Posttraumatic Stress Disorder Subscales Research Articles

A novel multifamily treatment targeting symptoms related to Latinx caregiver deportation.

Latinx youth who have experienced caregiver deportation show higher rates of posttraumatic stress disorder (PTSD) and internalizing symptoms compared to Latinx youth who have not. Thus, there is a need for culturally and linguistically appropriate therapeutic approaches to address psychiatric needs related to caregiver deportation. Positive Adaptations for Trauma and Healing (PATH) is a manualized 10-week group therapy for Latinx youth and their caregivers that integrates trauma-informed interventions with positive psychology and resilience interventions. The present study examined PATH for reducing trauma symptomatology for Latinx youth who endured at least three traumatic experiences in their caregiving system as well as differences for Latinx youth who experienced their caregiver's deportation. Self-identified Latinx youth (N = 31) and their Spanish-speaking caregivers were recruited from two urban hospitals. All youth experienced three or more traumatic events. Pre- to postintervention mean change was measured with t tests; mixed-effects analysis of variance assessed whether the program was feasible for youth who had experienced a caregiver deportation versus Latinx youth who did not. Assessment with the Trauma Symptom Checklist and the UCLA PTSD Index for Youth showed statistically significant reductions on Anxiety, Depression, Anger, and PTSD subscales. Latinx youth who experienced a caregiver's deportation exhibited larger reductions in anger symptoms and PTSD symptoms. Study results suggest that the novel group therapy intervention was feasible and acceptable for Latinx youth and their caregivers. Despite a small sample size, the intervention proved feasible for Latinx youth who experienced caregiver deportation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Validation of the post-traumatic stress disorder subscale of the child behaviour checklist (PTSD-CBCL): screening for post-traumatic stress disorder or attention deficit/hyperactivity disorder?

Almost 20% of children and adolescents who attend in mental health centres are witnesses of domestic violence (WDVs). It would therefore be clinically useful to have an appropriate screening instrument for this population, such as the PTSD-CBCL. Our aim here was thus to assess the psychometric properties of relevant tools by determining their internal consistency, sensitivity/specificity, and positive/negative predictive values in our centre's population. We recruited 194 parents of children aged 4-16 at the Child and Adolescent Mental Health Service of the Hospital Sant Joan de Déu and Els Pins primary school. This sample was divided into: (1) a WDV group (n = 104); (2) an ADHD diagnosis group (n = 28); and (3) a general population (GP) primary school group (n = 62). The PTSD-CBCL total reliability score was high (Cronbach's alpha = 0.87). We found significant mean difference for WDV vs. GP (MD = 8.57; p < 0.001) with significantly higher mean scores in WDV than in GP. We also found significant differences for ADHD vs. GP (MD = 6.91; p < 0.001) with higher mean scores in ADHD than in GP. We observed good discriminatory power indices in the following group comparisons: WDV vs. GP, ADHD vs. GP, WDV vs. ADHD + GP, and GP vs. WDV + ADHD. Nevertheless, the PTSD-CBCL did not discriminate WDV vs. ADHD. Thus, we conclude that the PTSD-CBCL instrument has good discriminatory power in general and clinical populations, and could be implemented in the context of prevention and early intervention after trauma.

The Influence of Personality Traits on Specific Coping Styles and the Development of Posttraumatic Stress Symptoms following Acute Coronary Syndrome: A Cluster Analytic Approach

