Posttraumatic Stress Disorder Personality Research Articles

Predictors of undocumented PTSD in persons using public mental health services

Individuals diagnosed with serious mental illness (SMI) have greater trauma exposure and are at increased risk for posttraumatic stress disorder (PTSD). However, PTSD is rarely documented in their clinical records. This study investigated the predictors of PTSD documentation among 776 clients with SMI receiving public mental health services, who had probable PTSD as indicated by a PTSD Checklist score of at least 45. Only 5.3% of clients had PTSD listed as a primary diagnosis, and 8.4% had PTSD as a secondary diagnosis, with a total 13.7% documentation rate. PTSD documentation rate was highest for clients with major depression (18.8%) compared to those with schizophrenia (4.1%) or bipolar disorder (6.3%). Factors that predicted a lower likelihood of having a chart diagnosis of PTSD included being diagnosed with schizophrenia/schizoaffective disorder or bipolar disorder. Factors that predicted a higher likelihood of having a chart diagnosis of PTSD included being of non-white race, being female, and experiencing eight or more types of traumatic events. Findings highlight the need for PTSD screening and trauma informed care for clients with SMI receiving public mental health services.

The mental health of forcibly displaced couples.

Most current research investigating traumatic stress is focused on its effects at the individual level, utilizing the implicit assumption that trauma-related disorders are mutually independent within families and communities. However, there is reason to assume that trauma-related symptoms within couples are influenced by each partner's risk factors and symptoms. Using the actor-partner interdependence model, this study aimed to test whether symptoms of posttraumatic stress disorder (PTSD) and depression were predicted by participants' partner's exposure to traumatic events over and above the influence of the participant's own experiences. For this purpose, we interviewed 687 heterosexual, married Iraqi and Syrian couples in Iraq's Kurdistan region who had been forcefully displaced. We assessed symptoms of PTSD and depression using locally validated scales. Nearly all participants (98.8%) reported exposure to at least one traumatic event, with husbands reporting exposure to a higher number of traumatic events than wives, d = 0.48, p < .001. More than half of the participants met the criteria for a probable PTSD (61.1%) or major depressive disorder diagnosis (60.4%). Within couples, significant actor effects of experienced trauma exposure on personal PTSD and depressive symptoms were observed for both husbands and wives. Further, there were significant partner effects of wives' traumatic experiences on husbands' PTSD and depressive symptoms as well as of husbands' traumatic experiences on wives' PTSD and depressive symptoms. The findings argue for the interdependence of trauma-related symptoms within dyads in a dual-trauma context, suggesting the presence of intracouple transmission of trauma-related symptoms.

#Me2PT: A qualitative analysis of a social media network campaign to raise awareness of the consequences of childhood sexual abuse

BackgroundChildhood sexual abuse (CSA) is a highly prevalent and serious stressor, linked to short- and long-term psychopathology and to posttraumatic stress disorder (PTSD) specifically. The hashtag #Me2PT, which stands for “me-too-post-trauma,” was created in order to raise awareness of the longitudinal consequences of sexual abuse, as specifically manifested in symptoms of PTSD or complex PTSD. It was disseminated on social media networks during 2019 and offered a platform for CSA survivors to share their own personal experience of living with CSA-related posttraumatic symptoms. ObjectiveThe current study was designed in order to examine the way survivors conveyed their experiences and perceptions with response to the invitation of the hashtag #Me2PT. All the posts were written in the Hebrew-language, and thematic analysis was carried on all the written narratives. Participants and setting40 Posts that were written in the Hebrew language under the hashtag campaign of #Me2PT. MethodsThematic analysis was carried on the 40 posts by two of the authors. Shenton four criterions for qualitative study trustworthiness were employed with peer discussion on main results were discussed with the leaders of the campaign, survivors of CSA. ResultsThe authors identified four main themes within the written narratives of the survivors: (1) why am I writing, (2) my personal PTSD, (3) between life and death, and (4) post-trauma as ‘a bleeding wound’. ConclusionsThese findings exemplify the constant mental pain and struggle that survivors deal with, but at the same time demonstrate the importance of hope, the comfort found in being understood, and the wish to live a meaningful life despite the pain. This paper may contribute to the understanding of survivors' experiences of living with CSA-related posttraumatic symptoms, as conveyed by them spontaneously and authentically, potentially informing best practice for professionals working with this population.

