Impact Of Posttraumatic Stress Disorder Research Articles

Impact of Posttraumatic Stress Disorder and Depression on Neuropsychological Functioning in Electrical Injury Survivors

To examine neuropsychological functioning in survivors of electrical injury with posttraumatic stress disorder (PTSD) and depression. This was a prospective research study that was done in an outpatient clinic of a rehabilitation hospital. Thirty participants were recruited for the study between January 2008 and December 2010. All participants completed questionnaires measuring depression, PTSD, and a series of standardized psychometric measures of neuropsychological functioning. Domains tested included verbal and visual memory, attention, and executive functioning. A correlation analysis was performed to explore association between variables. Based on the level of PTSD symptoms, subjects were divided into three groups: no PTSD, subclinical PTSD, and PTSD, and a series of one-way analyses of variance were done to explore this association further. A series of analyses of covariance were done to control for depression. PTSD had a significant (P < .05) negative association with immediate verbal memory and immediate and delayed visual memory. Subjects with PTSD had significantly (P < .05) worse scores on immediate and delayed verbal memory and visual memory than those with subclinical PTSD or no PTSD. Measures of attention, working memory, and executive functioning were not significantly different between PTSD groups. When depression was introduced as a covariate, verbal and visual memory scores were not significantly different between PTSD groups. The findings suggest that there is a negative association between PTSD and cognitive performance that may be related to depression among those with electrical injury. A larger sample size is warranted to explore this further.

The Impact of Posttraumatic Stress Disorder on CPAP Adherence in Patients with Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common comorbid condition in patients with posttraumatic stress disorder (PTSD); insufficiently treated OSA may adversely impact outcomes. Sleep fragmentation and insomnia are common in PTSD and may impair CPAP adherence. We sought to determine the impact of combat-related PTSD on CPAP adherence in soldiers. Retrospective case-control study. Objective measures of CPAP use were compared between OSA patients with and without PTSD. Groups were matched for age, BMI, and apnea-hypopnea index (AHI). We included 90 patients (45 Control, 45 PTSD). Among the cohort, mean age was 39.9 ± 11.2, mean BMI 27.9 ± 8.0, mean ESS 13.6 ± 5.7, and mean AHI 28.2 ± 22.4. There was a trend towards a higher rate of comorbid insomnia among patients with PTSD (25.8% vs. 11.1%, p = 0.10). PTSD was associated with significantly less use of CPAP. Specifically, CPAP was used on 61.4% ± 22.2% of nights in PTSD patients compared with 76.8% ± 16.4% in patients without PTSD (p = 0.001). Mean nightly use of CPAP was 3.4 ± 1.2 h in the PTSD group compared with 4.7 ± 2.2 h among controls (p < 0.001). Regular use of CPAP (> 4 h per night for > 70% of nights) was also lower among PTSD patients (25.2% vs. 58.3%, p = 0.01). Among soldiers with OSA, comorbid PTSD was associated with significantly decreased CPAP adherence. Given the potential for adverse clinical outcomes, resolution of poor sleep quality should be prioritized in the treatment of PTSD and potential barriers to CPAP adherence should be overcome in patients with comorbid OSA.

Impact of posttraumatic stress disorder on sinonasal symptoms and quality of life in patients with chronic rhinosinusitis

BackgroundSeverity of chronic rhinosinusitis (CRS), measured by disease-specific health-related quality-of-life questionnaires, is expected to increase in patients who also suffer from posttraumatic stress disorder (PTSD). Altered pain perception, sleep disorders, and fatigue may be associated with this comorbidity.MethodsSeverity of CRS was compared between a group of 28 patients with CRS and a group of 28 patients with CRS and concomitant PTSD using different disease-specific and generic instruments, such as visual analog scale (VAS), Short Form-36 test (SF-36), and Sino-Nasal Outcome Test-22 (SNOT 22).ResultsSNOT-22 test showed significantly higher CRS severity in patients with CRS and PTSD, compared to patients with CRS without PTSD.ConclusionPatients with less severe CRS, measured by objective outcome measures, due to the impact of comorbid PTSP, are classified as having severe rhinosinusitis, and are exposed to the risk of unnecessary diagnostic and therapeutic procedures. In patients with difficult-to-treat rhinosinusitis, diagnosis should be revised, and one item that should be evaluated is whether they suffer from PTSD.

