Number Of Trauma Types Research Articles

A nationally representative survey of ICD-11 PTSD among Danish adolescents and young adults aged 15-29.

Posttraumatic stress disorder (PTSD) is recognized as a debilitating psychiatric disorder affecting populations worldwide. This has inspired many countries to estimate the national prevalence rates of PTSD in Europe and beyond. At present, there are no published representative studies that have assessed the occurrence of trauma exposure and PTSD in Denmark using a valid measurement based on ICD-11 criteria. A national sample of the general population of young Danish residents, ranging in age between 15 to 29 years (n = 2,434), was surveyed cross-sectionally from April to October 2022. Data weights were applied to ensure representativity of the sample. Multiple regression was used to study the relationship between trauma exposure, sex, age, and PTSD. Accidents and violence were the most common types of trauma exposure with females being more likely to experience sexual violence. A total of 7.7% endorsed probable PTSD with women reporting higher rates of clinical and subclinical PTSD (12.3% and 12.7%, respectively) than men (3.5% and 7.3%, respectively). Findings from the multiple regression showed that female gender was associated with higher PTSD-severity, although the strongest predictor was trauma-type with other types of traumas, and sexual violence displaying the strongest relationship to PTSD-severity overall. A dose-response relationship between the number of trauma types and PTSD symptomatology was found. This is the first study of PTSD in a nationally representative Danish sample using a valid measure of ICD-11 PTSD. The identified PTSD rates were higher than Danish official estimates in a representative sample of the Danish adolescent and young adult population (7.7% weighted compared to 1%). The study replicated international findings of sex differences in probable PTSD endorsement.

The main and interactive effects of distress tolerance and reward function on posttraumatic stress disorder symptoms among firefighters.

Firefighters are at heightened risk of posttraumatic stress disorder (PTSD), underscoring the importance of understanding clinically targetable factors to inform evidence-based intervention development. Hedonic capacity, or the ability to experience pleasure, is a facet of reward functioning. Anhedonia (i.e., low or absent hedonic capacity) is a hallmark symptom of PTSD. Distress tolerance (DT), or the perceived ability to withstand negative emotional states, has also demonstrated associations with PTSD. The purpose of the present study was to examine the main and interactive effects of self-reported hedonic capacity (Snaith-Hamilton Pleasure Scale) and DT (Distress Tolerance Scale) on PTSD symptom severity among firefighters. A hierarchical linear regression was performed among a sample of 802 trauma-exposed career firefighters, who completed a battery of self-report questionnaires. Covariates included trauma load (i.e., number of trauma types), years in the fire service, and depression symptoms (excluding anhedonia). Both hedonic capacity (B = 2.71, SE = .95, p = .005) and DT (B = -.21, SE = .03, p < .001) were incrementally associated with PTSD symptom severity. The interactive effect of hedonic capacity and DT was associated with heightened PTSD symptom severity (B = .25, SE = .07, p < .001). Hedonic capacity and DT were independently and transactionally associated with heightened PTSD symptom severity among trauma-exposed firefighters. These findings provide evidence for the utility in developing interventions that target DT and impaired hedonic capacity among firefighters, particularly those experiencing PTSD symptomatology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Complex PTSD and treatment outcomes in TF-CBT for youth: a naturalistic study

ABSTRACT Background: Complex posttraumatic stress disorder (CPTSD) has recently been added to the ICD-11 diagnostic system for classification of diseases. The new disorder adds three symptom clusters to posttraumatic stress disorder (PTSD) related to disturbances in self-organization (affect dysregulation, negative self-concept, and disturbances in relationships). Little is known whether recommended evidence-based treatments for PTSD in youth are helpful for youth with CPTSD. Objectives: This study examined whether Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is useful in reducing PTSD and CPTSD in traumatized youth. Methods: Youth (n = 73, 89.0% girls, M age = 15.4 SD = 1.8) referred to one of 23 Norwegian child and adolescent mental health clinics that fulfilled the criteria for PTSD or CPTSD according to ICD-11 and received TF-CBT were included in the study. Assessments were conducted pre-treatment, and every fifth session. Linear mixed effects models were run to investigate whether youth with CPTSD and PTSD responded differently to TF-CBT. Results: Among the 73 youth, 61.6% (n = 45) fulfilled criteria for CPTSD and 38.4% (n = 28) fulfilled criteria for PTSD. There were no differences in sex, age, birth country, trauma type, number of trauma types or treatment length across groups. Youth with CPTSD had a steeper decline in PTSD and CPTSD compared to youth with PTSD. The groups reported similar levels of PTSD and CPTSD post-treatment. The percentage of youth who dropped out of treatment was not different across groups. Further, the groups did not differ significantly in number of received treatment sessions. Conclusions: This is the first study to examine whether TF-CBT is helpful for youth who have CPTSD using a validated instrument for measuring CPTSD. The results suggest that TF-CBT may be useful for treating CPTSD in youth. These are promising findings that should be replicated in studies with larger sample sizes.