Post-traumatic stress disorder symptoms and pain intensity in persons with spinal cord injury.

Cross-sectional. To examine the association between post-traumatic stress disorder (PTSD) symptoms and pain intensity, taking symptoms of anxiety and depression into account within persons with spinal cord injury (SCI). Persons with SCI, who visited a Dutch rehabilitation centre between 2005 and 2010, were invited to complete a survey. PTSD symptoms were measured with the Trauma Screening Questionnaire (TSQ), pain intensity with an 11-point Numerical Rating Scale (NRS), and symptoms of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). To determine associations between PTSD symptoms and pain intensity, linear regression analyses were performed. Confounding variables representing anxiety and depression were added to the final model. In total, 175 participants (55.8% traumatic, 29.1% complete) were included (response rate of 31.7%). Of them, 11.4% had clinically relevant symptoms of probable PTSD (TSQ score ≥6) 69.8% experienced moderate to severe pain levels (NRS ≥ 4), 14.9% had symptoms of anxiety and 20.8% symptoms of depression (HADS scores ≥11). Levels of PTSD symptoms were strongly associated with symptoms of anxiety (0.54) and depression (0.49). Bivariate analyses showed a moderate significant association (0.30) between PTSD symptoms and pain intensity. This association became small (0.10) when anxiety and depression comorbidity were factored into the final regression model. No independent association between PTSD symptoms and pain intensity was shown when adjusted for anxiety and depression. Results of this study suggest the usefulness of screening for PTSD in persons with SCI (regardless of injury cause or type/level) who score high on symptoms of anxiety/depression.

Tailoring Cognitive Behavioral Therapy for Trauma-Exposed Persons Living With HIV

This treatment development report describes the need for evidence-based psychosocial trauma-focused treatment for people living with comorbid posttraumatic stress disorder (PTSD) and HIV. Individuals with HIV have higher rates of exposure to traumatic events and PTSD than the general public, and they also experience additional consequences of PTSD on the management of their chronic disease (e.g., established link between PTSD symptoms and lack of adherence to antiretroviral therapy [ART]). We used the empirically supported ADAPT-ITT approach to consider the initial steps in adapting evidence-based Cognitive Processing Therapy (CPT) for individuals with PTSD and HIV. This paper reviews a case example that involved various clinical issues that may arise when providing trauma-focused treatment for people living with HIV including HIV-stigma, disease management, and the need for making multicultural adaptations to psychotherapy. This case example illustrates how trauma-focused treatment may benefit from enhancement to address additional barriers that may arise over the course of PTSD treatment in this population. Feasibility of engaging and delivering a "full dose" of evidence-based PTSD treatment among individuals living with HIV is discussed. While evidence-based treatments can reduce PTSD symptom severity, issues related to chronic disease coping and HIV-related stigma management could be integrated to augment the efficacy of treatment for individuals with HIV. Adaptive intervention research targeting PTSD in persons living with HIV warrants further attention, especially given the association between PTSD and adherence to ART.

Psychological consequences of post-traumatic stress disorder in post-conflict situations

this paper presents a scientific and theoretical study of the psychological consequences of post-traumatic stress disorder in a post-conflict region. These circumstances cause active attention to the region, where two military campaigns took place and for a long time residents of the Chechen Republic were under negative influences that affected their psychological state, causing symptoms of post-traumatic stress disorder. All these points require an active study of this issue, as at present there are residual effects of post-traumatic stress disorder in persons who have survived military conflicts. To resolve the psychological consequences it is necessary to increase psychological stability and mental security providing psychological security of the surrounding space. Various studies of PTSD symptoms have shown that the following psychological consequences are mainly observed: obsessive memories, repeated internal living of a negative traumatic situation, nightmares, stress, overstrain, accelerated physiological reactions, apathy. All the negative aspects of the manifestation of PTSD require the organization of psychological correction in the first place the psychological diagnosis using effective tools with which you can get objective comprehensive and reliable results.

Взаємозв’язок нейротизму з посттравматичними стресовими розладами в учасників бойових дій

На основі комплексного аналізу психофізіологічних властивостей була зроблена спроба знайти предикатори посттравматичного стресового розладу. Виявлені особливості взаємозв'язку генетично визначених властивостей темпераменту з посттравматичним стресовим розладом у осіб, що перебували в зоні бойових дій, а саме між рівнем нейротизму та показниками клініко-діагностичних критеріїв CAPS. Отже, особи з високим рівнем нейротизму мають значно більшу ймовірність страждати від ПТСР в екстремальних умовах.

