Levels Of Traumatic Stress Symptoms Research Articles

Lifelong effects of prenatal and early postnatal stress on the hippocampus, amygdala, and psychological states of Holocaust survivors

This study focuses on hippocampal and amygdala volume, seed-based connectivity, and psychological traits of Holocaust survivors who experienced stress during prenatal and early postnatal development. We investigated people who lived in Central Europe during the Holocaust and who, as Jews, were in imminent danger. The group who experienced stress during their prenatal development and early postnatal (PreP) period (n = 11) were compared with a group who experienced Holocaust-related stress later in their lives: in late childhood, adolescence, and early adulthood (ChA) (n = 21). The results of volumetry analysis showed significantly lower volumes of both hippocampi and the right amygdala in the PreP group. Seed-based connectivity analysis revealed increased connectivity from the seed in the right amygdala to the middle and posterior cingulate cortex, caudate, and inferior left frontal operculum in the PreP group. Psychological testing found higher levels of traumatic stress symptoms (TCS-40) and lower levels of well-being (SOS-10) in the PreP group than in the ChA group. The results of our study demonstrate that extreme stress experienced during prenatal and early postnatal life has a profound lifelong impact on the hippocampus and amygdala and on several psychological characteristics.

The Role of Pre-Treatment Traumatic Stress Symptoms in Adolescent Substance Use Treatment Outcomes

Background: Prominent theories suggest that individuals with co-occurring traumatic stress symptoms (TSS) and substance use (SU) may be less responsive to SU treatment compared to those with SU only. However, empirical findings in adult samples are mixed, and there has been limited work among adolescents. This study assesses the association between TSS and SU treatment outcomes among trauma-exposed adolescents, using statistical methods to reduce potential confounding from important factors such as baseline SU severity. Method: 2,963 adolescents with lifetime history of victimization received evidence-based SU treatment in outpatient community settings. At baseline, 3- and 6-months, youth were assessed using the Global Appraisal of Individual Needs Traumatic Stress Scale and the Substance Frequency Scale. Propensity score weighting was used to mitigate potential confounding due to baseline differences in sociodemographic characteristics and SU across youth with varying levels of TSS. Results: Propensity score weighting successfully balanced baseline differences in sociodemographic factors and baseline SU across youth. Among all youth, mean SU was lower at both 3- and 6- month follow-up relative to baseline, indicating declining use. After adjusting for potential confounders, we observed no statistically significant relationship between TSS and SU at either 3- or 6-month follow-up. Conclusions: Based on this investigation, conducted among a large sample of trauma-exposed youth receiving evidence-based outpatient SU treatment, baseline TSS do not appear to be negatively associated with SU treatment outcomes. However, future research should examine whether youth with TSS achieve better outcomes through integrative treatment for both SU and TSS.

Predictors of traumatic stress symptoms in police personnel exposed to sexual trauma

This article presents findings from a survey which explored exposure to sexual offence material in Police personnel ( N = 384). Factor analysis determined that two types of coping strategies were employed: ‘detachment’ and ‘avoidance’, with a further factor regarding ‘negative coping beliefs’. Two types of adverse impact analogous to post-traumatic stress disorder symptoms were identified: ‘cognitive/affective changes’ and ‘increased suspicion/vigilance’. Multiple regression analysis found that avoidance-based coping strategies, holding negative beliefs about coping, being a parent, and having personally experienced sexual abuse were all predictive of increased levels of traumatic stress symptoms.

Tracing the Neural Carryover Effects of Interpersonal Anger on Resting-State fMRI in Men and Their Relation to Traumatic Stress Symptoms in a Subsample of Soldiers.

Uncontrolled anger may lead to aggression and is common in various clinical conditions, including post traumatic stress disorder. Emotion regulation strategies may vary with some more adaptive and efficient than others in reducing angry feelings. However, such feelings tend to linger after anger provocation, extending the challenge of coping with anger beyond provocation. Task-independent resting-state (rs) fMRI may be a particularly useful paradigm to reveal neural processes of spontaneous recovery from a preceding negative emotional experience. We aimed to trace the carryover effects of anger on endogenous neural dynamics by applying a data-driven examination of changes in functional connectivity (FC) during rs-fMRI between before and after an interpersonal anger induction (N = 44 men). Anger was induced based on unfair monetary offers in a previously validated decision-making task. We calculated a common measure of global FC (gFC) which captures the level of FC between each region and all other regions in the brain, and examined which brain regions manifested changes in this measure following anger. We next examined the changes in all functional connections of each individuated brain region with all other brain regions to reveal which connections underlie the differences found in the gFC analysis of the previous step. We subsequently examined the relation of the identified neural modulations in the aftermath of anger with state- and trait- like measures associated with anger, including brain structure, and in a subsample of designated infantry soldiers (N = 21), with levels of traumatic stress symptoms (TSS) measured 1 year later following combat-training. The analysis pipeline revealed an increase in right amygdala gFC in the aftermath of anger and specifically with the right inferior frontal gyrus (IFG).We found that the increase in FC between the right amygdala and right IFG following anger was positively associated with smaller right IFG volume, higher trait-anger level and among soldiers with more TSS. Moreover, higher levels of right amygdala gFC at baseline predicted less reported anger during the subsequent anger provocation. The results suggest that increased amygdala-IFG connectivity following anger is associated with maladaptive recovery, and relates to long-term development of stress symptomatology in a subsample of soldiers.