Do positive memory characteristics influence daily-level trajectories of posttraumatic stress disorder symptoms? an exploratory daily diary study

ABSTRACT Background and Objectives Evidence links posttraumatic stress disorder (PTSD) with positive memory characteristics. To extend this research, we utilized daily diary data to examine (1) concurrent/lagged associations between daily PTSD symptom severity and positive memory vividness/accessibility; and (2) associations between baseline-assessed positive memory characteristics and changes in PTSD symptom severity over time. Design and Methods A sample of 238 trauma-exposed participants (M age = 21.19 years; 86% women) completed baseline and 10 daily measures of PTSD symptoms and positive memory characteristics. Multilevel models covaried for gender, number of trauma types, and number of completed surveys. Results Days with greater PTSD symptom severity than an individual’s average associated with less vividness (b = −0.02, p < .001) and accessibility (b = −0.02, p < .001) of the positive memory on the same day. Days with greater positive memory vividness (b = −1.06, p < .001) and accessibility (b = −0.93, p < .001) than an individual’s average associated with less PTSD symptom severity on the same day. There were no significant lagged associations between these constructs. There were significant interactions between baseline-assessed psychological distance and time (b = −0.04, p = .042) and between baseline-assessed visual perspective and time (b = 0.05, p = .023) on PTSD symptom severity across days. Conclusions Findings inform positive memory intervention targets for PTSD and provide impetus for longitudinal investigations on their inter-relations.

The relationship between number of trauma types, resilience, and psychological symptoms in ex-military personnel from India.

Traumatic event (TE) types have been shown to relate to adverse psychological outcomes. However, research in this area has relied almost exclusively on linear analysis and has been limited to Western countries with similar cultural values. Addressing these limitations, this study examined (a) presence and nature of relations between number of TE types and psychological outcomes and (b) minimum number of TE types predicting psychological symptoms in a culturally distinct sample of ex-military members from India. The sample of 144 trauma-exposed Indian ex-military members (Mage = 43.49; 90.90% males) completed a web-based survey. Curvilinear regression analyses indicated quadratic relationships between number of TE types and psychological symptoms (posttraumatic stress disorder [PTSD], depression, and anxiety severity) and resilience. Exploratory analyses showed (a) linear relationships between number of directly experienced TE types and psychological outcomes, (b) quadratic relationships between number of Predominant Death Threat TEs and psychological symptoms, (c) linear relationship between number of Predominant Death Threat TEs and resilience, and (d) linear relationships between other TE categories and psychological outcomes. Nonparametric receiver operating characteristic curve analyses indicated that a threshold of at least 10.5 TE types provided the optimal balance between sensitivity and specificity in classifying participants with (vs. without) probable PTSD, depression, and generalized anxiety disorder. For those reporting directly experienced TE types, this threshold was 2.5-3.5 TE types. Study results enhance an understanding of psychological difficulties faced by Indian ex-military members who have experienced multiple TE types, which can inform psychotherapeutic treatments for this population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The association between childhood trauma and the age of onset in drug-free bipolar depression

ObjectiveThis study aimed to investigate the relationship between childhood trauma and clinical correlates in bipolar depression. MethodsA total of 61 bipolar depression patients were enrolled and assessed based on the Childhood Trauma Questionnaire-Short Form (CTQ-SF), Patient Health Questionaire-15 (PHQ-15), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) systems. ResultsThe age of onset in bipolar depression patients with either trauma or abuse or neglect was significantly lower than in patients without these factors. There were statistically significant negative correlations between the age of onset and the number of different trauma types in bipolar depression patients. Multiple variable regression showed a significant association between the number of trauma types and the age of onset. Furthermore, there was a significant negative correlation between the age of onset with CTQ-SF total score (CTS), emotional abuse score and emotional neglect score, and physical neglect score. However, multiple variable regression analysis revealed that there was a significant association between emotional abuse score and the age of onset of bipolar depression patients.Conclusion: Our results suggest that childhood trauma may be associated with physical symptoms and the age of onset in bipolar depression patients.

