures and different samples. The first study investigated complex...... in the traumatized refugees an important challenge. The second study in the thesis examined the proposed diversity of psychiatric morbidity in complex PTSD using a global psychiatric measure –the Health of Nation Outcome Scales (HoNOS). Article 3 showed that a group of consecutive refugees outpatients from a Danish...

  8. Association between social support and post-traumatic stress disorder symptoms among Chinese patients with ovarian cancer: A multiple mediation model.

    Science.gov (United States)

    Liu, Chunli; Zhang, Yi; Jiang, Hong; Wu, Hui

    2017-01-01

    Post-traumatic stress disorder (PTSD) symptoms can develop after person experiences one or more traumatic events. Little research, however, has been done on PTSD symptoms of patients with ovarian cancer. The present study aimed to estimate the prevalence of PTSD symptoms in patients with ovarian cancer in China; the effects of demographic and clinical variables on PTSD symptoms; multiple mediation roles in the association between social support and PTSD symptoms in patients with ovarian cancer in China. We collected demographic and clinical information of patients with ovarian cancer in the first and second hospitals of China Medical University between January 1, 2014 and December 31, 2015. Qualified patients were asked to complete the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Duke-UNC Functional Social Support Questionnaire, Herth Hope Index (HHI), and Resilience Scale-14 (RS-14). 201 patients provided responses. We performed hierarchical linear regression to assess the correlation between social support and PTSD symptoms and bootstrapping to test the mediating role of hope and resilience as potential mediators. After controlling demographic and clinical characteristics, social support negatively correlated with PTSD symptoms (β = -0.406, P accounting for different proportions of the mediating effect. Future intervention plans should pay more attention to social support as well as hope and resilience to prevent, relieve and treat PTSD symptoms.

  9. The dissociative post-traumatic stress disorder (PTSD) subtype: A treatment outcome cohort study in veterans with PTSD.

    Science.gov (United States)

    Haagen, Joris F G; van Rijn, Allison; Knipscheer, Jeroen W; van der Aa, Niels; Kleber, Rolf J

    2018-06-01

    Dissociation is a prevalent phenomenon among veterans with post-traumatic stress disorder (PTSD) that may interfere with the effectiveness of treatment. This study aimed to replicate findings of a dissociative PTSD subtype, to identify corresponding patterns in coping style, symptom type, and symptom severity, and to investigate its impact on post-traumatic symptom improvement. Latent profile analysis (LPA) was applied to baseline data from 330 predominantly (97%) male treatment-seeking veterans (mean age 39.5 years) with a probable PTSD. Multinomial logistic models were used to identify predictors of dissociative PTSD. Eighty veterans with PTSD that commenced with psychotherapy were invited for a follow-up measure after 6 months. The majority (n = 64, 80% response rate) completed the follow-up measure. Changes in post-traumatic stress between baseline and follow-up were explored as a continuous distal outcome. Latent profile analysis revealed four distinct patient profiles: 'low' (12.9%), 'moderate' (33.2%), 'severe' (45.1%), and 'dissociative' (8.8%) PTSD. The dissociative PTSD profile was characterized by more severe pathology levels, though not post-traumatic reactions symptom severity. Veterans with dissociative PTSD benefitted equally from PTSD treatment as veterans with non-dissociative PTSD with similar symptom severity. Within a sample of veterans with PTSD, a subsample of severely dissociative veterans was identified, characterized by elevated severity levels on pathology dimensions. The dissociative PTSD subtype did not negatively impact PTSD treatment. The present findings confirmed the existence of a distinct subgroup veterans that fit the description of dissociative PTSD. Patients with dissociative PTSD subtype symptoms uniquely differed from patients with non-dissociative PTSD in the severity of several psychopathology dimensions. Dissociative and non-dissociative PTSD patients with similar post-traumatic severity levels showed similar levels of

  10. Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial.

    Science.gov (United States)

    Lewis, Catrin E; Farewell, Daniel; Groves, Vicky; Kitchiner, Neil J; Roberts, Neil P; Vick, Tracey; Bisson, Jonathan I

    2017-06-01

    There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h. Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy. © 2017 Wiley Periodicals, Inc.

  11. Platelet monoamine oxidase type B, MAOB intron 13 and MAOA-uVNTR polymorphism and symptoms of post-traumatic stress disorder.

    Science.gov (United States)

    Svob Strac, Dubravka; Kovacic Petrovic, Zrnka; Nikolac Perkovic, Matea; Umolac, Danica; Nedic Erjavec, Gordana; Pivac, Nela

    2016-07-01

    Post-traumatic stress disorder (PTSD), a disorder that develops following exposure to traumatic experience(s), is frequently associated with agitation, aggressive behavior and psychotic symptoms. Monoamine oxidase (MAO) degrades different biogenic amines and regulates mood, emotions and behavior, and has a role in the pathophysiology of various neuropsychiatric disorders. The aim of the study was to investigate the association between different symptoms occurring in PTSD [PTSD symptom severity assessed by the Clinician Administered PTSD Scale (CAPS), agitation and selected psychotic symptoms assessed by the Positive and Negative Syndrome Scale (PANSS)] and platelet MAO-B activity and/or genetic variants of MAOB rs1799836 and MAOA-uVNTR polymorphisms in 249 Croatian male veterans with PTSD. Our study revealed slightly higher platelet MAO-B activity in veterans with PTSD with more severe PTSD symptoms and in veterans with agitation, and significantly higher platelet MAO-B activity in veterans with more pronounced psychotic symptoms compared to veterans with less pronounced psychotic symptoms. Platelet MAO-B activity was associated with smoking but not with age. Genetic variants of MAOB rs1799836 and MAOA-uVNTR were not associated with agitation and selected psychotic symptoms in veterans with PTSD. A marginally significant association was found between MAOB rs1799836 polymorphism and severity of PTSD symptoms, but it was not confirmed since carriers of G or A allele of MAOB rs1799836 did not differ in their total CAPS scores. These findings suggest an association of platelet MAO-B activity, but a lack of association of MAOB rs1799836 and MAOA-uVNTR, with selected psychotic symptoms in ethnically homogenous veterans with PTSD.

  12. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2015-10-01

    injury (TBI) and posttraumatic stress disorder ( PTSD ) benefit fully from interventions for both conditions. PTSD and TBI occur together frequently in...veterans with comorbid traumatic brain injury and posttraumatic stress disorder : study protocol for a randomized controlled trial. CONCLUSION: In...moderate TBI (mTBI) and PTSD . Emotional symptoms are likely a main cause of the persistence of post -concussive symptoms while thinking problems

  13. Sleep and Posttraumatic Stress Disorder (PTSD)

    Science.gov (United States)

    ... National Center for PTSD » Public » Sleep and PTSD PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... code here Enter ZIP code here Sleep and PTSD Public This section is for Veterans, General Public, ...

  14. PTSD and Problems with Alcohol Use

    Science.gov (United States)

    ... PTSD » Public » PTSD and Problems with Alcohol Use PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Enter ZIP code here Enter ZIP code here PTSD and Problems with Alcohol Use Public This section ...

  15. Original article The structure of symptoms of posttraumatic stress disorder according to DSM-5 and assessed by PDS-5 – preliminary results

    Directory of Open Access Journals (Sweden)

    Bogdan Zawadzki

    2015-03-01

    Full Text Available Background The structure of posttraumatic stress disorder (PTSD symptoms has been studied and discussed since the introduction of PTSD as a diagnostic entity in the DSM-III (Diagnostic and Statistical Manual of Mental Disorders III in 1980. Many studies supported a four-factor or a five-factor models, both inconsistent with DSM-IV. It is unclear whether current DSM-5 criteria appropriately reflect the empirical structure of PTSD symptoms. Participants and procedure In this study the structure of PTSD symptoms was examined by confirmatory factor analysis conducted on the data obtained from 388 individuals (150 males and 239 females aged 18-83 who experienced a traumatic event and completed the PDS-5 (Posttraumatic Diagnostic Scale-5, a self-report scale according to the DSM-5 criteria. Results Fitting of different models based on DSM-IV, DSM-5 and other the most common four- and five-factor conceptualizations of PTSD symptoms structure was examined. The data analyses demonstrated the best fit of the six-factor model based on the conceptualization of Elhai et al. (2011 with the additional factor of negative cognitions and mood. Conclusions The DSM-5 diagnostic criteria do not reflect the empirical PTSD symptom structure. The data suggest also that it is reasonable to separate the core PTSD symptoms from broad PTSD symptomatology.

  16. Symptoms and subjective quality of life in post-traumatic stress disorder: a longitudinal study.

    Science.gov (United States)

    Giacco, Domenico; Matanov, Aleksandra; Priebe, Stefan

    2013-01-01

    Evidence suggests that post-traumatic stress disorder (PTSD) is associated with substantially reduced subjective quality of life (SQOL). This study aimed to explore whether and how changes in the levels of PTSD symptom clusters of intrusion, avoidance and hyperarousal are associated with changes in SQOL. Two samples with PTSD following the war in former Yugoslavia were studied, i.e. a representative sample of 530 people in five Balkan countries and a non-representative sample of 215 refugees in three Western European countries. They were assessed on average eight years after the war and re-interviewed one year later. PTSD symptoms were assessed on the Impact of Event Scale - Revised and SQOL on the Manchester Short Assessment of Quality of Life. Linear regression and a two-wave cross lagged panel analysis were used to explore the association between PTSD symptom clusters and SQOL. The findings in the two samples were consistent. Symptom reduction over time was associated with improved SQOL. In multivariable analyses adjusted for the influence of all three clusters, gender and time since war exposure, only changes in hyperarousal symptoms were significantly associated with changes in SQOL. The two-wave cross-lagged panel analysis suggested that the link between hyperarousal symptoms and SQOL is bidirectional. Low SQOL of patients with war-related PTSD is particularly associated with hyperarousal symptoms. The findings suggest a bidirectional influence: a reduction in hyperarousal symptoms may result in improved SQOL, and improvements in SQOL may lead to reduced hyperarousal symptoms.

  17. PTSD in relation to dissociation in traumatized police officers

    NARCIS (Netherlands)

    Carlier, I. V.; Lamberts, R. D.; Fouwels, A. J.; Gersons, B. P.

    1996-01-01

    The assumed relationship between dissociation and symptoms of posttraumatic stress disorder (PTSD) was examined. From a group of police officers who had experienced a traumatic event, the authors assessed the chronic dissociative symptoms of 42 police officers with PTSD, 50 police officers with

  18. Clinical utility of the Neurobehavioral Symptom Inventory validity scales to screen for symptom exaggeration following traumatic brain injury.

    Science.gov (United States)

    Lange, Rael T; Brickell, Tracey A; Lippa, Sara M; French, Louis M

    2015-01-01

    The purpose of this study was to examine the clinical utility of three recently developed validity scales (Validity-10, NIM5, and LOW6) designed to screen for symptom exaggeration using the Neurobehavioral Symptom Inventory (NSI). Participants were 272 U.S. military service members who sustained a mild, moderate, severe, or penetrating traumatic brain injury (TBI) and who were evaluated by the neuropsychology service at Walter Reed Army Medical Center within 199 weeks post injury. Participants were divided into two groups based on the Negative Impression Management scale of the Personality Assessment Inventory: (a) those who failed symptom validity testing (SVT-fail; n = 27) and (b) those who passed symptom validity testing (SVT-pass; n = 245). Participants in the SVT-fail group had significantly higher scores (pscales (range: d = 0.76 to 2.34). Similarly high sensitivity, specificity, positive predictive power (PPP), and negative predictive (NPP) values were found when using all three validity scales to differentiate SVT-fail versus SVT-pass groups. However, the Validity-10 scale consistently had the highest overall values. The optimal cutoff score for the Validity-10 scale to identify possible symptom exaggeration was ≥19 (sensitivity = .59, specificity = .89, PPP = .74, NPP = .80). For the majority of people, these findings provide support for the use of the Validity-10 scale as a screening tool for possible symptom exaggeration. When scores on the Validity-10 exceed the cutoff score, it is recommended that (a) researchers and clinicians do not interpret responses on the NSI, and (b) clinicians follow up with a more detailed evaluation, using well-validated symptom validity measures (e.g., Minnesota Multiphasic Personality Inventory-2 Restructured Form, MMPI-2-RF, validity scales), to seek confirmatory evidence to support an hypothesis of symptom exaggeration.