Traumatic Stress Symptoms, Forgiveness, and Meaning in Life in Four Traumatized Regions of the World

The present study examined self-reported levels of traumatic stress symptoms, forgiveness, and meaning in life in residents of regions experiencing ongoing violence (Middle East), recent past violence (Africa), distant past violence and disaster (Caucasus), and recent natural disaster (Caribbean). The sample included 900 individuals from Africa (Kenya n = 149; Burundi n = 104; Rwanda n = 57), the Middle East (Israel n = 34; Jordan n = 22; Palestine n = 220), the Caucasus (Armenia n = 109), and the Caribbean (Haiti n = 205). Analyses of covariance controlling for demographic factors revealed significant regional differences. Violent ongoing trauma in the Middle East and recent violent trauma in African countries were associated with higher traumatic stress symptoms than in the Caribbean where trauma was nonviolent and in the Caucasus region where trauma was quite distant. Forgiveness levels were lowest among participants in the Middle East and highest in Africa. Meaning in life was also lowest in the Middle East. There is wide diversity in the sociocultural traumatic events and calamities that befall societies; those events have unique impacts on survivors’ levels of traumatic stress symptoms, forgiveness, and meaning in life. Counselors, clergy, aid-workers, and policymakers should be apprised of the range of sociocultural traumatic experiences and associated differential outcomes.

PTSD Symptoms in Young Children Exposed to Intimate Partner Violence in Four Ethno-racial Groups

More than 15 million children are eyewitnesses to intimate partner violence (IPV) each year. IPV is associated with higher levels of both externalizing and internalizing problems and places children at a greater risk of developing posttraumatic stress disorder (PTSD) than those who are not exposed. As previous studies have not included a range of ethno-racial groups in their samples of children exposed to IPV, using standardized measures, the present study examines posttraumatic stress symptoms and PTSD diagnoses in four different ethno-racial groups of children, ages 4–6, who witnessed IPV in the last 2 years. Data are derived from interviews with 144 mothers with children participating in a study of the efficacy of an IPV intervention program. Results show high levels of traumatic stress symptoms and PTSD diagnoses (45 %) among the total sample, with significant differences by sex and ethno-racial group. Biracial and Latina females had the highest rates of PTSD relative to other groups. Greater exposure to IPV predicted more extensive PTSD symptoms.

A Qualitative Analysis of Military Couples With High and Low Trauma Symptoms and Relationship Distress Levels

The purpose of the current study was to understand the experiences of a subset of military couples regarding the effects of war deployment on couple functioning. The authors used the core “couple functioning” variables included in the Couple Adaptation to Traumatic Stress Model as sensitizing concepts to guide the qualitative analysis process. Participant interviews (n = 15 couples, 30 total participants) were divided into subgroups according to high and low trauma symptom and relationship satisfaction scale scores. Five primary themes were identified in the results: communication, conflict management, roles, support/nurturance, and posttraumatic growth. Overall, highly satisfied couples and those with the lowest levels of traumatic stress symptoms reported more positive relationship functioning in the identified areas, while couples reporting higher traumatic stress symptoms and lower relationship satisfaction indicated varied or inconsistent qualitative results. Clinical and research implications for military couples also are identified.

Posttraumatic Stress Symptoms after Exposure to Two Fire Disasters: Comparative Study

This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with “non-disaster” burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in the Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with “non-disaster” burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of “non-disaster” burn injuries. Excluding the industrial fire group, all participants’ symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort.

The moderating effect of relationship quality on partner secondary traumatic stress among couples coping with cancer.

A considerable amount of research has investigated symptoms of posttraumatic stress in cancer patients while the occurrence and correlates of secondary traumatic stress on patients' intimate partners has yet to be explored. This study examined the prevalence of secondary traumatic stress symptoms (Modified Secondary Trauma Questionnaire) in partners of cancer patients and evaluated the association of these symptoms with patients' posttraumatic stress symptoms (Impact of Event Scale-Revised). The study also investigated the moderation effect of relationship quality (Marital Satisfaction Inventory-Revised) on the association between patients' and partners' posttraumatic and secondary traumatic stress respectively. A heterogeneous sample of 90 patient-partner dyads was recruited through a provincial cancer agency. Multiple symptoms of secondary traumatic stress were reported by 23% of partners. These symptoms were experienced at a clinically significant level by 10% of all participating partners. Although patients' and partners' traumatic stress symptoms were correlated (r = .44, p < .001), only one dyad consisted of both a patient and a partner scoring clinically significant levels of traumatic stress symptoms. Therefore, of the 90 dyads in the study, 18% included at least one partner reporting clinically significant levels of traumatic stress. Relationship quality accounted for 11% of the variance in secondary traumatic stress, in addition to the 19% already accounted for by patients' posttraumatic stress. Relationship quality also exhibited buffering effects benefiting couples with higher quality relationships. Implications of results for future research and holistic health care models are discussed.