Objective: A growing body of literature suggests a relationship between personality traits and posttraumatic stress disorder (PTSD) symptoms after acute coronary events (ACS). However, specific personality profiles have not been examined in patients after ACS. Thus, the aim of the present study was to examine personality profiles created from response patterns on the resilience, alexithymia and type D personality (TDP) scales and to examine associations with PTSD symptoms, symptom clusters and coping styles among a sample of ACS patients. Methods: A cluster analytic approach was utilized to identify risk profiles based on personality variables and a series of ANOVAs in 154 patients. Post hoc analyses were conducted to examine the relationship between each profile, and interviewer-rated PTSD symptoms and different coping styles. Results: The analyses indicated a three-cluster solution, including low- (high resilience, low alexithymia and non-TDP), medium- (average resilience, average alexithymia and non-TDP) and high-risk (low resilience, high alexithymia and TDP) profiles. Clusters differed significantly in all three coping subscales. At 3-month follow up, clusters differed significantly in all three PTSD subscales (re-experiencing, avoidance and hyperarousal). At 12-month follow up, the differences remained significant for the hyperarousal subscale only. Conclusions: The personality profiles identified and the respective associations to PTSD symptoms and coping strategies highlight the potential impact for the psychological adjustment following ACS.

Potential traumatic events and symptoms of post-traumatic stress in unaccompanied refugee minors—a comparison with youth in foster care

Building knowledge on how child welfare services (CWS) should tailor services for unaccompanied refugee minors (URMs) is important. URMs and youth in foster care are high-risk groups taken care of by the CWS in Norway. Little is known on whether knowledge gained from youth in foster care can inform services for URMs, and if these groups are comparable in terms of experiences of potential traumatic events (PTEs) and post-traumatic stress disorder (PTSD) symptom load. Eighty-one URMs reported PTEs and PTSD-symptoms using an adapted version of the Child and Adolescent Trauma Screen (CATS). Responses were described and compared with a sample of 303 youth in foster care in linear regression models. We present relative risks (RR) and standardized mean differences (SMD) for the PTEs and the PTSD subscale and total score between the groups in forest plots. URMs had experienced a mean (standard deviation) of 6.4 (3.4) PTEs and 43.9% reported to have PTSD-symptoms at or above the clinical cut off. Compared to the foster youth, URMs reported more exposures of interpersonal violence outside of the family (RRs ranging from 66.4 [95%CI 18.1; 243.5) to 1.3 (1.0, 1.5)], and more PTSD-symptoms in the re-experiencing subscale [SMD = 0.3 (95% CI 0.1, 0.6)]. The frequency and types of PTEs and the PTSD-symptom load and profile among URMs and youth in foster care differed. Findings underscore the importance of qualified and targeted care for URMs, and that this care should differ to that of other high-risk groups in the CWS.

Validation of the Injured Trauma Survivor Screen: An American Association for the Surgery of Trauma multi-institutional trial.

Psychological distress is common following a traumatic injury event. The Injured Trauma Survivor Screen (ITSS) was developed at a level 1 trauma center to assess for posttraumatic stress disorder (PTSD) and major depressive episode (MDE) following admission for a traumatic injury. The ITSS sensitivity and specificity were analyzed 1 to 3 and 6 to 9 months postinjury to test the validity across trauma centers. Four level 1 trauma centers from the East, Midwest, South, and West in the United States recruited 375 eligible adult inpatients (excluded participants included those with moderate or severe traumatic brain injury, whose injury was self-inflicted, were noncommunicative, or were non-English speaking). Baseline sample (White/Caucasian, 63.2%; male, 62.4%; mean (SD) age, 45 (17.11) years; injured by motor vehicle collision, 42.4%) measurements were conducted during index hospitalization. At first follow-up, 69.6% (n = 261) were retained; at second follow-up, 61.3% (n = 230) were retained. Measurements included the ITSS, PTSD Checklist for DSM-5, Center for Epidemiologic Studies Depression Scale-Revised, and Clinician-Administered PTSD Scaled for DSM 5. At follow-up 1, the ITSS PTSD subscale had a sensitivity of 75% and specificity of 78.8%, and the MDE subscale had a sensitivity of 80.4% and specificity of 65.6%. At follow-up 2, the PTSD subscale had a sensitivity of 72.7% and specificity of 83.1%, and the MDE subscale had a sensitivity of 76.1% and specificity of 68.3%. A combined risk group using two symptom based measures administered at baseline produced increased specificity. The nine-item ITSS continues to be an efficient and effective risk screen for PTSD and MDE following traumatic injury requiring hospitalization. This multi-institutional validation study creates a solid foundation for further exploration of the generalizability of this screen's psychometric properties in distinct populations. Prognostic study, level III.