  19. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

    Directory of Open Access Journals (Sweden)

    Pascal Wabnitz

    2013-11-01

    Full Text Available Background: The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods: Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results: Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion: Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

  20. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

    Science.gov (United States)

    Wabnitz, Pascal; Gast, Ursula; Catani, Claudia

    2013-01-01

    Background The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD) has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D) to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients. PMID:24298325

  1. A Psychometric Comparison of the Clinical Assessment Interview for Negative Symptoms and the Brief Negative Symptom Scale.

    Science.gov (United States)

    Strauss, Gregory P; Gold, James M

    2016-11-01

    In 2005, the National Institute of Mental Health held a consensus development conference on negative symptoms of schizophrenia. Among the important conclusions of this meeting were that there are at least 5 commonly accepted domains of negative symptoms (blunted affect, alogia, avolition, anhedonia, asociality) and that new rating scales were needed to adequately assess these constructs. Two next-generation negative symptom scales resulted from this meeting: the Brief Negative Symptom Scale (BNSS) and Clinical Assessment Interview for Negative Symptoms (CAINS). Both measures are becoming widely used and studies have demonstrated good psychometric properties for each scale. The current study provides the first direct psychometric comparison of these scales. Participants included 65 outpatients diagnosed with schizophrenia or schizoaffective disorder who completed clinical interviews, questionnaires, and neuropsychological testing. Separate raters completed the BNSS and CAINS within the same week. Results indicated that both measures had good internal consistency, convergent validity, and discriminant validity. High correspondence was observed between CAINS and BNSS blunted affect and alogia items. Moderate convergence occurred for avolition and asociality items, and low convergence was seen among anhedonia items. Findings suggest that both scales have good psychometric properties, but that there are important distinctions among the items related to motivation and pleasure. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  2. Depression and dissociation as predictors of physical health symptoms among female rape survivors with posttraumatic stress disorder.

    Science.gov (United States)

    Scioli-Salter, Erica R; Johnides, Benjamin D; Mitchell, Karen S; Smith, Brian N; Resick, Patricia A; Rasmusson, Ann M

    2016-09-01

    To investigate the relative contributions of depression and dissociation, as well as posttraumatic stress disorder (PTSD), to physical health symptoms and to examine the relationships among somatic symptoms, PTSD, depression, and dissociation in relation to childhood and adult trauma exposure. Cross-sectional data are from 132 female rape survivors with PTSD assessed before engaging in a study of trauma-focused cognitive therapy for PTSD. Measures included the Pennebaker Inventory of Limbic Languidness, Clinician Administered PTSD Scale, Beck Depression Inventory, Trauma Symptom Inventory-Dissociation Subscale, Childhood Sexual Abuse Exposure Questionnaire, and Assessing Environments-III-Physical Punishment Scale. Hierarchical regression analyses revealed that only dissociative and depression symptoms contributed significantly to physical health symptoms. Similarly, among the subsample of women with either childhood sexual or physical abuse, depression and dissociation were significant predictors of somatic symptoms. However, among women without childhood abuse, only dissociation significantly predicted somatic symptoms. Understanding the psychological and biological mechanisms that link childhood versus adult trauma exposure, PTSD, and comorbid depression or dissociation to physical health symptoms may aid development of individualized treatments for the physical and psychological consequences of trauma. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Suicide and PTSD

    Science.gov (United States)

    ... higher for those with PTSD who have certain styles of coping with stress, such as not expressing ... manage stress. Search Pilots Search PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign ...

  4. Trauma and PTSD in the WHO World Mental Health Surveys.

    Science.gov (United States)

    Kessler, Ronald C; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Benjet, Corina; Bromet, Evelyn J; Cardoso, Graça; Degenhardt, Louisa; de Girolamo, Giovanni; Dinolova, Rumyana V; Ferry, Finola; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Huang, Yueqin; Karam, Elie G; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Levinson, Daphna; Navarro-Mateu, Fernando; Pennell, Beth-Ellen; Piazza, Marina; Posada-Villa, José; Scott, Kate M; Stein, Dan J; Ten Have, Margreet; Torres, Yolanda; Viana, Maria Carmen; Petukhova, Maria V; Sampson, Nancy A; Zaslavsky, Alan M; Koenen, Karestan C

    2017-01-01

    Background : Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their 'worst.' Objective : To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method : WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the 'worst' lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results : In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions : Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits

  5. Trauma cognitions are related to symptoms up to 10 years after cognitive behavioral treatment for posttraumatic stress disorder.

    Science.gov (United States)

    Scher, Christine D; Suvak, Michael K; Resick, Patricia A

    2017-11-01

    This study examined (a) relationships between trauma-related cognitions and posttraumatic stress disorder (PTSD) symptoms from pretreatment through a long-term period after cognitive-behavioral therapy (CBT) for PTSD and (b) whether these relationships were impacted by treatment type. Participants were 171 women randomized into treatment for PTSD after rape. Measures of self-reported trauma-related cognitions and interviewer-assessed PTSD symptoms (i.e., Posttraumatic Maladaptive Beliefs Scale, Trauma-Related Guilt Inventory, and Clinician-Administered PTSD Scale) were obtained at pretreatment, posttreatment, and 3-month, 9-month, and 5-10 year follow-ups. Multilevel regression analyses were used to examine relationships between trauma-related cognitions and PTSD symptoms throughout the study period and whether these relationships differed as a function of treatment type (i.e., Cognitive Processing Therapy or Prolonged Exposure). Initial multilevel regression analyses that examined mean within-participant associations suggested that beliefs regarding Reliability and Trustworthiness of Others, Self-Worth and Judgment, Threat of Harm, and Guilt were related to PTSD symptoms throughout follow-up. Growth curve modeling suggested that patterns of belief change throughout follow-up were similar to those previously observed in PTSD symptoms over the same time period. Finally, multilevel mediation analyses that incorporated time further suggested that change in beliefs was related to change in symptoms throughout follow-up. With 1 minor exception, relationships between beliefs and symptoms were not moderated by treatment type. These data suggest that trauma-related cognitions are a potential mechanism for long-term maintenance of treatment gains after CBT for PTSD. Moreover, these cognitions may be a common, rather than specific, treatment maintenance mechanism. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Assessing the existence of dissociative PTSD in sub-acute patients of whiplash.

    Science.gov (United States)

    Hansen, Maj; Hyland, Philip; Armour, Cherie; Andersen, Tonny E

    2018-03-16

    Numerous studies investigating dissociative posttraumatic stress disorder (D-PTSD) have emerged. However, there is a lack of studies investigating D-PTSD following a wider range of traumatic exposure. Thus, the present study investigates D-PTSD using latent class analysis (LCA) in sub-acute patients of whiplash and associated risk factors. The results of LCA showed a three-class solution primarily distributed according to posttraumatic stress disorder (PTSD) symptom severity and thus no indication of D-PTSD. Dissociative symptoms, psychological distress (i.e. anxiety/depression), and pain severity significantly predicted PTSD severity. Combined, the results support the component model of dissociation and PTSD, while still stressing the importance of dissociative symptoms when planning treatment for PTSD.

  7. Gender and offender status predicting treatment success in refugees and asylum seekers with PTSD

    Directory of Open Access Journals (Sweden)

    Håkon Stenmark

    2014-01-01

    Full Text Available Background: Current knowledge is limited regarding patient characteristics related to treatment outcome of posttraumatic stress disorders (PTSD in refugees and asylum seekers. Objective: Gender, torture status, offender status, level of anger, and level of depression were investigated for possible effects on the treatment outcome. Method: Patient characteristics were explored in 54 refugees and asylum seekers who had completed a treatment program for PTSD. Non-responders (10, those who had the same or higher levels of symptom severity after treatment, were compared with responders, those who had lower symptom severity after treatment (44. Symptom severity was measured by Clinician-Administered PTSD Scale. The non-responders and responders constituted the dichotomous, dependent variable. The independent variables were gender, torture status, offender status, level of anger, and level of depression. T-tests and Exact Unconditional Homogeneity/Independence Tests for 2X2 Tables were used to study the relationship to treatment outcome. Results: Being male and reporting to have been a violent offender were significantly more frequent characteristics among the non-responders compared to the responders. The levels of pretreatment anger, depression and torture status did not affect the treatment outcome. Conclusions: The study adds support to findings that females benefit more from treatment of PTSD than males and that violent offenders are difficult to treat within the standard treatment programs.

  8. Mediation and Moderation of the Relationship Between Combat Experiences and Post-Traumatic Stress Symptoms in Active Duty Military Personnel.

    Science.gov (United States)

    Steele, Marshall; Germain, Anne; Campbell, Justin S

    2017-05-01

    Post-traumatic stress disorder (PTSD) is a major health concern among the U.S. military population, affecting up to 12% to 24% of veterans returning from Iraq and Afghanistan. Sleep disturbances, neuroticism, and childhood trauma have all been associated with the development of PTSD in military populations, especially in relation to combat experiences. The effects of disrupted sleep and post-traumatic stress can affect the physical well-being of soldier and sailors in the field and impact them for years after deployment. This study aimed to evaluate the relationship between self-reported measures of combat experiences, PTSD symptoms, sleep, neuroticism, and childhood adversity in an active duty military population. 972 U.S. Navy Sailors serving in Afghanistan were given anonymous surveys that assess scales of combat stressors, PTSD symptoms, sleep problems, neuroticism, adverse child experiences (ACEs), and other covariates. Sleep disturbances were hypothesized as moderators, having an indirect effect on the relationship between combat experiences and PTSD symptoms. Neuroticism scores and ACEs were proposed as moderators of the combat-PTSD symptom relationship. Mediation and moderation models were developed and tested using logistic regressions. Increased number of combat experiences was found to be a significant predictor of PTSD, even when adjusting for all covariates (p moderating factor. These results indicate that the presence of nightmares may partially explain how traumatic combat experiences lead to the development of PTSD. The study also reaffirms neuroticism as risk factor for developing PTSD symptoms. These findings highlight the importance of sleep hygiene and operational stress models in combat situations and may help stress control professionals address risk factors associated with PTSD symptoms. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  9. Replicability and generalizability of PTSD networks

    DEFF Research Database (Denmark)

    Eiko I., Fried; Eidhof, Marloes B.; Palic, Sabina

    2018-01-01

    The growing literature conceptualizing mental disorders like Posttraumatic Stress Disorder (PTSD) as networks of interacting symptoms faces three key challenges. Prior studies predominantly used (a) small samples with low power for precise estimation, (b) non-clinical samples, and (c) single...... samples. This renders network structures in clinical data, and the extent to which networks replicate across datasets, unknown. To overcome these limitations, the present cross-cultural multisite study estimated regularized partial correlation networks of 16 PTSD symptoms across four datasets...... of traumatized patients receiving treatment for PTSD (total N=2,782). Despite differences in culture, trauma-type and severity of the samples, considerable similarities emerged, with moderate to high correlations between symptom profiles (0.43-0.82), network structures (0.62-0.74), and centrality estimates (0...

  10. Epigenetic Effects of PTSD Remediation in Veterans Using Clinical Emotional Freedom Techniques: A Randomized Controlled Pilot Study.