Supplemental Material for The Relationship Between Number of Trauma Types, Resilience, and Psychological Symptoms in Ex-Military Personnel From India

Supplemental Material for The Relationship Between Number of Trauma Types, Resilience, and Psychological Symptoms in Ex-Military Personnel From India

The impact of poly-traumatization on treatment outcomes in young people with substance use disorders

BackgroundIt is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce.MethodsUsing data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses.ResultsAnalyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment.ConclusionOverall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging.Trial registrationISRCTN88025085, date of registration: 29.08.2016, retrospectively registered.

Trauma Exposure and Mental Health Outcomes among Male Truck Drivers from Zambia, Zimbabwe, Tanzania, and the Democratic Republic of Congo: A Cross-sectional Study

ABSTRACT The purpose of this study is to examine potentially traumatic events (PTEs) and adverse mental health outcomes among long distance truck drivers in Zambia. This is the first study to quantitatively investigate PTE exposure and mental health outcomes among long distance truck drivers in Zambia and examine differences across country of origin. Male truck drivers were recruited along three commonly used trucking routes in Zambia. Participants included truck drivers originating from Zambia, Tanzania, Democratic Republic of Congo (DRC), and Zimbabwe. We assessed exposure to PTEs and adverse mental health outcomes. Descriptive statistics were examined. Following descriptive and bivariate analyses, a series of one-way ANOVAs were conducted to examine differences in the number of PTEs and mental health problems across country of origin, with Bonferroni post-hoc analyses. A total of 234 truck drivers participated in the study, with the majority from Zambia (38%). Participants reported an average of more than three traumatic events experienced (M = 3.79; SD = 3.38). Findings indicated that Zimbabweans experienced a significantly higher number of trauma types on the Life Events Checklist (M = 5.54; SD = 3.50) compared to truckers from DRC and Tanzania (both p < .000). Zambian truck drivers reported significantly higher symptom severity from the Global Post Trauma Symptom Scale-Zambia (M = 11.98; SD = 6.79) compared to truckers from Zimbabwe, DRC, and Tanzania (all p < .001). Findings indicate the need for mental health programming for long distance truckers in Zambia which addresses high exposure to PTEs and subsequent mental health problems, especially among Zimbabwean and Zambian truckers.

High physical activity is associated with post-traumatic stress disorder among individuals aged 15 years and older in South Africa.

BackgroundSome research seems to suggest that physical activity (PA) was beneficial for post-traumatic stress disorder (PTSD).AimThis study examined the association between levels of PA and PTSD among individuals 15 years and above in South Africa.SettingCommunity-based survey sample representative of the national population in South Africa.MethodsIn all, 15 201 individuals (mean age 36.9 years) responded to the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) in 2012.ResultsOne in five (20.1%) of participants reported exposure to at least one traumatic event in a lifetime, and 2.1% were classified as having a PTSD, 7.9% fulfilled PTSD re-experiencing criteria, 3.0% PTSD avoidance criteria and 4.3% PTSD hyperarousal criteria. Almost half (48.1%) of respondents had low PA, 17.4% moderate PA and 34.5% high PA. In logistic regression analysis, adjusted for age, sex, population group, employment status, residence status, number of trauma types, problem drinking, current tobacco use, sleep problems and depressive symptoms, high PA was associated with PTSD (odds ratio [OR] = 1.75, confidence interval [CI] = 1.11–2.75), PTSD re-experiencing symptom criteria (OR = 1.43, CI = 1.09–1.86) and PTSD avoidance symptom criteria (OR = 1.74, CI = 1.18–2.59), but high PA was not associated with PTSD hyperarousal symptom criteria. In generalised structural equation modelling, total trauma events had a positive direct and indirect effect on PTSD mediated by high PA, and high PA had a positive indirect effect on PTSD, mediated by psychological distress and problem drinking.ConclusionAfter controlling for relevant covariates, high PA was associated with increased PTSD symptomatology.

