scholarly journals Differential Effects of Comorbid Psychiatric Disorders on Treatment Outcome in Posttraumatic Stress Disorder from Childhood Trauma

2021 ◽  
Vol 10 (16) ◽  
pp. 3708
Author(s):  
Nele Assmann ◽  
Eva Fassbinder ◽  
Anja Schaich ◽  
Christopher W. Lee ◽  
Katrina Boterhoven de Haan ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcome ◽  
Posttraumatic Stress ◽  
Childhood Trauma ◽  
Stress Disorder ◽  
Secondary Outcome ◽  
Ptsd Symptoms ◽  
Moderator Effect ◽  
Ptsd Treatment ◽  
The Impact

Patients with posttraumatic stress disorder (PTSD) frequently have comorbid diagnoses such as major depressive disorder (MDD) and anxiety disorders (AD). Studies into the impact of these comorbidities on the outcome of PTSD treatment have yielded mixed results. The different treatments investigated in these studies might explain the varied outcome. The purpose of this study was to examine the impact of these comorbidities on the outcome of two specific PTSD treatments. MDD and AD were analyzed as predictors and moderators in a trial comparing 12 sessions of either eye movement desensitization and reprocessing (EMDR) or imagery rescripting (IR) in 155 adult patients with PTSD from childhood trauma. The primary outcome was reduction of PTSD symptoms (clinician-administered PTSD Scale for DSM-5, CAPS-5) assessed at eight-week follow-up and a secondary outcome was self-report PTSD symptoms (Impact of Event Scale, IES-R). MDD was not a predictor of treatment outcome but did have a significant moderator effect. Patients with MDD showed a better outcome if they were treated with IR, whereas patients without MDD improved more in the EMDR condition. No impact of AD emerged. It seems essential to consider comorbid MDD when planning PTSD treatment to improve treatment outcomes. More research is needed to replicate our findings and focus on different kinds of PTSD treatments and other comorbidities.

Foundations of posttraumatic stress disorder: Does early life trauma lead to adult posttraumatic stress disorder?

2011 ◽  
Vol 23 (2) ◽  
pp. 477-491 ◽  
Author(s):  
Laura C. Pratchett ◽  
Rachel Yehuda
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Childhood Abuse ◽  
Childhood Trauma ◽  
Stress Disorder ◽  
Biological Effects ◽  
Subsequent Development ◽  
Causal Link ◽  
Early Life Trauma ◽  
The Impact

AbstractThe effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic–pituitary–adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.

Neural Correlates of Posttraumatic Stress Disorder Symptoms, Trauma Exposure, and Postmigration Stress in Response to Fear Faces in Resettled Refugees

2019 ◽  
Vol 7 (4) ◽  
pp. 811-825 ◽  
Author(s):  
Belinda J. Liddell ◽  
Jessica Cheung ◽  
Tim Outhred ◽  
Pritha Das ◽  
Gin S. Malhi ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Brain Activity ◽  
Trauma Exposure ◽  
Anterior Cingulate ◽  
Magnetic Resonance Imaging Scan ◽  
Ptsd Symptoms ◽  
Cumulative Trauma ◽  
The Impact

Refugees are exposed to multiple traumatic events and postmigration stressors, elevating risk for posttraumatic stress disorder (PTSD), but there is limited research into how these factors affect emotional neural systems. Here, resettled refugees in Australia ( N = 85) completed a functional magnetic resonance imaging scan while viewing fear and neutral faces. We examined the influence of PTSD symptoms, cumulative trauma, and recent postmigration stress on neural reactivity and regional coupling within the refugee sample. Cumulative trauma and postmigration stress but not PTSD symptoms correlated with fear-related brain activity and connectivity. Trauma exposure correlated with stronger activity but overall decreased connectivity in the bilateral posterior insula/rolandic operculum, postcentral gyrus, ventral anterior cingulate cortex, and posterior cingulate gyrus. Postmigration stress correlated with fusiform gyrus hyperactivity and increased connectivity in face-processing networks. Findings highlight the impact of past trauma and recent postmigration stress on fear-related neural responses within refugees over and above PTSD symptoms.

Women’s Appraisals of Intimate Partner Violence Stressfulness and Their Relationship to Depressive and Posttraumatic Stress Disorder Symptoms

2009 ◽  
Vol 24 (6) ◽  
pp. 707-722 ◽  
Author(s):  
Cecilia Martinez-Torteya ◽  
G. Anne Bogat ◽  
Alexander von Eye ◽  
Alytia A. Levendosky ◽  
William S. Davidson
Keyword(s):  
Mental Health ◽  
Posttraumatic Stress Disorder ◽  
Intimate Partner Violence ◽  
Posttraumatic Stress ◽  
Partner Violence ◽  
Psychological Functioning ◽  
Stress Disorder ◽  
Intimate Partner ◽  
Ptsd Symptoms ◽  
The Impact

Intimate partner violence (IPV) increases risk for depressive and posttraumatic stress disorder (PTSD) symptoms. Most studies use a dose–response approach to examine the impact of IPV on mental health, but they often fail to explain mental health outcome specificity as well as to assess the impact of women’s subjective appraisals. The present research examined women’s IPV stressfulness appraisals and their psychological functioning (depressive and PTSD symptoms). Results indicate that IPV stressfulness appraisals are associated with depressive symptoms over and above frequency and severity of IPV. PTSD symptoms were associated with frequent and stressful IPV. Women who experienced highly frequent and highly stressful IPV were most likely to display comorbid depressive and PTSD symptoms. Results underscore the importance of women’s subjective experiences and the heterogeneity of women’s responses to IPV.

