Nature Of Posttraumatic Stress Disorder Research Articles

Reuniting with Michael: An Autoethnography of a Police Officer’s Experience with PTSD

This article presents an autoethnographic exploration of trauma experienced by the author, a former police officer turned academic and an offender whom the author knew in his former and current roles. By intertwining personal narratives, the study sheds light on the multifaceted nature of post-traumatic stress disorder (PTSD) and its profound consequences. The article’s objective is twofold: to provide an intimate and introspective account of trauma experienced within the context of violent victimization and to underscore the effects of PTSD, the transformative potential of therapeutic interventions, and the consequences of its absence. Writing in an evocative style, the author delves into his experiences as a police officer and reflects on the emotional and psychological effects of exposure to violence, both from his perspective and of the participant. The article emphasizes the importance of incorporating subjective dimensions of lived experiences expressed through personal voice. Ultimately, this autoethnographic study adds to the growing body of research on trauma by providing unique insights into the experiences of both trauma survivors. By sharing personal narratives, the article aims to contribute to a deeper understanding of trauma and its long-lasting effects while emphasizing the importance of therapeutic interventions for healing and resilience.

The nature of posttraumatic stress disorder in treatment-seeking first responders

ABSTRACT Background Approximately 10% of first responders report posttraumatic stress disorder (PTSD). Although reports within first responders suggest that they have distinct symptom presentations, there is a need to understand how the clinical profiles of first responders may differ from others seeking treatment for PTSD. Objective This study compared the PTSD symptom profiles of first responder and civilians seeking treatment for PTSD. Method Participants self-referred to the Traumatic Stress Clinic (University of New South Wales, Sydney) for enrolment in out-patient treatment trials for PTSD. Participants comprised people of mean age 41.72 years (SD = 10.71) who met DSM-IV criteria for PTSD. The sample was composed of 128 first responders and 182 civilians. Clinician-administered interviews of PTSD (Clinician-Administered PTSD Scale) and depression were conducted, as well as measures of self-report measures of depression, alcohol use, posttraumatic appraisals, and anger. Results First responders reported greater rates of dysphoric cluster of symptoms, including diminished interest, emotional numbing, and social detachment, and less psychological reactivity and avoidance of situations, than civilians with PTSD. Beyond PTSD symptoms, first responders also reported more severe levels of depression and suppressed anger. Conclusions These findings indicate that treatment-seeking first responders present with a distinct clinical profile that is characterized by dysphoric symptoms. These symptoms can predict poor treatment response and require specific attention in treating PTSD in first responders.

Disturbed Sleep Connects Symptoms of Posttraumatic Stress Disorder and Somatization: A Network Analysis Approach.

Posttraumatic stress disorder (PTSD) and physical health problems, particularly somatic symptom disorder, are highly comorbid. Studies have only examined this co-occurrence at the disorder level rather than assessing the associations between specific symptoms. Using network analysis to identify symptoms that act as bridges between these disorders may allow for the development of interventions to specifically target this comorbidity. We examined the association between somatization and PTSD symptoms via network analysis. This included 349 trauma-exposed individuals recruited through the National Centre for Mental Health PTSD cohort who completed the Clinician-Administered PTSD Scale for DSM-5 and the Patient Health Questionnaire-15. A total of 215 (61.6%) individuals met the DSM-5 diagnostic criteria for PTSD. An exploratory graph analysis identified four clusters of densely connected symptoms within the overall network: PTSD, chronic pain, gastrointestinal issues, and more general somatic complaints. Sleep difficulties played a key role in bridging PTSD and somatic symptoms. Our network analysis demonstrates the distinct nature of PTSD and somatization symptoms, with this association connected by disturbed sleep.