Emergency Department Use Following Pediatric Psychiatric Hospitalization.

Emergency department (ED) use has increased disproportionately for pediatric psychiatric care. This study aimed to identify predictors of ED use within 30 days of discharge from a pediatric psychiatric hospitalization. ED use was assessed in the 30 days after discharge. Univariate logistic regression modeling identified predictors of ED use, which were used in subsequent multivariate modeling. Greater number of trauma types (odds ratio [OR]=1.92, 95% confidence interval [CI]=1.50-2.45, z=2.67, p=0.008), generalized anxiety disorder (OR=3.20, 95% CI=1.78-5.76, z=1.98, p=.048), and longer length of stay (OR=1.05, 95% CI=1.03-1.07, z=2.74, p=0.006) were associated with increased ED use within 30 days of discharge. ED use may be an important marker of negative outcomes within 30 days of discharge from pediatric psychiatric hospitalization. Patients with high trauma exposure, anxiety, and acuity marked by increased length of stay may require additional services to prevent unplanned ED use for psychiatric crises.

Trauma characteristics and posttraumatic growth: The mediating role of avoidance coping, intrusive thoughts, and social support.

Previous research suggests trauma characteristics can impact on posttraumatic growth (PTG). The current study considers whether previously identified predictors of PTG may produce different outcomes dependent on the characteristics of the trauma experienced. Active coping, avoidant coping, emotional coping, intrusive thoughts, social support, and spirituality were examined as potential mediators of relationships between trauma characteristics (interpersonal trauma, number of trauma types, and childhood trauma) and PTG. The responses of 268 adults exposed to multiple and wide-ranging stressors were used to generate three multiple mediation models. Intrusive thoughts and social support exerted small but significant indirect effects in all three multiple mediation models. Avoidant coping mediated associations between the number of trauma types and PTG, and the relationship between childhood trauma to PTG. Relationships between trauma characteristics and PTG appear to be explained through the presence of avoidant coping strategies, intrusive thoughts, and the individual's social environment, which could be the focus of intervention efforts to promote positive change. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Typologies of PTSD clusters and reckless/self-destructive behaviors: A latent profile analysis

Posttraumatic stress disorder (PTSD) is comorbid with diverse reckless and self-destructive behaviors (RSDBs). We examined the nature and construct validity (covariates of age, gender, depression severity, number of trauma types, functional impairment) of the optimal class solution categorizing participants based on PTSD symptom and RSDB endorsement. The sample included 417 trauma-exposed individuals recruited through Amazon's MTurk platform who completed the Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, the Posttrauma Risky Behaviors Questionnaire, and Patient Health Questionnaire-9. Latent profile analyses indicated an optimal three-class solution: the Low PTSD-RSDBs, High PTSD-Low RSDBs, and High PTSD-RSDBs classes. Multinomial logistic regression indicated that impairment and depression predicted the High PTSD-Low RSDBs vs. the Low PTSD-RSDBs classes. Impairment, age, being female, and depression predicted the High vs. Low PTSD-RSDBs classes. Number of trauma types, age, being female, and depression predicted the High PTSD-RSDBs vs. High PTSD-Low RSDBs classes. Results support the presence of a reckless behaviors subtype of PTSD (characterized by greater depression, greater impariment, greater number of trauma types, being male, and being younger), conducting comprehensive assessments of RSDBs for individuals reporting PTSD symptoms and of PTSD symptoms for individuals reporting RSDBs, and the need to tailor interventions to treat PTSD and RSDBs concurrently.

Do trauma type, stressful life events, and social support explain women veterans' high prevalence of PTSD?

