Increased Posttraumatic Stress Disorder Symptoms Research Articles

Whole-brain correlates of post-traumatic stress disorder in military-related mild traumatic brain injury: A voxel-wise meta-analysis

Resting-state functional magnetic resonance imaging (rs-fMRI) is widely used in studying mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) among military service personnel (MSP). The risk for PTSD is greater after mTBI than after non-mTBI trauma, and PTSD is associated with worse biological, psychological, and social (biopsychosocial) outcomes after mTBI. Studying the neural correlates of mTBI-related PTSD in this population may provide insights into the pathophysiology of both conditions and help identify MSPs most at risk of developing persistent symptoms. This voxel-wise meta-analysis aimed to examine the current literature on rs-fMRI in mTBI-related PTSD, collect neuroimaging data, and perform a voxel-wise meta-analysis to identify significant nodes of functional connectivity across studies. We searched the literature using PubMed, EMBASE, and ScienceDirect. The database query yielded 1455 articles, narrowed with specified eligibility criteria to a final cohort of 33 studies, with 1521 experiment group participants and 1369 controls. Article quality was assessed using the QUADAS-2 instrument. Our meta-analysis revealed a robust correlation between PTSD-mTBI and increased whole-brain resting-state functional connectivity (rsFC) in the amygdala. Our meta-analysis also showed strong correlations between PTSD-mTBI and decreased whole-brain rsFC across regions implicated in speech and language processing. Our meta-regression highlighted robust correlations between less time after a recent mTBI and increased whole-brain rsFC in posterior regions of the default mode network. Our meta-regression also showed strong correlations between increased PTSD symptom severity, increased connectivity in the amygdala, and decreased connectivity in Broca's area.

Examining the unique and interactive associations of gender and race on PTSD symptom severity among military sexual trauma survivors.

Despite a robust association between military sexual trauma (MST) and posttraumatic stress disorder (PTSD), few studies have examined factors that are associated with increased symptom severity. To this end, the current study was designed to examine the unique and interactive effects of gender and race on PTSD symptoms using a sample of MST survivors. The sample included 126 veterans (71% Women, 29% Men; 70% Black/African American and 30% White/Caucasian) presenting for psychological services to a MST specialty clinic at a large Southeastern Veterans Affairs (VA) hospital. As part of their intake evaluation, veterans completed a diagnostic interview and battery of self-report questionnaires. Results revealed a main effect of gender and race such that veteran men and Black/African American veterans were found to have increased PTSD symptom severity. However, there was not a significant gender by race interaction. Findings are discussed with regard to previous research and treatment implications. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessment of post-traumatic stress disorder (PTSD) in elderly survivors of the Wenchuan earthquake: A cross-sectional study.

Post-traumatic stress disorder (PTSD) is a prevalent condition characterized by prolonged psychological distress following traumatic events encompassing serious health threats, domestic abuse, and natural disasters. The onset and persistence of PTSD can be attributed to advanced age. This study aimed to explore the occurrence and influencing factors of enduring post-traumatic stress disorder (PTSD) in survivors aged 60 years and over in the main area of the 2008 Wenchuan earthquake 10 years after the disaster. Data were collected using a multistage sampling method from individuals aged 60 years and older living in the main impacted areas of Wenchuan 10 years after the Wenchuan earthquake. The PTSD Checklist-Civilian Version (PCL-C) was used to evaluate PTSD symptoms. We evaluated participants based on their PTSD symptoms: those exhibiting and those without. The latter group was four times the size of the former and was matched based on gender and age (within±2 years). Conditional logistic regression was used to discern the risk factors. Out of the total, 56 participants were recognized as having probable PTSD as per the PCL-C checklist, leading to a rate of 9.4% (56/588). The univariate conditional logistic regression values showed that playing Mahjong/poker (odds ratio (OR)=0.394, 95% confidence interval (CI)=0.171-0.911) and displacement (OR=0.446, 95% CI=0.220-0.907) were protective factors for the long-term mental health of survivors in the hard-hit areas, while the presence of a 2-week illness (OR=3.605, 95% CI=1.751-7.424), possessing insurance (OR=0.250, 95% CI=0.072-0.864), suffering from a chronic ailment (OR=3.132, 95% CI=1.2-8.174), and having an injured family member (OR=2.26, 95% CI = 1.136-4.496) emerged as risk factors for PTSD symptoms. Multivariate analysis indicated that the absence of insurance and prevalence of 2-week illness correlated with increased PTSD symptoms. Ten years after the Wenchuan earthquake, the prevalence of probable PTSD remained significantly high in the elderly population. The major risk factors were the absence of insurance and the occurrence of a 2-week illness. Policymakers should incorporate these findings when devising strategies for aging societies.