Trauma and Temperament as Predictors of Intensity of Posttraumatic Stress Disorder Symptoms After Disaster

2005 ◽  
Vol 10 (2) ◽  
pp. 124-135 ◽  
Author(s):  
Jan Strelau ◽  
Bogdan Zawadzki
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Repeated Measures ◽  
Emotional Reactivity ◽  
Stress Disorder ◽  
Hierarchical Regression ◽  
Ptsd Symptoms ◽  
Posttraumatic Stress Disorder Symptoms ◽  
Two Samples ◽  
The Impact

Abstract. This study assesses the impact of temperament and trauma considered as predictors of Posttraumatic Stress Disorder (PTSD) symptoms experienced during flood and coal mining accidents. Five samples were studied - one comprised of coal miners who experienced a mining catastrophe (N = 52) and four samples of flood victims (N = 1041), including 562 females. PTSD symptoms were measured - depending on the sample under study - at different time periods (from 3 months to 3 years), and in two samples repeated measures were taken. For measuring symptoms of PTSD the PTSD-Factorial Version inventory constructed in our laboratory was applied. Temperamental traits were assessed by means of the Formal Characteristics of Behavior - Temperament Inventory. Intensity of trauma and prolonged trauma consequences were measured by means of an interview. For analyzing the data coefficients of correlation and hierarchical regression were used. In all samples such temperament traits as briskness and endurance act as buffers resulting in lowering the effect of trauma inducing events. On the other hand, perseverance and emotional reactivity act as augmenters that result in increasing the effect of experienced trauma. In all samples emotional reactivity was the best predictor of the intensity of PTSD symptoms. In samples in which measures of trauma were included both variables - trauma and emotional reactivity - contributed essentially as predictors of PTSD symptoms and this held true independent of whether PTSD was assessed 3 months, 15 months, or 3 years after experiencing the disaster (flood).

scholarly journals Dose-Related Effects of Ketamine for Antidepressant-Resistant Symptoms of Posttraumatic Stress Disorder in Veterans and Active Duty Military: A Double-blind, Randomized, Placebo-Controlled Multi-Center Clinical Trial

2021 ◽  
Author(s):  
Chadi Abdallah ◽  
John Roache ◽  
Ralitza Gueorguieva ◽  
Lynnette Averill ◽  
Stacey Young-McCaughon ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Low Dose ◽  
Stress Disorder ◽  
Standard Dose ◽  
Secondary Outcome ◽  
Ptsd Symptoms ◽  
Significant Group ◽  
Dsm 5

Background: This study tested the efficacy of repeated intravenous ketamine doses to reduce antidepressant-resistant symptoms of posttraumatic stress disorder (PTSD). Methods: Veterans and service members with PTSD (n=158) who failed previous antidepressant treatment were randomized to 8 infusions administered twice weekly of intravenous placebo (n=54), low dose (0.2mg/kg; n=53) or standard dose (0.5mg/kg; n=51) ketamine. Participants were assessed at baseline, during treatment, and for 4 weeks after their last infusion. Primary analyses used mixed effects models. The primary outcome measure was the self-report PTSD Checklist for DSM-5 (PCL-5), and secondary outcome measures were the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Montgomery Asberg Depression Rating Scale (MADRS). Results: There were no significant group-by-time interactions for PTSD symptoms measured by the PCL-5 or CAPS-5. The standard dose ketamine significantly reduced symptoms after the first infusion, while the low dose showed significant symptom reduction after the last infusion and at the 4-week follow-up. The standard ketamine dose also significantly ameliorated depression measured by the MADRS. Ketamine produced dose-related dissociative and psychotomimetic effects, which returned to baseline within 2 hours and were less pronounced with repeated administration. There was no evidence of differential treatment discontinuation by ketamine dose, consistent with good tolerability. Conclusions: This clinical trial failed to find a significant dose-related effect of ketamine on PTSD symptoms. Secondary analyses suggested that the low dose reduced PTSD symptoms and the standard dose exerted rapid antidepressant effects. Further studies are needed to determine the role of ketamine in PTSD treatment. ClinicalTrials.gov identifier: NCT02655692

scholarly journals Machine learning to reveal hidden risk combinations for the trajectory of posttraumatic stress disorder symptoms

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yuta Takahashi ◽  
Kazuki Yoshizoe ◽  
Masao Ueki ◽  
Gen Tamiya ◽  
Yu Zhiqian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Significant Risk ◽  
Bivariate Analysis ◽  
Ptsd Symptoms ◽  
Resting Time ◽  
The Impact ◽  
Walking Time

