Partial Posttraumatic Stress Disorder Research Articles

The Psychological Characteristics and Functional Magnetic Resonance Imaging Findings in Firefighters with Partial Posttraumatic Stress Disorder and the Effect of Treatment by Using Eye Movement Desensitization and Reprocessing

Yongho Chung, MD, Nam Hee Kim, MD, PhD, Daeho Kim, MD, PhD, Jae Hyun Bae, MA, Jun Soo Kwon, MD, PhD, Joon Hwan Jang, MD, PhD, Wi Hoon Jung, PhD, Seok Hyeon Kim, MD, PhD, Jun Ki Kim, MD, Dong Hoon Oh, MD, PhD, Da-Jung Shin, BS, and Kang-Ik Cho, BS Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Korea Department of Psychiatry and Behavioral Sciences, Ajou University School of Medicine, Suwon, Korea Department of Psychiatry, College of Medicine and Institute of Mental Health, Hanyang University, Seoul, Korea Seoul EMDR Institute, Seoul, Korea Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea Clinical Cognitive Neuroscience Center, Neuroscience Institute, Seoul National University-Medical Research Center, Seoul, Korea Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Korea

Trastorno de estrés postraumático en escolares tras el terremoto de Lorca (España) en 2011

ObjectiveTo determine the prevalence of post-traumatic stress disorder (PTSD) in children after the 2011 earthquake in Lorca (Spain). MethodsBy using a cross-sequential design, children aged from 8 to 12 years (495 students at 1 month and 374 at 1 year) were assessed for full and partial PTSD using the Post-traumatic Children's Symptoms Stress Disorder Scale. ResultsThe percentage of children with PTSD was 55.4% (65.6% of girls and 46.9% of boys) at 1 month and 40.1% (44.5% girls and 35.9% children) at 1 year. One in two young girls (8-10 years) had PTSD 1 year after the earthquake. DiscussionA differential effect was observed due to gender and age, in which younger children, especially girls, were particularly at risk, even 1 year after the earthquake.

Posttraumatic Stress Disorder and Cognitive Function

Prior studies have found that the patients with posttraumatic stress disorder (PTSD) have poorer performance on cognitive tests than patients without PTSD, but the underlying mechanisms remain unknown. We examined the association between PTSD and cognitive function in a large cohort and evaluated the role of potential biological and behavioral mediators. A cohort of 535 adult outpatients (≤ 65 years) without dementia, stroke, or other neurologic disorders was recruited from 2 Veterans Affairs medical centers between February 2008 and June 2010. PTSD was assessed with the Clinician Administered PTSD Scale (CAPS) using DSM-IV-TR criteria. Cognitive function tests included processing speed, Trails A and B, letter fluency, category fluency, and verbal learning and recognition. Linear regression was used to evaluate the association between PTSD and cognitive function test scores and to assess potential mediators of the association. For our analyses of PTSD and cognitive function, we combined 178 participants who met criteria for full PTSD and 18 who met criteria for partial PTSD and had a CAPS score > 40. After adjusting for demographics, these participants with PTSD scored significantly worse on processing speed (0.30 standard deviations [SDs], P ≤ .001), category fluency (0.23 SDs, P = .01), verbal learning (0.30 SDs, P = .001), and verbal recognition (0.18 SDs, P = .048) than those without PTSD. These associations were largely accounted for by health behaviors, vascular risk factors, and depression. In this cohort of veterans under age 65 years without known neurologic disease, patients with versus without PTSD had significantly poorer performance in several domains of cognitive function, particularly in tests involving processing speed, executive function, and learning. These cognitive deficits were largely explained by modifiable risk factors. Interventions targeted at these risk factors might minimize the impact of PTSD on cognitive decline and dementia risk as patients age.

