PTSD Factors Research Articles

Post-traumatic stress disorder in parturients delivering by caesarean section and the implication of anaesthesia: a prospective cohort study

BackgroundPost-traumatic stress disorder (PTSD) occurs in 1–7% of women following childbirth. While having a caesarean section (C-section) is known to be a significant risk factor for postpartum PTSD, it is currently unknown whether coexisting anaesthesia-related factors are also associated to the disorder. The aim of this study was to assess anaesthesia-linked factors in the development of acute postpartum PTSD.MethodsWe performed a prospective cohort study on women having a C-section in a tertiary hospital in Switzerland. Patients were followed up six weeks postpartum. Patient and procedure characteristics, past morbidity or traumatic events, psychosocial status and stressful perinatal events were measured. Outcome was divided into two categories: full PTSD disease and PTSD profile. This was based on the number of DSM-IV criteria of the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) present. The PTSD Checklist Scale and the Clinician Administered PTSD Scale were used for measurement.ResultsOf the 280 patients included, 217 (77.5%) answered the questionnaires and 175 (62.5%) answered to an additional phone interview. Twenty (9.2%) had a PTSD profile and six (2.7%) a PTSD. When a full predictive model of risk factors for PTSD profile was built using logistic regression, maternal prepartum and intrapartum complications, anaesthetic complications and dissociative experiences during C-section were found to be the significant predictors for PTSD profile.ConclusionThis is the first study to show in parturients having a C-section that an anaesthesia complication is an independent risk factor for postpartum PTSD and PTSD profile development, in addition to known perinatal and maternal risk factors.

The risk factors of possible PTSD in individuals exposed to a suicide attack in Turkey

The aims of this study were to determine both the rate of possible PTSD in individuals who were exposed to a suicide attack in Ankara, Turkey, and the factors that relate to the elevated risk for PTSD in individuals who survived that suicide attack. The researchers carried out the study with 93 participants who had attended a meeting held in Ankara on October 10, 2015. Participants completed a sociodemographic information form, the Traumatic Stress Symptom Checklist (TSSC), the Post-Traumatic Cognitions Inventory, the Beck Depression Inventory (BDI), and the Influence of Perceived Societal Attitudes Questionnaire (IPSAQ). Twenty-three of participants were determined to have possible PTSD (24.7%). Participants who were exposed previously to a suicide attack, who witnessed a life-threatening injury, who had the need for psychological help, and who had suicidal thoughts had significantly higher rates of possible PTSD. The IPSAQ, BDI, and TSSC scores were significantly higher in the participants with possible PTSD. The IPSAQ score was found to be related to the development of possible PTSD. This study demonstrated that in participants who had been exposed to a terrorist attack, the negative impact of perceived societal attitudes toward the victims was related to the possible development of PTSD.

PTSD and Depression Among Museum Workers After the March 18 Bardo Museum Terrorist Attack.

On March 18, 2015, two gunmen attacked the Bardo museum in Tunis, Tunisia, killing 23 foreign tourists. We assessed PTSD and depression symptoms 4-6 weeks after the event among museum workers, in relation to sociodemographic factors and social support, and we analysed the determinants and predictor factors of PTSD and depression symptoms among the participants. Our findings indicated that 68.6% of the respondents had posttraumatic stress symptoms above the cutoff point (IER-S scores >33), and 40.6% reported severe levels of depressive symptoms (DASS-depression scores >20). Male and female participants did not significantly differ in terms of their symptom severities. Low social support was the best predictor of PTSD and depression symptoms. Our results suggest that interventions designed to reinforce ties within social networks may be particularly helpful for victims in the aftermath of a terrorist attack.

A Study on the Survey of Post-Traumatic Stress Disorder of Korea Police Officers and Systematic Counter-measures