“Their pain is our pain”: The lived experience of intimate partners in Veteran recovery from PTSD

Introduction: Social support, particularly support from an intimate partner, is both a significant protective factor for trauma-exposed Veterans and critical for recovery in mental health, yet we know little about the experiences and support needs of their partners, particularly in the Australian context. This study examined the multidimensional nature of experiences of being an intimate partner of a contemporary Veteran with posttraumatic stress disorder (PTSD). Methods: The authors used a qualitative phenomenological approach to conduct an inductive thematic analysis of data collected through individual interviews with a purposive sample of 10 partners of contemporary Veterans living in Australia. Interviewees were recruited through a range of community support organizations. Results: Analysis revealed intimate partners are crucial participants in supporting the recovery journey for traumatized Veterans, effectively managing day-to-day care, encouraging autonomy and instilling hope. However, descriptions highlighted that lack of understanding of partners’ daily lives, and particularly their commitment to maintaining their intimate relationship, by health care providers and government results in a sense of invisibility and is the key barrier to receiving the support they need in order to support recovery in their Veteran partners. Discussion: The findings underscore the importance of recognizing the role of intimate relationships in trauma recovery and of responding to the support needs of intimate partners. In particular, the findings have clear implications for improving the engagement by health care providers of partners of Veterans with PTSD in Veteran clinical treatment. More formal recognition of the indirect impact of PTSD on partners of Veterans is also needed within organizational policies and procedures. Finally, there is clearly a need for continuing education of health care providers, government staff and the general community about the nature of PTSD and its impacts on relationships, particularly the intimate type.

Associations between changes in resilient coping and posttraumatic stress disorder symptoms.

The pervasive, damaging nature of posttraumatic stress disorder (PTSD) presents enormous clinical challenges. Understanding the relationship between patients' perceptions of PTSD symptoms and resilient coping strategies may prompt investigation of clinical interventions that improve adaptive, resilient coping skills. In this study, we examined whether changes in resilient coping were related to changes over time in the PTSD symptoms of intrusion and avoidance. A secondary analysis was conducted using longitudinal data from the community-based Washington State Twin Registry. Participants completed the four-item Brief Resilient Coping Scale (BRCS) and the Avoidance and Intrusion subscales of the Impact of Events Scale (IES) at two points in time that were at least 2 years apart. To limit analyses to participants reporting PTSD symptoms at baseline, an initial value of at least 1.0 on either Avoidance (n = 1,337) or Intrusion (n = 1,206) was required for inclusion in the sample. Using linear regression, we assessed associations of change in BRCS with a change in IES scores, controlling for the respective initial scores on each measure. Controlling for initial BRCS and IES-Intrusion values, we observed a small, statistically significant association between change in BRCS and change in IES-Intrusion scores (b* = -0.07; p = .003). There was no statistically significant association between change in BRCS and change in IES-Avoidance (b* < 0.01; p = .869). In this large, longitudinal sample, increases in resilient coping were related to decreases in intrusive thoughts over time. Because coping patterns can be taught, these results warrant further investigations into adaptive coping patterns associated with diminishing PTSD symptoms.

Violent and Threatening Behavior of War Veterans with Post Traumatic Stress Disorder! The Forced Psychiatric Treatment is an Obligation, or is A Violence of Human Rights? Case Presentation

This article presents the definition and nature of Posttraumatic Stress Disorder, Psychotic Depression as its co-morbidity, and consequences of untreated cases and also presents the models of treatment and psychological mechanisms of coping.

Self-affirmation attenuates death-thought accessibility after mortality salience, but not among a high post-traumatic stress sample.

According to anxiety buffer disruption theory (ABDT), people function effectively in the world, in part, by relying on anxiety-buffer systems to protect against death awareness; however, traumatic experiences can overwhelm and disrupt those anxiety-buffer systems, leaving people unprotected from death awareness and at increased risk for the major symptom clusters of posttraumatic stress disorder (PTSD). Based on that idea, it was hypothesized that (a) when posttraumatic stress symptoms are low, self-affirmation (a known worldview/self-esteem based anxiety-buffer) should prevent mortality reminders from causing increased death-thought accessibility (DTA); but that (b) when posttraumatic stress symptoms are high (indicating anxiety-buffer disruption), self-affirmation should fail to prevent mortality reminders from increasing DTA. To test these hypotheses, participants identified in a general population prescreen assessment as "low posttraumatic-stress symptom" (n = 222) and "high posttraumatic-stress symptom" (n = 210) were reminded of death (vs. control topic), prompted to engage in a self-affirmation (vs. nonself-affirmation) task, and then asked to complete a standard assessment of death-thought accessibility (DTA). The hypotheses were confirmed, revealing that posttraumatic stress symptoms were associated with the ineffectiveness of anxiety-buffer system in protecting against increased death awareness. The present findings support of a foundational concept of ABDT, and point to new insights about the nature of PTSD and its treatment, because failure to manage death awareness is known to cause anxiety and exacerbate anxiety-related disorders (e.g., PTSD). (PsycINFO Database Record