Evaluation of an Early Risk Screener for PTSD in Preschool Children After Accidental Injury

To evaluate the effectiveness and most powerful selection of predictors of an early screening tool for posttraumatic stress disorder (PTSD) in a sample of 87 children ages 2 to 6 years after unintentional injury. The examined screener was administered within 6 to 13 days post accident and consisted of an adapted version of the Pediatric Emotional Distress Scale (PEDS), the PEDS-ES (PEDS Early Screener), and questions on 5 additional risk factors (preexisting child behavioral problems, parental preexisting chronic mental or physical illness, pretraumatic life events in the family, parental feelings of guilt, parental posttraumatic stress). The PTSD Semi-structured Interview and Observational Record for Infants and Young Children served as criterion measure 6 months after the accident. A case was deemed positive when meeting criteria for full or partial PTSD. Use of the PEDS-ES without the additional risk factors performed best, with good sensitivity (85%) and moderate specificity (63%) for full or partial PTSD. The PEDS-ES allows for successful early screening of preschool-aged children after single accidental trauma. It may be used within a stepped-care model for early identification of individuals designated for possible secondary preventative interventions.

72 Mental outcome of workers 12 months after occupational injury

ObjectivesWorkers hospitalised after occupational injury are at risk for psychiatric disorders. This study aimed to examine prevalence rates of both post-traumatic stress disorder (PTSD) and major depression at 12 months...

Post-traumatic stress disorder in DSM-5: Estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors

BackgroundThe latest edition of DSM (DSM-5) introduced important revisions to PTSD symptomatological criteria, such as a four-factor model and the inclusion of new symptoms. To date, only a few studies have investigated the impact that the proposed DSM-5 criteria will have on prevalence rates of PTSD. MethodsAn overall sample of 512 adolescents who survived the L'Aquila 2009 earthquake and were previously investigated for the presence of full and partial PTSD, using DSM-IV-TR criteria, were reassessed according to DSM-5 criteria. All subjects completed the Trauma and Loss Spectrum-Self Report (TALS-SR). ResultsA DSM-5 PTSD diagnosis emerged in 39.8% of subjects, with a significant difference between the two sexes (p<0.001), and an overall 87.1% consistency with DSM-IV-TR. Most of the inconsistent diagnoses that fulfilled DSM-IV-TR criteria but not DSM-5 criteria can be attributed to the subjects not fulfilling the new criterion C (active avoidance). Each DSM-5 symptom was more highly correlated with its corresponding symptom cluster than with other symptom clusters, but two of the new symptoms showed moderate to weak item-cluster correlations. Among DSM-5 PTSD cases: 7 (3.4%) endorsed symptom D3; 151 (74%) D4; 28 (13.7%) both D3 and D4; 75 (36.8%) E2. LimitationsThe use of a self-report instrument; no information on comorbidity; homogeneity of study sample; lack of assessment on functional impairment; the rates of DSM-IV-TR qualified PTSD in the sample was only 37.5%. ConclusionsThis study provides an inside look at the empirical performance of the DSM-5 PTSD criteria in a population exposed to a natural disaster, which suggests the need for replication in larger epidemiological samples.

Posttraumatic Stress Disorder and Not Depression Is Associated with Shorter Leukocyte Telomere Length: Findings from 3,000 Participants in the Population-Based KORA F4 Study

BackgroundA link between severe mental stress and shorter telomere length (TL) has been suggested. We analysed the impact of Posttraumatic Stress Disorder (PTSD) on TL in the general population and postulated a dose-dependent TL association in subjects suffering from partial PTSD compared to full PTSD.MethodsData are derived from the population-based KORA F4 study (2006–2008), located in southern Germany including 3,000 individuals (1,449 men and 1,551 women) with valid and complete TL data. Leukocyte TL was measured using a quantitative PCR-based technique. PTSD was assessed in a structured interview and by applying the Posttraumatic Diagnostic Scale (PDS) and the Impact of Event Scale (IES). A total of 262 (8.7%) subjects qualified for having partial PTSD and 51 (1.7%) for full PTSD. To assess the association of PTSD with the average TL, linear regression analyses with adjustments for potential confounding factors were performed.ResultsThe multiple model revealed a significant association between partial PTSD and TL (beta = −0.051, p = 0.009) as well as between full PTSD and shorter TL (beta = −0.103, p = 0.014) indicating shorter TL on average for partial and full PTSD. An additional adjustment for depression and depressed mood/exhaustion gave comparable beta estimations.ConclusionsParticipants with partial and full PTSD had significantly shorter leukocyte TL than participants without PTSD. The dose-dependent variation in TL of subjects with partial and full PTSD exceeded the chronological age effect, and was equivalent to an estimated 5 years in partial and 10 years in full PTSD of premature aging.