국회는 2012년 8월 ｢경찰공무원 보건안전 및 복지기본법｣을 제정하였다. 동법의 시행령은 “경찰관의 질병 및 건강에 관한 현황을 조사한 후 PTSD에 대한 건강장애요인을 고려하여 검진대상의 경찰관과 검진항목”을 정하도록 하고 있다. 경찰관은 직무특성상 외상사건에 노출되는 경우가 빈번하여, 잠재적인 외상 후 스트레스장애요인의 위험군으로 분류될 수 있다. 그러나 현재 우리나의 경찰트라우마센터는 4개소 밖에 되지 않는 등 상담인력, 교육, 홍보 등 인프라구축이 미흡하며, 경찰의 조직문화특성으로 인한 정신건강의 잘못된 인식과 오해로 인해 병원에 내원하기를 꺼리고 있다. 본 연구는 이와 같은 문제의식을 가지고, 국내 경찰관 649명을 대상으로 외상사건, 외상 후 스트레스장애, 우울증에 대한 스트레스 점수와 외상사건요인, 그리고 PTSD 위험군과 인구학적 특성과의 상관성을 비교하였다. 연구결과는 다음과 같다. 첫째, 스트레스 점수에서 외상사건의 경험유무와 횟수보다는 외상사건 요인에 따라 그 점수가 높게 나타났다. 이를테면, “동료의 부상 및 사망”, “다수의 사상자가 발생한 교통사고”, “신체가 상당히 훼손된 살인사건”, “영유아사건” 등과 같은 요인으로 높은 점수가 나타나고 있었다. 둘째, 외상사건 혹은 외상 후 스트레스장애의 위험군은 PCL, IES-R-K, PHQ-9의 3가지 유형의 검사를 하여 고위험, 저위험, 일반군으로 분류하였는데 각각의 유형은 다양한 인구학적 특성과 상관성이 있는 것으로 나타났다. 특히 경찰관의 기능에 따른 차이는 IES-R-K와 PHQ-9에서 공통적인 특성으로 나타났다. 이와 같은 결과는 외상사건 혹은 외상 후 스트레스장애와 우울증 간의 상관성이 있는 것으로 해석되어 경찰관 기능 중 생활안전, 수사, 형사업무 순으로 위험군이 나타났다. 이와 같은 연구결과를 기초자료로 하여, 경찰조직은 경찰관의 외상 후 스트레스장애의 외부요인, 다양한 특성을 고려한 위험군 분류 등을 활용하여 정책수립을 고려할 필요가 있다.Congress made law ｢FRAMEWORK ACT ON HEALTH, SAFETY, AND WELFARE OF POLICE OFFICERS｣at Aug, 2012. This decree provides that Mental health checkups shall be conducted for police officials suspected of having a mental condition, such as post-traumatic stress disorder. In such cases, the Commissioner General of the Korean National Police Agency may entrust diagnosis of mental health conditions of police officials to a private institution specializing in psychological counselling, if necessary in order to determine persons subject to mental health checkups. Because Police officers mainly faced to traumatic events due to the nature of their jobs they belong to potential risk group in post-traumatic stress disorder. But Korea National Police Agency have only 4 police trauma centers and fall short of having professional counselors, education, public relation of mental health. Moreover the police officer of korea do not want to check their mental health because of police subculture. This study, taking problematic points, analyze traumatic events, PTSD, PCL, IES-R-K, PHQ-9 and correlation between potential risk group in post-traumatic stress disorder and social and demographic characteristics of 649 police officers. This study shows: First, stress scores shows high in traumatic events factor more than the existence of traumatic events experience and counts. For example, “injury or death of colleague”, “accidents which have heavy casualties”, “murder case was dead body was ruined”, “ infants and children case” factors get a high score. Second, traumatic events and PTSD risk groups were classified under 3 heads as high risk, low risk, general group(estimated prevalence) by testing PCL, IES-R-K, PHQ-9 types and each type has a correlation with social and demographic characteristics. These results can be understood that there are correlation with traumatic events, PTSD and tristimania. Therefore Korea National Police Agency need to make a mental health plan using factors of PTSD and results of estimated prevalence for police officers.

Do gender and directness of trauma exposure moderate PTSD's latent structure?

The PTSD diagnosis and latent structure were substantially revised in the transition from DSM-IV to DSM-5. However, three alternative models (i.e., anhedonia model, externalizing behavior model, and hybrid model) of PTSD fit the DSM-5 symptom criteria better than the DSM-5 factor model. Thus, the psychometric performance of the DSM-5 and alternative models' PTSD factor structure needs to be critically evaluated. The current study examined whether gender or trauma directness (i.e., direct or indirect trauma exposure) moderates the PTSD latent structure when using the DSM-5 or alternative models. Model performance was evaluated with measurement invariance testing procedures on a large undergraduate sample (n=455). Gender and trauma directness moderated the DSM-5 PTSD and externalizing behavior model and did not moderate the anhedonia and hybrid models' latent structure. Clinical implications and directions for future research are discussed.

