Lower Posttraumatic Stress Disorder Research Articles

From pregnancy to the postpartum: Unraveling the complexities of symptom profiles among trauma-exposed women

BackgroundMany women experience new onset or worsening of existing posttraumatic stress disorder (PTSD) symptoms during pregnancy and the early postpartum period. However, perinatal PTSD symptom profiles and their predictors are not well understood. MethodsParticipants (N = 614 community adults) completed self-report measures across three methodologically similar longitudinal studies. Mixture modeling was used to identify latent subgroups of trauma-exposed women with distinct patterns of symptoms at pregnancy, 1-month, and 3-month postpartum. ResultsMixture modeling demonstrated two classes of women with relatively homogenous profiles (i.e., low vs. high symptoms) during pregnancy (n = 237). At 1-month postpartum (n = 391), results suggested a five-class solution: low symptoms, PTSD only, depression with primary appetite loss, depression, and comorbid PTSD and depression. At 3-months postpartum (n = 488), three classes were identified: low symptoms, elevated symptoms, and primary PTSD. Greater degree of exposure to interpersonal trauma and reproductive trauma, younger age, and minoritized racial/ethnic identity were associated with increased risk for elevated symptoms across the perinatal period. LimitationsOnly a subset of potential predictors of PTSD symptoms were examined. Replication with a larger and more racially and ethnically diverse sample of pregnant women is needed. ConclusionsResults highlight limitations of current perinatal mental health screening practices, which could overlook women with elevations in symptoms (e.g., intrusions) that are not routinely assessed relative to others (e.g., depressed mood), and identify important risk factors for perinatal PTSD symptoms to inform screening and referral.

501 Maternal PTSD and Child Brain Function During Implicit Emotion Regulation

OBJECTIVES/GOALS: Maternal mental health, such as post-traumatic stress disorder (PTSD), is closely linked to child mental health. PTSD in mothers is associated with their children’s emotional responses. We examined associations between maternal PTSD and child brain function during emotion regulation. METHODS/STUDY POPULATION: Eight children ages 10-12 years, whose mothers had trauma histories, performed the Emotional N-Back task during functional MRI scanning. Mothers and children each reported on their trauma exposure and PTSD symptom severity. BOLD response to fearful faces during the Emotional N-Back was extracted from two specific brain regions of interest, amygdala and anterior cingulate cortex. These regions are involved in emotional response and attentional control, which are processes intrinsic to emotion regulation. An independent samples t-test was conducted on children’s BOLD response to fearful faces, with maternal PTSD symptom severity (high, low) as the independent variable. A parallel analysis was conducted with child PTSD symptom severity (high, low) as the independent variable. RESULTS/ANTICIPATED RESULTS: We found a main effect of maternal PTSD within brain regions of relevance to implicit emotion regulation. Compared to children whose mothers reported low PTSD symptom severity (n=4), children whose mothers reported high PTSD symptom severity (n=4) showed greater responsiveness to fearful faces in anterior cingulate cortex (t=2.04, p=.09,d=1.44) and amygdala (t=2.44, p=.05, d=1.72) at trending significance. A parallel analysis with child PTSD symptom severity showed no differences in brain function by this factor (ps=.55-.61). DISCUSSION/SIGNIFICANCE: Our pilot study is the first, to our knowledge, to examine associations between maternal PTSD and brain function during emotion regulation in their children. This study lays a foundation for future work; our goal is to explore dysfunction in emotion regulation neurocircuitry as one mechanism linking maternal PTSD to their children’s mental health.

Exploring the prevalence and predictors of low resilience and likely PTSD in residents of two provinces in Canada during the 2023 wildfires.