Impact of the COVID-19 Pandemic on U.S. Women's Mental Health.

Background: Women are more likely than men to be diagnosed with depression and anxiety with rates increasing since the COVID-19 pandemic. This study sought to understand how women's intersecting identities, personal strengths, and COVID-19-related stressors were associated with their anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms early in the pandemic. Methods: During May-June 2020, American women (N = 398) recruited via MTurk completed an online questionnaire assessing mental health (PTSD, anxiety, and depression), demographic characteristics, personal strengths (coping, hope, social support), and experiences with COVID-19-specific stressors. Results: Women who had a child younger than 18 years of age, lived in rural or urban areas (compared with suburban), and identified as sexual minority reported increased levels of PTSD, depression, and anxiety symptoms. Social support and hope (Agency) were associated with fewer mental health symptoms. Engagement in maladaptive coping and greater perception of COVID-19 threat and perceived stress was associated with more PTSD, depression, and anxiety symptoms. COVID-19-related illness events and difficulty accessing living essentials were associated with increased anxiety symptoms. COVID-19-related disruption to living and income were associated with increased PTSD symptoms. Loneliness was associated with increased anxiety and depression symptoms. Conclusions: Results of this study can inform prevention and intervention efforts to address depression and anxiety among women with intersecting identities during times of stress. Specifically, supporting the development of women's resilience and adaptive coping and intervening to address maladaptive coping strategies, such as drinking, provide paths to supporting women's mental health.

Everyday life experiences for evaluating post-traumatic stress disorder symptoms

ABSTRACT Background: Previous research has highlighted the importance of regularizing daily routines for maintaining mental health. Little is known about whether and how regularity of daily routines is associated with reduced post-traumatic stress disorder (PTSD) symptoms. Objective: We aimed to examine the associations between regularity of daily routines and PTSD symptoms in two studies (N = 796). Method: In Study 1, prospective data were analysed with the latent change score model to investigate the association between sustainment of regular daily routines and change in PTSD symptoms over time amid massive civil unrest in Hong Kong in 2019. Study 2 used vignette as a quasi-experimental method to assess the ability of maintaining regular daily routines in face of a major stressor, and tested its associations with PTSD symptoms. Results: In Study 1, increased regularity of diverse daily routines was inversely associated with increased PTSD symptoms amid the civil unrest in Hong Kong (β = −.427 to −.224, 95% confidence intervals [−.543 to −.359, −.310 to −.090], p values < .01). In Study 2, a greater ability to maintain regular daily routines during stress was associated with lower levels of PTSD symptoms (β = −.285 to −.096, 95% confidence intervals [−.379 to −.189, −.190 to −.003], p values < .05). Conclusions: Our findings suggest the benefit of considering diverse everyday activities in evaluating PTSD symptoms in both clinical and subclinical populations. Interventions with the direct focus on the role of daily living could promote psychological resilience during and after potentially traumatic events.

Psychosocial and Economic Impacts of the COVID-19 Pandemic on the Mental Health of Veteran Men and Women.

