Posttraumatic Sleep Research Articles

Provision of Psychological Support to a 31-Year-Old Man with SARS-CoV2-Induced Pneumonia during and after Hospitalization: A Clinical Case Report

A 31-year-old man hospitalized during the first wave of the pandemic in 2020 suffering from severe psychological distress, requested psychological assistance as his condition progressively worsened, eventually requiring intubation. After being referred to the clinical psychology service by a ward physician, the patient was assisted remotely for two months for a total of 22 sessions during hospitalization and after discharge. A psychometric evaluation was carried out when the patient was close to discharge and longitudinally, for a total of four times, for depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder Scale-7 (GAD-7)), post-traumatic stress disorder (Impact of Event Scale-Revised (IES-R)) and insomnia (Insomnia Severity Index (ISI)). Support was provided remotely, mainly through audio and video calls, and text chats were also utilized when possible and as required. The initial psychometric evaluation indicated moderate depression, severe anxiety, the presence of post-traumatic stress disorder and sleep problems. Psychological distress decreased until reaching a situation of no distress in the final evaluation. Psychological interventions from which the patient benefitted were stress reduction and breathing techniques, empathic support, elaboration of the possibility of grief and cognitive restructuring regarding fears relative to his condition. Psychological support provided remotely and the monitoring of psychological status after discharge are highly advisable in pandemic emergency situations. The CARE checklist of information to include when writing a case report was utilized in the writeup of this case report.

Association between traumatic brain injury and suicidality using a mediation approach and MarketScan

IntroductionNegative outcomes, including suicidal ideation/attempts, are a major public health concern, particularly among individuals who sustain a traumatic brain injury (TBI). TBI is associated with high rates of postinjury substance...

Posttraumatic stress disorder (PTSD), sleep, and cardiovascular disease risk: A mechanism-focused narrative review.

Growing longitudinal research has demonstrated that posttraumatic stress disorder (PTSD) precedes and predicts the onset of cardiovascular disease (CVD), and a number of physiological (e.g., dysregulation of the hypothalamic-pituitary-adrenal axis and autonomic nervous system, chronic systemic inflammation) and behavioral (e.g., physical inactivity, smoking, poor diet) factors might underlie this association. In this narrative review, we focus on sleep as a modifiable risk factor linking PTSD with CVD. We summarize the evidence for sleep disturbance after trauma exposure and the potential cardiotoxic effects of poor sleep, with an emphasis on mechanisms. In addition, we review the literature that has examined sleep in the context of the PTSD-CVD risk relation. Although sleep disturbance is a hallmark symptom of PTSD and a well-established risk factor for the development of CVD, the role of sleep in the association between PTSD and CVD has been largely unexamined in the extant literature. However, such work has the potential to improve our understanding of mechanisms of risk and inform intervention efforts to offset elevated CVD risk after trauma. We outline several recommendations for future research and behavioral medicine models in order to help define and address the role of sleep behavior in the development of CVD among trauma-exposed individuals with PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Post-Traumatic Stress Disorder Symptoms, Psychosomatic Symptoms, and Sleep Quality in Health Care Workers in Turkey During the COVID-19 Outbreak: Data From a Large Tertiary Care Hospital

The aim of this study was to examine psychosomatic symptoms, sleep quality, and post-traumatic stress disorder (PTSD) symptoms of health care workers actively fighting against Coronavirus-19 disease (COVID-19). Six hundred seventy-six health care workers were included in the study. The Depression Anxiety Stress Scale-21 (DASS-21), Impact of Event Scale–Revised (IES-R), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire-15 (PHQ-15) were applied to the participants. Of the participants, 55.4% were female health care workers. PTSD symptoms were observed in 24.3% of the participants and 42.55% had sleep disorder symptoms. The anxiety, depression, and stress, PHQ-15, and PSQI were determined to be the predictors for potential PTSD. Gender, job title, depression, PHQ-15, and IES-R were determined to be significant predictors for a sleep disorder. Gender, anxiety, IES-R, and PSQI were found to be significant predictors for psychosomatic symptoms. Determining which individuals are likely to be more affected in terms of psychosomatic symptoms, potential PTSD, and sleep disorder during the COVID-19 pandemic and detecting possible risk factors are of great importance. [ Psychiatr Ann . 2022;52(10):427–441.]