The recent wildfires in Canada serve as a stark example of the substantial and enduring harm they cause to the health of individuals and communities. Assessing the prevalence and correlates of Post-traumatic stress disorder (PTSD) and low resilience is valuable for policymakers in public health. The study aimed to assess the prevalence and predictors of low resilience and likely PTSD among subscribers of Text4Hope, an e-mental health program that delivered daily supportive messages to residents of Nova Scotia (NS) and Alberta(AB) during the recent wildfires. Data collection was through a self-administered online survey completed by residents of the affected regions of NS and AB from May 14 to June 23, 2023. Data were analyzed using Statistical Package for the Social Sciences. Out of 298 respondents, the prevalence of low resilience and likely PTSD in our sample were 52.0 and 39.3%, respectively. Unemployed respondents were about 3 times more likely to experience both low resilience and PTSD symptoms compared to those employed. Respondents with a history of mental health diagnosis were about 4 times more likely to experience likely PTSD compared to those with no history of mental health diagnosis. This study established that unemployment and a history of mental health diagnosis predicted likely PTSD, while unemployment was associated with low resilience during the wildfire. These findings offer insights for clinical interventions and the creation of psychosocial support programs for vulnerable populations.

PTSD, depression, and treatment outcomes: A latent profile analysis among active duty personnel in a residential PTSD program

Depression frequently co-occurs with posttraumatic stress disorder (PTSD), including among active duty service members. However, symptom heterogeneity of this comorbidity is complex and its association with treatment outcomes is poorly understood, particularly among active duty service members in residential treatment. This study used latent profile analysis (LPA) to identify symptom-based subgroups of PTSD and depression among 282 male service members in a 10-week, residential PTSD treatment program with evidence-based PTSD psychotherapies and adjunctive interventions. The PTSD Checklist–Military Version and Patient Health Questionnaire-8 were completed by service members at pre- and posttreatment and weekly during treatment. Multilevel models compared subgroups on PTSD and depression symptom change across treatment. LPA indicated four subgroups provided optimal fit: Depressive (high depression severity, low PTSD avoidance; n = 33, 11.7%), Avoidant (high PTSD avoidance, moderate depression severity; n = 89, 31.6%), Moderate (moderate PTSD and depression severity; n = 27, 9.6%), and Distressed (high PTSD and depression severity; n = 133, 47.2%). Treatment response differed across classes for both PTSD and depression outcomes (time × LPA class interaction ps < 0.001). In PTSD models, post-hoc comparisons indicated the Moderate class was associated with less PTSD symptom improvement relative to the other classes (ps < 0.006). In depression models, symptom reduction was greatest for the Distressed and Depressive subgroups relative to the other two classes (ps < 0.009). Study results provide an initial model for two prevalent, impairing disorders among service members and show how these symptom-based subgroups may differentially respond to residential PTSD treatment.

Posttraumatic growth EEG neuromarkers: translational neural comparisons with resilience and PTSD in trauma-exposed healthy adults

ABSTRACT Background: Supporting wellbeing beyond symptom reduction is necessary in trauma care. Research suggests increased posttraumatic growth (PTG) may promote wellbeing more effectively than posttraumatic stress disorder (PTSD) symptom reduction alone. Understanding neurobiological mechanisms of PTG would support PTG intervention development. However, most PTG research to-date has been cross-sectional data self-reported through surveys or interviews. Objective: Neural evidence of PTG and its coexistence with resilience and PTSD is limited. To advance neural PTG literature and contribute translational neuroscientific knowledge necessary to develop future objectively measurable neural-based PTG interventions. Method: Alpha frequency EEG and validated psychological inventories measuring PTG, resilience, and PTSD symptoms were collected from 30 trauma-exposed healthy adults amidst the COVID-19 pandemic. EEG data were collected using custom MNE-Python software, and a wireless OpenBCI 16-channel dry electrode EEG headset. Psychological inventory scores were analysed in SPSS Statistics and used to categorise the EEG data. Power spectral density analyses, t-tests and ANOVAs were conducted within EEGLab to identify brain activity differentiating high and low PTG, resilience, and PTSD symptoms. Results: Higher PTG was significantly differentiated from low PTG by higher alpha power in the left centro-temporal brain area around EEG electrode C3. A trend differentiating high PTG from PTSD was also indicated in this same location. Whole-scalp spectral topographies revealed alpha power EEG correlates of PTG, resilience and PTSD symptoms shared limited, but potentially meaningful similarities. Conclusion: This research provides the first comparative neural topographies of PTG, resilience and PTSD symptoms in the known literature. Results provide objective neural evidence supporting existing theory depicting PTG, resilience and PTSD as independent, yet co-occurring constructs. PTG neuromarker alpha C3 significantly delineated high from low PTG and warrants further investigation for potential clinical application. Findings provide foundation for future neural-based interventions and research for enhancing PTG in trauma-exposed individuals.