    Science.gov (United States)

    Church, Dawson; Yount, Garret; Rachlin, Kenneth; Fox, Louis; Nelms, Jerrod

    2018-01-01

    To assess the feasibility of measuring changes in gene expression associated with post-traumatic stress disorder (PTSD) treatment using emotional freedom techniques (EFT). Participants were randomized into an EFT group receiving EFT and treatment as usual (TAU) throughout a 10-week intervention period and a group receiving only TAU during the intervention period and then receiving EFT. A community clinic and a research institute in California. Sixteen veterans with clinical levels of PTSD symptoms. Ten hour-long sessions of EFT. Messenger RNA levels for a focused panel of 93 genes related to PTSD. The Symptom Assessment 45 questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Scale, SF-12v2 for physical impairments, and Rivermead Postconcussion Symptoms Questionnaire. Pre-, posttreatment, and follow-up mean scores on questionnaires were assessed using repeated measures 1-way analysis of variance. A Student t test and post hoc analyses were performed on gene expression data. Post-traumatic stress disorder symptoms declined significantly in the EFT group (-53%, P expression of 6 genes was found ( P expression levels before and after the intervention period in participants receiving EFT. Study results identify candidate gene expression correlates of successful PTSD treatment, providing guidelines for the design of further studies aimed at exploring the epigenetic effects of EFT.

  11. Fear learning alterations after traumatic brain injury and their role in development of posttraumatic stress symptoms.

    Science.gov (United States)

    Glenn, Daniel E; Acheson, Dean T; Geyer, Mark A; Nievergelt, Caroline M; Baker, Dewleen G; Risbrough, Victoria B

    2017-08-01

    It is unknown how traumatic brain injury (TBI) increases risk for posttraumatic stress disorder (PTSD). One potential mechanism is via alteration of fear-learning processes that could affect responses to trauma memories and cues. We utilized a prospective, longitudinal design to determine if TBI is associated with altered fear learning and extinction, and if fear processing mediates effects of TBI on PTSD symptom change. Eight hundred fifty two active-duty Marines and Navy Corpsmen were assessed before and after deployment. Assessments included TBI history, PTSD symptoms, combat trauma and deployment stress, and a fear-potentiated startle task of fear acquisition and extinction. Startle response and self-reported expectancy and anxiety served as measures of fear conditioning, and PTSD symptoms were measured with the Clinician-Administered PTSD Scale. Individuals endorsing "multiple hit" exposure (both deployment TBI and a prior TBI) showed the strongest fear acquisition and highest fear expression compared to groups without multiple hits. Extinction did not differ across groups. Endorsing a deployment TBI was associated with higher anxiety to the fear cue compared to those without deployment TBI. The association of deployment TBI with increased postdeployment PTSD symptoms was mediated by postdeployment fear expression when recent prior-TBI exposure was included as a moderator. TBI associations with increased response to threat cues and PTSD symptoms remained when controlling for deployment trauma and postdeployment PTSD diagnosis. Deployment TBI, and multiple-hit TBI in particular, are associated with increases in conditioned fear learning and expression that may contribute to risk for developing PTSD symptoms. © 2017 Wiley Periodicals, Inc.

  12. Identification of PTSD in cancer survivors.

    Science.gov (United States)

    Alter, C L; Pelcovitz, D; Axelrod, A; Goldenberg, B; Harris, H; Meyers, B; Grobois, B; Mandel, F; Septimus, A; Kaplan, S

    1996-01-01

    The authors measured the rate and determinants of posttraumatic stress disorder (PTSD) in a group of cancer survivors. Patients who had a history of cancer diagnosis with at least 3 years since diagnosis, receiving no active treatment, such as chemotherapy or radiation, were interviewed (N = 27). Patients, who were part of the DSM-IV PTSD field trial, were compared with a community-based control group matched for age and socioeconomic status. One member of the survivor group (4%) and no members of the control group met criteria for current PTSD (NS). Six of the survivors (22%) and no control subjects met lifetime criteria (P Cancer patients have a higher rate of PTSD than found in the community. Symptoms closely resemble those of individuals who have experienced other traumatic events.

  13. Recovery from PTSD following Hurricane Katrina.

    Science.gov (United States)

    McLaughlin, Katie A; Berglund, Patricia; Gruber, Michael J; Kessler, Ronald C; Sampson, Nancy A; Zaslavsky, Alan M

    2011-06-01

    We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina. A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview. An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD. The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina. © 2011 Wiley-Liss, Inc.

  14. The Relationship Between Intradialytic Nutrition and Gastrointestinal Symptoms Using a Modified Version of the Gastrointestinal Symptom Rating Scale.

    Science.gov (United States)

    Kistler, Brandon M; Biruete, Annabel; Chapman-Novakofski, Karen; Wilund, Kenneth R

    2018-03-01

    Intradialytic nutrition has been shown to improve nutritional status in maintenance hemodialysis (HD) patients but remains controversial due in part to concerns over hemodynamic stability and gastrointestinal (GI) distress. There are limited data on the relationship between intradialytic nutrition and GI symptoms, possibly due to the lack of a validated tool. Therefore, we intended to validate a questionnaire to measure GI symptoms associated with a single HD treatment and determine the relationship between intradialytic nutrition and GI symptoms. Cross-sectional study. Forty-eight maintenance HD patients. GI symptoms and dietary intake during HD treatment. In general, we found acceptable internal consistency (Cronbach's alpha >0.5, exception reflux domain) and repeatability in all 5 domains of a modified version of the Gastrointestinal Symptom Rating Scale. The prevalence of GI symptoms associated with a single HD treatment (generalized score greater than 1) was 54.2, 43.7, 6.2, 41.7, and 45.8% for the abdominal pain, indigestion, reflux, diarrhea, and constipation domains, respectively. More than two-thirds of patients chose to eat during treatment (168.6 ± 165.6 kcal) with the most commonly consumed items being candy, oral supplements, and cookies. There was no difference in GI symptoms among patients who did or did not eat (P > .05). However, the amount of total dietary fat and fiber consumed during treatment was associated with greater indigestion (P < .05) prior to accounting for outliers or multiple comparisons. In this sample, the modified version of the Gastrointestinal Symptom Rating Scale was a generally valid tool for measuring GI symptoms associated with a single HD treatment. Patients who ate during treatment did not experience greater GI symptoms than those who did not; however, high amounts of fat and fiber may be associated with greater GI symptoms. Prospective trials should examine the relationship between GI symptoms and dietary intake

  15. Detecting Symptom Exaggeration in Combat Veterans Using the MMPI-2 Symptom Validity Scales: A Mixed Group Validation

    Science.gov (United States)

    Tolin, David F.; Steenkamp, Maria M.; Marx, Brian P.; Litz, Brett T.

    2010-01-01

    Although validity scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989) have proven useful in the detection of symptom exaggeration in criterion-group validation (CGV) studies, usually comparing instructed feigners with known patient groups, the…

  16. Test-retest reliability of Brazilian version of Memorial Symptom Assessment Scale for assessing symptoms in cancer patients.

    Science.gov (United States)

    Menezes, Josiane Roberta de; Luvisaro, Bianca Maria Oliveira; Rodrigues, Claudia Fernandes; Muzi, Camila Drumond; Guimarães, Raphael Mendonça

    2017-01-01

    To assess the test-retest reliability of the Memorial Symptom Assessment Scale translated and culturally adapted into Brazilian Portuguese. The scale was applied in an interview format for 190 patients with various cancers type hospitalized in clinical and surgical sectors of the Instituto Nacional de Câncer José de Alencar Gomes da Silva and reapplied in 58 patients. Data from the test-retest were double typed into a Microsoft Excel spreadsheet and analyzed by the weighted Kappa. The reliability of the scale was satisfactory in test-retest. The weighted Kappa values obtained for each scale item had to be adequate, the largest item was 0.96 and the lowest was 0.69. The Kappa subscale was also evaluated and values were 0.84 for high frequency physic symptoms, 0.81 for low frequency physical symptoms, 0.81 for psychological symptoms, and 0.78 for Global Distress Index. High level of reliability estimated suggests that the process of measurement of Memorial Symptom Assessment Scale aspects was adequate. Avaliar a confiabilidade teste-reteste da versão traduzida e adaptada culturalmente para o português do Brasil do Memorial Symptom Assessment Scale. A escala foi aplicada em forma de entrevista em 190 pacientes com diversos tipos de câncer internados nos setores clínicos e cirúrgicos do Instituto Nacional de Câncer José de Alencar Gomes da Silva e reaplicada em 58 pacientes. Os dados dos testes-retestes foram inseridos num banco de dados por dupla digitação independente em Excel e analisados pelo Kappa ponderado. A confiabilidade da escala mostrou-se satisfatória nos testes-retestes. Os valores do Kappa ponderado obtidos para cada item da escala apresentaram-se adequados, sendo o maior item de 0,96 e o menor de 0,69. Também se avaliou o Kappa das subescalas, sendo de 0,84 para sintomas físicos de alta frequência, de 0,81 para sintomas físicos de baixa frequência, de 0,81 também para sintomas psicológicos, e de 0,78 para Índice Geral de Sofrimento

  17. Symptoms of post-traumatic stress disorder among battered women in Lebanon: an exploratory study.

    Science.gov (United States)

    Khadra, Christelle; Wehbe, Nancy; Lachance Fiola, Jacinthe; Skaff, Wadih; Nehmé, Mona

    2015-01-01

    Intimate partner violence against women is common in Lebanon and can lead to major health problems. However, the incidence of symptoms of post-traumatic stress disorder (PTSD) in battered women has not been extensively explored in the Lebanese cultural context. The objectives of this study were as follows: (a) to determine the prevalence of PTSD symptoms among women in Lebanon who have been physically abused by their partners, (b) to assess whether the rate of PTSD symptoms varied according to sociodemographic variables, and (c) to reveal other attributes that might be risk factors for developing symptoms of PTSD. Of the 95 physically abused women who met inclusion criteria, 85 completed a questionnaire including sociodemographic questions, the physical abuse subscale of the Composite Abuse Scale (CAS), and the PTSD Checklist-Civilian Version (PCL-C). Results showed a high prevalence of PTSD symptoms (97%), positively correlated with physical violence (r = .719). Lower education level and recent abuse were correlated with symptom severity, as were the number of problematic habitual behaviors in the abusive partner and the use of psychotherapy. Increased involvement of health care professionals in the detection of women at risk, with referral to appropriate resources, is suggested to improve prevention and management efforts. © The Author(s) 2014.

  18. Does the Association between Workplace Bullying and Post-Traumatic Stress Symptoms differ across Educational Groups?

    DEFF Research Database (Denmark)

    Islamoska, Sabrina; Grynderup, Matias Brødsgaard; Nabe-Nielsen, Kirsten

    2018-01-01

    The aim of this study was to investigate whether the level of reported post-traumatic stress (PTSD) symptoms among targets of workplace bullying differ depending on their educational level. Exposure to workplace bullying was assessed by the behavioural experience method and the self-labelling met......The aim of this study was to investigate whether the level of reported post-traumatic stress (PTSD) symptoms among targets of workplace bullying differ depending on their educational level. Exposure to workplace bullying was assessed by the behavioural experience method and the self......-labelling method among 563 Danish employees. PTSD symptoms were assessed by the Impact of Event Scale – Revised. Educational level was measured as years of education. The results showed that workplace bullying was significantly associated with the reporting of PTSD symptoms. However, PTSD symptoms were...... of this study was to investigate whether the level of reported post-traumatic stress (PTSD) symptoms among targets of workplace bullying differ depending on their educational level. Exposure to workplace bullying was assessed by the behavioural experience method and the self-labelling method among 563 Danish...