Posttraumatic Stress Disorder in Survivors of Acute Lung Injury

Survivors of acute lung injury (ALI) and other critical illnesses often experience substantial posttraumatic stress disorder (PTSD) symptoms. However, most questionnaires have not been validated against a PTSD diagnostic reference standard in this patient population. Hence, in the current study of survivors of ALI, we evaluated the Impact of Events Scale-Revised (IES-R), a questionnaire measure of PTSD symptoms, against the Clinician-Administered PTSD Scale (CAPS), the current state-of-the-art PTSD diagnostic reference standard, which also provides a quantitative assessment of PTSD symptoms.We evaluated the IES-R questionnaire vs the CAPS diagnostic interview in 60 of 77 consecutively recruited survivors of ALI from two prospective cohort studies of patients 1 to 5 years after ALI.The IES-R total score (range: 0.0-3.2) and the CAPS total severity score (range: 0-70) were strongly related (Pearson r=0.80, Spearman ρ=0.69). Using CAPS data, eight of the 60 patients (13%) had PTSD at the time of assessment, and an additional eight patients had partial PTSD (total prevalence, 27%). In a receiver operating characteristics curve analysis with CAPS PTSD or partial PTSD as criterion variables, the area under the curve ranged from 95% (95% CI, 88%-100%) to 97% (95% CI, 92%-100%). At an IES-R threshold of 1.6, with the same criterion variables, sensitivities ranged from 80% to 100%, specificities 85% to 91%, positive predictive values 50% to 75%, negative predictive values 93% to 100%, positive likelihood ratios 6.5 to 9.0, negative likelihood ratios 0.0 to 0.2, and efficiencies 87% to 90%.The IES-R appears to be an excellent brief PTSD symptom measure and screening tool in ALI survivors.

Longitudinal Changes in Serum Brain-Derived Neurotrophic Factor in Accident Survivors with Posttraumatic Stress Disorder

Background: This prospective cohort study investigated the serum levels of brain-derived neurotrophic factor (BDNF), which mediates synaptic plasticity crucial for fear memory extinction, in patients severely injured in motor vehicle accidents (MVAs). Method: A nested, case-controlled study was conducted with 103 MVA survivors: 8 medication-naïve patients who met the criteria for full diagnosis of posttraumatic stress disorder (PTSD) at 6 months after MVA, 10 medication-naïve patients with partial PTSD and 85 patients with no PTSD. PTSD was evaluated by the Clinician-Administered PTSD Scale (CAPS). Serum BDNF levels were measured shortly after the MVA (baseline) and at 6-month follow-up. Results: Posttrauma serum BDNF levels differed between the 3 groups after controlling for age and sex (F = 3.41, p = 0.04), with unexpectedly higher serum BDNF levels seen in the full-PTSD group compared with the no-PTSD group. Additional analysis of patients with serum samples taken at baseline and at 6 months revealed the full-PTSD group had significantly higher serum BDNF levels over the 6 months than the no-PTSD group after controlling for age and sex (F = 6.44, p < 0.01). A positive correlation was seen between changes in serum BDNF levels over 6 months and the CAPS score at 6 months (r = 0.26, p = 0.014). Conclusions: The findings of this study, the first to report longitudinal serum BDNF levels in MVA survivors, suggest that elevated serum BDNF levels could be a biomarker of PTSD after a traumatic event.

No evidence for an association of posttraumatic stress disorder with circulating levels of CRP and IL-18 in a population-based study

Several studies have shown associations of posttraumatic stress disorder (PTSD) with the development of cardiometabolic diseases. The underlying psychopathological mechanisms, including potential links to inflammatory processes, have been discussed but remain elusive. Therefore, the aim of the present study was to evaluate the association of PTSD symptoms with the inflammatory biomarkers C-reactive protein (CRP) and interleukin-18 (IL-18). The study population consisted of 3012 participants aged 32–81years drawn from the population-based KORA F4 study conducted in 2006–08 in the Augsburg region (Southern Germany). PTSD symptoms were measured by the Impact of Event Scale, the Posttraumatic Diagnostic Scale and interview data and classified as no, partial or full PTSD. The associations of PTSD with CRP and IL-18 concentrations were estimated by multiple regression analyses with adjustments for age, sex and cardiometabolic risk factors. Linear regression analyses showed no significant association between PTSD and CRP or IL-18 concentration: adjusted for age and sex, the geometric mean concentrations in participants with full PTSD was for CRP 9% lower and for IL-18 1% higher than in participants with no PTSD (p values 0.53 and 0.89). However, further analyses indicated that individuals with partial PTSD had an increased chance of belonging to the highest quartile of the IL-18 concentration. No significant association was observed for any of the three subscales intrusion, avoidance or hyperarousal with CRP or IL-18 concentration. This large, population-based study could not find an association of full PTSD with CRP and IL-18 concentrations. Further research is needed to analyse these relationships.