High Lifetime Blast Exposure Using the Blast Exposure Threshold Survey Is Associated With Worse Warfighter Brain Health Following Mild Traumatic Brain Injury.

The purpose of this study was to extend previous research by examining the relationship between lifetime blast exposure and neurobehavioral functioning after mild TBI (MTBI) by (a) using a comprehensive measure of lifetime blast exposure, and (b) controlling for the influence of post-traumatic stress disorder (PTSD). Participants were 103 United States service members and veterans (SMVs) with a medically documented diagnosis of MTBI, recruited from three military treatment facilities (74.8%) and community-based recruitment initiatives (25.2%, e.g., social media, flyers). Participants completed a battery of neurobehavioral measures 12 or more months post-injury (Neurobehavioral Symptom Inventory, PTSD-Checklist PCLC, TBI-Quality of Life), including the Blast Exposure Threshold Survey (BETS). The sample was classified into two lifetime blast exposure (LBE) groups: High (n = 57) and Low (n = 46) LBE. In addition, the sample was classified into four LBE/PTSD subgroups: High PTSD/High LBE (n = 38); High PTSD/Low LBE (n = 19); Low PTSD/High LBE (n = 19); and Low PTSD/Low LBE (n = 27). The High LBE group had consistently worse scores on all neurobehavioral measures compared with the Low LBE group. When controlling for the influence of PTSD (using ANCOVA), however, only a handful of group differences remained. When comparing measures across the four LBE/PTSD subgroups, in the absence of clinically meaningful PTSD symptoms (i.e., Low PTSD), participants with High LBE had worse scores on the majority of neurobehavioral measures (e.g., post-concussion symptoms, sleep, fatigue). When examining the total number of clinically elevated measures, the High LBE subgroup consistently had a greater number of clinically elevated scores compared with the Low LBE subgroup for the majority of comparisons (i.e., four to 15 or more elevated symptoms). In contrast, in the presence of clinically meaningful PTSD symptoms (i.e., High PTSD), there were no differences between High versus Low LBE subgroups for all measures. When examining the total number of clinically elevated measures, however, there were meaningful differences between High versus Low LBE subgroups for those comparisons that included a high number of clinically elevated scores (i.e., six to 10 or more), but not for a low number of clinically elevated scores (i.e., one to five or more). High LBE, as quantified using a more comprehensive measure than utilized in past research (i.e., BETS), was associated with worse overall neurobehavioral functioning after MTBI. This study extends existing literature showing that lifetime blast exposure, that is largely subconcussive, may negatively impact warfighter brain health and readiness beyond diagnosable brain injury.

Effect of traumatic experiences and future threats on executive functioning and verbal fluency amongst Farsi-Dari speaking immigrants, refugees, and asylum seekers

BackgroundImpairments in executive functioning associated with posttraumatic stress disorder (PTSD) may impact the capacity of refugees and asylum seekers. AimsTo examine the association between executive functioning and PTSD with and without prominent future-focused threat (FFT) intrusions at rest and after threat priming. Method66 Farsi and Dari-speaking asylum-seekers, refugees, and immigrants were recruited into 3 groups: High PTSD & FFT Symptoms; High PTS Symptoms; Low PTSD & FFT symptoms. The Category Fluency Test (animals; food; flora) in Farsi was administered at baseline and after two counter-balanced future- and past-focused threat narrative tasks. Results: Higher PTSD and FFT symptom scores was associated with reduced verbal fluency [correct words (PTS p < 0.001; FFT p < 0.007), clustered words (PTS, p < 0.004; FFT p < 0.009) and clusters (PTS p < 0.017; FFT p < 0.009)]. The PTSD group retrieved fewer correct words (17.6, p < 0.009) using fewer clusters (p < 0.008) than the low-symptom group at baseline. It was only after exposure to the narrative task that the FFT group displayed comparable impairment. ConclusionsA subset of displaced persons with future threat symptoms exhibit cognitive impairment when asked to recount narrative details. Future threat may limit capacity to engage in cognitively demanding activities, such as participating in Refugee Status Determination.