Anxiety sensitivity as a transdiagnostic risk factor for trajectories of adverse posttraumatic neuropsychiatric sequelae in the AURORA study

Anxiety sensitivity, or fear of anxious arousal, is cross-sectionally associated with a wide array of adverse posttraumatic neuropsychiatric sequelae, including symptoms of posttraumatic stress disorder, depression, anxiety, sleep disturbance, pain, and somatization. The current study utilizes a large-scale, multi-site, prospective study of trauma survivors presenting to emergency departments. Hypotheses tested whether elevated anxiety sensitivity in the immediate posttrauma period is associated with more severe and persistent trajectories of common adverse posttraumatic neuropsychiatric sequelae in the eight weeks posttrauma. Participants from the AURORA study (n = 2,269 recruited from 23 emergency departments) completed self-report assessments over eight weeks posttrauma. Associations between heightened anxiety sensitivity and more severe and/or persistent trajectories of trauma-related symptoms identified by growth mixture modeling were analyzed. Anxiety sensitivity assessed two weeks posttrauma was associated with severe and/or persistent posttraumatic stress, depression, anxiety, sleep disturbance, pain, and somatic symptoms in the eight weeks posttrauma. Effect sizes were in the small to medium range in multivariate models accounting for various demographic, trauma-related, pre-trauma mental health-related, and personality-related factors. Anxiety sensitivity may be a useful transdiagnostic risk factor in the immediate posttraumatic period identifying individuals at risk for the development of adverse posttraumatic neuropsychiatric sequelae. Further, considering anxiety sensitivity is malleable via brief intervention, it could be a useful secondary prevention target. Future research should continue to evaluate associations between anxiety sensitivity and trauma-related pathology.

Dual orexin antagonist normalized sleep homeostatic drive, enhanced GABAergic inhibition, and suppressed seizures after traumatic brain injury.

Traumatic brain injury (TBI) can result in posttraumatic epilepsy (PTE) and sleep disturbances. We hypothesized that treatment with sleep aids after TBI can ameliorate PTE. CD-1 mice underwent controlled cortical impact (CCI), sham injury, or no craniotomy. Sham and CCI groups underwent a monthlong daily treatment with sleep aids including a dual orexin antagonist (DORA-22) or THIP (gaboxadol) or a respective vehicle starting on the day of CCI. We performed continuous EEG (electroencephalography) recordings at week 1 and months 1, 2, and 3 for ~1 week each time. Seizure analysis occurred at all-time points and sleep analysis occurred in week 1 and month-1/2 in all groups. Subsets of CCI and sham groups were subjected to voltageclamp experiments in hippocampal slices to evaluate GABAergic synaptic inhibition. DORA-22 treatment suppressed seizures in month 1-3 recordings. TBI reduced the amplitude and frequency of miniature inhibitory synaptic currents (mIPSCs) in dentate granule cells and these changes were rescued by DORA-22 treatment. Sleep analysis showed that DORA-22 increased nonrapid eye movement (NREM) sleep during lights-off whereas THIP increased REM sleep during lights-on in week 1. Both treatments displayed subtle changes in time spent in NREM or REM at month-1/2 as well. TBI not only increased normalized EEG delta power (NΔ) at week-1 and month-1 but also resulted in the loss of the homeostatic diurnal oscillation of NΔ, which was restored by DORA-22 but not THIP treatment. Dual orexin antagonists may have a therapeutic potential in suppressing PTE potentially by enhancing GABAergic inhibition and impacting sleep homeostatic drive.