PTSD Women Veterans’ Prevalence of PTSD Care

To the Editor:—Posttraumatic stress disorder (PTSD) among women who have experienced assaultive violence is being studied and better understood. Women veterans who have PTSD commonly have fair or poor health, depression, anxiety and disability. This problem is also associated with higher rates of reproductive and substance use disorders.1 A recent publication by Washington, et al. discusses the incidence of PTSD among women Veterans and that a significant segment of this group does not receive mental health care. The majority of women Veterans receive care outside of the US Department of Veterans Affairs (VA) and their healthcare providers may be unaware of the increased risk of PTSD among this patient population. The authors feel that the patients and their providers should be made more aware so that appropriate treatment may be offered.1 Other informative recent articles have explored PTSD in women. Betts, et al. have described a female-specific risk to partial and full PTSD following physical assault. These author postulate that traumatic events affect males and females differently, with females at increased risk for PTSD when controlling for trauma type.2 Inslicht et al. have written about enhanced acquisition of conditioned fear in women with PTSD. They state that stress hormones and neuromodulators may enhance fear conditioning during traumatic stress exposure. Inslicht et al. suggest a sex specific vulnerability to increased fear conditioning from heightened levels of pituitary adenylate cyclase-activating polypeptide, which is modulated by estrogen.3 Physiological changes have been demonstrated by Liberzon et al. They state that PTSD patients have altered regional cerebral blood flow in multiple areas that regulate the hypothalmis-pituitary-adrenal axis, have exaggerated emotional responses and changes in sensitivity to glucocorticoids.4 These important publications focus on the increased incidence of PTSD following assaultive violence, the specific risk to women as well as physiological changes that occur in the patients affected. If physicians are made aware of these facts, they will provide improved care for the patients suffering from this serious problem.1–4

The Characteristics and Severity of Psychological Distress After Abortion Among University Students

Controversy over abortion inhibits recognition and treatment for women who experience psychological distress after abortion (PAD). This study identified the characteristics, severity, and treatment preferences of university students who experienced PAD. Of 151 females, 89 experienced an abortion. Psychological outcomes were compared among those who preferred or did not prefer psychological services after abortion to those who were never pregnant. All who had abortions reported symptoms of post-traumatic stress disorder (PTSD) and grief lasting on average 3 years. Yet, those who preferred services experienced heightened psychological trauma indicative of partial or full PTSD (Impact of Event Scale, M = 26.86 versus 16.84, p < .05), perinatal grief (Perinatal Grief Scale, M 62.54 versus 50.89, p < 0.05), dysthymia (BDI M = 11.01 versus 9.28, p < 0.05), (M = 41.86 versus 39.36, p < 0.05), and co-existing mental health problems. PAD appeared multi-factorial, associated with the abortion and overall emotional health. Thus, psychological interventions for PAD need to be developed as a public health priority.

The Prevalence of Full and Partial Posttraumatic Stress Disorder Among People With Severe Mental Illness in Israel

Research has shown higher rates of trauma exposure and posttraumatic stress disorder (PTSD) among persons with severe mental illness (SMI). The aim of this study was to assess the prevalence of traumatic events and full and partial PTSD among people with SMI and their associations with trauma-related cognitions and depressive symptoms. A total of 122 persons with SMI were assessed for trauma exposure and PTSD. A subsample of 40 participants, 20 with PTSD and 20 without PTSD, were randomly selected, and their posttraumatic cognitions and depressive symptoms were assessed. The prevalence of traumatic events was 90%, and 19% met full diagnostic criteria for PTSD, and 20% had partial PTSD. The people with PTSD had more depressive symptoms and negative cognitions. PTSD in SMI is highly prevalent and underdiagnosed.