Early Aftermath of February 6 Earthquakes in Turkey: PTSD, PTG, and Resilience

On February 6, 2023, earthquakes with magnitudes of 7.7 and 7.6 on the Richter scale struck Turkey, impacting eleven cities within Turkey and adjacent parts of Syria. This study investigates the immediate aftermath (50 days after the disaster) effects of these earthquakes on survivors. The primary focus is on posttraumatic stress disorder (PTSD) and post-traumatic growth (PTG), coupled with an exploration of the explanatory roles played by resilience, intolerance to uncertainty, and anxiety. For data collection, the study employs instruments such as the PTSD Checklist for DSM-5, Beck Anxiety Inventory, Brief Resilience Scale, PTG Inventory, and Intolerance to Uncertainty Scale. For the analysis, PTSD groups were formed (categorized using cutoff scores based on PTSD severity [69% high PTSD, 31% low PTSD]) and subjected to t-tests. In addition, multiple regression analysis is utilized to assess whether anxiety, resilience, and intolerance to uncertainty account for variations in PTSD and PTG. The findings revealed that the high PTSD group exhibited higher levels of anxiety, PTG, and intolerance to uncertainty, while displaying lower age and resilience in comparison to the low PTSD group. Moreover, the study found that intolerance to uncertainty (specifically in the inhibitory anxiety subscale), anxiety, and age significantly contributed to explaining PTSD. For PTG, the predictors were intolerance to uncertainty (inhibitory anxiety subscale), resilience, and age. This study underscores the significance of anxiety, resilience, and intolerance to uncertainty in comprehending PTG and PTSD. While PTSD was perceived as a negative aftermath of trauma, PTG was seen as a positive facet.

Posttraumatic stress symptom profiles of aid workers: Identifying risk and protective factors.

Researchers have documented elevated rates of posttraumatic stress disorder (PTSD) in aid workers. Yet, few have investigated the heterogeneity of PTSD presentations in this population. This study examined clinically relevant patterns of PTSD symptomatology in aid workers and examined whether factors such as the degree of trauma exposure (e.g., morally injurious events), social support, and sociodemographic and work characteristics predict symptom profiles. Participants were 243 aid workers who had completed 8.2 assignments on average. They completed measures of trauma exposure, PTSD symptoms, and various types of social support. Latent profile analysis was used to identify PTSD symptom profiles using PCL-5 subscale scores. Next, profiles were compared on 15 potential risk and protective factors. Five profiles were identified: a no PTSD profile (49.4%), a low subclinical PTSD profile (21.8%), a dysphoric subclinical PTSD profile (5.8%), an intermediate clinical PTSD profile (14.8%), and a severe clinical PTSD profile (8.2%). Profiles differed in terms of witnessed traumatic events, morally injurious exposure, social support adequacy, age, number of assignments, types of assignments, and organizational support. This study is the first to identify distinct patterns of PTSD symptomatology in aid workers and to investigate novel psychological risk factors such as potentially morally injurious events. Overall, these findings provide further insight into the risk and protective factors for the psychological well-being of aid workers as well as avenues for improving the psychological assessment and support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Latent class analysis of post-traumatic stress disorder symptoms following exposure to Hurricane Ike