Posttraumatic stress disorder, sleep and medical cannabis treatment: A daily diary study

Despite increasing use of Medical Cannabis (MC) among posttraumatic stress disorder (PTSD) patients, research is lacking on how MC treatment relates to PTSD symptomatology, in particular sleep disturbances. This study examines the time gap between MC use and sleep onset and its association with (1) number of awakenings throughout the night, (2) early awakenings, (3) nightmares. Each morning over a two week period, 77 licensed MC patients suffering from PTSD reported on the timing of previous night MC use and sleep disturbances. Within-person analyses found that shorter time gaps between previous night MC use and sleep start time was associated with lower likelihood of experiencing nightmares throughout the night, but it was not associated with nightly awakenings or waking up too early. Between-person analyses showed that individuals who used MC products with higher CBD concentrations reported fewer early awakenings. These preliminary results indicate that future research should test causal relations between MC use and sleep problems in PTSD patients. Future research is warranted in order to explore causal relationships between MC use, nightmares and insomnia in PTSD patients.

CE: Pain and Mental Health Symptoms After Traumatic Orthopedic Injury

This article highlights the need to screen survivors of traumatic orthopedic injuries for postinjury symptoms associated with stressor-related disorders such as acute stress disorder and posttraumatic stress disorder, including pain, sleep disturbances, anxiety, and depression. The authors discuss the presentation of these postinjury symptoms, the instruments used to screen for each, the various pharmacological and nonpharmacological treatments, and the nursing implications for managing postinjury symptoms in traumatic orthopedic injury survivors.

0642 Characterizing Actigraphy-Measured Sleep Disturbance in Veterans and Service Members with Post-traumatic Headache following Mild Traumatic Brain Injury

Abstract Introduction Post-traumatic headache (PTH) frequently occur following traumatic brain injury (TBI) is particularly prevalent in Veterans with deployment-related TBI. PTH is associated with a range of physical and mental health symptoms, including post-traumatic stress disorder (PTSD), depression, anxiety, post-concussive symptoms, and subjective sleep complaints. Subjective sleep disturbance is associated with greater pain severity, and headaches (HA) are associated with poorer sleep. Poor sleep may be a mechanism by which PTH exerts both direct and indirect effects on health outcomes Despite the high prevalence of sleep problems in individuals with PTH, we know little about sleep disturbance in Veterans and military personnel with PTH. This study sought to characterize the relationship between objective sleep disturbance and HA in Veterans and military personnel with chronic PTH following mild TBI. Methods Veterans and active-duty service members (N=39, Mage= 49.4, 89.7% male) were included from a larger study evaluating prazosin as prophylactic treatment for persistent PTH. Participants completed baseline measures of PTSD symptoms, insomnia, sleep quality, HA frequency and impairment, as well as 7-day actigraphy, sleep diary, and HA logs. Actigraphy-derived sleep parameters include sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE), and wake after sleep onset (WASO). Daily HA logs were used to assess HA severity and duration. Analyses were conducted in SPSS 26.0 using multilevel modeling, controlling for the effects of time. Results Preliminary results suggest number of HA days at baseline was significantly associated with self-reported sleep quality (r=-.398, p= .016), but not with subjective SOL, TST, or WASO. Number of HA days was significantly correlated with actigraphy-measured WASO (r=.178, p=.003). Actigraphy-measured SOL, SE, WASO, and TST were not significantly associated with same-day HA severity and duration. Conclusion This preliminary data suggest examination of sleep fragmentation may be important in enhancing our understanding of PTH and related impairment. Findings support the importance of using both subjective and objective measures in the assessment of sleep in Veterans and service members with PTH. Support (If Any) This project was supported by a VA Career Development Award 5IK2RX001136 from the United States Department of Veterans Affairs Rehabilitation Research and Development Service. The contents of this work do not represent the views of the Department of Veterans Affairs or the United States government.

Health-Related Quality of Life by Gulf War Illness Case Status.