Army STARRS Study Hints at Association Between PTSD, Immune-Related Disorders

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessArmy STARRS Study Hints at Association Between PTSD, Immune-Related DisordersAaron LevinAaron LevinSearch for more papers by this authorPublished Online:1 Jun 2016https://doi.org/10.1176/appi.pn.2016.6a25AbstractA genomewide association study of 13,000 U.S. Army soldiers identifies two genetic variants that may be associated with posttraumatic stress disorder.Two coordinated genomewide association studies including more than 13,000 U.S. Army soldiers have found only elusive genetic associations with posttraumatic stress disorder (PTSD).iStock/tab1962The studies were part of the Army STARRS collaboration, a multi-year, multimillion-dollar effort designed “to improve understanding of suicide and PTSD and related mental health risk and resilience in the U.S. Army.”Genetic studies of people with PTSD are valuable because only a small minority of individuals exposed to trauma develop the disorder. While the difference between those who do and do not develop PTSD could be due to social factors or preexisting risk factors, several twin studies have shown that genetic variation contributes to risk for PTSD symptoms. For the current study, Murray Stein, M.D., M.P.H., a professor of psychiatry, family medicine, and public health at the University of California, San Diego, and colleagues analyzed DNA from two study groups within STARRS: The New Soldier Study (NSS) compared 3,167 patients with PTSD with 4,607 trauma-exposed control individuals; the Pre/Post Deployment Study (PPDS) compared 947 patients with PTSD with 4,969 trauma-exposed controls.In the NSS group, a single-nucleotide polymorphism (SNP) on chromosome 19 was associated with PTSD in European Americans. A SNP on chromosome 5 was also associated with PTSD among African Americans. Neither of these associations were seen in the PPDS sample.Within the African-American sample in the NSS, however, the authors observed genomewide significant association with PTSD for SNPs in anankyrin repeat domain 55 (ANKRD55) gene on chromosome 5. Why this association is limited to African Americans is not clear.“[Controlling] for population stratification increases the likelihood of finding genetic variation that is not spuriously associated with ancestry markers and increases the chances of finding differences that are marked by variation in one group and not another,” explained Kerry Ressler, M.D., Ph.D., a professor of psychiatry and chief scientific officer at McLean Hospital in Belmont, Mass., in an accompanying editorial.The function of ANKRD55 is not known but has been reported to be associated with certain autoimmune and inflammatory disorders, like multiple sclerosis, type 2 diabetes mellitus, celiac disease, and rheumatoid arthritis.The authors also reported significant pleiotropy was observed for PTSD and rheumatoid arthritis and psoriasis in the European American samples.“Intriguingly, all of these immune-related disorders have been associated, to different extents, with environmental and psychological stress exposure,” commented Ressler. “This set of findings adds to the literature the idea that although a number of different genetic and trauma-related mechanisms intersect to create increased risk for PTSD, some of these mechanisms may directly involve inflammatory responses,” Ressler continued. “In fact, inflammation as a mediator—or a result—of dysregulated stress responses, in part via dysregulated hypothalamic-pituitary-adrenal regulation, is increasingly being appreciated as an important component of a variety of stress-related syndromes, including depression and PTSD.”Stein and colleagues noted that while the association of ANKRD55 with PTSD in African American participants was “small in magnitude,” the findings may help to elucidate “the nature of PTSD and its association with other illnesses.”The authors concluded, “The finding of pleiotropy between PTSD and rheumatoid arthritis and psoriasis should further motivate the study of immune-related factors in PTSD, their potential contribution to comorbidity with inflammatory disorders, and a possible role for anti-inflammatory treatments in PTSD.” The findings appeared online May 11 in JAMA Psychiatry. The study was sponsored by the Department of the Army and supported by the Department of Health and Human Services, National Institutes of Health, and National Institute of Mental Health. ■“Genomewide Association Studies of Posttraumatic Stress Disorder in 2 Cohorts of US Army Soldiers” can be accessed here. The related editorial, “The Intersection of Environment and the Genome in Posttraumatic Stress Disorder,” is available here. ISSUES NewArchived

Post-Traumatic Stress Disorder: Recovery After Accident and Disaster Gournay Kevin Post-Traumatic Stress Disorder: Recovery After Accident and Disaster 116pp £8.99 Sheldon Press 9781847093202 1847093205

THIS IS a short and precise book that explains the nature of post-traumatic stress disorder (PTSD), treatments available and some self-help tools and techniques. It lists some useful organisations that people living with PTSD and allied problems can contact for help.