PTSD Is a Chronic, Fluctuating Disorder Affecting the Mental Quality of Life in Older Adults

Examine the longitudinal course of posttraumatic stress disorder (PTSD) in older adults and its influence on mental health quality of life (MHQoL). Evaluation performed at baseline, and 3 and 6 months postrandomization as part of a longitudinal trial. A total of 1,185 participants, with a mean (±SD) age of 73.53 (±5.98) years, at seven primary care sites (including five Veterans Affairs clinics), were divided into four groups, namely, no trauma (n= 661), trauma only (n= 319), partial PTSD (n= 114), and PTSD (n= 81), based on reports of trauma and associated PTSD symptoms. The prevalence of comorbid depression, anxiety, and alcohol use disorders, assessed using the Diagnostic and Statistical Manual, Fourth Edition, criteria and changes in MHQoL, as assessed by the Short Form-36 mental component score. At baseline, the PTSD group had higher frequencies of comorbid depression and anxiety disorders and worse MHQoL than the other groups. Both chronic (participants diagnosed with PTSD at all three assessments) and fluctuating (participants moving to or from one of the other groups) trajectories of course were observed during the follow-up period, which appeared to be separate from that of the comorbid disorders. Even after accounting for those comorbid disorders, PTSD had anindependent association with poorer MHQoL at multiple time points, especially in men, whereas trauma without PTSD symptoms (trauma only) had better MHQoL. PTSD had chronic and fluctuating courses, with negative effects on MHQoL, while partial PTSD might represent a transitional state, underscoring the need to better identify and treat PTSD at any phase in later life.

Exploring the Female Specific Risk to Partial and Full PTSD Following Physical Assault

Previous studies have shown that females are at an increased risk of developing posttraumatic stress disorder (PTSD) in response to physical assault compared with males. Our aims were to (a) test if this gender-specific risk generalised to subclinical levels of PTSD, (b) observe how this relationship was affected by including possible confounding factors, and (c) estimate how this trauma contributed to the overall prevalence of PTSD in females. Data came from an Australian birth cohort study (n = 2,547) based in Brisbane, Australia that commenced in 1981. Using ordinal logistic regression adjusted for a wide range of confounding factors, including polyvictimisation and internalising and externalising symptoms, we found females were at a significantly greater risk compared to males of developing either partial or full PTSD, odds ratio (OR) = 7.68; 95% confidence interval (CI) = [2.94, 20.08], as well as full PTSD only, OR = 9.23; 95% CI = [2.77, 30.79], following the experience of assaultive violence (p value for test of interaction = .004). In addition to the high prevalence of sexual assault (12.9%), attributable risk analysis suggested that due to the strong risk of PTSD in females exposed to physical assault, physical assault is possibly a contributor to the overall female increased prevalence of PTSD.

Relationship between posttraumatic stress disorder and Type 2 Diabetes in a population-based cross-sectional study with 2970 participants

ObjectivesTo evaluate the association of posttraumatic stress disorder (PTSD) with type 2 diabetes (T2D) or prediabetes in a large population-based sample. MethodsIn 2970 subjects (aged 32–81years) drawn from the population-based cross-sectional study KORA F4 from the Augsburg region (Southern Germany) a PTSD screening was performed employing the Posttraumatic Diagnostic Scale, the Impact of Event Scale, and interview data. The exposure variable PTSD was sub-classified into partial and full PTSD and additionally in subjects with traumatic event but no PTSD” to “The exposure variable PTSD was classified into (1) no traumatic event (2) traumatic event, but no PTSD, (3) partial PTSD, (4) full PTSD. A total of 50 (1.7%) subjects qualified for full PTSD, whereas 261 (8.8%) qualified for partial PTSD. A total of 333 subjects (11.2%) suffered from T2D and 498 (16.8%) from prediabetes as assessed by an oral glucose tolerance test and physicians’ validation. The associations of PTSD with T2D and prediabetes were estimated by multinomial logistic regression analyses with adjustments for sociodemographic characteristics, metabolic risk factors or psychopathological conditions. ResultsIn the model adjusted for sociodemographic characteristics and metabolic risk factors, full PTSD was significantly associated with T2D (OR: 3.90, 95% CI: 1.61–9.45, p=0.003) compared to subjects with no traumatic event. Significance remained after additional adjustment for other psychopathological conditions (OR: 3.56, 95% CI: 1.43–8.85, p=0.006). Regarding prediabetes, no significant associations were observed. ConclusionsSuffering from PTSD might activate chronic stress symptoms and trigger physiological mechanisms leading to T2D. Prospective studies are needed to investigate temporal and causal relationships between PTSD and T2D.