This study examines how health-related quality of life (HRQOL) and related indices vary by Gulf War illness (GWI) case status. The study population included veterans from the Gulf War Era Cohort and Biorepository (n = 1116). Outcomes were physical and mental health from the Veterans RAND 12 and depression, post-traumatic stress (PTSD), sleep disturbance, and pain. Kansas (KS) and Centers for Disease Control and Prevention (CDC) GWI definitions were used. Kansas GWI derived subtypes included GWI (met symptom criteria; no exclusionary conditions (KS GWI: Sym+/Dx−)) and those without GWI: KS noncase (1): Sym+/Dx+, KS noncase (2): Sym−/Dx+, and noncase (3): Sym−/Dx−. CDC-derived subtypes included CDC GWI severe, CDC GWI mild-to-moderate and CDC noncases. Case status and outcomes were examined using multivariable regression adjusted for sociodemographic and military-related characteristics. Logistic regression analysis was used to examine associations between GWI case status and binary measures for depression, PTSD, and severe pain. The KS GWI: Sym+/Dx− and KS noncase (1): Sym+/Dx+ groups had worse mental and physical HRQOL outcomes than veterans in the KS noncase (2): Sym−/Dx+ and KS noncase (3): Sym−/Dx− groups (ps < 0.001). Individuals who met the CDC GWI severe criteria had worse mental and physical HRQOL outcomes than those meeting the CDC GWI mild-to-moderate or CDC noncases (ps < 0.001). For other outcomes, results followed a similar pattern. Relative to the less symptomatic comparison subtypes, veterans who met the Kansas symptom criteria, regardless of exclusionary conditions, and those who met the CDC GWI severe criteria experienced lower HRQOL and higher rates of depression, PTSD, and severe pain.

Long COVID and neuropsychiatric manifestations (Review).

There is accumulating evidence in the literature indicating that a number of patients with coronavirus disease 2019 (COVID-19) may experience a range of neuropsychiatric symptoms, persisting or even presenting following the resolution of acute COVID-19. Among the neuropsychiatric manifestations more frequently associated with ‘long COVID’ are depression, anxiety, post-traumatic stress disorder, sleep disturbances, fatigue and cognitive deficits, that can potentially be debilitating and negatively affect patients' wellbeing, albeit in the majority of cases symptoms tend to improve over time. Despite variations in results obtained from studies using different methodological approaches to define ‘long COVID’ syndrome, the most widely accepted factors associated with a higher risk of developing neuropsychiatric manifestations include the severity of foregoing COVID-19, the female sex, the presence of comorbidities, a history of mental health disease and an elevation in the levels of inflammatory markers, albeit further research is required to establish causal associations. To date, the pathophysiological mechanisms implicated in neuropsychiatric manifestations of ‘long COVID’ remain only partially elucidated, while the role of the indirect effects of the COVID-19 pandemic, such as social isolation and uncertainty concerning social, financial and health recovery post-COVID, have also been highlighted. Given the alarming effects of ‘long-COVID’, interdisciplinary cooperation for the early identification of patients who are at a high risk of persistent neuropsychiatric presentations, beyond COVID-19 recovery, is crucial to ensure that appropriate integrated physical and mental health support is provided, with the aim of mitigating the risks of long-term disability at a societal and individual level.

The Oneiric Activity during and after the COVID-19 Total Lockdown in Italy: A Longitudinal Study.

A growing body of evidence highlights that the COVID-19 pandemic affected oneiric activity. However, only a few studies have assessed the longitudinal changes in dream phenomenology during different phases of the pandemic, often focused on a limited number of dream variables. The aim of the present study was to provide an exhaustive assessment of dream features during total lockdown (TL) and a post-lockdown (PL) period characterized by eased restrictive measures in Italy. We performed a longitudinal study using a web-based survey to collect demographic, COVID-19 related, clinical, sleep, and dream data at TL and PL. Our final sample included 108 participants. The high frequency of poor sleep quality, anxiety, and depressive symptoms observed during TL remained stable at PL, while sleep latency (t = −4.09; p < 0.001) and PTSD-related disruptive nocturnal behaviors (t = −5.68; p < 0.001) exhibited a reduction at PL. A PL decrease in time spent with digital media was observed (t = −2.77; p = 0.007). We found a strong PL reduction in dream frequency (t = −5.49; p < 0.001), emotional load (t = −2.71; p = 0.008), vividness (t = −4.90; p < 0.001), bizarreness (t = −4.05; p < 0.001), length (t = −4.67; p < 0.001), and lucid dream frequency (t = −2.40; p = 0.018). Fear was the most frequently reported emotion in dreams at TL (26.9%) and PL (22.2%). Only the frequency of specific lockdown-related dream contents exhibited a reduction at PL. These findings highlight that the end of the home confinement had a strong impact on the oneiric activity, in the direction of reduced dream frequency, intensity, and lockdown-related contents. The co-occurrence of such changes with a decline in nocturnal PTSD-related symptoms, sleep latency, and time with digital media suggests an influence of post-traumatic stress levels, lifestyle modifications, and sleep pattern on dream changes during different phases of the pandemic. The stable prevalence of fear in dreams and the large frequency of poor sleep quality, depressive symptoms, and anxiety are probably related to the persistence of many negative consequences of the pandemic. Overall, these results are consistent with the continuity hypothesis of dreams.