AbstractThe nature of the recovery process of posttraumatic stress disorder (PTSD) symptoms is multifactorial. The Massive Parallel Limitless-Arity Multiple-testing Procedure (MP-LAMP), which was developed to detect significant combinational risk factors comprehensively, was utilized to reveal hidden combinational risk factors to explain the long-term trajectory of the PTSD symptoms. In 624 population-based subjects severely affected by the Great East Japan Earthquake, 61 potential risk factors encompassing sociodemographics, lifestyle, and traumatic experiences were analyzed by MP-LAMP regarding combinational associations with the trajectory of PTSD symptoms, as evaluated by the Impact of Event Scale-Revised score after eight years adjusted by the baseline score. The comprehensive combinational analysis detected 56 significant combinational risk factors, including 15 independent variables, although the conventional bivariate analysis between single risk factors and the trajectory detected no significant risk factors. The strongest association was observed with the combination of short resting time, short walking time, unemployment, and evacuation without preparation (adjusted P value = 2.2 × 10−4, and raw P value = 3.1 × 10−9). Although short resting time had no association with the poor trajectory, it had a significant interaction with short walking time (P value = 1.2 × 10−3), which was further strengthened by the other two components (P value = 9.7 × 10−5). Likewise, components that were not associated with a poor trajectory in bivariate analysis were included in every observed significant risk combination due to their interactions with other components. Comprehensive combination detection by MP-LAMP is essential for explaining multifactorial psychiatric symptoms by revealing the hidden combinations of risk factors.

scholarly journals The Relationship Between Working Alliance and Symptom Improvement in Cognitive Therapy for Posttraumatic Stress Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Esther T. Beierl ◽  
Hannah Murray ◽  
Milan Wiedemann ◽  
Emma Warnock-Parkes ◽  
Jennifer Wild ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcome ◽  
Posttraumatic Stress ◽  
Working Alliance ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Ptsd Symptoms ◽  
Symptom Change ◽  
Symptom Scores ◽  
The Relationship

Background: Working alliance has been shown to predict outcome of psychological treatments in multiple studies. Conversely, changes in outcome scores have also been found to predict working alliance ratings.Objective: To assess the temporal relationships between working alliance and outcome in 230 patients receiving trauma-focused cognitive behavioral treatment for posttraumatic stress disorder (PTSD).Methods: Ratings of working alliance were made by both the patient and therapist after sessions 1, 3, and 5 of a course of Cognitive Therapy for PTSD (CT-PTSD). Autoregressive, cross-lagged panel models were used to examine whether working alliance predicted PTSD symptom severity at the next assessment point and vice versa. Linear regressions tested the relationship between alliance and treatment outcome.Results: Both patients' and therapists' working alliance ratings after session 1 predicted PTSD symptom scores at the end of treatment, controlling for baseline scores. At each assessment point, higher therapist working alliance was associated with lower PTSD symptoms. Crossed-lagged associations were found for therapist-rated alliance, but not for patient-rated alliance: higher therapists' alliance ratings predicted lower PTSD symptom scores at the next assessment point. Similarly, lower PTSD symptoms predicted higher therapist working alliance ratings at the next assessment point. Ruminative thinking was negatively related to therapists' alliance ratings.Conclusions: Working alliance at the start of treatment predicted treatment outcome in patients receiving CT-PTSD and may be an important factor in setting the necessary conditions for effective treatment. For therapists, there was a reciprocal relationship between working alliance and PTSD symptom change in their patients during treatment, suggesting that their alliance ratings predicted symptom change, but were also influenced by patients' symptom change.

scholarly journals Posttraumatic Stress Disorder symptoms in persons involved in road accidents and paramedics

2021 ◽  
Vol 90 (2) ◽  
pp. e515
Author(s):  
Aleksandra Parobkiewicz ◽  
Michał Ziarko ◽  
Julia Krawczyk ◽  
Jagna Jasielska
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptoms ◽  
Road Accidents ◽  
Impact Of Event Scale ◽  
Event Scale ◽  
Posttraumatic Stress Disorder Symptoms ◽  
Significant Difference ◽  
The Impact

Aim. The aim of the study was to assess the risk of posttraumatic stress disorder (PTSD) among persons involved in road accidents and paramedics. Little is known about similarity or difference of PTSD symptoms between these two groups involved in accident in voluntary and involuntary way. Material and Methods. Persons involved in road accidents (N = 78) and paramedics (N = 106) completed the Polish version of the Impact of Event Scale–Revised.Results. The percentage of those who reported PTSD symptoms was similar and insignificant among persons involved in road accidents (56%) and among paramedics (45%). A significant difference (p < 0,01) was observed between these groups, however. The total PTSD, intrusions, and avoidance were higher for persons involved in road accidents.Conclusions. Victims, perpetrators, and helpers in road accidents were at a similar risk of PTSD. Peritraumatic interventions are recommended for all these groups.

Sign in / Sign up

Export Citation Format

Share Document