Neuropsychological predictors of response to cognitive behavioral therapy for posttraumatic stress disorder in persons with severe mental illness

This study examined whether cognitive functioning was related to treatment outcomes in persons with severe mental illness who received a cognitive behavioral therapy (CBT) program for co-occurring posttraumatic stress disorder (PTSD). The study sample was drawn from a larger controlled trial of 108 persons with severe mental illness and PTSD comparing the effects of CBT with treatment as usual on PTSD and related outcomes, with assessments conducted at baseline, post-treatment, and 3- and 6-month follow-ups. Among the 54 persons in CBT, 49 were administered a neuropsychological battery at baseline and 40 were exposed to the CBT program. Statistical analyses of these 40 participants were conducted to evaluate whether cognitive functioning was related to participation in the CBT program, completion of homework assignments, and improvements in PTSD, and other outcomes. Cognitive functioning was not related to participation in CBT or completion of homework. Lower cognitive functioning predicted less learning of information about PTSD at post-treatment and follow-up, but not less clinical benefit from CBT in PTSD diagnosis or symptoms, other symptoms, or health. The results suggest that cognitive impairment does not attenuate response to the CBT for PTSD program in persons with severe mental illness. Clinical Trials.gov Identifier: NCT00053690

Prevalence of Posttraumatic Stress Disorder in Persons with Chronic Pain: A Meta-analysis.

To summarize evidence for the prevalence of posttraumatic stress disorder (PTSD) among persons with chronic pain (CP). We searched databases for studies published between January 1995 and December 2016, reporting the prevalence of PTSD in persons with CP. Two reviewers independently extracted data and assessed the risk of bias. We calculated the pooled prevalence using a random-effects model and performed subgroup analyses according to pain location, the population and assessment method. Twenty-one studies were included and the PTSD prevalence varied from 0-57%, with a pooled mean prevalence of 9.7%, 95% CI (5.2-17.1). In subgroup analysis, the PTSD prevalence was 20.5%, 95% CI (9.5-39.0) among persons with chronic widespread pain, 11.2%, 95% CI (5.7-22.8) among persons with headache, and 0.3%, 95% CI (0.0-2.4) among persons with back pain. The prevalence in clinical populations was 11.7%, 95% CI (6.0-21.5) and in non-clinical populations 5.1%, 95% CI (0.01-17.2). In studies of self-reported PTSD symptoms, PTSD prevalence was 20.4%, 95% CI (10.6-35.5), and in studies where structured clinical interviews had been used to assess PTSD its prevalence was 4.5%, 95% (CI 2.1-9.3). The risk of bias was medium for most studies and the heterogeneity was high (I2 = 98.6). PTSD is overall more prevalent in clinical cohorts of persons with CP and particularly in those with widespread pain, but may not always be more prevalent in non-clinical samples of persons with CP, compared to the general population. There is a large heterogeneity in prevalence across studies. Future research should identify sources of heterogeneity and the mechanisms underlying the comorbidity of the two conditions.

Identification of PTSD in adults with intellectual disabilities in five patients in a specialised psychiatric inpatient unit

Purpose – The purpose of this paper is to describe and discuss assessment of post-traumatic stress disorder (PTSD) in adults with intellectual disabilities. Existing research in this area encompasses case studies, and includes, for the most part, persons with mild intellectual disabilities. Design/methodology/approach – The aim of this study is to investigate symptom presentation and subsequent identification of PTSD in persons with more severe intellectual disabilities; i.e. persons with moderate or severe intellectual disabilities. Five patients in a specialised psychiatric inpatient unit for patients with intellectual disabilities were included. Information about the patients was collected through case files and interviews with key informants: family, milieu therapists, and caregivers in community settings, and observations through inpatient admission. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients. The five patients all met criteria for PTSD according to the Diagnostic Manual – Intellectual Disability. Findings – Previously, it was not suspected that the five patients suffered from PTSD, although they had experienced terrifying incidents. All patients displayed severe changes in behaviour, which may have overshadowed symptoms of PTSD. PTSD in persons with more severe intellectual disabilities may be interpreted as challenging behaviour, or other psychiatric disorders such as psychosis. Research limitations/implications – The limitation of the study is the small number of participants. Practical implications – Practical implication is linked to clinical practice related to identification of PTSD in persons with intellectual disabilities. Originality/value – The paper may encourage more research into how PTSD can be identified in persons with moderate and severe intellectual disabilities. The case reports may help clinicians to look for traumatic experiences in persons with intellectual disabilities who have experienced terrifying incidents.