Purpose: The psychosocial impacts of the coronavirus disease-2019 (COVID-19) pandemic on women Veterans' mental health compared to men are understudied, with few studies examining the differential impact of COVID-19 stressors on depression and post-traumatic stress disorder (PTSD). Furthermore, little is known about whether social support may buffer against adverse pandemic-related outcomes for this population. In the present study, we examined (1) gender differences in the impact of the COVID-19 pandemic on numerous life domains, including economic, work, home, social, and health; (2) how pandemic impacts in these domains were associated with depression and PTSD symptoms; and (3) whether social support buffered against worse mental health outcomes. Materials and Methods: Data from 1530 Veterans enrolled in the Longitudinal Investigation of Gender, Health, and Trauma (LIGHT) study were analyzed using descriptive statistics and multiple groups' path analyses. Results: Women reported higher pandemic impact scores across life domains. For both men and women, higher health impacts were associated with increased PTSD symptoms; differential findings emerged for depressive symptoms. Home and economic impacts were associated with increased depression for both men and women, social and health impacts were associated with depression for women, and work impacts were associated with depression for men. Higher social support was associated with decreased depressive symptoms for both men and women; however, social support moderated the relationship between pandemic impacts and both PTSD and depressive symptoms for women only. Conclusions: Findings highlight the value of social support in mitigating effects of pandemic-related stress, particularly for women Veterans.

Traumatic Events as Risk Factors for PTSD and Suicidal Ideation: A Nine-Year Study of Justice-Involved Adolescents

ABSTRACT Traumatic events are a serious public health concern, linked cross-sectionally and longitudinally with post-traumatic stress disorder (PTSD) and suicidal ideation (SI). While much research has focused on broadly defined traumatic events as they relate to PTSD and SI, fewer projects have investigated the disparate associations that specific traumatic events have with PTSD and SI. In this study of 1,829 adolescents held at the Cook County Juvenile Temporary Detention Center (measured during adolescence and again nine years later during adulthood), the cross-sectional and prospective links between various traumatic events (i.e. being physically assaulted, threatened with a weapon, sexually assaulted, in a serious accident, seeing someone be killed, experiencing a natural disaster, seeing a dead body, or being forced to fight), PTSD symptoms, and SI were investigated. Findings indicate that every traumatic event endorsed at baseline was cross-sectionally associated with increased PTSD symptoms and SI. Experiencing sexual assault or a serious accident during adolescence predicted greater SI at follow-up. Moreover, the positive association between PTSD symptoms at baseline and SI at follow-up was stronger among individuals who experienced sexual assault or a serious accident versus those who were not trauma exposed. Implications for justice-involved adolescents are discussed.

Exploring the Relationships Between Child Maltreatment and Risk Factors for Pregnancy Complications

ObjectiveThis study explored the pathways underlying the relationships between child maltreatment (CM) subtypes (i.e., physical, sexual, and emotional abuse and neglect) and factors associated with a heightened risk of pregnancy complications by examining post-traumatic stress disorder (PTSD) symptoms as a potential mediator. MethodsA sample of 98 pregnant parents between the ages of 18 and 29 years was recruited through social media and community organizations throughout Canada. Participants completed a series of surveys on their exposure to CM, PTSD symptoms, and pregnancy experiences on a secure online platform. Following data cleaning procedures, 85 participants were included in this study. ResultsFour separate mediation analyses were conducted with child neglect, physical abuse, sexual abuse, and emotional abuse as factors associated with a heightened risk of pregnancy complications (i.e., a congregate score of limited prenatal care, weight gain concerns, smoking, second-hand smoke, alcohol consumption, substance use, and insufficient food intake during pregnancy). Each CM subtype was associated with increased PTSD symptoms, which were in turn associated with the presence of more factors known for increasing the risk of pregnancy complications. Neglect, physical abuse, sexual abuse, and emotional abuse were all indirectly associated with the presence of more factors associated with a heightened risk of pregnancy complications through their association with PTSD symptoms. ConclusionsFindings from this study could encourage prenatal care providers to screen for CM history and PTSD symptoms. Furthermore, mental health treatment early in the prenatal period may improve pregnant parents’ health and lower their risk of pregnancy complications.