THE EFFECT OF A RESİLİENCE TRAİNİNG TO PROMOTE THE MENTAL WELL-BEİNG OF FRONTLİNE WORKERS: A BRİEF REPORT OF A SEMİ-EXPERİMENTAL STUDY ON THE COMMUNİTY RESİLİENCE MODEL

Problem of the Study: Frontline workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae. These; depression, anxiety, suicidality, post-traumatic stress disorder, sleep and substance use disorders. Frontline workers (FLW) need self-care programs to support their mental health. The research problem of the study is handled in this context. Methods: A quasi-experimental study was conducted to evaluate the effect of a simple training on mental well-being and emotional regulation, using an appropriate example of the Community Resilience Model (CRM), FLW (Front line workers). Baseline scores on mental health and stress measures are compared with follow-up scores at three time points. Outcomes, psychological well-being (World Health Organization-5 Well-Being Index); endurance (Connor-Davidson Endurance Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8) were evaluated within the scope of concepts. Results: 73 (70.2%) of the 104 participants enrolled and participated in the CRM training completed at least 1 post-test. Well-being scores increased at 1 year with a small-medium effect size. (Cohen d=0.32). Resilience scores increased by 1 year with a small-medium effect size (Cohen d=0.36). Although secondary traumatic stress scores showed the greatest effect in 1 week (Cohen d=0.49), reductions were found in the scores obtained. Somatic symptoms decreased at each posttest and the greatest change occurred from baseline to 1 week (Cohen d=0.39). Participants reported that awareness of their body sensations helped them when they were very bored as a way to calm themselves. Conclusions: After three hours of Community Resilience Model (CRM) training, participants report improved mental health and reduced secondary traumatic stress and somatic symptoms. This simple body awareness intervention can be cited as a good resource during the COVID-19 pandemic.

Psychological and Physiological Complications of Post-Burn Patients in Pakistan: A narrative review.

Pakistan has a burn mortality rate of 6.5%, with a considerable percentage of survivors suffering from long-term complications due to lack of rehabilitation. This review aimed to outline the important physiological and psychological after-effects of burn injuries. Google Scholar, MEDLINE® and PubMed were searched for relevant articles between March and May 2020. Psychological complications of burns include depression, post-traumatic stress disorder, anxiety, sleep disturbance, phobias, guilt, suicidal thoughts and personality changes. Physiological complications include scarring, contractures, pain, muscle wasting and hypothermia; other complications include infections. This review revealed a scarcity of literature regarding the prevalence and impact of long-term complications in post-burn patients. A lack of rehabilitative services and high rate of post-burn complications in Pakistan were found. Rehabilitation of burn patients should be a continuation of active treatment and should begin from the day of admission, to reduce the morbidity and improve the quality of life of burn patients.