Impact of posttraumatic stress disorder on the relationship quality and psychological distress of intimate partners: A meta-analytic review.

The authors conducted a meta-analysis of the literature on associations between trauma survivors' PTSD symptoms and the (a) relationship quality and (b) psychological distress of intimate partners. Results yielded a small combined effect size (r = -.24) for the association between PTSD and partners' perceived relationship quality. Gender and military status moderated this association with a larger effect size for female partners of male trauma survivors than for male partners of female trauma survivors and a larger effect size for military samples than for civilians. The effect size of the association between PTSD and partners' psychological distress was moderate in magnitude (r = .30). Analysis of hypothesized moderators indicated this association was stronger among military than civilian samples. The association was also stronger among samples of survivors who experienced traumatic events in the more distant past compared with those who experienced more recent events. Results support the systemic impact of one family member's PTSD symptoms and highlight areas for future research.

Impact of Posttraumatic Stress Disorder and Injury Severity on Recovery in Children with Traumatic Brain Injury

The adverse impact on recovery of posttraumatic stress disorder (PTSD) in mild traumatic brain injury (TBI) has been demonstrated in returned veterans. The study assessed this effect in children's health outcomes following TBI and extended previous work by including a full range of TBI severity, and improved assessment of PTSD within a longitudinal design. There were 205 children and adolescents (6 to 15 years of age) who experienced a TBI that were assessed at 2, 3, 6, 12, and 18 months following the TBI. Severity of TBI was classified as mild, moderate, or severe. After controlling for the impact of the severity of TBI, premorbid behavioral and emotional problems and executive function, children with TBI and PTSD did not experience as much psychosocial recovery as those without PTSD. Furthermore the level of psychosocial function was no better than that experienced by children with a severe TBI. In contrast, severe TBI was predictive of a poorer physical recovery in the first 6 months, after which recovery was equivalent across all severity levels.

The Impact of Posttraumatic Stress Disorder on Clinical Outcomes in Patients with Schizophrenia

ResultsZZThirty three patients (94.2%) had at least one trauma and average 3.9 traumatic events in their life time. There were 12 patients (34.3%) who were diagnosed with PTSD. There were no differences of sociodemographic, duration of illness, number of admission, and duration of admission between the PTSD and non-PTSD groups. After one year treatment, the non-PTSD group had significantly improved in PANSS positive, negative, and general psychopathology scale. How ever, the PTSD group demonstrated no significant changes in PANSS negative and general psy chopathology scale. ConclusionZZIn this study, there were high rate of prevalence of trauma and PTSD in patients with schizophrenia. PTSD had negative effects on clinical outcomes in patients with schizophrenia. Careful trauma-focused approach is necessary within this population. J Korean Neuropsychiatr Assoc 2012;51:249-254 KEY WORDSZZSchizophrenia · Psychological trauma · Posttraumatic stressdisorder ·

The Impact of Posttraumatic Stress Disorder on Continuous Positive Airway Pressure Adherence in Patients With Comorbid OSA

PURPOSE: Therapeutic adherence is frequently poor among patients with posttraumatic stress disorder (PTSD). OSA is common in patients with PTSD and inadequately treated OSA may adversely impact outcomes. The treatment for OSA is continuous positive airway pressure (CPAP), and achieving compliance is often challenging. The poor sleep quality, including initiation insomnia and sleep fragmentation, common among patients with PTSD, may impair CPAP adherence. We sought to determine the impact of PTSD on CPAP adherence.

Poster 140 Electrical Injury and PTSD: A Deficit in Delayed Recall

To examine the impact of posttraumatic stress disorder (PTSD) symptoms on neuropsychological functioning in electrical injury (EI) patients.