Cortical complexity in world trade center responders with chronic posttraumatic stress disorder

Approximately 23% of World Trade Center (WTC) responders are experiencing chronic posttraumatic stress disorder (PTSD) associated with their exposures at the WTC following the terrorist attacks of 9/11/2001, which has been demonstrated to be a risk factor for cognitive impairment raising concerns regarding their brain health. Cortical complexity, as measured by analyzing Fractal Dimension (FD) from T1 MRI brain images, has been reported to be reduced in a variety of psychiatric and neurological conditions. In this report, we hypothesized that FD would be also reduced in a case-control sample of 99 WTC responders as a result of WTC-related PTSD. The results of our surface-based morphometry cluster analysis found alterations in vertex clusters of complexity in WTC responders with PTSD, with marked reductions in regions within the frontal, parietal, and temporal cortices, in addition to whole-brain absolute bilateral and unilateral complexity. Furthermore, region of interest analysis identified that the magnitude of changes in regional FD severity was associated with increased PTSD symptoms (reexperiencing, avoidance, hyperarousal, negative affect) severity. This study confirms prior findings on FD and psychiatric disorders and extends our understanding of FD associations with posttraumatic symptom severity. The complex and traumatic experiences that led to WTC-related PTSD were associated with reductions in cortical complexity. Future work is needed to determine whether reduced cortical complexity arose prior to, or concurrently with, onset of PTSD.

The Association between Patient Health Status and Surrogate Decision Maker Post-Traumatic Stress Disorder Symptoms in Chronic Critical Illness.

Rationale: Surrogate decision-makers of patients with chronic critical illness (CCI) are at high risk for symptoms of post-traumatic stress disorder (PTSD). Whether patient health status after hospital discharge is a risk factor for surrogate PTSD symptoms is not known. Objectives: To determine the association between patient health status 90 days after the onset of CCI and surrogate symptoms of PTSD. Methods: We performed a secondary analysis of the data from a multicenter randomized trial of a communication intervention for adult patients with CCI and their surrogate decision-makers. Results: Surrogate PTSD symptoms were measured at 90 days using the Impact of Events Scale-Revised. For patients who were alive at 90 days, location was used as a marker of health status and included the following categories: 1) home (relatively good health and low acuity), 2) acute rehabilitation (moderate care needs and impairments, generally expected to improve), 3) skilled nursing facility (moderate care needs and impairments, generally not expected to improve significantly or quickly), 4) long-term acute care facility (persistently high acute care needs and functional impairment), and 5) readmission to an acute care hospital (suggesting the highest acuity of illness and care needs of the cohort). Patients who died before 90 days were categorized as deceased. In the analyses, 365 surrogates and 256 patients were included. Among patients, 49% were female, and the mean age was 59 years. Among surrogates, 71% were female, and the mean age was 51 years. A directed acyclic graph was constructed to identify covariates to be included in the model. Compared with symptoms seen among surrogates of patients living at home, heightened PTSD symptoms were seen among surrogates of patients who were readmitted to an acute care hospital (β coefficient, 15.9; 95% confidence interval [CI], 4.5 to 27.3) or had died (β coefficient, 14.8; 95% CI, 8.8 to 20.9) at 90 days. Conclusions: Surrogates of patients with CCI who have died or have been readmitted to an acute care hospital at 90 days experience increased PTSD symptoms as compared with surrogates of patients who are living at home. These patients and surrogates represent a readily identifiable group who may benefit from enhanced emotional support.

Rates of Occurrence and Influence of Trauma Exposure on Posttraumatic Stress Disorder Symptoms Among Survivors of Terrorist Attacks in Northeast Nigeria

Research has shown that trauma exposure is associated with increased symptoms of posttraumatic stress disorder (PTSD). However, knowledge is sparse on whether there are differential predictions of specific clusters of PTSD symptoms by trauma exposure. We investigated the rate of trauma exposure and prevalence of PTSD as well as the contributions of trauma exposure to severity of four PTSD symptoms clusters among persons who were displaced due to terrorist attacks. Participants were Nigerian internally displaced persons (IDPs, N = 1059, 54.8% males; mean age = 34.30 years, SD = 13.69) who completed Hausa language versions of the Harvard Trauma Questionnaire – Part 1 for measuring trauma exposure and the Posttraumatic Stress Disorder Checklist for DSM-5 for assessing PTSD symptoms. The most frequently reported traumatic stressors were lack of basic needs, losses, maltreatment/torture, and violent deaths. Prevalence of PTSD was high (65.72%). Trauma exposure uniquely and strongly predicted increased PTSD symptoms severity across all the PTSD symptoms clusters by adding more variances above and beyond the demographic factors. Regular provision of relief materials is necessary in IDPs’ camps. Psychological interventions and mental healthcare services should be prioritized in comprehensive management of the displacement crisis resulting from terrorist attacks.