Prediction of Trauma-Related Disorders

In the month following a motor vehicle accident, the rate of posttraumatic stress disorder (PTSD) and other trauma-related disorders (ie, mood, other anxiety disorders, and substance use disorders) may reach 30%.1 From a clinical perspective, there is an unmet need to develop screening tools that can help identify individuals at risk of developing such disorders. The Peritraumatic Distress Inventory (PDI) is a 13-item self-report measure—validated in several languages—that has been shown in several studies to predict the development of posttraumatic stress symptoms or disorder.2–4 In a prospective study of 79 motor vehicle accident victims, Nishi et al5 proposed an optimum cutoff point of 23 for the PDI to predict acute PTSD 1 month after the accident. However, to this day, the measure has not been used to predict the full spectrum of trauma-related disorders. The aim of this study was to fill that gap. Method. The study, approved by an independent ethics committee, included 211 subjects consecutively hospitalized in a Trauma Center following a motor vehicle accident from January 2003 to July 2006. The PDI was administered within 5 days of admission after written informed consent was obtained. Six weeks after the accident, the patients underwent a semistructured PTSD diagnostic interview6 as well as the Mood, Anxiety, and Substance Use Disorders sections of a structured psychiatric interview7 by trained psychiatrists. Partial PTSD as described by Blanchard et al8 was also screened for. Subjects with a history of posttraumatic amnesia were excluded. Nineteen subjects were lost at the 6-week follow-up and therefore dropped from the analyses. Results. The final cohort consisted of 192 subjects, 137 adult men and 55 women. The mean age of subjects was 35.14 years (SD = 15.39). Injury severity was classified as mild (10%), moderate (49%), or severe (41%). In the final cohort, 154 subjects fulfilled DSM-IV-TR criteria A1 and A2 for trauma exposure. The mean PDI total score was 15.68 (SD = 8.71). At the follow-up, 66 patients fulfilled criteria for partial (n = 31) or full (n = 35) PTSD, 19 for major depressive disorder, 10 for at least 1 anxiety disorder, and 3 for a psychoactive substance disorder. No association was found between injury severity and PTSD (χ2 = 0.96, df = 1, NS). The PDI score was, however, significantly associated with an increased risk of acute PTSD (χ2 = 5.15, df = 1, P = .02). According to the occurrence of traumatic events, receiver operating characteristic curve analysis showed an area under the curve (AUC) of 0.7 (Figure 1). The optimum predictive cutoff point of the PDI was a score of 14 (sensitivity 68%, specificity 61%). On the one hand, 90% of the victims with a PDI score > 28 developed PTSD or partial PTSD at follow-up. On the other hand, 90% of those with a score < 7 did not develop PTSD. In order to detect PTSD or partial PTSD 6 weeks later, we propose a cutoff score of 14 (PTSD: sensitivity 84% and specificity 47%, AUC 0.6; partial PTSD: sensitivity 73% and specificity 60%, AUC 0.7). Figure 1 Receiver Operating Characteristic (ROC) Curve for Occurrence of PTSD and PDI Scorea The PDI could be a useful tool for screening individuals at risk of developing trauma-related disorders. We recommend that trauma survivors with a PDI score 28 would need immediate care and follow-up. Finally, for those with a score of 7 through 28, we propose a checkup after a few weeks.

Psychometrics of the overall anxiety severity and impairment scale (OASIS) in a sample of women with and without trauma histories

Many women have unidentified anxiety or trauma histories that can impact their health and medical treatment-seeking behavior. This study examined the sensitivity, specificity, efficiency, and sensitivity to change of the Overall Anxiety Severity and Impairment Scale (OASIS) for identifying an anxiety disorder in a female sample with and without trauma history related to intimate partner violence (IPV). Forty-three women with full or partial PTSD from IPV and 41 women without PTSD completed the OASIS. All participants with trauma history completed the Clinician Administered PTSD Scale. This report is a secondary analysis of a study on the neurobiology of psychological trauma in survivors of IPV recruited from the community. A cut-score of 5 best discriminated those with PTSD from those without, successfully classifying 91% of the sample with 93% sensitivity and 90% specificity. The measure showed strong sensitivity to change in a subsample of 20 participants who completed PTSD treatment and strong convergent and divergent validity in the full sample. This study suggests that the OASIS can identify the presence of an anxiety disorder among a female sample of IPV survivors when PTSD is present.