Long-term effectiveness of eye movement desensitization and reprocessing in children and adolescents with medically related subthreshold post-traumatic stress disorder: a randomized controlled trial

Medical procedures and hospitalizations can be experienced as traumatic and can lead to post-traumatic stress reactions. Eye movement desensitization and reprocessing (EMDR) shows promising results but very few long-term studies have been published. Therefore, our aim was to test the long-term (8 months post-treatment) effectiveness of EMDR in children and adolescents with medically related subthreshold post-traumatic stress disorder (PTSD). Seventy-four children (including 39 with congenital or acquired heart disease) aged 4-15 (M = 9.6 years) with subthreshold PTSD after previous hospitalization were included into a parallel group randomized controlled trial. Participants were randomized to EMDR (n = 37) or care-as-usual (CAU) (n = 37; medical care only). The primary outcome was PTSD symptoms of the child. Secondary outcomes were symptoms of depression and blood-injection-injury (BII) phobia, sleep problems, and health-related quality of life (HrQoL) of the child. Assessments of all outcomes were planned at baseline and 8 weeks and 8 months after the start of EMDR/CAU. We hypothesized that the EMDR group would show significantly more improvements on all outcomes over time. Both groups showed improvements over time on child's symptoms of PTSD (only parent report), depression, BII phobia, sleep problems, and most HrQoL subscales. GEE analyses showed no significant differences between the EMDR group (nT2 = 33, nT3 = 30) and the CAU group (nT2 = 35, nT3 = 32) on the primary outcome. One superior effect of EMDR over time was found for reducing parent-reported BII phobia of the child. EMDR did not perform better than CAU in reducing subthreshold PTSD up to 8 months post-treatment in previously hospitalized children. Possible explanations and clinical implications are discussed.

Investigating centrality in PTSD symptoms across diagnostic systems using network analysis*

ABSTRACT Background: The posttraumatic stress disorder (PTSD) diagnosis has been widely debated since it was introduced into the diagnostic nomenclature four decades ago. Recently, the debate has focused on consequences of having two different descriptions of PTSD: 20 symptoms belonging to four symptom clusters in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5), and three symptoms clusters in the 11th edition of the International Classification of Diseases (ICD-11) most often operationalized by six symptoms in the International Trauma Questionnaire (ITQ) (2017) and Hansen, Hyland, Armour, Shevlin, & Elklit (2015). Research has provided support for both models of PTSD, but at the same time indicates differences in estimated prevalence rates of PTSD (Hansen et al., 2015, 2017). A growing body of research has modelled PTSD both theoretically and statistically as a network of interacting symptoms (Birkeland, Greene, & Spiller, 2020), yet it remains more unclear how the two diagnostic systems perform regarding which symptoms are more central/interconnected. Objectives and methods: We estimated two 23-item Gaussian Graphical Models to investigate whether ICD-11 or DSM-5 PTSD symptoms are more central in two trauma-exposed samples: a community sample (N = 2,367) and a military veteran sample (N = 657). PTSD DSM-5 was measured with the PTSD checklist-5 (PCL-5) and the PTSD ICD-11 was measure by the ITQ PTSD subscale. Results: Five of the six most central symptoms estimated via the expected influence centrality metric across the two samples were identical and represented symptoms from both diagnostic systems operationalized by the PCL-5 and the ITQ. Conclusions: The results of the present study underline that symptoms from both diagnostic systems hold central positions. The implications of the results are discussed from the perspectives of an indexical (i.e. the diagnostic systems reflect both shared and different aspects of PTSD) and a constitutive view (i.e., the diagnostic systems represent different disorders and the results cannot be reconciled per se) of mental health diagnoses (Kendler, 2017).