BackgroundThere is substantial heterogeneity in how people react to potentially traumatic events (PTEs). Although some literature has explored this heterogeneity, there are only a few studies identifying factors associated with it within the disaster literature. ObjectiveThe current investigation identified latent classes of post-traumatic stress disorder (PTSD) symptoms and differences between these classes after exposure to Hurricane Ike. MethodsAdults living in Galveston and Chambers County, Texas, (n = 658) completed a battery of measures during an interview conducted two to five months after Hurricane Ike. Latent class analysis (LCA) was performed to identify latent classes of PTSD symptoms. Additionally, gender, age, racial or ethnic minority status, depression severity, anxiety severity, quality of life, perceived need for services, and disaster exposure were examined to explore class differences. ResultsLCA supported a 3-class model with low (n = 407, 61.9%), moderate (n = 191, 29.0%), and high PTSD symptoms (n = 60, 9.1%). Women appeared most at-risk for a moderate-severity presentation as compared to a low-severity presentation. Further, racial or ethnic minority groups appeared most at-risk for a high-severity presentation as compared to a moderate-severity presentation. Overall, the high symptom class had the poorest well-being, the most perceived need for services, and the highest exposure to the disaster, followed by the moderate symptom class, and finally the low symptom class. ConclusionsPTSD symptom classes appeared to be differentiated primarily by overall severity as well as important psychological, contextual, and demographic dimensions.

Posttraumatic stress as a moderator of the association between HPA-axis functioning and alcohol use disorder among a community sample of women currently experiencing intimate partner violence.

Women experiencing intimate partner violence (IPV) experience a heightened prevalence of alcohol use disorder (AUD). Hypothalamic-pituitary-adrenal (HPA)-axis functioning has been associated with increased risk for AUD in other populations, including individuals with posttraumatic stress disorder (PTSD) symptoms. The goal of the present study was to determine whether PTSD symptom severity exacerbates the relationship between HPA-axis functioning and AUD. Participants were 151 community women who had experienced physical or sexual IPV in the past 30 days by their current male partners and used any amount of alcohol or drugs. A two-phase emotion induction protocol was utilized: Neutral mood induction followed by randomly assigned negative, positive, or neutral emotion induction. Saliva cortisol samples were obtained immediately following the neutral mood induction (baseline HPA-axis functioning), 20 min following the individualized emotion induction script (HPA-axis reactivity), and 40 min post the emotionally evocative cue (HPA-axis recovery). Findings revealed that PTSD symptom severity moderated the relations between baseline HPA-axis functioning and HPA-axis recovery and log odds of meeting criteria for AUD. Specifically, baseline HPA-axis functioning was positively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity, whereas HPA-axis recovery was negatively associated with log odds of meeting criteria for AUD at high (but not low) PTSD symptom severity. Results contribute to our understanding of the biological processes involved in the etiology and maintenance of AUD among women experiencing IPV-specifically the prominent role of PTSD symptom severity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Assessment of Post-Traumatic Stress Disorders and its Associations with Suicidal Behaviour among Adults Following Movement Control Order During COVID-19 Pandemic in Malaysia

A rapid review of previous outbreaks shows that a quarantine policy had greater effects on one’s psychological state including post-traumatic stress disorder (PTSD), confusion and anger caused by various stressors. This study aimed to assess the levels of Post-Traumatic Stress Disorder (PTSD) and its associations with suicidal behavior among Malaysian adults following Movement Control Order (MCO) during the COVID-19 pandemic in Malaysia. This cross-sectional study was distributed using an online standardized questionnaire composed of three parts, the socio-demographic characteristics, PTSD assessment using PTSD Checklist for DSM-5 and the suicidal behavior assessment using Suicidal Behaviors Questionnaire-Revised (SBQ-R). Almost half of the respondents had high PTSD symptoms (41.7 %) and low PTSD was 58.3 % among Malaysian adults. Furthermore, 69.6 % of participants had no suicidal behavior but, 30.4 % from the participants has suicidal behavior. This study found single status with highest PTSD (83.3 %) and marital status had significant correlation with PTSD which p-value was &lt; 0.05. Malay was high percentage in high PTSD (74.6 %) and significant correlation between race and PTSD (p &lt; 0.05). Employment status also had significant correlation with PTSD with p-value was 0.002 and students was counted highest PTSD (65.7 %). This study identified some socio-demographic factors and suicidal behavior associated with PTSD among Malaysian adults, which may lay ground for further interventions.

Posttraumatic stress disorder and functional impairment among World Trade Center Health Registry enrollees 14-15 years after the September 11, 2001, terrorist attacks.