A Prospective Study of Mental Health During the COVID-19 Pandemic in Childhood Trauma-Exposed Individuals: Social Support Matters.

The novel coronavirus disease 2019 (COVID‐19) pandemic and its unprecedented social restrictions may have serious mental health implications, especially in individuals who have experienced childhood traumatic experiences (CTEs). This prospective study aimed to investigate whether general psychopathology and posttraumatic stress disorder (PTSD) symptom severity increased during the pandemic as compared to prepandemic baseline data collected approximately 1 year earlier. Furthermore, we investigated whether an increase in symptomatology was linked to CTEs and mediated by a lack of perceived social support and fear of COVID‐19. An online survey was administered to 85 individuals, including both participants with PTSD, major depression, or somatic symptom disorder (n = 63) and healthy volunteers (n = 22), during a period of the most severe social restrictions in Germany. The survey included the Childhood Trauma Questionnaire, Brief Symptom Inventory, PTSD Checklist for DSM‐5, ENRICHD Social Support Inventory, and Fear of COVID‐19 Scale. In the whole sample, we found significant increases in general psychopathology and PTSD symptom severity, ω2 = .07–.08, during as compared to before the COVID‐19 pandemic, with CTEs predicting increased PTSD symptom severity, β = .245, p = .042. This effect was mediated by a lack of perceived social support, indirect effect = .101, 95% CI [.013, .209], but not fear of COVID‐19, indirect effect = .060, 95% CI [−.035, .167]. These findings emphasize the importance of interventions that promote social inclusion to mitigate the potentially detrimental effects of public health actions implemented against the COVID‐19 pandemic in individuals with CTEs.

Epigenome-Wide Study of Posttraumatic Stress Disorder Symptom Severity in a Treatment-Seeking Adolescent Sample.

Emerging research has demonstrated that psychosocial trauma exposure may elicit epigenetic changes, with downstream effects on the transcriptional regulation of genes. Epigenome-wide association studies (EWAS) offer an agnostic approach to examine DNA methylation (DNAm) associations and are a valuable tool to aid in the identification of biological pathways involved in posttraumatic stress disorder (PTSD). This study represents the first EWAS of PTSD in an adolescent sample, an important group given the significance of this developmental period regarding both DNAm changes and PTSD risk. The sample (n = 39, M age = 15.41 years, SD = 1.27, 84.6% female) comprised adolescents who experienced interpersonal trauma and were enrolled in a treatment study. Participants were assessed using the UCLA PTSD Reaction Index for DSM-IV-Adolescent Version and provided a blood sample at baseline. Genomic DNA was isolated from whole blood and assayed using the Illumina Infinium MethylationEPIC BeadChip. The primary analysis estimated the associations among individual CpG sites and PTSD symptom scores. Of the 793,575 screened probes tested, two were significant at a false discovery rate (FDR) < 10%. Hypomethylation of both sites was associated with increased PTSD symptom scores. Analysis of differentially methylated regions (DMR) identified a DMR associated with PTSD symptom scores at an FDR < 10%. Results from follow-up models are also discussed. Findings from this preliminary investigation suggest the importance of further research conducted in adolescent samples. The analytic pipeline and results are documented for use in future meta-analytic work as more such samples become available.

Meditating in virtual reality: Proof-of-concept intervention for posttraumatic stress.