Late-Life Health Consequences of Exposure to Trauma in a General Elderly Population

A history of trauma is associated with poor mental and physical health, but the specific impact of posttraumatic stress disorder (PTSD) symptoms on physical health using objective indicators of health status has rarely been evaluated in elderly civilians. This study investigates the long-term consequences of a lifetime exposure to trauma on health in a French elderly general population. Data from this retrospective study were derived from a longitudinal study (the Enquête de Santé Psychologique-Risques, Incidence et Traitement [ESPRIT]) of community-dwelling participants. Psychiatric health, medical history, and clinical examination (ICD-10 criteria) were assessed in 1,662 subjects (mean [SD] age = 72.5 [5.2] years). Lifetime traumatic exposure, PTSD, and psychiatric diagnoses were obtained using the Watson PTSD Inventory and the Mini-International Neuropsychiatric Interview. The outcome measures used were the Mini-International Neuropsychiatric Interview, Center for Epidemiologic Studies Depression Scale, Mini-Mental State Examination, and measures of physical health. We observed an increase in the number and severity of health-related outcomes between groups, with nontraumatized subjects having the lowest risk and those with trauma leading to recurrent reexperiencing of events (nonresilient subjects) having the highest risk. Traumatized persons who did not report reexperiencing symptoms (resilient subjects) showed better current mental health than traumatized subjects who did and nontraumatized subjects. Nonresilient subjects were more likely to have current depressive symptoms (P = .003), current major depression (P < .0001), current anxiety disorder (P = .032), and psychiatric comorbidity (P = .002) than nontraumatized subjects. Resilient subjects differed from nontraumatized subjects in having significantly less current suicidal ideation (P = .054) and psychiatric comorbidity (P = .035). Both groups of traumatized subjects showed a higher rate of cardio-ischemic diseases, notably current angina pectoris (multivariate, adjusted OR = 2.27; 95% CI, 1.31-3.91; and OR = 2.34; 95% CI, 1.22-4.49; for resilient and nonresilient groups, respectively). Traumatized persons, specifically those nonresilient, showed a higher waist-hip ratio, higher triglyceride levels, and a greater frequency of hypertension. Our findings suggest that trauma could be associated with cardio-ischemic diseases independently of PTSD symptoms expression. However, the presence of these symptoms appears associated with additional metabolic risk factors.

Pathological Gambling and Posttraumatic Stress Disorder: A Study of the Co-Morbidity versus Each Alone

This report is the first empirical study to compare pathological gambling (PG), posttraumatic stress disorder (PTSD), and their co-occurrence. The sample was 106 adults recruited from the community (35 with current PG; 36 with current PTSD, and 35 with BOTH). Using a cross-sectional design, the three groups were rigorously diagnosed and compared on various measures including sociodemographics, psychopathology (e.g., dissociation, suicidality, comorbid Axis I and II disorders), functioning, cognition, life history, and severity of gambling and PTSD. Overall, the PG group reported better psychological health and higher functioning than PTSD or BOTH; and there were virtually no differences between PTSD and BOTH. This suggests that it is the impact of PTSD, rather than comorbidity per se, that appears to drive a substantial increase in symptoms. We also found high rates of additional co-occurring disorders and suicidality in PTSD and BOTH, which warrants further clinical attention. Across the total sample, many reported a family history of substance use disorder (59%) and gambling problems (34%), highlighting the intergenerational impact of these. We also found notable subthreshold PTSD and gambling symptoms even among those not diagnosed with the disorders, suggesting a need for preventive care. Dissociation measures had mixed results. Discussion includes methodology considerations and future research areas.

Comorbilidad del trastorno por estrés postraumático en pacientes con trastorno mental grave. Implicaciones clínicas

Posttraumatic stress disorder (PTSD) appears by comorbid severe mental illness (SMI) in 16%–48% of cases, higher than in the general population (7.8% to 9.2%). Although these patients with severe primary psychiatric diagnosis of PTSD is often missed. Several etiopathogenic hypotheses could explain the high prevalence of PTSD in patients with SMI: diathesis trauma itself, a high risk of exposure to trauma, genetic predisposition to psychosis in a group of patients with PTSD and antidopaminergic effect of treatment itself. The impact of PTSD in patients with SMI is well documented in the literature. PTSD patients with more severe psychiatric symptoms, more alcohol use disorders and other substances, have a greater number of visits and psychiatric hospitalizations, lower work integration, poorer adherence to drug treatment, more risk behaviours, suicide attempts and self-harm, and poorer cognitive function. Antidepressants especially selective serotonin reuptake of serotonin and cognitive behavioral therapy would be the treatments of choice in PTSD. Recent studies indicate that cognitive behavioral therapy may also be useful in post-traumatic symptoms of patients with SMI. In clinical practice it is advisable to systematically perform an assessment of the traumas and investigate the existence of PTSD symptoms in clinical interviews.