The September 11, 2001, terrorist attacks on the World Trade Center (WTC) in New York City (9/11) had health-related consequences, including posttraumatic stress disorder (PTSD). PTSD is associated with functional impairment, which varies by symptom severity and other factors. This study aimed to identify predictors of functional impairment in individuals with low versus high PTSD symptom severity levels. WTC Health Registry enrollees exposed to 9/11 were surveyed four times between 2003 and 2015; cumulated data for individuals who endorsed at least one symptom on the PTSD Checklist-Civilian Version (PCL-C) at Wave 4 (2015-2016) were included (N = 30,287) and examined cross-sectionally. Individuals were classified based on PCL-C scores as having low/no (2-29) or high levels of PTSD symptom severity (≥ 44). Functional impairment was defined as subsequent difficulties in daily living. Among low/no PTSD severity participants, adjusted odds ratios (aORs) for the associations between functional impairment and poor self-rated health (vs. good), low social support (vs. high), and no physical activity (vs. active) were 1.23-1.92. In the same group, low versus high household income was associated with more functional impairment, aOR = 1.34, 95% CI [1.13, 1.59]. Among participants with high-level PTSD symptoms, women, aOR = 1.70, 95% CI [1.31, 2.20], and Hispanic enrollees, aOR = 1.76, 95% CI [1.31, 2.36], were more likely to report an absence of impairment. Self-rated health, social support, and physical activity emerged as important predictors of PTSD-related functional impairment across PTSD symptom severity levels, supporting clinical interventions targeting these factors.

Posttraumatic stress disorder symptoms and timing of menopause and gynecological surgery in the Nurses' Health Study II

BackgroundEarlier menopause, either natural or through gynecologic surgeries, has been associated with various negative health sequelae. While posttraumatic stress disorder (PTSD) has been linked to dysregulated biological processes, including reproductive system changes that could alter menopausal timing, little work has examined whether trauma and PTSD are associated with greater risk of early cessation of menses. MethodsData are from 46,639 women in the Nurses' Health Study II, a prospective cohort study of women followed for up to 26 years. Lifetime trauma and PTSD symptoms were assessed with the Brief Trauma Questionnaire and a PTSD symptom screener in 2008. Age at cessation of menses and reason for cessation of menses (i.e., natural menopause, gynecologic surgery including hysterectomy and/or bilateral salpingo-oophorectomy [BSO]) were assessed. Cox proportional hazards models estimated hazards ratios (HR) of cessation of menses (separately for naturally or surgically) associated with trauma alone or PTSD symptoms, relative to no trauma, adjusting for covariates. ResultsTrauma/PTSD status was associated with earlier cessation of menses due to surgery, but not natural menopause. Women with trauma exposure, low, and high PTSD symptoms had higher hazard of cessation of menses due to surgery relative to those with no trauma exposure (HRtrauma = 1.16, 95%CI 1.07–1.26; HRlow PTSD = 1.25, 95%CI 1.15–1.36; HRhigh PTSD = 1.29, 95%CI 1.17–1.42). Trauma exposure and PTSD symptoms were associated with similarly increased risk of hysterectomy and BSO surgeries. ConclusionsWomen who experienced trauma and PTSD may be at elevated risk for common gynecological surgeries premenopausally, potentially due to increased clinical indications or gynecological conditions.

Supporting business educators and students against COVID-19 trauma using trauma-focused cognitive behavioral therapy.