Postulating Traumatic Stress Disorders

This special issue of Biological Psychiatry, “Understanding PTSD: From Mind to Molecules,” is focused on neurobiological studies that inform our scientific approach to posttraumatic stress disorder (PTSD). By virtue of the requirement that a lifethreatening stressor precede its onset, PTSD is distinguished from other mental disorders. Although mental health clinicians and researchers acknowledge the contributions (and presumably very complex interactions) of psychological, social, and biological factors in the generation of virtually all mental disorders, only PTSD (and the other trauma and stressorrelated disorders with it shares a chapter in DSM-5) has exposure to a traumatic stressor or stressors as a mandatory antecedent. In other words, PTSD is the quintessential biopsychosocially determined disorder; as such, it demands the efforts of a diverse and eclectic set of researchers and experimental methods to understand its etiology and consider novel approaches to its treatment. Such is the spirit of this special issue, where we have brought together a multitalented group of basic and translational researchers to share their insights into the nature of PTSD and its potential prevention and management. The time frame of inquiry begins very early in development, with Rodgers and Bale (1) describing an intriguing body of preclinical work positing the transgenerational transmission of stress through male germ cells; this work has been echoed in clinical studies demonstrating not only an increase in PTSD among adult offspring of survivors of extreme trauma (i.e., the Holocaust) but also a possible epigenetic reflection of that increased risk in glucocorticoid-relevant genes or their promoters (2). Bock et al. (3) review and insightfully integrate a body of animal and human literature that emphasizes possible molecular bases for prenatal stress exposures adversely affecting emotional and cognitive development of the brain. Zannas et al. (4) provide a comprehensive review of epigenetic studies relevant to PTSD and in so doing forge a path for future research in this area, highlighting opportunities and challenges that lie ahead. Together, these articles paint a picture of the brains of certain individuals being primed in utero to experience stressful life experiences differently than others. How can we begin to tie together these observations with findings of specific genetic vulnerabilities for PTSD that may operate through altering stress responsiveness (e.g., FKBP5 and allele-specific demethylation in association with childhood trauma exposure (5))? What is the physiologic and molecular nature of this altered brain response to stress? There is evidence that exposure of the hippocampus to glucocorticoids after stress results in a PTSD-like set of memory impairments that includes the inability to restrict fear to the appropriate context (i.e., there is an overgeneralization of the fear response (6)). Could it be that the hippocampus of individuals at risk for PTSD is exposed to functionally elevated levels of

Panicogens in Patients with Post-Traumatic Stress Disorder (PTSD)

Symptom provocation has proved its worth for understanding the pathophysiology of diseases and in general for the development of new therapeutic approaches in the medical field. In the research of anxiety disorders, investigations using experimentally induced panic attacks by various agents, such as sodium lactate, carbon dioxide, cholezystokinine-tetrapetid etc., have a long tradition and allow the exploration of usually naturally occuring spontaneous psychopathological phenomena under controlled conditions. Post-Traumatic Stress Disorder (PTSD) is a prevalent disorder that can develop following exposure to an extreme traumatic event. In DSM-IV it is currently classified as an anxiety disorder and shares phenomenological similarities with panic disorder. The use of panicogenic challenge tests is also an interesting neurobiological approach to learn more about the nature of PTSD and may be a possibility to develop new therapeutic strategies for the treatment of PTSD symptoms. Not only panic anxiety, but also flashbacks and other dissociative symptoms can be provoked by several panicogens in PTSD. The purpose of this review is to evaluate studies using panicogens in PTSD. Methodological short-comings of current studies and needed directions of further research are discussed.