Posttraumatic stress disorder in convalescent severe acute respiratory syndrome patients: a 4-year follow-up study

Objective To measure the incidence and impact of posttraumatic stress disorder (PTSD) in a cohort of 70 subjects with severe acute respiratory syndrome (SARS). Methods Clinical assessments of PTSD were conducted at 2, 7, 10, 20 and 46 months after discharge from medical hospitalization for treatment of SARS. Diagnoses of PTSD were established by a trained psychiatrist using the Chinese Classification of Mental Disorders ( CCMD-III) and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition ( DSM-IV) criteria. To study the impact of PTSD, we used the Impact of Event Scale (IES), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), Symptom Checklist 90 (SCL-90), Short Form-36 (SF-36 Health Survey) and Social Disability Screening Schedule (SDSS). Results Of the 68 subjects who finished at least two follow-up interviews, 30 developed PTSD over the study period (44.1%). Scores on IES, SAS, SDS and SCL-90 ( P<.0001) were higher, and functional impairment as measured by SF-36 ( P<.0001) and SDSS was more severe ( P=.0073) for subjects with PTSD. Conclusion PTSD occurs in a significant percentage of subjects who recover from SARS, and the occurrence of PTSD predicts persistent psychological distress and diminished social functioning in the 4 years after SARS treatment.

Posttraumatic stress disorder and health functioning in a non-treatment-seeking sample of Iraq war veterans: A prospective analysis

To evaluate the impact of posttraumatic stress disorder (PTSD) on health-related functioning, we assessed 800 U.S. Army soldiers before and after 1-year military deployments to Iraq. As part of the Neurocognition Deployment Health Study procedures, each soldier completed at both time points self-report indexes of PTSD symptom severity, health behaviors (smoking, alcohol use), and somatic health-related functioning. Participants also completed a health-symptom checklist at the postdeployment assessment. Structural equation modeling revealed that postdeployment PTSD severity was associated with change in somatic health-related functioning, with postdeployment health symptoms as an intermediary variable. These relationships were independent of health risk behaviors, which had little association with somatic symptoms or PTSD. Our findings highlight the functional impact of PTSD, which extends beyond psychological symptoms to health-related daily functioning.

The impact of posttraumatic stress disorder on impairment in the UK military at the time of the Iraq war

The aims of this study were to assess: (1) the relationship between PTSD and impairment, (2) whether there is a threshold in the association of PTSD score and impairment, and (3) whether any of the PTSD criteria are more strongly associated with impairment. We studied 10,069 service personnel from a representative sample of the British Armed Forces to assess the effects of the Iraq war. Participants completed the PTSD checklist (PCL), the general health questionnaire-12 (GHQ-12), the alcohol use disorder identification test (AUDIT) and five questions to assess impairment. 78% of those with a PCL-score of 50 or more endorsed at least one impairment item in comparison to 27% of those with a score below 50. The odds ratio (OR) of impairment in the PCL group with a score of 50 or more was 16.7 (95% CI 12.9–21.6). There was an increasing risk of impairment with an increasing category of PCL-score without a noticeable threshold. For each PTSD subscale: intrusiveness, avoidance/numbing and hyper-arousal, divided into four score categories, there was an increased association with impairment, but the association of avoidance/numbing with impairment was the greatest and independent of the other two criteria (OR 7.2 (95% CI 4.8–10.9). Having a good relationship with a partner had minimal effect on the level of association between PTSD and impairment. Functional impairment is a serious problem for those with PTSD. The impairment is not confined to those with the highest PCL-score. Avoidance/numbing is the criterion which makes the greatest independent contribution to impairment

Impact of Posttraumatic Stress Disorder on early smoking lapse and relapse during a self-guided quit attempt among community-recruited daily smokers