A Pilot Study Comparing Traumatic Stress Symptoms by Child and Parent Report Across Pediatric Chronic Illness Groups

Researchers have recently used a framework of traumatic stress to describe the psychological functioning of children experiencing a chronic illness and their families; however, few studies are available directly comparing symptoms across disease groups. This study compared traumatic stress symptoms of youth being considered for solid organ and bone marrow transplantation, youth diagnosed with human immunodeficiency virus, youth diagnosed with sickle cell disease and their parents. Correlates of traumatic stress across these populations were also examined. Participants included 64 youth and caregiver dyads with previously scheduled appointments at 1 of 3 specialty clinics. Parents completed measures of family demographics, traumatic stress symptoms, and child functional status. Youth (n = 45) and parents each completed self-report and parent-proxy measures of youth traumatic stress symptoms. Ten percent of youth by self-report, 18% of youth by parent-proxy report, and 13% of caregivers described symptoms suggestive of posttraumatic stress disorder. Parents of pediatric transplant self-reported greater symptoms than caregivers of youth with human immunodeficiency virus and sickle cell disease (p < .05). Although child functional impairment did not predict child symptoms, a trend was found where parents experiencing more traumatic stress symptoms themselves reported their children experienced greater symptoms by parent-proxy report (p =.07). Findings suggest that although most children and parents across disease groups report subclinical levels of traumatic stress symptoms, traumatic stress symptoms may be especially salient for families of pediatric transplant candidates. Although interventions are currently available to treat posttraumatic stress disorder symptoms, they will likely need to be individualized to meet the needs of specific disease groups.

The Influence of Clinicians' Previous Trauma Exposure on Their Assessment of Child Abuse Risk

Research has identified high levels of trauma exposure and PTSD in professionals responsible for assessing children at risk for abuse. An important question arising is the influence of stress and trauma on professional judgment. This study examined the association between critical incident exposure, PTSD and workers' judgments of child risk. Ninety-six child protection workers participated in 2 simulated clinical interviews and subsequently completed standardized risk assessment measures. Workers reported high levels of exposure to critical events in the workplace and high levels of traumatic stress symptoms. Number of prior critical events encountered was negatively associated with assessment of risk. Level of traumatic stress symptoms was negatively associated with risk on one, but not other measures of risk. It is concluded that standardized measures for assessing a child's risk of abuse may be influenced by previous exposure to critical workplace events and levels of traumatic stress in workers.

Stress and depression of facing death: Investigation of psychological symptoms in patients with mesothelioma

Cancer often results in psychological impairment, and lung cancer has been associated with greater morbidity and higher levels of psychological distress than any other form. Chronic exposure to asbestos is a significant risk factor for development of lung cancer, called mesothelioma. Few have studied the psychological consequences of chronic asbestos exposure and mesothelioma. This study investigated stress and depression symptoms in 49 men (M = 51.1 years, SD = 6.0) diagnosed with mesothelioma. Participants completed traumatic stress, depression and general psychological health questionnaires. All participants reported significant levels of traumatic stress symptoms, which was associated with increased symptoms of depression, anxiety, somatic complaints and social dysfunction. The results provide important suggestions for clinicians treating such terminally ill patients.

Does Posttraumatic Stress Disorder (PTSD) Affect Performance?

Research has increasingly identified alarming levels of traumatic stress symptoms in individuals working in emergency services and other high stress jobs. This study examined the effects of prior critical incident exposure and current posttraumatic symptoms on the performance of a nonpatient population, police recruits, during an acutely stressful event. A stressful policing situation was created through the use of a video simulator room that was responsive to actions of participants. The performance of participants to the simulated emergency was evaluated by 3 independent blinded raters. Prior exposure to critical incidents was measured using the Critical Incident History Questionnaire and current level of traumatic stress symptoms was measured using the Impact of Events Scale-Revised. Neither previous exposure to critical incidents nor trauma symptoms correlated with performance level. Recruits with high or severe levels of trauma symptoms did not demonstrate impairments in judgment, communication, or situation control compared with their colleagues with lesser or no trauma symptoms. On the basis of these findings, there is no reason to believe that police recruits with PTSD are prone to making errors of communication or judgment that would place them or others at increased risk.

Secondary traumatic stress: An investigation of Canadian mental health workers.

In the past decade, there has been an increased awareness of the deleterious effects for professionals working in the field of trauma. Claims have been made that professionals working with traumatized clients are vulnerable and at risk of developing trauma symptoms similar to those experienced by their clients. Terms used to describe this phenomenon are “vicarious traumatization” and “secondary traumatic stress.” The results of survey data collected from 280 Canadian mental health professions on work setting and client type variables, personal histories of trauma, current levels of traumatic stress symptoms, and self-report ratings on experiencing secondary traumatic stress are reported. Implications for mental health professionals working in the field of trauma are addressed.