  19. Prevalence and correlates of symptoms of post-traumatic stress disorder among Chinese healthcare workers exposed to physical violence: a cross-sectional study

    Science.gov (United States)

    Shi, Lei; Wang, Lingling; Jia, Xiaoli; Li, Zhe; Mu, Huitong; Liu, Xin; Peng, Boshi; Li, Anqi; Fan, Lihua

    2017-01-01

    Objectives Post-traumatic stress disorder (PTSD) is a common psychological maladjustment to undergoing a traumatic event. Our aim was to measure the prevalence of PTSD among Chinese healthcare workers exposed to physical violence‚ and explore the associations of their demographic characteristics, social support, personality traits‚ and coping styles with their PTSD symptoms. Methods A cross-sectional study was conducted using the Workplace Violence Scale, Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), Social Support Rating Scale (SSRS), Eysenck Personality Questionnaire-Revised Short Scale and Trait Coping Style Questionnaire. We used convenience sampling method to collect data from March 2015 to September 2016. Healthcare workers (n=2706) from 39 public hospitals located in Heilongjiang, Hebei and Beijing provinces of China completed the questionnaires (effective response rate=84.25%). Results Overall, the prevalence of physical violence in the previous 12 months was 13.60% (n=2706). The prevalence of PTSD among the healthcare workers who experienced physical violence was 28.0% (n=368). Most of the victims of physical violence (50.80%) did not exhibit PTSD symptoms based on their PCL-C scores, and 47.0% did not manifest the diagnostic criteria for PTSD after experiencing physical violence. The level of PTSD symptoms was negatively correlated with their scores on the SSRS (r=−0.188, pviolence contributes to the current prevalence of PTSD. The positive effects of social support on PTSD symptoms suggest that it has practical implications for interventions to promote psychological health. The healthcare workers’ coping styles influenced the development of PTSD symptoms. Therefore, adopting effective coping styles and receiving social support have potential roles in the recovery from trauma after experiencing physical violence. PMID:28765135

  20. A Placebo-Controlled Augmentation Trial of Prazosin for Combat Trauma PTSD

    Science.gov (United States)

    2013-08-01

    the three CAPS symptom clusters (reexperiencing, avoidance, and hyperarousal); the Hamilton Depression Rating Scale ( HAM -D) (19); the Patient Health...significantly more with prazosin than placebo (p=0.003). Differences in the CAPS reexperiencing and avoidance clusters, the HAM -D, and the PHQ–9 depres...measures and sleep in combat-related PTSD. Biol Psychiatry 1995; 38:174–179 9. Geracioti TD Jr, Baker DG, Ekhator NN, West SA, Hill KK, Bruce AB, Schmidt D

  1. Reconsolidation of Traumatic Memories for PTSD: A randomized controlled trial of 74 male veterans.

    Science.gov (United States)

    Gray, Richard; Budden-Potts, Denise; Bourke, Frank

    2017-12-14

    A randomized waitlist-controlled design (n = 74) examined the efficacy of Reconsolidation of Traumatic Memories (RTM) among male veterans with current-month flashbacks and nightmares. Volunteers were randomly assigned to immediate treatment (three 120-minute sessions of RTM), or to a 3-week waiting condition before receiving the RTM treatment. Blinded psychometricians evaluated the symptoms at intake, 2 weeks, and 6 weeks post. Wait-listed participants were re-evaluated and then treated. Sixty-five volunteers completed the treatment. Of those treated, 46 (71%) lost DSM diagnosis for post-traumatic stress disorder (PTSD) by one of the following definitions: 42 persons (65%) were in complete remission (PTSD Symptom Scale Interview (PSS-I) ≤ 20 and DSM criteria not met). Four others (6%) lost the DSM diagnosis or were otherwise sub-clinical by dichotomous criteria (PSS-I < 20 and absence of flashbacks and nightmares) but non-ambiguous on the PTSD Checklist Military Version measures. Within-group RTM effect sizes (Hedges' g) for PSS-I score changes ranged from 1.5 to 2.2. The between-group comparison between the treatment group and the untreated controls was significant (p < .001) with an effect size equivalent to two standard deviations (g = -2.121; 95% CI [-4.693-0.453]). Patient satisfaction with the intervention was high. RTM shows promise as a brief, cost-effective intervention for PTSD characterized primarily by intrusive symptoms. Clinical or methodological significance of this article: The article provides evidence to support a fast (5 hours or fewer) robust intervention for PTSD characterized by intrusive symptoms including current-month flashbacks, nightmares, and accompanied by sympathetic arousal in response to trauma narratives. The intervention is well tolerated and has demonstrated efficacy up to one year.

  2. A Randomized, Double-blind Evaluation of D-cycloserine or Alprazolam Combined with Virtual Reality Exposure Therapy for Posttraumatic Stress Disorder (PTSD) in Iraq and Afghanistan War Veterans

    Science.gov (United States)

    Rothbaum, Barbara Olasov; Price, Matthew; Jovanovic, Tanja; Norrholm, Seth D.; Gerardi, Maryrose; Dunlop, Boadie; Davis, Michael; Bradley, Bekh; Duncan, Erica; Rizzo, Albert “Skip”; Ressler, Kerry J.

    2014-01-01

    Objective To determine the effectiveness of Virtual Reality Exposure (VRE) augmented with D-cycloserine (50mg) or alprazolam (0.25mg), compared to placebo, in reducing PTSD due to military trauma in Iraq and Afghanistan. Method A double-blind, placebo-controlled randomized clinical trial comparing augmentation methods for VRE for subjects (n= 156) with PTSD was conducted. Results PTSD symptoms significantly improved from pre- to post-treatment over the 6-session VRE treatment (p<.001) across all conditions and were maintained at 3, 6, and 12 months follow-up. There were no overall differences between the D-cycloserine group on symptoms at any time-point. The alprazolam and placebo conditions significantly differed on the post-treatment Clinician Administered PTSD scale (p = .006) and the 3-month post-treatment PTSD diagnosis, such that the alprazolam group showed greater rates of PTSD (79.2% alprazolam vs. 47.8% placebo). Between-session extinction learning was a treatment-specific enhancer of outcome for the D-cycloserine group only (p<.005). At post-treatment, the D-cycloserine group was the lowest on cortisol reactivity (p<.05) and startle response during VR scenes (p<.05). Conclusions A small number of VRE sessions were associated with reduced PTSD diagnosis and symptoms in Iraq/Afghanistan veterans, although there was no control condition for the VRE. Overall, there was no advantage of D-cycloserine on PTSD symptoms in primary analyses. In secondary analyses, benzodiazepine use during treatment may impair recovery, and D-cycloserine may enhance VRE in patients who demonstrate within-session learning. D-cycloserine augmentation treatment in PTSD patients may reduce cortisol and startle reactivity compared to the alprazolam and placebo treatment, consistent with the animal literature. PMID:24743802

  3. Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.

    Science.gov (United States)

    Lindelow, M; Hardy, R; Rodgers, B

    1997-01-01

    OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity. PMID:9425466

  4. Psychological interventions for post-traumatic stress disorder (PTSD) in people with severe mental illness.

    Science.gov (United States)

    Sin, Jacqueline; Spain, Debbie; Furuta, Marie; Murrells, Trevor; Norman, Ian

    2017-01-24

    for quality of life, symptoms of co-morbid psychosis, depression, anxiety and health economics.3. TF-CBT versus EMDROne trial compared TF-CBT with EMDR. PTSD symptom severity, based on skewed data (1 RCT, n = 88, MD -1.69, 95% CI -12.63 to 9.23, very low-quality evidence) was similar between treatment groups. No data were available for the other main outcomes.4. TF-CBT versus psychoeducationOne trial compared TF-CBT with psychoeducation. Results were equivocal for PTSD symptom severity (1 RCT, n = 52, MD 0.23, 95% CI -14.66 to 15.12, low-quality evidence) and general quality of life (1 RCT, n = 49, MD 0.11, 95% CI -0.74 to 0.95, low-quality evidence) by medium term. No data were available for the other outcomes of interest. Very few trials have investigated TFPIs for individuals with SMI and PTSD. Results from trials of TF-CBT are limited and inconclusive regarding its effectiveness on PTSD, or on psychotic symptoms or other symptoms of psychological distress. Only one trial evaluated EMDR and provided limited preliminary evidence favouring EMDR compared to waiting list. Comparing TF-CBT head-to-head with EMDR and brief psychoeducation respectively, showed no clear effect for either therapy. Both TF-CBT and EMDR do not appear to cause more (or less) adverse effects, compared to waiting list or usual care; these findings however, are mostly based on low to very low-quality evidence. Further larger scale trials are now needed to provide high-quality evidence to confirm or refute these preliminary findings, and to establish which intervention modalities and techniques are associated with improved outcomes, especially in the long term.

  5. Perceived Discrimination and Mental Health Symptoms among Black Men with HIV

    Science.gov (United States)

    Bogart, Laura M.; Wagner, Glenn J.; Galvan, Frank H.; Landrine, Hope; Klein, David J.; Sticklor, Laurel A.

    2011-01-01

    Objective People living with HIV (PLWH) exhibit more severe mental health symptoms than do members of the general public (including depression and post-traumatic stress disorder/PTSD symptoms). We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). Method A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. Results In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., re-experiencing, avoidance, and arousal subscales) (all p-values discrimination types (p discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmas when developing interventions to improve mental health among PLWH. PMID:21787061

  6. PTSD: An Elusive Definition.

    Science.gov (United States)

    Kirkbride, Jared F

    2012-01-01

    The Global War on Terrorism became the longest standing conflict in United States military history on June 7, 2010. It is estimated that 1.64 million U.S. troops have been deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom (p xix).1 Both conflicts have produced high numbers of casualties as the result of ground combat. The amount of casualties though has been relatively low compared to other conflicts. Some of this can be attributed to the advances in body armor and emergency medicine that allow many servicemembers to survive conditions that previously led to death. Conversely, surviving these situations leaves those same members with memories that are psychologically difficult to live with and cause chronic difficulties. Unlike an amputee, or the victim of severe burns where the signs and symptoms of their injuries are obvious, patients with psychological disorders can have a range of signs and symptoms common in many other mental disorders, making it difficult to diagnose and treat Soldiers suffering from Post-traumatic Stress Disorder (PTSD). 2012.

  7. Resource Loss and Naturalistic Reduction of PTSD among Inner-City Women

    Science.gov (United States)

    Walter, Kristen H.; Hobfoll, Stevan E.

    2009-01-01

    Halting the process of psychosocial and material resource loss has been theorized as being associated with the reduction of posttraumatic stress disorder (PTSD). This study examines how the limiting of resource loss is related to alleviation of PTSD symptoms among 102 inner-city women, who originally met diagnostic criteria for PTSD after…

  8. Complex posttraumatic stress disorder: an exploratory investigation of PTSD and DES NOS among Dutch war veterans

    NARCIS (Netherlands)

    Jongedijk, R. A.; Carlier, I. V.; Schreuder, B. J.; Gersons, B. P.