Mechanisms of estrogen-dependent regulation of ADCYAP1R1, a risk factor for PTSD

The study provides an overview of coastal erosion of northern Sardinia, indicating the causes and the effects of the most relevant and identifies critical areas to the possible scenarios of extreme events. The knowledge of the state of natural balance of the coasts is essential for planning and protection in the medium-long term and requires careful evaluation of the risks and potential dangers, obtainable through geomorphological, sedimentological and meteomarine data interpretation, and degree and the human settlement type. Many of sardinians waterways are torrential and have poor solids discharges due to existence of the dams, was 393 (56 large reservoirs and 336 small reservoirs) that remove sediment to natural beach nourishment. It is enough to calculate the volume of sediment trapped from the reservoir to have a phenomenon dimension, total 4,372,933.5 m3 for Cedrino in use from 1989 to 1,085,700.0 m3 for Cixerri in activity since 1992 and 2498.226,2 m3 for Bidighinzu in use since 1959. An interference with such significant contributions to the sea involves a sedimentary deficit in the system which leads to an inevitable retreat of shorelines. For the evaluation of the areas with greater sensitivity and vulnerability, it is over considered the human load resulting from the infrastructure presence and activities along the coast and next to the river banks. It has also been decided through a questionnaire meant to assess the value of an environmental asset (in this case a stretch of coastline) which is understood as a “sense of well received” by the people, because it has become clear that the remediation or enhancement cannot be delegated to a mere technical-scientific approach but there has to be shared with the community. The integrated analysis of these factors helped to identify critical situations and vulnerabilities along the coasts of Northern Sardinia that led to the mapping of areas at risk.

Prevalence and risk factors of posttraumatic stress disorder among teachers 3 months after the Lushan earthquake: A cross-sectional study.

Teachers and students often suffer from the same disaster. The prevalence of PTSD in students has been given great attention. However, in acting as mentors to students and their families, teachers are more likely to have vicarious and indirect exposure via hearing stories of their aftermath and witnessing the consequences of traumatic events. There are limited data pertaining to the prevalence of PTSD and its risk factors among teachers. A total of 316 teachers from 21 primary and secondary schools in Baoxing County were administered a project-developed questionnaire which included the items regarding demographic characteristics, earthquake-related experiences, somatic discomforts, emotional reactions, support status, and everyday functioning 2 weeks after the Lushan earthquake, and they finished a 1-to-1 telephone interview for addressing the PTSD criteria of the Mini International Neuropsychiatric Interview (MINI) 3 months after the earthquake. The prevalence of PTSD was 24.4% among teachers. Somatic discomforts (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.06–3.37) were positive risk factors of PTSD. Perceived social support (OR 0.30, 95% CI 0.14–0.62) and being able to calm down (OR 0.25, 95% CI 0.09–0.75) in teaching were negative risk factors. PTSD is commonly seen among teachers after an earthquake, and risk factors of PTSD were identified. These findings may help those providing psychological health programs to find the teachers who are at high risk of PTSD in schools after an earthquake in China.

Anxiety Sensitivity Prospectively Predicts Posttraumatic Stress Symptoms Following a Campus Shooting

Anxiety sensitivity (AS), the feared consequences of anxious arousal, is known to be related to posttraumatic stress symptoms (PTSS) concurrently and longitudinally. However, no studies have demonstrated whether AS prior to a Criterion A traumatic event predicts later PTSS. The present study evaluated whether preshooting AS predicted PTSS following a campus shooting, as well as whether preshooting AS interacted with shooting exposure to predict PTSS. Participants comprised undergraduates (N=71) who completed a self-report battery upon enrolling in Introductory Psychology. After a campus shooting later in the semester, they were invited to complete measures of PTSS and level of exposure to the shooting. Preshooting levels of AS significantly predicted PTSS after the shooting. This effect was qualified by a significant AS by shooting exposure interaction, such that those with high AS who were exposed to the shooting reported the greatest levels of PTSS. Though all three of the preshooting physical, cognitive, and social AS subfactors demonstrated main effects significantly predicting postshooting PTSS, only AS physical concerns significantly interacted with shooting exposure. The implications of this study concerning AS as a causal risk factor for PTSD are discussed.