To examine factors that account for women veterans' higher prevalence of past-year DSM-5 posttraumatic stress disorder (PTSD) compared to women civilians and men veterans. Cross-sectional analyses of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Face-to-face interviews with 379 women veterans, 20,007 women civilians, and 2740 men veterans were conducted. Trauma type (child abuse, interpersonal violence, combat or war zone, and other), number of trauma types, past-year stressful life events, current social support, and DSM-5 PTSD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Generalized linear models were used that accounted for the complex survey design. Women veterans had a higher unadjusted prevalence of past-year PTSD (11.40%) compared to their civilian (5.96%) and male (5.19%) counterparts. Individual predictor models indicated that the difference between women veterans' and civilians' prevalence of PTSD was attenuated when adjusting for number of trauma types, whereas the difference between men and women veterans was attenuated when adjusting for child abuse, interpersonal violence, and stressful life events. Nonetheless, while full adjustment in a multiple predictor model accounted for the difference in PTSD between women veterans and civilians, gender differences between men and women veterans remained. Number of trauma types, type of trauma, and social factors may together help explain women veterans' higher PTSD prevalence compared to women civilians, but do not fully account for differences between men and women veterans. Results highlight a need to explore additional explanatory factors and evaluate associations with longitudinal data.

Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China

BackgroundChildhood trauma has long-term adverse effects on physical and psychological health. Previous studies demonstrated that suicide and mental disorders were related to childhood trauma. In China, there is insufficient research available on childhood trauma in patients with mental disorders. MethodsOutpatients were recruited from a psychiatric hospital in southern China, and controls were recruited from local communities. The demographic questionnaire, the Childhood Trauma Questionnaire–Short Form (CTQ-SF), and the Social Support Rating Scale (SSRS) were completed by all participants, and the Self-rating Idea of Suicide Scale (SIOSS) were completed only by patients. Prevalence rates of childhood trauma were calculated. Kruskal-Wallis test and Dunnett test were used to compare CTQ-SF and SSRS scores between groups. Logistic regression was used to control demographic characteristics and examine relationships between diagnosis and CTQ-SF and SSRS scores. Spearman's rank correlation test was conducted to analyze relationships between suicidal ideation and childhood trauma and suicidal ideation and social support. ResultsThe final sample comprised 229 patients with depression, 102 patients with bipolar, 216 patient with schizophrenia, and 132 healthy controls. In our sample, 55.5% of the patients with depression, 61.8% of the patients with bipolar disorder, 47.2% of the patients with schizophrenia, and 20.5% of the healthy people reported at least one type of trauma. In patient groups, physical neglect (PN) and emotional neglect (EN) were most reported, and sexual abuse (SA) and physical abuse (PA) were least reported. CTQ-SF and SSRS total scores, and most of their subscale scores in patient groups were significantly different from the control group. After controlling demographic characteristics, mental disorders were associated with higher CTQ-SF scores and lower SSRS scores. CTQ-SF scores and number of trauma types were positively correlated with the SIOSS score. Negative correlations existed between SSRS scores and the SIOSS score. LimitationsOur sample may not be sufficiently representative. Some results might have been interfered by demographic characteristics. The SIOSS was not completed by controls. Data from self-report scales were not sufficiently objective. ConclusionsIn southern China, childhood trauma is more severe and more prevalent in patients with mental disorders (depression, bipolar disorder and schizophrenia) than healthy people. Among patients with mental disorders in southern China, suicidal ideation is associated with childhood trauma and poor social support.

Childhood trauma and cortisol awakening response in eating disorders: A dose-dependent trauma effect

IntroductionA role for the hypothalamus-pituitary-adrenal (HPA) axis has been suggested in the pathophysiology of anorexia nervosa (AN) and bulimia nervosa (BN), and childhood trauma experiences have been detected frequently in patients with AN and BN. Since trauma exposure in the childhood may persistently affect HPA axis functioning, we explored HPA axis activity in AN and BN patients with and without childhood trauma history.Objectives and aimsWe aimed to examine possible associations between childhood traumatic experiences and HPA axis functioning, as assessed by the cortisol awakening response (CAR), in adult patients with AN or BN as compared to adult healthy controls.MethodsSaliva samples were collected by 41 patients with symptomatic AN, 32 with symptomatic BN and 45 healthy controls at wakening and after 15, 30 and 60 min. They filled in the Childhood Trauma Questionnaire (CTQ), which assesses five specific types of childhood trauma.ResultsAs compared to the control group, the no-maltreated AN patient group exhibited an enhanced CAR whereas the no-maltreated BN patient group showed a similar CAR. On the contrary, both AN and BN patients with a positive history of childhood maltreatment exhibited statistically significant blunted CAR as compared to no-maltreated patients. Moreover, in maltreated ED patients the CAR tended to decrease when the number of trauma types increased.DiscussionPresent findings confirm a dysregulation of the HPA axis activity in symptomatic patients with AN and BN and suggest a dose-dependent effect of childhood adverse experiences on the CAR of adult ED patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Polyvictimization: Latent profiles and mental health outcomes in a clinical sample of adolescents.