    1996-01-01

    The recently developed concept Disorder of Extreme Stress Not Otherwise Specified (DES NOS) or complex posttraumatic stress disorder (complex PTSD) is designed to encompass long-standing symptoms not present in PTSD. An exploratory investigation of PTSD and DES NOS was performed with the Structured

  9. Assessing the structure and meaningfulness of the dissociative subtype of PTSD.

    Science.gov (United States)

    Ross, Jana; Baník, Gabriel; Dědová, Mária; Mikulášková, Gabriela; Armour, Cherie

    2018-01-01

    Studies conducted in the USA, Canada and Denmark have supported the existence of the dissociative PTSD subtype, characterized primarily by symptoms of depersonalization and derealization. The current study aimed to examine the dissociative PTSD subtype in an Eastern European, predominantly female (83.16%) sample, using an extended set of dissociative symptoms. A latent profile analysis was applied to the PTSD and dissociation data from 689 trauma-exposed university students from Slovakia. Four latent profiles of varying PTSD and dissociation symptomatology were uncovered. They were named non-symptomatic, moderate PTSD, high PTSD and dissociative PTSD. The dissociative PTSD profile showed elevations on depersonalization and derealization, but also the alternative dissociative indicators of gaps in awareness and memory, sensory misperceptions and cognitive and behavioural re-experiencing. The core PTSD symptoms of 'memory impairment' and 'reckless or self-destructive behaviour' were also significantly elevated in the dissociative PTSD profile. Moreover, anxiety and anger predicted membership in the dissociative PTSD profile. The results provide support for the proposal that the dissociative PTSD subtype can be characterized by a variety of dissociative symptoms.

  10. Predicting Treatment Outcome in PTSD : A Longitudinal Functional MRI Study on Trauma-Unrelated Emotional Processing

    NARCIS (Netherlands)

    Van Rooij, Sanne J H; Kennis, Mitzy; Vink, Matthijs; Geuze, Elbert

    2016-01-01

    In about 30-50% of patients with posttraumatic stress disorder (PTSD), symptoms persist after treatment. Although neurobiological research has advanced our understanding of PTSD, little is known about the neurobiology underlying persistence of PTSD. Two functional MRI scans were collected from 72

  11. Sleep Disturbance Predicts Posttraumatic Stress Disorder and Depressive Symptoms: A Cohort Study of Chinese Adolescents.

    Science.gov (United States)

    Fan, Fang; Zhou, Ya; Liu, Xianchen

    2017-07-01

    To examine the cross-sectional and longitudinal associations between sleep disturbance and posttraumatic stress disorder (PTSD) and depressive symptoms in a large cohort of adolescents exposed to the 2008 Wenchuan earthquake in China. Participants were 1,573 adolescents (mean age at initial survey = 15.0 years, SD = 1.3 years; 46% male) in the Wenchuan Earthquake Adolescent Health Cohort (WEAHC) in Dujiangyan, China, 20 km away from the east epicenter. The Pittsburgh Sleep Quality Index, Post-Traumatic Stress Disorder Self-Rating Scale, and Depression Self-Rating Scale for Children were used to assess participants' sleep, PTSD symptoms, and depressive symptoms, respectively, at 12 months (T12m) and 24 months (T24m) after the Wenchuan earthquake that occurred on May 12, 2008. At T12m and T24m, 38.3% and 37.5% of participants reported sleep disturbance, 22.5% and 14.0% reported PTSD symptoms, and 41.0% and 38.3% reported depressive symptoms, respectively. The prevalence rates of PTSD and depressive symptoms at T12m and T24m significantly increased with sleep disturbance and short sleep duration. After adjusting for demographics, earthquake exposure, and PTSD/depressive symptoms at T12m, sleep disturbance at T12m was significantly associated with increased risk for PTSD (odds ratio [OR] = 1.80; 95% CI, 1.17-2.75) and depressive symptoms (OR = 1.51; 95% CI, 1.14-2.02) at T24m. Furthermore, sleep disturbance predicted the persistence of PTSD (OR = 2.35; 95% CI, 1.43-3.85) and depressive symptoms (OR = 2.41; 95% CI, 1.80-3.24). Sleep disturbance, PTSD, and depressive symptoms were prevalent and persistent in adolescents at 12 and 24 months after exposure to the Wenchuan earthquake. Sleep disturbance predicts the development and persistence of PTSD and depressive symptoms. Early assessment and treatment of sleep disturbance may be an important strategy for prevention and intervention of PTSD and depression in adolescent trauma survivors. © Copyright 2017 Physicians

  12. Interaction of the ADRB2 gene polymorphism with childhood trauma in predicting adult symptoms of posttraumatic stress disorder.

    Science.gov (United States)

    Liberzon, Israel; King, Anthony P; Ressler, Kerry J; Almli, Lynn M; Zhang, Peng; Ma, Sean T; Cohen, Gregory H; Tamburrino, Marijo B; Calabrese, Joseph R; Galea, Sandro

    2014-10-01

    Posttraumatic stress disorder (PTSD), while highly prevalent (7.6% over a lifetime), develops only in a subset of trauma-exposed individuals. Genetic risk factors in interaction with trauma exposure have been implicated in PTSD vulnerability. To examine the association of 3755 candidate gene single-nucleotide polymorphisms with PTSD development in interaction with a history of childhood trauma. Genetic association study in an Ohio National Guard longitudinal cohort (n = 810) of predominantly male soldiers of European ancestry, with replication in an independent Grady Trauma Project (Atlanta, Georgia) cohort (n = 2083) of predominantly female African American civilians. Continuous measures of PTSD severity, with a modified (interview) PTSD checklist in the discovery cohort and the PTSD Symptom Scale in the replication cohort. Controlling for the level of lifetime adult trauma exposure, we identified the novel association of a single-nucleotide polymorphism within the promoter region of the ADRB2 (Online Mendelian Inheritance in Man 109690) gene with PTSD symptoms in interaction with childhood trauma (rs2400707, P = 1.02 × 10-5, significant after correction for multiple comparisons). The rs2400707 A allele was associated with relative resilience to childhood adversity. An rs2400707 × childhood trauma interaction predicting adult PTSD symptoms was replicated in the independent predominantly female African American cohort. Altered adrenergic and noradrenergic function has been long believed to have a key etiologic role in PTSD development; however, direct evidence of this link has been missing. The rs2400707 polymorphism has been linked to function of the adrenergic system, but, to our knowledge, this is the first study to date linking the ADRB2 gene to PTSD or any psychiatric disorders. These findings have important implications for PTSD etiology, chronic pain, and stress-related comorbidity, as well as for both primary prevention and treatment

  13. Cut points on 0-10 numeric rating scales for symptoms included in the edmonton symptom assessment scale in cancer patients: A systematic review

    NARCIS (Netherlands)

    W.H. Oldenmenger (Wendy); P.J. de Raaf (Pleun); C. de Klerk (Cora); C.C.D. van der Rijt (Carin)

    2013-01-01

    textabstractContext: To improve the management of cancer-related symptoms, systematic screening is necessary, often performed by using 0-10 numeric rating scales. Cut points are used to determine if scores represent clinically relevant burden. Objectives: The aim of this systematic review was to

  14. The influence of sense of coherence and mindfulness on PTSD symptoms and posttraumatic cognitions in a sample of elderly Austrian survivors of World War II.

    Science.gov (United States)

    Glück, Tobias M; Tran, Ulrich S; Raninger, Simone; Lueger-Schuster, Brigitte

    2016-03-01

    Sense of Coherence (SOC) and mindfulness are known protective factors against psychopathology, also in older age. We set out to investigate the influence of SOC and mindfulness on posttraumatic symptoms and cognitions in the context of lifetime trauma in elderly persons with a history of childhood war-experiences. Elderly Austrians (N = 97) filled in questionnaires on traumatic lifetime experiences and posttraumatic symptoms (ETI), posttraumatic cognitions (PTCI), SOC (SOC-13) and mindfulness (FFMQ). We expected the influence of SOC scores on posttraumatic symptoms and cognitions to be on one hand influenced by mindfulness. On the other hand, we expected that both aspects would uniquely explain fewer posttraumatic symptoms and cognitions. Participants reported various lifetime traumas (M = 2.42), including experiences during World War II (WWII) as children and adolescents. Mindfulness partially mediated the association of SOC scores with posttraumatic cognitions, but not with posttraumatic symptoms. However, in a two-stage mediation model, mindfulness significantly predicted posttraumatic symptoms via its effects on posttraumatic cognitions. Although SOC was the strongest predictor of posttraumatic symptoms, mindfulness influenced the severity of posttraumatic symptoms via its effects on posttraumatic cognitions. We discuss implications for mindfulness-based interventions on trauma-related cognitions in the elderly.

  15. A population-based study of associations between current posttraumatic stress symptoms and current fatigue.

    Science.gov (United States)

    Lerdal, Anners; Lee, Kathryn A; Rokne, Berit; Knudsen, Øistein; Wahl, Astrid K; Dahl, Alv A

    2010-10-01

    This study explores current experience with posttraumatic stress disorder (PTSD) symptoms and other variables (sociodemographic, mental distress, somatic morbidity, self-rated health, and quality of life [QoL]) in relation to fatigue. A representative sample of the Norwegian population (N = 3,944) was invited to participate in a mailed survey, and 1,857 (47%) returned valid responses on the questionnaire that included the Fatigue Severity Scale and the Posttraumatic Symptom Scale-10. Posttraumatic stress disorder symptoms showed a strong association with fatigue in univariate (β = .41) and multivariate analyses (β = .33). Associations between psychosocial health variables, QoL, and fatigue were confirmed. However, PTSD symptoms showed the strongest association with fatigue in the analyses. Findings need to be replicated in other population samples and in clinical samples with PTSD and fatigue.

  16. Posttraumatic stress disorder (PTSD) Treatment

    Science.gov (United States)

    ... does the current evidence say about treatment for PTSD? Read Psych Health Evidence Briefs , which summarize available ... first-line and emerging PTSD treatments. Psychotherapy for PTSD According to the VA/DoD Clinical Practice Guideline ...

  17. A symptom self-rating scale for schizophrenia (4S): psychometric properties, reliability and validity.

    Science.gov (United States)

    Lindström, Eva; Jedenius, Erik; Levander, Sten

    2009-01-01

    The objective of the study was to validate a self-administrated symptom rating scale for use in patients with schizophrenia spectrum disorders by item analysis, exploration of factor structure, and analyses of reliability and validity. Data on 151 patients, initially treated by risperidone, obtained within the framework of a naturalistic Phase IV longitudinal study, were analysed by comparing patient and clinician ratings of symptoms, side-effects and global indices of illness. The Symptom Self-rating Scale for Schizophrenia (4S) is psychometrically adequate (item analysis, internal consistency, factor structure). Side-effect ratings were reliable. Symptom ratings displayed consistent associations with clinicians' ratings of corresponding symptom dimensions, suggesting construct validity. Patients had most difficulties assessing negative symptom items. Patients were well able to assess their own symptoms and drug side-effects. The factor structure of symptom ratings differs between patients and clinicians as well as how they construe global indices of illness. Clinicians focus on psychotic, patients on affective symptoms. Use of symptom self-ratings is one way to improve communication and thereby strengthen the therapeutic alliance and increase treatment adherence.

  18. Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

    OpenAIRE

    Freedman, Sara A.; Gilad, Moran; Ankri, Yael; Roziner, Ilan; Shalev, Arieh Y.

    2015-01-01

    Background: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD), but the association’s underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD.Objective: This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS) in a large cohort of recent trauma survivors. It also explores the ef...

  19. Longitudinal Associations Among Pain, Posttraumatic Stress Disorder Symptoms, and Stress Appraisals.

    Science.gov (United States)

    Vaughan, Christine A; Miles, Jeremy N V; Eisenman, David P; Meredith, Lisa S

    2016-04-01

    Comorbidity of posttraumatic stress disorder (PTSD) and pain is well documented, but the mechanisms underlying their comorbidity are not well understood. Cross-lagged regression models were estimated with 3 waves of longitudinal data to examine the reciprocal associations between PTSD symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS), and pain, as measured by a brief self-report measure of pain called the PEG (pain intensity [P], interference with enjoyment of life [E], and interference with general activity [G]). We evaluated stress appraisals as a mediator of these associations in a sample of low-income, underserved patients with PTSD (N = 355) at federally qualified health centers in a northeastern metropolitan area. Increases in PTSD symptom severity between baseline and 6-month and 6- and 12-month assessments were independently predicted by higher levels of pain (β = .14 for both lags) and appraisals of life stress as uncontrollable (β = .15 for both lags). Stress appraisals, however, did not mediate these associations, and PTSD symptom severity did not predict change in pain. Thus, the results did not support the role of stress appraisals as a mechanism underlying the associations between pain and PTSD. Copyright © 2016 International Society for Traumatic Stress Studies.