The Various Care Requirements of Psychotraumatized Subjects: From Linguistic Desert to Therapeutic Perspectives

Background: The cardinal symptoms of posttraumatic stress disorder, which is exhibited as intrusions, avoidance strategies and hypervigilance, are rarely highlighted by psycho traumatized patients when they seek care. Furthermore, the clinical features of posttraumatic stress disorder (PTSD) change over time and vary between patients; thus, a classical description of PTSD that can apply to all patients is more of the exception than the rule. Clinical findings: Many comorbidities affect both the clinical presentation and the development of PTSD. The demand for care is generally expressed via addictive and somatic comorbidities in psycho traumatized subjects: physical bodily injuries are more socially acceptable than psychological injuries. Indeed, the multifaceted nature of PTSD can often mislead clinicians because they tend to focus on the somatic complaints. Psychological comorbidities can also be present, such as depressive and anxiety disorders, dissociative disorders, psychoactive substance use and suicidal behavior. Literature findings: PTSD is favored by a polygenic vulnerability, and a preponderance of susceptibility to neuromodulation implicates various endophenotypes, which explain the different clinical dimensions that are encountered. But no neurobiological study has revealed a biological marker which would apparently and inevitably destine a subject to structure a PTSD in reaction to a stress. In contrast, the psychopathological study discovers afterwards that a particular subject has necessarily built a traumatic repetition syndrome according to the concordance of significant data relating to their history. Conclusion: Although the only FDA-approved drugs for the treatment of PTSD are sertraline and paroxetine, numerous studies have evaluated the use of Serotonin-norepinephrine reuptake inhibitors and atypical antipsychotics. The psychotherapy will thus require active commitment of the subject who far from clearing themselves of the traumatic scene will produce meaning by breaking away from a purely passive position taken at the heart of the tragedy. If the trauma is in essence nonsense, the psychotherapeutic reconstruction will promote this search for a meaning enabling the subject to continue to produce rather than again returning to real death.

Trauma in Children and Adolescents: Issues Related to Age and Complex Traumatic Reactions

Accurate assessment is important to treatment selection, and following traumas is particularly important for children. Traumas may undermine a child's developmental progression as well as emotional health and functioning. A number of developmental issues influence the nature and accurate assessment of traumatic reactions in children and adolescents. Youth reactions and reporting differ from those of adults, which suggest the need for diagnostic criteria and assessment measures specifically designed for varying developmental age groups. This introductory article discusses trauma-related developmental issues and the structure and nature of posttraumatic stress disorder now debated for adults and children. Also addressed are children's complicated trauma-related disorders, which are still being tested and for which measures are newly developed or undergoing revision.

Posttraumatic Stress Disorder: A Case Study of an Elite Rifle Shooter

While posttraumatic stress disorder (PTSD) is most commonly associated with survivors of traumatic events (e.g., combat), PTSD can occur after any situation in which victims perceive that their life or safety is threatened. In sport, athletes often place themselves in dangerous situations and are also exposed to the same lifestyle dangers as the general population. The literature on PTSD among athletes is sparse, and consequently, it is possible that many (non-clinical) sport psychologists would fail to recognize the symptoms and may subsequently fail to refer the athlete to the appropriate professional for clinical assistance. In the following case study, we present an example of an athlete suffering from PTSD following a serious bicycle accident in which she sustained head and facial injuries. We briefly detail the nature of PTSD and discuss how sport psychology services can be implemented alongside a parallel clinical intervention program. Finally, we offer recommendations for practice when working with athletes with PTSD.

Post-traumatic amnesia and the nature of post-traumatic stress disorder after mild traumatic brain injury

The prevalence and nature of post-traumatic stress disorder (PTSD) following mild traumatic brain injury (MTBI) is controversial because of the apparent paradox of suffering PTSD with impaired memory for the traumatic event. In this study, 1167 survivors of traumatic injury (MTBI: 459, No TBI: 708) were assessed for PTSD symptoms and post-traumatic amnesia during hospitalization, and were subsequently assessed for PTSD 3 months later (N = 920). At the follow-up assessment, 90 (9.4%) patients met criteria for PTSD (MTBI: 50, 11.8%; No-TBI: 40, 7.5%); MTBI patients were more likely to develop PTSD than no-TBI patients, after controlling for injury severity (adjusted odds ratio: 1.86; 95% confidence interval, 1.78-2.94). Longer post-traumatic amnesia was associated with less severe intrusive memories at the acute assessment. These findings indicate that PTSD may be more likely following MTBI, however, longer post-traumatic amnesia appears to be protective against selected re-experiencing symptoms.