The present investigation examined whether daily smokers with posttraumatic stress disorder (PTSD), as compared to daily smokers with either anxiety psychopathology or no current Axis I psychopathology, have decreased success in the early phases of a self-guided smoking quit attempt. Participants were 140 daily smokers (81 women; M (age) = 29.5; SD = 11.9; range = 18-65 years); approximately one-third of the sample met criteria for current PTSD (n = 47), one-third met criteria for other current anxiety disorders (without PTSD; n = 33), and one-third did not meet criteria for any current Axis I disorder (n = 60). Consistent with prediction, membership in the PTSD group, compared to membership in the other anxiety disorders group and the group with no current Axis I psychopathology, was associated with increased risk of lapse during the first week following quit day. Additionally, daily smokers with PTSD and other anxiety disorders were at significantly increased risk of relapse during the first week post-cessation compared to persons without Axis I psychopathology. However, the PTSD group and the other anxiety disorders group did not differ from one another in terms of relapse. Results suggest that PTSD is associated with increased risk of smoking lapse and relapse compared to smokers with no current Axis I psychiatric problems, and increased risk of early smoking lapse but not relapse, as compared to those with other anxiety disorders. Findings provide novel evidence that PTSD, and perhaps anxiety disorders more generally, may be important factors in reducing the odds of successful unaided quit attempts in the early phases of cessation.

PTSD Compromises Battered Women's Future Safety

Intimate partner violence continues to be a social crisis that results in a complex array of physical and mental health problems. Although resources to counteract the effects of the violence are sometimes available, the posttrauma sequelae may prevent access by those in need. Using the Chicago Women's Health Risk Study, a naturalistic longitudinal study of 320 abused women, the current study examined the impact of posttraumatic stress disorder (PTSD) and depression on battered women's safety at follow-up. Participants completed both a baseline and follow-up interview, including data on abuse experiences. Results suggest symptoms of PTSD predict severity of violence at follow-up over the impact of help-seeking behaviors, perceived helpfulness of these behaviors, and social support. Implications of results are discussed.

Update on Heroin Dependence Research

Mills, K. L., Teeson, M., Ross, J., & Darke, S. (2007). The impact of post-traumatic stress disorder on treatment outcomes for heroin dependence. Addiction, 102(3), 447–454.This study was part of t...

Year in review 2007: Critical Care – intensive care unit management

With the development of new technologies and drugs, health care is becoming increasisngly complex and expensive. Governments and health care providers around the world devote a large proportion of their budgets to maintaining quality of care. During 2007, Critical Care published several papers that highlight important aspects of critical care management, which can be subdivided into structure, processes and outcomes, including costs. Great emphasis was given to quality of life after intensive care unit stay, especially the impact of post-traumatic stress disorder. Significant attention was also given to staffing level, optimization of intensive care unit capacity, and drug cost-effectiveness, particularly that of recombinant human activated protein C. Managing costs and providing high-quality care simultaneously are emerging challenges that we must understand and meet.

Dexamethasone suppression test in borderline personality disorder: Impact of PTSD symptoms

The purpose of the present study was to investigate the impact of post-traumatic stress disorder (PTSD) symptoms on hypothalamic-pituitary-adrenal axis feedback regulation in 18 female patients with borderline personality disorder (BPD) and 21 healthy controls. Reduced feedback sensitivity was found in BPD patients with a low number of PTSD symptoms, while findings in the BPD group with a high number of PTSD symptoms did not differ from those in controls. The results suggest a hypo-suppression in the dexamethasone suppression test in BPD with few PTSD symptoms.

The Impact of Posttraumatic Stress Disorder on Dysfunctional Implicit and Explicit Emotions Among Women With Borderline Personality Disorder

A comorbid posttraumatic stress disorder (PTSD) aggravates symptoms, course of illness and social functioning of persons with borderline personality disorder (BPD). However, it is largely unclear how this effect is mediated. In 60 women with BPD of whom 23 had a comorbid current PTSD we investigated whether dysfunctional explicit and implicit emotions were associated with a comorbid PTSD. Shame and guilt proneness, anxiety, anger-hostility, and general psychopathology were assessed by self-report measures. Implicit anxiety-related self-concept was measured using the Implicit Association Test. Self-reported guilt proneness and general psychopathology, but not shame proneness or trait anxiety, were significantly higher in women with BPD and PTSD than in women with BPD alone. A comorbid PTSD was associated with a more anxiety-prone (relative to shame-prone) implicit self-concept as assessed by the Implicit Association Test. Self-reported guilt proneness and implicit anxiety may mediate the negative impact of comorbid PTSD on women with BPD.