Some Wounds Don’t Bleed: An Examination of Unresolved Trauma in Vietnam Veterans and Its Ethical Implications Through the Lens of One Man’s Story and Beyond

The Vietnam War left in its wake not only physical casualties but psychological ones as well. Among the most significant features of the war’s aftermath are numerous and well-documented cases of posttraumatic stress disorder (PTSD). Despite having been observed by writers, scholars, and others as early as biblical times, it was not until the emotional and psychological aftereffects suffered by Vietnam veterans became too numerous and significant to ignore that medicine, psychology, and the U.S. military undertook serious study of the disorder. David Rose, himself a veteran, shares his personal PTSD journey, having been diagnosed some 45 years after his return from Vietnam. David’s story and poetry paint a picture that is both deeply personal and yet all too common among veterans of military conflict. Through David’s story, we explore the questions of what PTSD is and how it has been addressed by the military as well as those charged with providing treatment. Also explored is the concept of moral injury and the ethical implications of exposing service members to circumstances, which inevitably bear psychological consequences.

Risk Factors for Posttraumatic Stress Disorder in Persons With Spinal Cord Injury

Many of the events that cause spinal cord injury (SCI) are traumatic events that can result in posttraumatic stress disorder (PTSD). It therefore appears that most persons with SCI are at risk for developing PTSD. This study retrospectively examined risk factors for PTSD symptoms in a sample of 71 persons with SCI. The Structured Clinical Interview for DSM-IV was used to assess full and partial PTSD diagnoses. Self-administered questionnaires were used to measure potential risk factors. Results indicated that 11% of the participants met the criteria for full PTSD, and an additional 20% met the criteria for partial PTSD at some point after their SCI. Hierarchical linear regression analyses revealed that trauma history, peritraumatic reactions, and intolerance of uncertainty predicted the number of PTSD symptoms. This study highlights the importance of trauma history, peritraumatic reactions, and intolerance of uncertainty in the development of PTSD symptoms. Patients at risk for PTSD should be identified early in the rehabilitation process and could benefit from psychological interventions with the aim of preventing PTSD development.

Post-traumatic reactions to psychosis in people with multiple psychotic episodes

Psychotic symptoms, coercive interventions, and other negative treatment experiences have been found to lead to posttraumatic stress disorder (PTSD) symptoms. However, prior research has not examined the importance of the DSM-IV A1 (perception of threat) and A2 (negative emotion at time of event) criteria for a traumatic event due to a psychotic episode. To address this question, 50 clients with a history of multiple episodes of psychosis were interviewed to identify distressing experiences related to past episodes, with PTSD assessed (including A1/A2 criteria) related to those events, and other psychiatric symptoms, psychosocial functioning, and coping style. Participants reported intense distress related to psychotic symptoms (66%), treatment experiences (25%), and their combination (8%), with 69% meeting symptom criteria for PTSD (excluding A1/A2 criteria), and 31% meeting full diagnostic criteria for PTSD (including A1/A2 criteria). Clients meeting symptom criteria for PTSD, as well as those meeting full diagnostic criteria for PTSD were similar, with both groups reporting more severe symptoms and distress, and more problems in daily functioning, than clients with fewer or no PTSD symptoms. The results are similar to a previous study of PTSD in persons with recent onset of psychosis (Mueser et al., 2010), and suggest that individuals with PTSD symptoms related to psychosis and coercive treatment may benefit from interventions designed to help them integrate their experiences into their lives and reduce PTSD symptoms, regardless of whether the triggering event(s) meet DSM-IV A1/A2 criteria for a traumatic event.