Anhedonia and emotional numbing in combat veterans with PTSD

We explored relationships between anhedonia and posttraumatic stress disorder (PTSD) symptom clusters, including their role in predicting psychiatric comorbidity. Our measure of anhedonia was derived from an examination of the latent structure of the Beck Depression Inventory. We found evidence for a two-factor solution, leading to anhedonia and undifferentiated, global depressive symptoms scales. In primary analyses, anhedonia had a unique positive relationship with PTSD's emotional numbing symptoms and minimal relationships with other PTSD symptoms. Upon examining the incremental validity of appetitive functioning (i.e., anhedonia, emotional numbing) over and above aversive functioning (i.e., re-experiencing, avoidance, and hyperarousal PTSD symptoms) variables, greater emotional numbing increased the likelihood of being diagnosed with a major depressive disorder, and greater anhedonia increased the likelihood of being diagnosed with additional anxiety disorders and to a lesser extent, psychotic disorders. Results were consistent with research on the distinction of appetitive and aversive functioning, providing insight into the nature of PTSD.

The nature and longitudinal course of psychological trauma

In comprehending the nature of posttraumatic reactions, time is a critical dimension in understanding the nature and severity of reactions. The relationship between the acute reaction to the traumatic event and posttraumatic stress disorder (PTSD) is an issue that is frequently referred to, and many assumptions are presumed. In particular, it is often presumed that those who develop PTSD behave in maladaptive ways at the time of the trauma. Increasingly it appears that there are relatively few differences in the immediate proximity of traumatic events between those who go on to develop PTSD, as opposed to those who do not develop any disorder or develop conditions such as posttraumatic depression. It appears that the disorder emerges in the days and weeks that follow the event, suggesting some abnormality of dampening of reactivity. While PTSD is a valuable construct in describing the long‐term outcomes of trauma, it is important to recognize that there are a range of other psychiatric disorders such as depression, substance abuse and anxiety which can emerge in the aftermath of these experiences. The longer term follow‐up of traumatized populations also increasingly demonstrates the impact on their health and health‐seeking behaviors. The long‐term course of PTSD can best be understood by considering the interaction between a range of biological, psychological and social variables that influence the individual's propensity and predisposition. The nature of the biological stress response at the time of the trauma may be a critical factor that influences the long‐term outcome. As well, the patterns of substance abuse can also modify the longitudinal phenomenology of this disorder. The emergence of findings from longitudinal studies is increasingly indicating that the nature of PTSD at different points in its life history may need to be distinguished. It is possible that treatment interventions that are effective at one point may not be so in the more chronic forms. The progressive psychobiological changes in this condition require greater clarification.

An overview of research findings on the nature of posttraumatic stress disorder

In this article we review current knowledge about the nature of posttraumatic stress disorder (PTSD) in order to assist clinicians in the diagnosis and treatment of reactions to traumatic life events. The review is limited to information about PTSD in adults, although some of the material may generalize to child and adolescent populations. Information presented includes prevalence, course, and comorbidity. We also briefly summarize findings on information processing and psychobiology. After presenting research findings, we then discuss the assessment of trauma and PTSD. © 1997 John Wiley & Sons, Inc.

An overview of research findings on the nature of posttraumatic stress disorder

An overview of research findings on the nature of posttraumatic stress disorder

Long‐term psychiatric morbidity after a natural disaster: Implications for disaster planners and emergency services

The prevalence and longitudinal course of post-traumatic stress disorder were studied in a group of 459 firefighters who were exposed to the Ash Wednesday bushfires in South Australia. The main finding, that the level of morbidity four months after the disaster remained almost unchanged at 29 months, indicates the long-term nature of post-traumatic stress disorder. Twenty-nine months after the fire, 21% of the firefighters were continuing to experience imagery of the disaster, in a way that interfered with their lives. The failure of present disaster management plans to recognize the psychological impact of natural disasters and the long-term nature of post-traumatic stress disorder is emphasized, and the need for preventive mental health programmes to minimize such morbidity in the future is discussed.