Objective: We investigate the potential therapeutic application of virtual reality (VR) technology as an aid to meditation practice among persons varying in posttraumatic stress disorder (PTSD) symptoms. Method: In this within-group mixed-methods study, 96 young adults practiced both VR- and non-VR-guided meditations and reported on their experience of positive affect (PA), negative affect (NA), other meditative experiences and perceived satisfaction-credibility of each meditation. Results: Participants reported more PA and greater perceived satisfaction-credibility following the VR as compared to non-VR-guided meditations primarily when the VR meditation was practiced first, before the non-VR meditation, as opposed to vice versa. The experience of NA during meditation practice was infrequent, although persons with increased PTSD symptoms reported increased distress during both VR and non-VR meditation. Conclusions: Further study of therapeutic applications of VR as an aid to meditation practice among people with PTSD symptoms is warranted. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Family emotional climate in childhood and risk of PTSD in adult children of Australian Vietnam veterans

The mechanisms of intergenerational transmission of posttraumatic stress disorder (PTSD) from parent to child are not yet known. We hypothesised that the mechanisms involved in trauma transmission may be dependent upon sex specific caregiver-child dyads and these dyads may have a differential impact on post-traumatic stress disorder (PTSD). A non-clinical sample of adult offspring (N = 306) of Australian Vietnam veterans was interviewed in-person to assess the relationship between family emotional climate and caregiver attachment with the offspring's adult experience of post-traumatic stress disorder (PTSD). Attachment to the veteran father was not associated with sons’ PTSD, but was for daughters. Attachment to mother was associated with PTSD and depression for both sons and daughters, with positive and warm attachment related to reduced PTSD diagnosis and its symptom clusters. A less positive family emotional environment was related to increased PTSD symptoms in daughters, while for sons a negative relationship style with their mother was related to increased frequency and severity of numbing/avoidance behaviours and hyperarousal symptoms. The findings suggest that sex-related differences in caregiver-child dyads do have a differential impact on PTSD symptom domains and may be one environmental mechanism by which trauma is transmitted across generations.

Sex differences in the association between PTSD symptoms with cardiac autonomic function and subclinical atherosclerotic risk.

Post-traumatic stress disorder (PTSD) is a public health concern that may elevate the risk for cardiovascular disease (CVD). There are established sex differences in both PTSD risk and CVD risk. To examine sex-specific associations between subclinical PTSD symptom severity and subclinical CVD risk in young men and women. A total of 61 young adults (women: n=29, mean age: 26±7years) completed the post-traumatic stress disorder civilian checklist (PCL) and the Center for Epidemiologic Studies Depression Scale (CES-D). Aortic stiffness was measured as carotid-femoral pulse wave velocity (cfPWV). Peripheral vasomotor function was measured as flow-mediated slowing (FMS) of carotid-radial PWV following 5-min forearm occlusion. Heart rate variability was used to assess sympathovagal balance as LF/HF ratio. PCL score was positively correlated with CES-D score (r=0.79, p<.001), cfPWV (r=0.33, p=.03) and LF/HF ratio (r=0.42, p=.009) in men. PCL score was positively correlated to CES-D score (r=0.80, p<.001) in women, but was inversely correlated to cfPWV (r=-0.38, p=.02) and LF/HF ratio (r=-0.34, p=.04). PCL score was also inversely associated with FMS in women (r=-0.49, p=.01). There are sex differences in the association of PTSD symptoms and subclinical atherosclerosis. In men, increased PTSD symptoms may increase CVD risk by increasing sympathovagal balance and aortic stiffness. In women, increased PTSD symptoms may increase CVD risk via reducing vasomotor function.

Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students

Background College students report high rates of alcohol consumption and Criterion A traumatic events, which puts them at higher risk for dangerous alcohol-related negative consequences when compared to the general population. The self-medication theory suggests coping as the potential link between substance use and psychological distress, and it has been found that ineffective coping styles are related to increased PTSD symptom severity and harmful drinking behaviors. Purpose: This study evaluated the mediating role of coping styles (i.e. problem-solving and avoidance coping) on the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol outcomes (i.e. hazardous drinking and alcohol-related negative consequences [ARNC]). Methods: A national sample of 672 traditional age (i.e. 18–25 years old; M = 22.35, SD = 1.97) college students who reported alcohol consumption in the past month were recruited via Amazon’s Mechanical Turk website. Participants were 55.1% male and 60.9% White and completed measures of PTSD symptoms, coping styles, hazardous drinking, and ARNC. Results: Problem-solving coping mediated the positive relationship between PTSD symptoms and hazardous drinking such that PTSD symptoms were negatively associated with problem-solving coping, which was negatively associated with hazardous drinking. Avoidance coping mediated the positive relationship between PTSD symptoms and ARNC through a positive association between PTSD symptoms and avoidance coping. Conclusions: These novel findings highlight the importance of adaptive coping styles as a protective factor for college students experiencing co-occurring PTSD symptoms and harmful alcohol use.