Childhood physical punishment as risk factor for combat-related PTSD

IntroductionRisk and protective factors for PTSD can be grouped into pretraumatic, peritraumatic, and posttraumatic. Reported childhood abuse has predictive risk effects for PTSD than most other pretraumatic risk factors.ObjectiveTo examine childhood physical abuse history in war veterans.AimsTo determine whether childhood physical abuse is risk factor for PTSD in war veterans.MethodsCross-sectional study of 205 war veterans tested by Harvard Trauma Questionnaire and sociobiographic Questionnaire (with data of childhood physical punishment).ResultsA significant difference in reported childhood physical punishment between war veterans with and without PTSD was found. Veterans with PTSD were identified as recipients of childhood physical punishment.ConclusionsChildhood physical punishment has positive correlation with development of PTSD in war veterans.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Supplemental Material for An Application of an Ecological Framework to Understand Risk Factors of PTSD Due to Prolonged Conflict Exposure: Israeli and Palestinian Adolescents in the Line of Fire

Supplemental Material for An Application of an Ecological Framework to Understand Risk Factors of PTSD Due to Prolonged Conflict Exposure: Israeli and Palestinian Adolescents in the Line of Fire

The prevalence and risk factors of Post-Traumatic Stress Disorder among workers injured in Rana Plaza building collapse in Bangladesh.

Prevalence and risk factors of PTSD among injured garment workers who survived a major factory collapse. Survivors receiving treatment or rehabilitation care at one year post event were surveyed, which included Post Traumatic Stress Disorder Checklist Specific version. The respondents consisted of 181 people with a mean age of 27.8 years and a majority had less than high school education (91.2%). Multivariable logistic regression found that the odds of having PTSD was higher among married (OR: 3.2 [95% CI: 1.3-8.0]), those who used to work more than 70 hr/week (OR: 2.4 [1.1-5.3]), workers who used to hold higher job positions (OR: 2.6 [1.2-5.6]) or who had a concussion injury (OR: 3.7 [1.4-9.8]). Among the respondents, 83.4% remained unemployed, and only 57.3% (63 people) reported receiving a quarter or less of what they were promised as compensation. Probable PTSD was prevalent among surviving workers of the Rana Plaza building collapse in Bangladesh.

Protective role of coping flexibility in PTSD and depressive symptoms following trauma

The aim of the study was to examine whether coping flexibility would function as a protective factor for PTSD and depressive symptoms in trauma-exposed adults in Korea. A total of 510 adults with a lifetime history of traumatic events completed the Perceived Ability to Cope with Trauma (PACT), the Korea version of the Posttraumatic Stress Diagnostic Scale (PDS-K), and the Patient Health Questionnaire (PHQ-9). Hierarchical regression indicated that coping flexibility was associated with a reduced level of PTSD or depressive symptoms after controlling for comorbid symptoms, age, and elapsed time since the most distressing traumatic event. The interaction of traumatic events and coping flexibility was significant only on PTSD symptom severity but not on depressive symptom severity. Specifically, individuals with low coping flexibility reported higher levels of PTSD symptoms as the number of traumatic events increased. These findings supported the hypothesis that coping flexibility is a protective factor for PTSD and depression following trauma, and lack of coping flexibility may aggravate the risk for PTSD among people with multiple trauma.

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

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.

Structural relations between DSM-5 PTSD and major depression symptoms in military soldiers

BackgroundPosttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are frequently comorbid. One explanation for this comorbidity is that PTSD has a constellation of “dysphoria” symptoms resembling depression. MethodUsing confirmatory factor analysis we tested the role of DSM-5 PTSD׳s dysphoria factor in relation to MDD symptom dimensions of somatic and non-somatic psychopathology. 672 Ohio National Guard soldiers completed DSM-5 measures of PTSD and MDD symptoms in an epidemiological study. ResultsResults indicated that in contrast to other PTSD factors, PTSD׳s dysphoria factor was more related to MDD׳s somatic and non-somatic factors. LimitationsLimitations include generalizability to the epidemiological population of trauma-exposed military veterans rather than civilians, and reliance on self-report measures. ConclusionsImplications concerning clinical psychopathology and comorbidity of PTSD are discussed, including whether PTSD should be refined by removing its non-specific symptoms.