Background:The outbreak of COVID-19 manifests in peoples’ mental health and psychological dispositions and may also result to acute distress, depression, anxiety and post-traumatic stress disorder (PTSD) on victims. The objective of this study was to support business educators’ and students’ mental health against coronavirus trauma using trauma-focused cognitive behavioral therapy (TF-CBT).Methods:The participants (n = 74 – educators and students) who indicated PTSD symptoms based on the self-reporting questionnaire they filled, were randomly assigned to treatment and waitlist control groups. The TF-CBT manual was used for the intervention. The intervention was a 14-week treatment with 2 weeks follow-up meeting. Using repeated measures of Analysis of Variance, we determined the level of improvement of each participant in the treatment group against Coronavirus trauma at the end of the intervention.Results:The study established that gender has no significant difference in determining the effects of Coronavirus trauma on participants. Through intervention, the PTSDs and depression arising from Coronavirus event were significantly reduced in the treatment group. Again, there was a significant improvement in the participants’ general mental health at the end of the intervention. Hence, we established the implication for research and practice in line with the outcome of the study. The study advocates that TF-CBT should be employed by educational institutions in Nigeria to cushion the traumatic effects of coronavirus and future disasters on both workers and students.Conclusion:We conclude that mental health problems remain a serious challenge among business educators and students in this COVID-19 pandemic era. The study established that low educational qualifications, PTSD symptoms and negative coping strategies are the factors aggravating the general low mental health of the study participants. Finally, we advocate that the educational institutions in Nigeria should adopt TF-CBT interventions to support staff and students’ mental health against adverse effects of COVID-19.

A latent profile analysis of the dissociative subtype of PTSD in a sample of UK Armed Forces veterans residing in Northern Ireland

Background: Posttraumatic stress disorder (PTSD) and dissociation have long been associated with each other. In recent years, studies have examined support for the dissociative subtype of PTSD in several different populations. To date, no study has examined whether this subtype exists in UK Armed Forces military veterans residing in Northern Ireland. Northern Ireland has a history of prolonged civil conflict, differentiating the veterans who live in the region from veterans who live in the remainder of the United Kingdom; and increasing the likelihood that they will experience mental health difficulties. Methods: Data was collected through a cross-sectional, self-report survey from military veterans living in Northern Ireland. The effective sample for the current study was 834 veterans (90.38% males, mean age 55.81 years). A latent profile analysis of PTSD and dissociative indicators was conducted to examine the existence of the dissociative PTSD subtype. Results: Four quantitatively different latent profiles were identified; Non-symptomatic, Low PTSD, Moderate PTSD and High PTSD. There was no evidence of a dissociative PTSD subtype. Several military-type variables differentially predicted membership in the latent profiles, including combat exposure, length of service, physical injuries during service and having been medically discharged. Conclusions: The results do not support the Subtype model of the relationship between PTSD and dissociation. However, they have important implications for clinicians working with veterans in the region, as it appears that dissociation is an integral part of the PTSD presentation in Northern Irish veterans.

The impact of neurotoxicant exposures on posttraumatic stress disorder trajectories: The Ft. Devens Gulf War Veterans Cohort.

Gulf War veterans (GWVs) were exposed to neurotoxicants, including sarin nerve gas, anti–nerve agent pills, pesticides, oil well fires, and fumes from unvented tent heaters, all of which have been associated with subsequent adverse health. Posttraumatic stress disorder (PTSD) symptoms have also been associated with GW deployment; however, associations between exposures and PTSD symptoms have not been investigated. We assessed PTSD symptom trajectories and associations with neurotoxicant exposures in Ft. Devens Cohort (FDC) veterans (N = 259) who endorsed trauma exposure during deployment and completed the PTSD Checklist at three follow‐ups (1992–1993, 1997–1998, 2013–2017). Results indicate that among veterans with more severe initial PTSD symptoms, symptoms remained significantly higher across follow‐ups, Bs = −1.489–1.028, whereas among those with low initial PTSD symptoms, symptom severity increased significantly over time, Bs = 1.043–10.304. Additionally, neurotoxicant exposure was associated with a significant increase in PTSD symptoms, Bs = −1.870–9.003. Significant interactions between time and exposures were observed for PTSD symptom clusters, suggesting that among participants with high initial PTSD symptom, unexposed veterans experienced symptom alleviation, whereas exposed veterans’ PTSD symptoms remained high. In GWVs with low initial PTSD symptoms, both unexposed and exposed veterans experienced PTSD symptom exacerbations over time; however, this occurred at a faster rate among exposed veterans. These findings suggest that in the years following deployment, GWVs who were exposed to both traumatic events and neurotoxicants may experience more severe and chronic PTSD symptoms than those without neurotoxicant exposures.

Vulnerability and resilience among older South Korean Vietnam war veterans: A latent profile analysis.