Relieving Pandemic-Related Psychological Distress: Key Protective Factors Against Mental Health Impairment

Over the two past years, mental health professionals have warned about the negative mental health consequences related to the covid pandemic. Most commonly reported are increased rates of depression, anxiety disorders, post-traumatic stress symptoms, sleep and appetite disturbance, contagion fears, frustration, burden, boredom, and suicidal behavior [1-5]. Previous resreach by our group has found that in low-resourced, high-risk communities characterized by pre-existing condition of extreme poverty, violence, and limited educational and occupational opportunities, there is a high prevalence of Persistent Pandemic-Related Distress Syndrome (Authors, in press), a condition representing on-going mental health impairment consisting of psychological distress and physical symptomatology persisting for an extended period of at least 6-months after mitigation efforts such as lockdown and social distancing restrictions were lifted and unrelated to contagion and infection fears.

Women with abuse-related posttraumatic stress disorder sleep more fitfully but just as long as healthy controls: an actigraphic study.

Subjective reports of sleep impairments are common in individuals with posttraumatic stress disorder (PTSD), but objective assessments of sleep have yielded mixed results. We investigated sleep via actigraphy and e-diary on 6 consecutive nights in a group of 117 women with PTSD after childhood abuse (CA; PTSD group), a group of 31 mentally healthy women with a history of CA (healthy trauma controls, HTC group) and a group of 36 nontraumatized mentally healthy women (healthy controls, HC group). The PTSD group reported lower sleep quality, more nights with nightmares, and shorter sleep duration than both HTC and HC. Actigraphic measures showed more and longer sleep interruptions in the PTSD group compared to HTC and HC, but no difference in sleep duration. While the PTSD group underestimated their sleep duration, both HTC and HC overestimated their sleep duration. HTC did not differ from HC regarding sleep impairments. Sleep in women with PTSD after CA seems to be more fragmented but not shorter compared to sleep patterns of mentally healthy control subjects. The results suggest a stronger effect of PTSD psychopathology on sleep compared to the effect of trauma per se. Treating Psychosocial and Neural Consequences of Childhood Interpersonal Violence in Adults (RELEASE), https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00000000, German Clinical Trials registration number: DRKS00005578.

Sleep apnea and posttraumatic stress after traumatic brain injury (TBI): A Veterans Affairs TBI Model Systems study.

Traumatic brain injury (TBI) is a complex health problem in military veterans and service members (V/SM) that often co-occurs with psychological and medical conditions such as posttraumatic stress disorder (PTSD) and sleep apnea. We aimed to examine if sleep apnea is associated with the presence and severity of PTSD in V/SM with TBI of all severities. The study examined participants at varying times since their TBI (N = 602) enrolled in the Veterans Affairs TBI Model Systems database. Frequency of self-reported sleep apnea diagnosis was calculated in a cross-sectional sample. Prevalence of co-occurring sleep apnea and probable PTSD was tested with a chi-square analysis. A multivariable regression model evaluated the association between sleep apnea and PTSD symptom severity while controlling for relevant covariates. Almost 32% of the sample stated they had been diagnosed with sleep apnea. In those reporting sleep apnea, 32% also had probable PTSD; 19% of those without sleep apnea had probable PTSD. The regression demonstrated sleep apnea was significantly associated with PTSD symptom severity (p < .001). Greater number of TBIs, recent mental health treatment, being deployed to a combat zone, and greater years since TBI were also significant predictors of PTSD symptom severity (all p < .05). TBI, PTSD, and sleep apnea are often comorbid in V/SM. We expand the literature by demonstrating that sleep apnea was associated with PTSD severity. A multipronged approach to TBI rehabilitation that addresses sleep and psychological distress is recommended for enhancing health outcomes in this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Longitudinal associations between hair cortisol, PTSD symptoms, and sleep disturbances in a sample of firefighters with duty-related trauma exposure