  20. Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?

    Science.gov (United States)

    Hansen, Maj; Műllerová, Jana; Elklit, Ask; Armour, Cherie

    2016-08-01

    For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victims with PTSD. This study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared with a non-dissociative PTSD class. The results of LCA revealed a two-class solution with two highly symptomatic classes: a dissociative class and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVAs) suffering from whiplash. The results are discussed in light of their clinical implications and suggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.

  1. The PHQ-12 Somatic Symptom scale as a predictor of symptom severity and consulting behaviour in patients with irritable bowel syndrome and symptomatic diverticular disease

    OpenAIRE

    Spiller , Robin; Humes , David; Campbell , Eugene; Hastings , Margaret; Neal , Keith; Dukes , George; Whorwell , Peter

    2010-01-01

    Abstract BACKGROUND Anxiety, depression and non-gastrointestinal symptoms are often prominent in IBS but their relative value in patient management has not been quantitatively assessed. We modified the Patient Health Questionnaire 15 (PHQ-15) by excluding the 3 gastrointestinal items to create the PHQ-12 Somatic Symptom scale (PHQ-12 SS). AIMS To compare the value of the PHQ-12 SS scale to the Hospital Anxiety and Depression (HAD) scale in predicting symptoms and patient beha...

  2. Substance use disorders and PTSD: an exploratory study of treatment preferences among military veterans.

    Science.gov (United States)

    Back, Sudie E; Killeen, Therese K; Teer, Andrew P; Hartwell, Emily E; Federline, Amanda; Beylotte, Frank; Cox, Elizabeth

    2014-02-01

    Substance use disorders (SUDs) and Post Traumatic Stress Disorder (PTSD) frequently co-occur among Veterans and are associated with poor treatment outcomes. Historically, treatments for SUDs and PTSD have been delivered sequentially and independently. More recently, however, integrated treatments have shown promise. This study investigated Veterans' perceptions of the interrelationship between SUDs and PTSD, as well as treatment preferences. Participants were 35 Veterans of recent military conflicts in Iraq and Afghanistan, and prior operations, who completed the Treatment Preferences Questionnaire as well as an in-depth interview. The majority (94.3%) perceived a relationship between their SUD and PTSD symptoms. Veterans reported that PTSD symptom exacerbation was typically (85.3%) associated with an increase in substance use, and PTSD symptom improvement was typically (61.8%) followed by a decrease in substance use (pdevelopment and provision of care for Veterans with SUDs and PTSD. Published by Elsevier Ltd.

  3. A novel, simple scale for assessing the symptom severity of atrial fibrillation at the bedside: the CCS-SAF scale.

    Science.gov (United States)

    Dorian, Paul; Cvitkovic, Suzan S; Kerr, Charles R; Crystal, Eugene; Gillis, Anne M; Guerra, Peter G; Mitchell, L Brent; Roy, Denis; Skanes, Allan C; Wyse, D George

    2006-04-01

    The severity of symptoms caused by atrial fibrillation (AF) is extremely variable. Quantifying the effect of AF on patient well-being is important but there is no simple, commonly accepted measure of the effect of AF on quality of life (QoL). Current QoL measures are cumbersome and impractical for clinical use. To create a simple, concise and readily usable AF severity score to facilitate treatment decisions and physician communication. The Canadian Cardiovascular Society (CCS) Severity of Atrial Fibrillation (SAF) Scale is analogous to the CCS Angina Functional Class. The CCS-SAF score is determined using three steps: documentation of possible AF-related symptoms (palpitations, dyspnea, dizziness/syncope, chest pain, weakness/fatigue); determination of symptom-rhythm correlation; and assessment of the effect of these symptoms on patient daily function and QoL. CCS-SAF scores range from 0 (asymptomatic) to 4 (severe impact of symptoms on QoL and activities of daily living). Patients are also categorized by type of AF (paroxysmal versus persistent/permanent). The CCS-SAF Scale will be validated using accepted measures of patient-perceived severity of symptoms and impairment of QoL and will require 'field testing' to ensure its applicability and reproducibility in the clinical setting. This type of symptom severity scale, like the New York Heart Association Functional Class for heart failure symptoms and the CCS Functional Class for angina symptoms, trades precision and comprehensiveness for simplicity and ease of use at the bedside. A common language to quantify AF severity may help to improve patient care.

  4. Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women.

    Science.gov (United States)

    Gelaye, Bizu; Zheng, Yinnan; Medina-Mora, Maria Elena; Rondon, Marta B; Sánchez, Sixto E; Williams, Michelle A

    2017-05-12

    The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. The reliability of the PCL-C was excellent (Cronbach's alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78-0.92) and a specificity of 0.63 (95% CI: 0.62-0.65). The area under the ROC curve was 0.75 (95% CI: 0.71-0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis.

  5. Guilt, Shame and Compassionate Imagery in War: Traumatized German Soldiers with PTSD, a Pilot Study

    Directory of Open Access Journals (Sweden)

    Christina Alliger-Horn

    2016-10-01

    Full Text Available Background: The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. Objective: The purpose of this study was to examine the extent to which soldiers’ PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today and their TRAUMATIZED SELF (back then. Method: The sample comprised 24 male German soldiers diagnosed with PTSD who were examined on the Posttraumatic Diagnostic Scale (PDS and two additional measures: the Emotional Distress Inventory (EIBE and the Quality of Interaction between the CURRENT SELF and the TRAUMATIZED SELF (QUI-HD: Qualität der Interaktion zwischen HEUTIGEN ICH und DAMALIGEN ICH at pre- and post-treatment and again at follow-up. The treatment used was imagery rescripting and reprocessing therapy (IRRT. Results: Eighteen of the 24 soldiers showed significant improvement in their PTSD symptoms at post-treatment and at follow-up (on their reliable change index. A significant change in trauma-associated guilt and shame emerged when compassionate imagery was developed towards one’s TRAUMATIZED SELF. The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the PDS scores. Conclusions: For soldiers suffering from specific war-related trauma involving PTSD, the use of self-nurturing, compassionate imagery that fosters reconciling with the traumatized part of the self can effectively diminish trauma-related symptoms, especially when guilt and shame are central emotions.

  6. The impact of the refugee decision on the trajectory of PTSD, anxiety, and depressive symptoms among asylum seekers: a longitudinal study.

    Science.gov (United States)

    Silove, Derrick; Steel, Zachary; Susljik, Ina; Frommer, Naomi; Loneragan, Celia; Chey, Tien; Brooks, Robert; le Touze, Dominique; Ceollo, Mariano; Smith, Mitchell; Harris, Elizabeth; Bryant, Richard

    2007-01-01

    To examine prospectively the trajectory of trauma-related psychiatric symptoms and disability amongst asylum seekers over the course of the refugee determination process. To identify the direct impact of the refugee decision on psychiatric symptoms by adjusting for other variables, namely sociodemographic characteristics, past trauma, and ongoing postmigration stresses. A prospective cohort study of asylum seekers recruited from a random sample of immigration agents in Sydney, Australia. Consecutive asylum seekers were referred for interview by immigration agents. Interviews were undertaken after the initial application and on average, 3.8 months after the refugee decision. Measures assessed premigration trauma and postmigration stressors. Mental health status was assessed using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25. Functional impairment was assessed with the Medical Outcomes Study-Short Form 12. Sixty-two of 73 asylum seekers were retained at follow-up. The accepted (16) and rejected (46) groups did not differ on premigration trauma or baseline psychiatric symptoms. Postdecision, the accepted group showed substantial improvements in posttraumatic stress disorder, anxiety, depression, and in mental health functioning, whereas the rejected group maintained high levels of symptoms on all psychiatric indices. Establishing secure residency status for asylum seekers may be important to their recovery from trauma-related psychiatric symptoms. The practical and theoretical implications are discussed.

  7. In-Home Exposure Therapy for Veterans with PTSD

    Science.gov (United States)

    2017-10-01

    the therapist comes to the Veterans’ homes for treatment). We aim to investigate whether symptoms of PTSD, depression , and anxiety get better (less...if symptoms of PTSD, depression , and anxiety get better (less severe) after the treatment and six months later. We will also see if there are...preferences for care (see full reference below) For the full project sample, we have been referred 900 Veterans. Of the 900 referred, 736 are males (82

  8. Evaluation of the effectiveness of a novel brain and vestibular rehabilitation treatment modality in PTSD patients who have suffered combat related traumatic brain injuries

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-02-01

    Full Text Available Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a signature injury. Vestibular complaints are the most frequent sequelae of mTBI and vestibular rehabilitation (VR has been established as the most important treatment modality for this group of patients. Material and Methods:We studied the effectiveness of a novel brain and VR treatment PTSD in subjects who had suffered combat related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6. We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS scores pre and post treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%. Results:Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. 41 subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment we observed a large reduction in CAPS severity scores with both statistical and substantive significance. Discussion:Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family and society.

  9. Posttraumatic stress disorder and somatic symptoms among child and adolescent survivors following the Lushan earthquake in China: A six-month longitudinal study.

    Science.gov (United States)

    Zhang, Jun; Zhu, Shenyue; Du, Changhui; Zhang, Ye

    2015-08-01

    To explore somatic conditions in a sample of 2299 child and adolescent survivors of an earthquake and their relationship to posttraumatic stress disorder (PTSD) symptoms. The Children's Revised Impact of Event Scale, the Patient Health Questionnaire (PHQ)-13 scale, a short version of PHQ-15 scale that omits two items involving sexual pain/problems and menstrual problems, and a project-developed questionnaire were administered to participants three and six months after the earthquake. Among child and adolescent survivors, the prevalence rates of probable PTSD were 37.4 and 24.2% three and six months, respectively, after the earthquake. The most common somatic symptoms were trouble sleeping (58.4 and 48.4%), feeling tired or having low energy (52.0 and 46.1%), and stomach pain (45.8 and 45.4%) after three and six months, respectively. Several specific somatic symptoms evaluated three months after the earthquake including trouble sleeping, headache, and shortness of breath were predictors of the overall PTSD symptoms evaluated six months after the earthquake. Additionally, the symptom of hyperarousal evaluated after three months could predict the overall somatic symptoms evaluated after six months. PTSD and somatic symptoms were common after the earthquake, and a longitudinal association between PTSD and somatic symptoms was detected among child and adolescent survivors. These findings have implications in China and possibly elsewhere. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Karolinska Scales of Personality, cognition and psychotic symptoms in patients with schizophrenia and healthy controls.