Post-traumatic Stress Symptoms in a Violently Injured Civilian Population: A Need for Hospital Identification and Resources

ABSTRACT Background Post-traumatic stress disorder (PTSD) has become a recognized healthcare crisis. Urban trauma centers (UTC) treat a high rate of violently injured patients, a known risk factor for PTSD. A quality improvement (QI) project related to PTSD was implemented to assess the prevalence of PTSD symptomology post-discharge and the need for inpatient screening and referral. Study design In 2013, 3,525 patients were admitted to a UTC, of which 560 suffered a violent injury. One hundred and twentysix (23%) were provided PTSD education and offered resources for mental health treatment (MHT). Patients in police custody, with self-inflicted injuries, with injuries related to domestic violence, or who were non-English speaking were not included in the QI analysis (37%). At 4 to 6 weeks post-discharge, patients were contacted and administered a four item PTSD screening tool. Referral to MHT was offered and provided if requested. Results One hundred and twenty-six patients were evaluated. Sixty-four (51%) patients were reached at 4 to 6 weeks postdischarge and 60 (48%) completed the full 4-item tool. Fifty (78%) had GSW, 7 (11%) had stab wounds, and 7 (11%) had assault. Sixty-two percent reported experiencing at least one major symptom of PTSD, and 52% experienced >2 major symptoms. Eighty-seven percent of patients who developed symptoms of PTSD refused referrals pre-discharge. Post-discharge, patients with at least one PTSD symptom (37) requested MHT at a significantly higher rate than those without symptoms (23; p = < 0.0001). Patients with 3 to 4 symptoms requested referral information at a higher rate than those with 0 to 2 symptoms (p ≤0.0001). Conclusion Violently injured patients are at risk for the development of PTSD symptoms post-discharge. Trauma centers have a unique opportunity to implement PTSD screening, referral and post-discharge follow-up to effect change for this at-risk population. How to cite this article Jordan A, Goldberg S, Bivins J, Hogue B, Wolfe L, Aboutanos MB. Post-traumatic Stress Symptoms in a Violently Injured Civilian Population: A Need for Hospital Identification and Resources. Panam J Trauma Crit Care Emerg Surg 2015;4(2):54-58.

Long-term outcomes among child and adolescent survivors of the 2010 Haitian earthquake.

We examined the prevalence and predictive factors of PTSD and depression in relation with peritraumatic distress, trauma exposure, and sociodemographic characteristics among children and adolescent who survived the 2010 Haiti's earthquake. We analyzed data collected between June and July 2012 from a sample of 872 participants aged 7 to 17 in 12 schools, door-to-door canvassing and two centers for street children at Port-au-Prince. Participants completed the Impact of Event Scale Revised (IES-R), Peritraumatic Distress Inventory, Child Depression Inventory 2 (CDI), and sociodemographic and traumatic exposure questionnaires. Of 872 participants, respectively 322 (36.93%); and 403 (46.21%) reported a clinically significant symptoms of PTSD and depression, which were significantly higher among girls. The best predictive variables are peritraumatic distress for PTSD (β=0.53,P<.0001) a traumatic exposure for depression (β=0.23,P<.0001). The comorbidity between PTSD and depression symptoms is 22.25%. This first study in children on the prevalence of PTSD and depression resulting from the 2010 Haiti earthquake demonstrates a need for improvement in treatment aimed at reducing PTSD and depression. Such treatment should be geared primarily toward girls, adolescents between the ages of 14 and 17 and those children and adolescents who have lost a family member in the earthquake.

Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adults survivors of earthquake in Haiti after 30 months

BackgroundOn January 12, 2010, a powerful 7.0 magnitude earthquake struck the Republic of Haiti and destroyed Port-au-Prince, the capital and others cities across the country. While some studies have examined the long-term traumatic effects of the seismic event on children and adolescents victims, so far no study has examined the consequences on adults generally. As such, this study aims to investigate the traumatic consequences of the earthquake among adults related to degree of exposure, peritraumatic distress, depressive symptoms and sociodemographic factors two and a half years after. In addition, predictive factors of PTSD and depressive symptoms were also identified. MethodsFrom June to July 2012, a total of 1355 adults (660 women) was assessed by means the traumatic exposure questionnaire, the Life Events Checklist subscale, the Peritraumatic Distress Inventory (PDI), the Impact of Event Scale – Revised (IES-R) and the Beck Depression Inventory (BDI), in addition to social demographic characteristics. ResultsThe prevalence rates of PTSD and depressive symptoms were 36.75% (498 cases) and 25.98% (352 cases) respectively. The risk factors for PTSD and depressive symptoms were young and old age, female gender, unemployed status and low level of education. The bests predictives variables were peritraumatic distress for PTSD (β=.57, p<.0001) and for depressive symptoms (β=.21, p<.0001). The commorbidity between PTSD and depression was 13.36%. ConclusionsThis study found that psychological symptoms are frequent event 30 months after the earthquake. The different mental health care providers, the public health ministry, NGOs working on the ground in Haiti should design programmes in order to aid the psychological wellbeing of the population focussing on youth, older and retired adults, females, people with low levels of education and those who do not work.