Comorbidity of post traumatic stress disorder, attention deficit with hyperactivity, conduct, and oppositional defiant disorder in Palestinian children affected by war on Gaza

Aim: The aim of this study was to investigate the impact of war on children and comorbidity of post traumatic stress disorder, attention deficit with hyperactivity, conduct, and oppositional defiant disorder in Palestinian children. Methods: The study was conducted in the entire Gaza Strip 6 months after the end of the war on Gaza that lasted for 23 days. The study sample included 410 children aged 6 to 17 years. Children completed measures of experience of traumatic events (Gaza Traumatic Checklist-War on Gaza), post traumatic stress disorder index, attention deficit with hyperactivity scale for parents and self, conduct disorder scale, and oppositional defiant disorder. Results: Palestinians children investigated 6 months after the war on Gaza still reported traumatic experiences: 94.6% heard the sonic sounds of the jet fighters, 91.7% heard shelling of the area by artillery, 92% watched mutilated bodies on television, 80% were deprived from water or electricity during the war, 50.7% said they left home for safer place. Using Diagnostic Manual of Mental Disorders-IV (DSM-IV) criteria for post traumatic stress disorder, 25.1% of children reported no psychological reactions, 25.9% of children reported one criteria, 39.3% of children reported partial post traumatic stress disorder and 9.8% of children reported full criteria for post traumatic stress disorder. According to the parents’ report, the results showed 31.3% of children met the criteria for inattentive type, 36.3% of children were impulsive and 29% met criteria for combined type. According to the children’s report, the results showed 28.8% of children met the criteria for inattentive type, 37.3% of children were impulsive and 28.3% met criteria for combined type. Using DSM-IV diagnostic criteria of conduct disorder and oppositional defiant disorder, the study showed that 38.1% of parents reported conduct disorder in their children and 46.3% reported oppositional defiant disorder. While 39.3% of children themselves reported conduct disorder and 44% of them reported oppositional defiant disorder. The study showed that 5.1% of children had comorbidity of post traumatic stress disorder and attention deficit disorder, 4.4% had comorbidity of post traumatic stress disorder and impulsivity-hyperactivity disorder, and 4.4% had comorbidity of post traumatic stress disorder and attention deficit with hyperactivity combined type. Also, 4.6% of children had comorbidity of conduct and post traumatic stress disorder and 6.1% had comorbidity of oppositional defiant disorder and post traumatic stress disorder. Conclusions: This study revealed that children living in areas of conflict and war are the main group at risk of developing post traumatic stress disorder and other behavioral problems including attention deficit with hyperactivity, conduct, and oppositional defiant disorder, and the internationallaws must protect the civilians during the conflict, establishing safe havens for children and their families to decrease the effect of war on children.

Transition and change: Prospective effects of posttraumatic stress on smoking trajectories in the first year of college.

College matriculation begins a period of transition that is marked by new freedoms and responsibilities and by increases in a variety of risky behaviors, including smoking. Trauma and posttraumatic stress disorder (PTSD) are well-established risk factors for smoking outcomes, and thus may be a point of intervention for college smoking. Yet, no studies have examined associations among trauma, PTSD, and smoking in college students. The present study provides such an examination. Matriculating student smokers (N = 346) completed surveys in September (T1) and at 5 subsequent time points (T2-T6) over their first year of college. With latent growth analysis, we modeled smoking trajectories conditioned on PTSD symptom status (i.e., No PTSD Symptoms vs. Partial PTSD vs. Full PTSD). Results showed that although smoking tended to decline during the first semester for all groups, significant risk for escalation in smoking during the second semester was conferred specifically by the presence of PTSD at matriculation. Interventions that offer support and resources to students entering college with PTSD may help to prevent smoking behaviors from escalating and may ultimately prevent the adoption of daily smoking in later adulthood.