    Science.gov (United States)

    Nilsson, Björn Mikael; Holm, Gunnar; Ekselius, Lisa

    2016-01-01

    Studies on both personality dimensions and cognition in schizophrenia are scarce. The objective of the present study was to examine personality traits and the relation to cognitive function and psychotic symptoms in a sample of patients with schizophrenia and healthy controls. In total 23 patients with schizophrenia and 14 controls were assessed with the Karolinska Scales of Personality (KSP). A broad cognitive test programme was used, including the Wechsler Adult Intelligence Scales, the Finger-Tapping Test, the Trail Making Test, the Verbal Fluency Test, the Benton Visual Retention Test, the Wisconsin Card Sorting Test and Rey Auditory Verbal Learning Test . Compared with controls, the patients exhibited prominent elevations on KSP scales measuring anxiety proneness and neuroticism (P = 0.000005-0.0001), on the Detachment scale (P < 0.00009) and lower value on the Socialization scale (P < 0.0002). The patients also scored higher on the Inhibition of Aggression, Suspicion, Guilt and Irritability scales (P = 0.002-0.03) while the remaining five scales did not differ between patients and controls. KSP anxiety-related scales correlated with the Positive and Negative Symptoms Scale (PANSS) general psychopathology subscale. Cognitive test results were uniformly lower in the patient group and correlated with PANSS negative symptoms subscale. There was no association between KSP scale scores and PANSS positive or negative symptoms. The patients revealed a highly discriminative KSP test profile with elevated scores in neuroticism- and psychoticism-related scales as compared to controls. Results support previous findings utilizing other personality inventories in patients with schizophrenia. Cognitive test performance correlated inversely with negative symptoms.

  11. Negative symptoms in bipolar disorder and schizophrenia: A psychometric evaluation of the brief negative symptom scale across diagnostic categories.

    Science.gov (United States)

    Strauss, Gregory P; Vertinski, Mary; Vogel, Sally J; Ringdahl, Erik N; Allen, Daniel N

    2016-02-01

    Past studies have demonstrated that the Brief Negative Symptom Scale (BNSS) has excellent psychometric properties in patients with schizophrenia. In the current study, we extended this literature by examining psychometric properties of the BNSS in outpatients diagnosed with bipolar disorder (n=46), outpatients with schizophrenia (n=50), and healthy controls (n=27). Participants completed neuropsychological testing and a clinical interview designed to assess negative, positive, disorganized, mood, and general psychiatric symptoms. Results indicated differences among the 3 groups in the severity of all BNSS items, with SZ and BD scoring higher than CN; however, SZ and BD only differed on blunted affect and alogia items, not anhedonia, avolition, or asociality. BD patients with a history of psychosis did not differ from those without a history of psychosis on negative symptom severity. The BNSS had excellent internal consistency in SZ, BD, and CN groups. Good convergent and discriminant validity was apparent in SZ and BD groups, as indicated by relationships between the BNSS and other clinical rating scales. These findings support the validity of the BNSS in broadly defined serious mental illness populations. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. ICD-11 trauma questionnaires for PTSD and complex PTSD

    DEFF Research Database (Denmark)

    Dokkedahl, Sarah Bøgelund; Oboke, Henry; Ovuga, Emilio

    2015-01-01

    Objectives: ICD-11 is expected to introduce a new diagnosis of C-PTSD, along with a revision of the current PTSD diagnosis. Are the suggested diagnostic tools for PTSD and C-PTSD valid in a developing country? Method: The tools have been tested on former abducted and regular civilians in northern...

  13. Shamanic Healing for Veterans with PTSD: A Case Series.

    Science.gov (United States)

    Wahbeh, Helané; Shainsky, Lauri; Weaver, Angela; Engels-Smith, Jan

    Posttraumatic stress disorder (PTSD) is a serious health concern. Current evidence-based treatments for PTSD are efficacious; however, they are not appropriate or tolerated by everyone who needs them. Alternative treatment approaches are needed. Shamanic healing is one such therapy that may potentially be beneficial but no systematic research has been conducted on it for PTSD. The objectives of the case series are to (1) develop a structured replicable shamanic treatment plan for veterans with posttraumatic stress disorder (PTSD); (2) collect preliminary data on PTSD-related outcomes, and (3) explore the feasibility and potential for adverse events of the plan. Case series. Clinical. Veterans with PTSD. Shamanic healing. PTSD symptoms, quality of life, and piritual wellness. A semi-structured shamanic healing protocol was created with the following components: rapport building, power animal retrieval, extraction, compassionate spirit release, curse unraveling, soul retrieval, forgiveness/cord-cutting, aspect maturing/soul rematrixing, and divination. Six veterans enrolled in the study (mean age = 49.3 ± 13.1). Qualitative descriptions of the participants, their histories, and effects from the intervention are reported. Preliminary data was collected on PTSD-related outcomes. The protocol was found feasible and acceptable and recommendations for its future use are suggested. Future research is warranted and needed to evaluate the efficacy of shamanic healing as a potential therapy for veterans with PTSD. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. An Assessment of Five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used Symptoms Rating Scales in Schizophrenia and Comparison to Newer Scales (CAINS, BNSS).

    Science.gov (United States)

    Kumari, Suneeta; Malik, Mansoor; Florival, Christina; Manalai, Partam; Sonje, Snezana

    2017-01-01

    Scales measuring positive and negative symptoms in schizophrenia remain the primary mo Scales measuring positive and negative symptoms in schizophrenia remain the primary mode of assessing and diagnosing schizophrenia by clinicians and researchers. The scales are mainly used to monitor the severity of positive and negative symptoms and track treatment response in schizophrenics. Although these scales are widely used, quality as well as general utility of each scale varies. The quality is determined by the validity and reliability of the scales. The utility of the scale is determined by the time of administration and the settings for which the scales can be administered in research or clinical settings. There are relatively fewer articles on the utility of newer scales like CAINS (Clinical Assessment Interview for Negative Symptoms) and the BNSS (Brief Negative Symptom Scale) that compare them to the older scales PANSS (Positive and Negative Symptoms Scale), SAPS (Scale for the Assessment of Positive Symptoms) SANS (the Scale for the Assessment of Negative Symptoms), NSA-16 (Negative Symptom Assessment-16) and CGI-SCH (Clinical Global Impression Schizophrenia. The older scales were developed more than 30 years ago. Since then, our understanding of negative symptoms has evolved and currently there are newer rating scales evaluating the validity of negative symptoms. The older scales do not incorporate the latest research on negative symptoms. CAINS and BNSS are attractive for both their reliability and their concise accessible format, however, a scale that is simpler, accessible, user-friendly, that incorporates a multidimensional model of schizophrenia, addresses the psychosocial and cognitive component has yet to be developed.

  15. [PTSD-positive screening and factors influencing the mental state in victims evacuated/ not evacuated from Wenchuan earthquake area within 1 month].

    Science.gov (United States)

    Gao, Xueping; Luo, Xingwei

    2009-06-01

    To explore posttraumatic stress disorder (PTSD) positive screening and factors influencing the mental state in victims who were evacuated/were not evacuated from Wenchuan earthquake area within 1 month. The 3 groups included 235 victims who were not evacuated from Shifang territory (the incident scene, Group A), 44 victims who were evacuated to Second Xiangya Hospital (the wounded, Group B) and 36 relatives (the relatives, Group C). The mental state of all subjects was evaluated by Impact of Event Scale-Revised (IES-R) and other tools. (1) One month after the disaster, and the positive rate of PTSD screening in these survivors was 35.56%, the positive rate in women was significantly higher than that in men (chi(2)=16.27,PGender, place of residence and evacuating from the earthquake area or not were factors of PTSD symptoms. One month after the earthquake, the victims suffered psychologically. PTSD symptoms, anxiety and depression symptoms were their major mental problems, more attention to especially women victims. The protection factors include dispersing victims to the secure place as soon as possible, expanding and strengthening society support. Early psychological interventions will help victims to raise their psychological endurance and prevent PTSD effectively.

  16. A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood.

    Science.gov (United States)

    Butollo, Willi; Karl, Regina; König, Julia; Rosner, Rita

    2016-01-01

    Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised; Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms. © 2015 S. Karger AG, Basel.

  17. Specificity of posttraumatic stress disorder symptoms: an investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatment-seeking veterans.

    Science.gov (United States)

    Gros, Daniel F; Simms, Leonard J; Acierno, Ron

    2010-12-01

    In response to high levels of comorbidity and symptom overlap between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and other disorders, much attention has been devoted to the role of specific and nonspecific symptoms among the disorders. The present study investigated the overlapping symptoms of PTSD and MDD in treatment-seeking veterans. Exploratory factor analyses were used to identify latent factors of both self-reported and clinician-rated symptoms of PTSD and MDD. Results of exploratory factor analyses supported a 2-factor model representing symptoms of depression and PTSD; however, a subset of PTSD symptoms, characterized by emotional numbing and dysphoria, loaded onto the depression factor, rather than the PTSD factor. These nonspecific PTSD symptoms were predictive of comorbid MDD and increased depression symptomatology in patients with PTSD. Together, these findings demonstrate the importance of accounting for nonspecific symptoms in diagnosis and treatment of PTSD, highlighting a need for revisions to our current diagnostics.

  18. Body Dysmorphic Symptoms Scale for patients seeking esthetic surgery: cross-cultural validation study.

    Science.gov (United States)

    Ramos, Tatiana Dalpasquale; Brito, Maria José Azevedo de; Piccolo, Mônica Sarto; Rosella, Maria Fernanda Normanha da Silva Martins; Sabino, Miguel; Ferreira, Lydia Masako

    2016-01-01

    Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.

  19. A Pilot Study of Mindfulness-based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social-Emotional Processing

    Directory of Open Access Journals (Sweden)

    Anthony King

    2016-09-01

    Full Text Available Combat-related PTSD is common among returning veterans, and is a serious and debilitating disorder. While highly effective treatments involving trauma exposure exist, difficulties with engagement and early drop may lead to sub-optimal outcomes. Mindfulness training may provide a method for increasing emotional regulation skills that may improve engagement in trauma-focused therapy. Here we examine potential neural correlates of mindfulness training and in vivo exposure (non-trauma focused using a novel group therapy (Mindfulness-based Exposure Therapy in Afghanistan (OEF or Iraq (OIF combat veterans with PTSD. OEF/OIF combat veterans with PTSD (N=23 were treated with MBET (N = 14 or a comparison group therapy (Present-centered group therapy [PCGT], N = 9. PTSD symptoms were assessed at pre- and post-therapy with Clinician Administered PTSD scale (CAPS. Functional neuroimaging (3 Tesla fMRI before and after therapy examined responses to emotional faces (angry, fearful, and neutral faces. Patients treated with MBET had reduced PTSD symptoms (effect size d = .92 but effect was not significantly different from PCGT (d = .43. Improvement in PTSD symptoms from Pre- to Post treatment in both treatment groups was correlated with increased activity in rostral ACC, dorsal medial PFC, and left amygdala. The MBET group showed greater increases in amygdala and fusiform gyrus responses to Angry faces, as well as increased response in left medial PFC to Fearful faces. These preliminary findings provide intriguing evidence that MBET group therapy for PTSD may lead to changes in neural processing of social-emotional threat related to symptom reduction.

  20. EMDR for Syrian refugees with posttraumatic stress disorder symptoms: results of a pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ceren Acarturk

    2015-05-01

    Full Text Available Background: The most common mental health problems among refugees are depression and posttraumatic stress disorder (PTSD. Eye movement desensitization and reprocessing (EMDR is an effective treatment for PTSD. However, no previous randomized controlled trial (RCT has been published on treating PTSD symptoms in a refugee camp population. Objective: Examining the effect of EMDR to reduce the PTSD and depression symptoms compared to a wait-list condition among Syrian refugees. Method: Twenty-nine adult participants with PTSD symptoms were randomly allocated to either EMDR sessions (n=15 or wait-list control (n=14. The main outcome measures were Impact of Event Scale-Revised (IES-R and Beck Depression Inventory (BDI-II at posttreatment and 4-week follow-up. Results: Analysis of covariance showed that the EMDR group had significantly lower trauma scores at posttreatment as compared with the wait-list group (d=1.78, 95% CI: 0.92–2.64. The EMDR group also had a lower depression score after treatment as compared with the wait-list group (d=1.14, 95% CI: 0.35–1.92. Conclusion: The pilot RCT indicated that EMDR may be effective in reducing PTSD and depression symptoms among Syrian refugees located in a camp. Larger RCTs to verify the (cost- effectiveness of EMDR in similar populations are needed.