PTSD in persons with burns: An explorative study examining relationships with attributed responsibility, negative and positive emotional states

A sample of 90 persons who had been hospitalized for severe burns were interviewed 1–4 years after the incident. Current DSM-IV post-traumatic stress disorder (PTSD) was assessed with the Composite International Diagnostic Interview. Perceived attributed responsibility and related positive and negative emotional states were examined using a semi-structured interview. Findings showed that PTSD was established in 8% of the participants and partial PTSD in 13%. In a homogeneity analysis (HOMALS), PTSD was associated with the attribution of responsibility for the incident to impersonal relationships and with a negative emotional state. The absence of (partial) PTSD was associated with the attribution of responsibility to close relationships, internal and circumstance-related attribution of responsibility and neutral or forgiving feelings. In logit analyses, both emotional state as well as attributed responsibility are significantly related to (partial) PTSD. However, the model including emotional state showed to have the best fit. Although further research is needed, these results may indicate that professionals working in burn care should consider the emotional state in relation to perceived attribution of responsibility when considering PTSD. Promoting forgiveness may be a beneficial strategy in dealing with post-traumatic stress reactions.

Post‐traumatic stress disorder in a person with a diagnosis of schizophrenia: Examining the efficacy of psychological intervention using single N methodology

AbstractPsychological intervention for post‐traumatic stress disorder (PTSD) in a person with a diagnosis of schizophrenia is presented using single N methodology. Psychological formulation and intervention were informed by psychological models of PTSD symptom persistence that focus on dual maintaining factors of (a) disturbance in the form of trauma autobiographical memory and (b) problematic trauma‐related appraisals. Baseline assessment of difficulties related to intrusive memories, problematic trauma‐related appraisals (e.g., responsibility appraisals) and associated negative emotions (e.g., anger) was followed by two phases of intervention: (1) written elaboration of the trauma memory and (2) cognitive restructuring of problematic trauma‐related appraisals. Treatment produced reduction in ratings of distress in all domains and there were clinically significant reductions in PTSD symptomatology and co‐morbid depression on standardized self‐report measures. There were, however, differential effects of treatment components as evidenced during the sequential introduction of treatment components. These are discussed and directions for future research in the treatment of PTSD in persons with severe mental health problems are highlighted. Copyright © 2007 John Wiley &amp; Sons, Ltd.

Posttraumatic Stress Disorder Symptoms During the First Six Months After Traumatic Brain Injury

Posttraumatic Stress Disorder Symptoms During the First Six Months After Traumatic Brain Injury

Crisis Support and Coping as Mediators of Well-Being in Persons with Spinal Cord Lesion

This study aims to investigate whether crisis support and coping mediate symptoms of posttraumatic stress disorder (PTSD) in individuals with spinal cord lesions (SCL). PTSD, crisis support, and coping were assessed an average of 83 days after the injury (T1), at discharge from the rehabilitation center (T2), and an average of 121 days following discharge (T3). Sixty-nine newly injured paraplegics and tetraplegics completed the questionnaire at T1, 40 (58%) at T2, and 38 (55%) at T3. Individuals with PTSD experienced significantly lower levels of social support, and used more emotional coping than did those without PTSD. On the basis of logistic regression analyses, emotional coping and the interaction between negative response and emotional coping predicted PTSD. Emotional coping is a strong predictor of PTSD in persons with new SCL.

Posttraumatic stress disorder in persons with developmental disabilities

Persons with developmental disabilities are more frequently abused physically, emotionally and sexually than nondisabled persons (Ammerman, Van-Hasselt, Herson, McGonigle, & Lubetsky, 1989; Sobsey, Gray, Pyper, & Reimer-Heck, 1991). Persons with developmental disabilities are susceptible to the full range of psychiatric disorders (Szymanski, Madow, Mallory, Menolascino, & Pace, 1991). There has been no comprehensive study of posttraumatic stress disorder (PTSD) in this population (Hudson & Pilek, 1990), a recent textbook of mental health and mental retardation does not contain index listings on this condition (Fletcher & Menolascino, 1989), and psychometric tests currently proposed for use with the retarded do not examine for this condition (Aman, Watson, Singh, Turbott, & Wilsher, 1986). In this preliminary study, descriptive data from 51 persons with developmental disabilities who met DSM-IIIR criteria for posttraumatic stress disorder are reported. The majority of cases were detected upon routine initial psychiatric interview and record review. Demographics, family histories, and comorbid psychiatric conditions are described. In this sample all patients who received comprehensive recommended treatment improved.