Relatively little is known about South Korean Vietnam War veterans, despite their being the second largest contingent of troops during the Vietnam War. Earlier research found elevated levels (39%) of post-traumatic stress disorder (PTSD) in this older population, due to high exposure to combat and malevolent environments (Lee et al., 2020). The present study investigated classes of vulnerability and resilience among older South Korean Vietnam War veterans, using a latent profile analysis (LPA) on PTSD symptoms, late onset stress symptomology (LOSS), and mental well-being (MWB). The sample consisted of 367 older male veterans from South Korea (Mage = 72, SD = 2.66) who completed surveys. The LPA yielded five classes. The largest (38%) was Average (average PTSD, LOSS, and MWB levels), and the second largest (31%) was characterized by Moderate Distress (moderately high PTSD and LOSS, average MWB). A small group (13%) reported Low Affect (low PTSD, LOSS, and MWB levels), and 7% expressed Severe Distress (high LOSS and PTSD levels, average MWB). Only a small percentage (12%) were characterized by Resilience (low PTSD, average LOSS, high MWB). Optimism, positive appraisals of military service, and social support from family, significant others, friends, and military peers were highest among veterans in the Resilience class. To our knowledge, this is the first study of resilience among East Asian military veterans, and more research is needed on how resilience can be improved. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Frontal Alpha Asymmetry in Posttraumatic Stress Disorder: Group Differences Among Individuals With and Without PTSD During an Inhibitory Control Task.

The current study examined frontal alpha asymmetry (FAA) as a marker of approach- and avoidance-related prefrontal activity in participants with and without trauma exposure and posttraumatic stress disorder (PTSD). We investigated FAA in an inhibitory control paradigm (threatening vs nonthreatening cues) under 2 levels of cognitive demand (baseline: images constant within a block of trials; vs filtering: images varied randomly within a block) in 3 groups of participants: individuals with PTSD (n = 16), exposed to trauma but without PTSD (n = 14), and a control group without PTSD or trauma exposure (n = 15). Under low demand (baseline), both PTSD and trauma-exposed participants exhibited significantly greater relative left than right frontal brain activity (approach) to threatening than to nonthreatening images. Under high demand (filtering), no FAA differences were found between threatening and nonthreatening images, but PTSD participants revealed more relative left than right FAA, whereas trauma-exposed participants showed reduced left relative right FAA. In all conditions, healthy controls exhibited reduced left relative to right FAA and no differences between threatening and nonthreatening images. Study findings suggest dysfunctional prefrontal mechanisms of emotion regulation in PTSD, but adaptive prefrontal regulation in trauma-exposed individuals without PTSD.

Delayed post-traumatic stress and memory inflation of life-threatening events following a natural disaster: prospective study.

The causes of delayed post-traumatic stress disorder (PTSD) are debated, and the validity of late-onset PTSD has been questioned. We aimed to examine predictors of delayed PTSD in a community sample of survivors of a natural disaster. Norwegian survivors of the 2004 Indian Ocean tsunami (n = 532) responded to a questionnaire at 6 and 24 months post-disaster. The questionnaire measured PTSD symptoms, recalled exposure and immediate stress responses to the disaster, recalled perceived life threat, personality dimensions, social support and other subsequent adverse life events. When dichotomising PTSD symptom scores, 331 participants had low and 194 had high PTSD scores (early-onset PTSD) at 6 months. Of those with initially low scores, 43 (13.0%) had high symptom scores (delayed PTSD) at 24 months. The delayed PTSD group had a lower degree of initially assessed threat and witness experiences of death or suffering, lower immediate stress response and higher degree of memory inflation of perceived threat than the early-onset PTSD group. Among those with low PTSD scores at 6 months, onset of delayed PTSD was associated with neuroticism and memory inflation of life threat, but not with the degree of initially assessed disaster exposure or reports of subsequent adverse life events. Lack of association between trauma exposure and delayed onset of PTSD symptoms casts doubt on whether the traumatic event is actually the primary causative factor for delayed PTSD. Our findings suggest that delayed PTSD may be a manifestation of personality factors and memory inflation of the severity of an event.