Exposure to multiple traumatic events (polyvictimization) is a reliable predictor of deleterious health outcomes and risk behaviors in adolescence. The current study extends the literature on the prevalence and consequences of adolescent trauma exposure by (a) empirically identifying and characterizing trauma exposure profiles in a large, ethnically diverse, multi-site, clinical sample of adolescents, and (b) evaluating relations among identified profiles with demographic characteristics and clinical correlates. Data from the National Child Traumatic Stress Network Core Data Set were used to identify and characterize victimization profiles using latent class analysis in a sample of 3,485 adolescents (ages 13-18, 63% female, 35.7% White, 23.2% Black/African American, 35.0% Hispanic/Latino). Multiple measures of psychological distress and risk behaviors were evaluated as covariates of trauma exposure classes. Five trauma exposure classes, or profiles, were identified. Four classes-representing approximately half the sample-were characterized by polyvictimization. Polyvictimization classes were differentiated on number of trauma types, whether emotional abuse occurred, and whether emotional abuse occurred over single or multiple developmental epochs. Unique relations with demographic characteristics and mental health outcomes were observed. Results suggest polyvictimization is not a unidimensional phenomenon but a diverse set of trauma exposure experiences with unique correlates among youth. Further research on prevention of polyvictimization and mechanisms linking chronic trauma exposure, gender, and ethnicity to negative outcomes is warranted.

Kriegstraumata und PTBS bei deutschen Kriegsüberlebenden

Stressful war experiences can cause posttraumatic stress disorder (PTSD) in survivors. To what extent were the soldiers and young women of World War II affected by PTSD symptoms over the course of their lives? Do these men and women differ in the traumatic experiences and PTSD symptom severity? To investigate these questions 52 male and 20 female Germans aged 81-95 years were recruited through newspaper advertisements and notices and interviewed regarding war experiences and PTSD symptoms. Of the men 2% and 7% met the criteria for current and lifetime PTSD diagnoses, respectively, as compared to 10% and 30% of the women, respectively. Using multiple linear regression a dose-response relationship between the number of trauma types experienced and PTSD symptom severity could be demonstrated. The slope of the regression curve was steeper for women than for men. When controlling for the number of different traumatic experiences women reported a significantly higher severity of PTSD symptoms than men. It is presumed that this difference in severity of symptoms can be attributed to qualitative differences in the type of traumatic stress factors during the war. The present study provides evidence that even today people continue to be affected by PTSD symptoms due to events which occurred during World War II; therefore, during patient contact with this age group the war experiences specific to each individual need to be considered as potential moderators of symptoms.

Smoking status and exercise in relation to PTSD symptoms: A test among trauma-exposed adults

The present investigation examined the interactive effect of cigarette smoking status (i.e., regular smoking vs. non-smoking) and weekly exercise (i.e., weekly metabolic equivalent) in terms of posttraumatic stress (PTSD) symptom severity among a community sample of trauma-exposed adults. Participants included 86 trauma-exposed adults (58.1% female; Mage = 24.3). Approximately 59.7% of participants reported regular (≥10 cigarettes per day) daily smoking over the past year. The interactive effect of smoking status by weekly exercise was significantly associated with hyperarousal and avoidance symptom cluster severity (p ≤ .05). These effects were evident above and beyond number of trauma types and gender, as well as the respective main effects of smoking status and weekly exercise. Follow-up tests indicated support for the moderating role of exercise on the association between smoking and PTSD symptoms, such that the highest levels of PTSD symptoms were observed among regular smokers reporting low weekly exercise levels. Theoretical and clinical implications of the findings are discussed.