  1. Appetitive aggression as a resilience factor against trauma disorders: appetitive aggression and PTSD in German World War II veterans.

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    Roland Weierstall

    Full Text Available Repeated exposure to traumatic stressors such as combat results in chronic symptoms of PTSD. However, previous findings suggest that former soldiers who report combat-related aggression to be appetitive are more resilient to develop PTSD. Appetitive Aggression should therefore prevent widespread mental suffering in perpetrators of severe atrocities even after decades.To test the long-term relationship between trauma-related illness and attraction to aggression, we surveyed a sample of 51 German male World-War II veterans (age: M = 86.7, SD = 2.8. War-related appetitive aggression was assessed with the Appetitive Aggression Scale (AAS. Current- and lifetime PTSD symptoms were assessed with the PSS-I. In a linear regression analysis accounting for 31% of the variance we found that veterans that score higher on the AAS show lower PSS-I symptom severity scores across their whole post-war lifetime (β = - .31, p = .014. The effect size and power were sufficient (f(2 = 0.51, (1-β = .99. The same was true for current PTSD (β = - .27, p = .030.Appetitive Aggression appears to be a resilience factor for negative long-term effects of combat experiences in perpetrators of violence. This result has practical relevance for preventing trauma-related mental suffering in Peace Corps and for designing adequate homecoming reception for veterans.

  2. Heart rate response to fear conditioning and virtual reality in subthreshold PTSD.

    Science.gov (United States)

    Roy, Michael J; Costanzo, Michelle E; Jovanovic, Tanja; Leaman, Suzanne; Taylor, Patricia; Norrholm, Seth D; Rizzo, Albert A

    2013-01-01

    Posttraumatic stress disorder (PTSD) is a significant health concern for U.S. military service members (SMs) returning from Afghanistan and Iraq. Early intervention to prevent chronic disability requires greater understanding of subthreshold PTSD symptoms, which are associated with impaired physical health, mental health, and risk for delayed onset PTSD. We report a comparison of physiologic responses for recently deployed SMs with high and low subthreshold PTSD symptoms, respectively, to a fear conditioning task and novel virtual reality paradigm (Virtual Iraq). The high symptom group demonstrated elevated heart rate (HR) response during fear conditioning. Virtual reality sequences evoked significant HR responses which predicted variance of the PTSD Checklist-Military Version self-report. Our results support the value of physiologic assessment during fear conditioning and combat-related virtual reality exposure as complementary tools in detecting subthreshold PTSD symptoms in Veterans.

  3. Validation of the Expanded Versions of the Adult ADHD Self-Report Scale v1.1 Symptom Checklist and the Adult ADHD Investigator Symptom Rating Scale.

    Science.gov (United States)

    Silverstein, Michael J; Faraone, Stephen V; Alperin, Samuel; Leon, Terry L; Biederman, Joseph; Spencer, Thomas J; Adler, Lenard A

    2018-02-01

    The aim of this study is to validate the Adult ADHD Self-Report Scale (ASRS) and Adult ADHD Investigator Symptom Rating Scale (AISRS) expanded versions, including executive function deficits (EFDs) and emotional dyscontrol (EC) items, and to present ASRS and AISRS pilot normative data. Two patient samples (referred and primary care physician [PCP] controls) were pooled together for these analyses. Final analysis included 297 respondents, 171 with adult ADHD. Cronbach's alphas were high for all sections of the scales. Examining histograms of ASRS 31-item and AISRS 18-item total scores for ADHD controls, 95% cutoff scores were 70 and 23, respectively; histograms for pilot normative sample suggest cutoffs of 82 and 26, respectively. (a) ASRS- and AISRS-expanded versions have high validity in assessment of core 18 adult ADHD Diagnostic and Statistical Manual of Mental Disorders ( DSM) symptoms and EFD and EC symptoms. (b) ASRS (31-item) scores 70 to 82 and AISRS (18-item) scores from 23 to 26 suggest a high likelihood of adult ADHD.

  4. Different regional gray matter loss in recent onset PTSD and non PTSD after a single prolonged trauma exposure.

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    Yunchun Chen

    Full Text Available OBJECTIVE: Gray matter loss in the limbic structures was found in recent onset post traumatic stress disorder (PTSD patients. In the present study, we measured regional gray matter volume in trauma survivors to verify the hypothesis that stress may cause different regional gray matter loss in trauma survivors with and without recent onset PTSD. METHOD: High resolution T1-weighted magnetic resonance imaging (MRI were obtained from coal mine flood disaster survivors with (n = 10 and without (n = 10 recent onset PTSD and 20 no trauma exposed normal controls. The voxel-based morphometry (VBM method was used to measure the regional gray matter volume in three groups, the correlations of PTSD symptom severities with the gray matter volume in trauma survivors were also analyzed by multiple regression. RESULTS: Compared with normal controls, recent onset PTSD patients had smaller gray matter volume in left dorsal anterior cingulate cortex (ACC, and non PTSD subjects had smaller gray matter volume in the right pulvinar and left pallidum. The gray matter volume of the trauma survivors correlated negatively with CAPS scores in the right frontal lobe, left anterior and middle cingulate cortex, bilateral cuneus cortex, right middle occipital lobe, while in the recent onset PTSD, the gray matter volume correlated negatively with CAPS scores in bilateral superior medial frontal lobe and right ACC. CONCLUSION: The present study identified gray matter loss in different regions in recent onset PTSD and non PTSD after a single prolonged trauma exposure. The gray matter volume of left dorsal ACC associated with the development of PTSD, while the gray matter volume of right pulvinar and left pallidum associated with the response to the severe stress. The atrophy of the frontal and limbic cortices predicts the symptom severities of the PTSD.

  5. Stress-Related Mental Health Symptoms in Coast Guard: Incidence, Vulnerability, and Neurocognitive Performance

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    Richard J. Servatius

    2017-09-01

    Full Text Available U.S. Coast Guard (CG personnel face occupational stressors (e.g., search and rescue which compound daily life stressors encountered by civilians. However, the degree CG personnel express stress-related mental health symptoms of posttraumatic stress disorder (PTSD and major depressive disorder (MDD is understudied as a military branch, and little is known concerning the interplay of vulnerabilities and neurocognitive outcomes in CG personnel. The current study addressed this knowledge gap, recruiting 241 active duty CG personnel (22% female to assess mental health, personality, and neurocognitive function. Participants completed a battery of scales: PTSD Checklist with military and non-military prompts to screen for PTSD, Psychological Health Questionnaire 8 for MDD, and scales for behaviorally inhibited (BI temperament, and distressed (Type D personality. Neurocognitive performance was assessed with the Defense Automated Neurobehavioral Assessment (DANA battery. Cluster scoring yielded an overall rate of PTSD of 15% (95% CI: 11–20% and 8% (95% CI: 3–9% for MDD. Non-military trauma was endorsed twice that of military trauma in those meeting criteria for PTSD. Individual vulnerabilities were predictive of stress-related mental health symptoms in active duty military personnel; specifically, BI temperament predicted PTSD whereas gender and Type D personality predicted MDD. Stress-related mental health symptoms were also associated with poorer reaction time and response inhibition. These results suggest rates of PTSD and MDD are comparable among CG personnel serving Boat Stations to those of larger military services after combat deployment. Further, vulnerabilities distinguished between PTSD and MDD, which have a high degree of co-occurrence in military samples. To what degree stress-related mental healthy symptoms and attendant neurocognitive deficits affect operational effectiveness remains unknown and warrant future study.

  6. Avoidance symptoms and assessment of posttraumatic stress disorder in Arab immigrant women.

    Science.gov (United States)

    Norris, Anne E; Aroian, Karen J

    2008-10-01

    This study investigates whether the avoidance symptom criterion required for a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994) diagnosis of posttraumatic stress disorder (PTSD) is overly conservative. Arab immigrant women (N = 453), many of whom reported experiencing multiple traumatic events, completed the Posttraumatic Diagnostic Scale in Arabic as part of a face to face interview. Analyses indicated all but one avoidance symptom was reported less frequently than reexperiencing and arousal symptoms. However, those who fully met reexperiencing, avoidance, and arousal symptom criteria had worse symptom severity and functioning than those who fully met reexperiencing and arousal symptom criteria, but only partially met avoidance symptom criterion. Study findings support importance of the PTSD avoidance symptom criterion.

  7. Pre-migration Trauma, Repatriation Experiences, and PTSD Among North Korean Refugees.

    Science.gov (United States)

    Kim, Eunyoung; Yun, Minwoo; Jun, Jin Yong; Park, Woong-Sub

    2018-04-12

    Many studies on refugees suggested that refugees' traumatic events associated with post-traumatic stress disorder (PTSD). However, it is unknown whether refugees' PTSD was caused by their negative experience before or after the entry of their destination country. Thus, a separation of refugees' pre-migration from their post-migration experience is particularly important in understanding the causal impact of trauma. Using a sample from North Korean refugees, this study investigates the prevalence of PTSD symptoms, the impact of tortured trauma, repatriation experiences, on PTSD among North Korean refugees (n = 698). We found that North Korean refugees in our sample (a) demonstrated a high rate of current probable PTSD; (b) were demonstrated a higher frequency of repatriation experiences with a greater risk for PTSD symptoms. The findings suggest that particular types of trauma for populations with particular socio-demographic characteristics may be at a greater risk of PTSD.

  8. Cognitive predictors and risk factors of PTSD following stillbirth: a short-term longitudinal study.

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    Horsch, A.; Jacobs, I.; McKenzie-McHarg, K.

    2015-01-01

    This short-term longitudinal study investigated cognitive predictors and risk factors of posttraumatic stress disorder (PTSD) in mothers following stillbirth. After a stillbirth at ≥ 24 weeks gestational age, 65 women completed structured clinical interviews and questionnaires assessing PTSD symptoms, cognitive predictors (appraisals, dysfunctional strategies), and risk factors (perceived social support, trauma history, obstetric history) at 3 and 6 months. PTSD symptoms decreased between 3 a...

  9. Body Dysmorphic Symptoms Scale for patients seeking esthetic surgery: cross-cultural validation study

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    Tatiana Dalpasquale Ramos

    Full Text Available ABSTRACT: CONTEXT AND OBJECTIVE: Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. METHODS: Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. RESULTS: The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P < 0.001 and intra-rater reproducibility (ICC = 0.939; P < 0.001. Significant differences in total scores were found between patients with and without symptoms (P < 0.001. A strong correlation (r = 0.841; P < 0.001 was observed between the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. CONCLUSIONS: The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.

  10. The Effectiveness of Behavior Therapy and Symptoms of PTSD in Trauma Survivors Fire Accident in Industrial Pole of Shahid Babaie City Shazand

    OpenAIRE

    M. Sadeghi; M. Naderi-Nabi; M. Chegini; A. Ghaedniaye-Jahromi

    2015-01-01

    Background: The aim of this present study was to the effectiveness of behavior therapy in the treatment of posttraumatic stress disorder symptoms and general health of in Trauma Survivors Fire Accident in Industrial Pole of Shahid Babaie City Shazand in 1387. Methods: The present plan study of experimental design with pre - and post - test method after the test. community study all the survivors industrial hub of fire martyr Babaie city shazand township to approach the census initial screenin...

  11. PTSD symptoms among tsunami exposed mothers in Sri Lanka: the role of disaster exposure, culturally specific coping strategies, and recovery efforts.

    Science.gov (United States)

    Wickrama, Thulitha; Wickrama, K A S; Banford, Alyssa; Lambert, Jessica

    2017-07-01

    Women in Sri Lanka have been uniquely exposed to a complex and protracted set of stressors stemming from a civil war conflict spanning over 25 years and the tsunam