Relations Between PTSD and Distress Dimensions in an Indian Child/Adolescent Sample Following the 2008 Mumbai Terrorist Attacks

Posttraumatic stress disorder's (PTSD) four-factor dysphoria model has substantial empirical support (reviewed in Elhai & Palmieri, Journal of Anxiety Disorders, 25, 849-854, 2011; Yufik & Simms, Journal of Abnormal Psychology, 119, 764-776, 2010). However, debatable is whether the model's dysphoria factor adequately captures all of PTSD's emotional distress (e.g., Marshall et al., Journal of Abnormal Psychology, 119(1), 126-135, 2010), which is relevant to understanding the assessment and psychopathology of PTSD. Thus, the present study assessed the factor-level relationship between PTSD and emotional distress in 818 children/adolescents attending school in the vicinity of the 2008 Mumbai terrorist attacks. The effective sample had a mean age of 12.85 years (SD = 1.33), with the majority being male (n = 435, 53.8 %). PTSD and emotional distress were measured by the UCLA PTSD Reaction Index (PTSD-RI) and Brief Symptom Inventory-18 (BSI-18) respectively. Confirmatory factor analyses (CFA) assessed the PTSD and BSI-18 model fit; Wald tests assessed hypothesized PTSD-distress latent-level relations; and invariance testing examined PTSD-distress parameter differences using age, gender and direct exposure as moderators. There were no moderating effects for the PTSD-distress structural parameters. BSI-18's depression and somatization factors related more to PTSD's dysphoria than PTSD's avoidance factor. The results emphasize assessing for specificity and distress variance of PTSD factors on a continuum, rather than assuming dysphoria factor's complete accountability for PTSD's inherent distress. Additionally, PTSD's dysphoria factor related more to BSI-18's depression than BSI-18's anxiety/somatization factors; this may explain PTSD's comorbidity mechanism with depressive disorders.

Reduction of cognitive concerns of anxiety sensitivity is uniquely associated with reduction of PTSD and depressive symptoms: A comparison of civilians and veterans

PTSD and comorbid depression are common among civilians and veterans, resulting in substantial impairment. Anxiety sensitivity (AS) may be a common malleable vulnerability factor for PTSD and depression. The AS cognitive concerns subscale is most strongly related to symptoms of PTSD and depression, and thus, may be an efficient route to reduce these symptoms. The current study evaluated a brief computerized intervention targeting AS cognitive concerns. Specifically, we evaluated whether reduction in AS cognitive concerns was associated with reduction in symptoms of PTSD and depression. Also, we evaluated whether there was a significant difference between civilians and veterans in response to the intervention. The single session intervention utilized psychoeducation and interoceptive exposure to target AS cognitive concerns. This intervention was compared to a health information condition among a sex-matched sample of civilians and veterans with elevated AS cognitive concerns (N = 56). Reduction in AS cognitive concerns over one month was uniquely associated with reduction in PTSD and depressive symptoms in the same time frame. There were no significant differences between civilians and veterans in response to the intervention suggesting the intervention has efficacy for both groups. Treatment implications are discussed.

Longitudinal course of anxiety sensitivity and PTSD symptoms in cognitive-behavioral therapies for PTSD

Anxiety sensitivity (AS) has been conceptualized as trait-like vulnerability and maintenance factor for PTSD. Although recent literature has demonstrated its malleability during treatment, few have examined its influence on and effect from PTSD treatment. Using multilevel regression analyses we examined: (a) changes in AS during treatment and (b) whether pre-treatment AS predicted PTSD treatment response, in sample of female victims of interpersonal trauma receiving one of three treatments (cognitive processing therapy, cognitive processing therapy-cognitive, and written accounts). Participants exhibited reductions in total ASI scores from pre- to post-treatment. Growth curve modeling revealed slightly different trajectories of PTSD symptoms as a function of pre-treatment AS, and overall decreases in PTSD symptoms during treatment were not associated with pretreatment AS. Pretreatment AS dimensions impacted PTSD total scores and symptoms clusters differentially. Clinical and theoretical implications for these results are discussed.