Several studies have found evidence of altered cortisol levels in patients with posttraumatic stress disorder (PTSD). Based on these findings, it is assumed that these patients may show signs of cortisol dysregulation after trauma. Posttrauma cortisol levels are thus considered a potential biomarker of PTSD. However, longitudinal studies using indicators of long-term cortisol secretion such as hair cortisol concentrations (HCC) are scarce. The current study investigated prospective associations between HCC and PTSD symptoms in a sample of Dutch firefighters taking into account varying levels of work-related trauma severity. In addition, we assessed posttraumatic sleep disturbances as a secondary outcome measure to investigate whether effects generalize to this frequent comorbidity of PTSD. Three hundred seventy-one Dutch firefighters with a mean of 14.01 years of work experience were included in the analyses. Baseline assessment included the collection of hair samples and the measurement of work-related trauma severity, PTSD symptoms, and sleep disturbances. PTSD symptoms and sleep disturbance were re-assessed after six and twelve months. Multilevel analyses indicate a significant positive correlation between HCC and baseline PTSD symptoms in those with average or above-average work-related trauma severity. A similar pattern was evident for posttraumatic sleep disturbances at baseline. Moreover, higher HCC predicted more posttraumatic sleep disturbances after 6 months in participants with above-average work-related trauma severity. No other associations emerged for PTSD symptoms or posttraumatic sleep disturbances at six or twelve months. As such, our study supports the existence of a cross-sectional association between HCC and trauma symptoms, which may vary for different levels of subjective trauma severity. The longitudinal stability of this association should be reinvestigated by future research.

Artificial intelligence language predictors of two-year trauma-related outcomes

BackgroundRecent research on artificial intelligence has demonstrated that natural language can be used to provide valid indicators of psychopathology. The present study examined artificial intelligence-based language predictors (ALPs) of seven trauma-related mental and physical health outcomes in responders to the World Trade Center disaster. MethodsThe responders (N = 174, Mage = 55.4 years) provided daily voicemail updates over 14 days. Algorithms developed using machine learning in large social media discovery samples were applied to the voicemail transcriptions to derive ALP scores for several risk factors (depressivity, anxiousness, anger proneness, stress, and personality). Responders also completed self-report assessments of these risk factors at baseline and trauma-related mental and physical health outcomes at two-year follow-up (including symptoms of depression, posttraumatic stress disorder, sleep disturbance, respiratory problems, and GERD). ResultsVoicemail ALPs were significantly associated with a majority of the trauma-related outcomes at two-year follow-up, over and above corresponding baseline self-reports. ALPs showed significant convergence with corresponding self-report scales, but also considerable uniqueness from each other and from self-report scales. LimitationsThe study has a relatively short follow-up period relative to trauma occurrence and a limited sample size. ConclusionsThis study shows evidence that ALPs may provide a novel, objective, and clinically useful approach to forecasting, and may in the future help to identify individuals at risk for negative health outcomes.

Individuals with and without military-related PTSD differ in subjective sleepiness and alertness but not objective sleepiness

Posttraumatic stress disorder-related sleep disturbances may increase daytime sleepiness and compromise performance in individuals with posttraumatic stress disorder. We investigated nighttime sleep predictors of sleepiness in Veterans with and without posttraumatic stress disorder. Thirty-seven post-9/11 Veterans with posttraumatic stress disorder and 47 without posttraumatic stress disorder (Control) completed a 48-h lab stay. Nighttime quantitative EEG and sleep architecture parameters were collected with polysomnography. Data from daytime sleepiness batteries assessing subjective sleepiness (global vigor questionnaire), objective sleepiness (Multiple Sleep Latency Tests) and alertness (psychomotor vigilance task) were included in analyses. Independent samples t-tests and linear regressions were performed to identify group differences in sleepiness and nighttime sleep predictors of sleepiness in the overall sample and within each group. Participants with posttraumatic stress disorder had higher subjective sleepiness (t = 4.20; p < .001) and lower alertness (psychomotor vigilance task reaction time (t = -3.70; p < .001) and lapses: t = -2.13; p = .04) than the control group. Objective daytime sleepiness did not differ between groups (t = -0.79, p = .43). In the whole sample, higher rapid eye movement delta power predicted lower alertness quantified by psychomotor vigilance task reaction time (β = 0.372, p = .013) and lapses (β = 0.388, p = .013). More fragmented sleep predicted higher objective sleepiness in the posttraumatic stress disorder group (β = −.467, p = .005) but no other nighttime sleep measures influenced the relationship between group and sleepiness. Objective measures of sleep and sleepiness were not associated with the increased subjective sleepiness and reduced alertness of the posttraumatic stress disorder group.