The association of PTSD symptom severity with amygdala nuclei volumes in traumatized youths

The amygdala is a core component in neurobiological models of stress and stress-related pathologies, including post-traumatic stress disorder (PTSD). While numerous studies have reported increased amygdala activity following traumatic stress exposure and in PTSD, the findings regarding amygdala volume have been mixed. One reason for these mixed findings may be that the amygdala has been considered as a homogenous entity, while it in fact consists of several nuclei with unique cellular and connectivity profiles. Here, we investigated amygdala nuclei volumes of the basolateral and the centrocorticomedial complex in relation to PTSD symptom severity in 47 young survivors from the 2011 Norwegian terror attack 24–36 months post-trauma. PTSD symptoms were assessed 4–5, 14–15 and 24–36 months following the trauma. We found that increased PTSD symptom severity 24–36 months post-trauma was associated with volumetric reductions of all basolateral as well as the central and the medial nuclei. However, only the lateral nucleus was associated with longitudinal symptom development, and mediated the association between 4–5 months and 24–36 months post-trauma symptoms. The results suggest that the amygdala nuclei may be differentially associated with cross-sectional and longitudinal measures of PTSD symptom severity. As such, investigations of amygdala total volume may not provide an adequate index of the association between amygdala and stress-related mental illness.

Mindfulness and Posttraumatic Stress Disorder Symptom Severity in Urban African-American High School Students.

The aim of the current study was to examine the relations among mindfulness, posttraumatic stress disorder (PTSD) symptom severity, and stressful life events (SLEs) in African-American urban adolescents. Another aim was to examine mindfulness as a moderator of the relation between SLEs and PTSD symptom severity in this population. Eighty-eight African-American high school students from a low-income urban community completed measures of demographics, PTSD symptom severity, SLEs, and mindfulness. Mindfulness was significantly negatively related to PTSD symptom severity, r(86) = -.70, p < .001, 95% CI [-.58, -79], and SLEs were significantly positively related to PTSD symptom severity, r(86) = .29, p = .003, 95% CI [.09, .47]. Mindfulness was an independent predictor of PTSD symptom severity after accounting for SLEs, B = -1.16, t(84) = -9.06, p < .001, 95% CI [-1.41, -0.90], and SLEs were an independent predictor of PTSD symptom severity after accounting for mindfulness, B = 0.49, t(84) = 2.92, p = .004, 95% CI [0.16, 0.82]. Mindfulness did not moderate the relation between SLEs and PTSD symptom severity, B = -.003, t(84) = -0.15, p = .89, 95% CI [-.04, .03]. This study has implications for both mindfulness as a potential protective factor against PTSD symptom severity and SLEs as a potential risk factor for increased PTSD symptom severity in African-American urban adolescents.

Tonic immobility predicts poorer recovery from posttraumatic stress disorder

BackgroundTonic immobility (TI; a state of motor arrest during threat) and has been found to be associated with the development of psychopathology. It also hindered recovery from posttraumatic stress disorder (PTSD) after pharmacological treatment. The present study investigated the role of TI in recovery from PTSD in a large representative community sample with mixed traumas outside an exclusive treatment context. MethodsParticipants with PTSD from the panel for Longitudinal Internet Studies for the Social Sciences (LISS) completed measures for trauma, PTSD symptoms, and peritraumatic responses (fear, dissociation, and TI) in two subsequent years. Traumatized participants with PTSD were selected for the analyses (N = 262). ResultsTI was a relevant predictor for increased PTSD symptoms in year 2 after controlling for peritraumatic fear, peritraumatic dissociation, and PTSD symptoms in year 1, especially in abuse victims. Peritraumatic fear and dissociation no longer predicted PTSD in year 2 after entering TI in the model. ConclusionsOur results indicate that TI may indeed hinder recovery from PTSD. TI may thus be a relevant factor to take into account after trauma and in treatment. The effects of TI may be especially negative for abuse victims.