DSM-5-TR prolonged grief disorder and DSM-5 posttraumatic stress disorder are related, yet distinct: confirmatory factor analyses in traumatically bereaved people

ABSTRACT Background: Prolonged grief disorder (PGD) is newly included in the text revision of the DSM-5 (DSM-5-TR). So far, it is unknown if DSM-5-TR PGD is distinguishable from bereavement-related posttraumatic stress disorder (PTSD). Prior research examining the distinctiveness of PTSD and pathological grief focused on non-traumatic loss samples, used outdated conceptualizations of grief disorders, and has provided mixed results. Objective: In a large sample of traumatically bereaved people, we first evaluated the factor structure of PTSD and PGD separately and then evaluated the factor structure when combining PTSD and PGD symptoms to examine the distinctiveness between the two syndromes. Methods: Self-reported data were used from 468 people bereaved due to the MH17 plane disaster (N = 200) or a traffic accident (N = 268). The 10 DSM-5-TR PGD symptoms were assessed with the Traumatic Grief Inventory-Self Report Plus (TGI-SR+). The 20-item Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) was used to tap PTSD symptoms. Confirmatory factor analyses were conducted. Results: For PTSD, a seven factor, so-called ‘Hybrid’ model yielded the best fit. For PGD, a univariate factor model fits the data well. A combined model with PGD items loading on one factor and PTSD items on seven factors (associations between PGD and PTSD subscales r ≥ .50 and ≤.71), plus a higher-order factor (i.e. PTSD factors on a higher-order PTSD factor) (association between higher-order PTSD factor and PGD factor r = .82) exhibited a better fit than a model with all PGD and PTSD symptom loading on a single factor or two factors (i.e. one for PGD and one for PTSD). Conclusions: This is the first study examining the factor structure of DSM-5-TR PGD and DSM-5 PTSD in people confronted with a traumatic loss. The findings provide support that PGD constitutes a syndrome distinguishable from, yet related with, PTSD.

Network Analysis of Posttraumatic Stress and Eating Disorder Symptoms in a Community Sample of Adults Exposed to Childhood Abuse.

Posttraumatic stress disorder (PTSD) and eating disorders (EDs) are individually debilitating and highly comorbid conditions. Childhood abuse is a prominent risk factor for PTSD and ED symptoms both individually and as a comorbid syndrome (PTSD-ED). There may be a functional association between comorbid PTSD-ED symptoms whereby disordered eating behaviors are used to avoid trauma-related thoughts and feelings. The current study used a network analytic approach to examine key associations between PTSD and ED symptom subscales (i.e., PCL-5 and EPSI, respectively) in a community sample of 120 adults who endorsed at least one experience of childhood abuse (i.e., physical, sexual, or emotional abuse; witnessing domestic violence). Participants completed an anonymous online survey using Amazon's Mechanical Turk Prime. We used three network analysis indices (i.e., strength centrality, key players, and bridge symptoms) to identify symptoms that may maintain the comorbid PTSD-ED network. The results indicated that reexperiencing symptoms had the highest strength centrality in the PTSD-ED network and bridged the PTSD and ED clusters. For ED, cognitive restraint was a bridge to all PTSD symptoms. Hyperarousal, negative alterations in cognitions and mood (NACM), and purging were key players, indicating they are integral to the network structure. If replicated in prospective studies, these results may indicate that reexperiencing and cognitive restraint are core drivers of PTSD-ED comorbidity, whereas hyperarousal, NACM, and purging may be downstream consequences maintaining the comorbid condition. Concurrent treatments that address PTSD and ED symptoms simultaneously may result in the best outcomes.

The mediating effect of rumination between posttraumatic stress disorder symptoms and anger reactions.

The relationship between posttraumatic stress disorder (PTSD) and anger is well established. However, further investigation into the underlying mechanisms of this PTSD-anger relationship is needed. Rumination, a construct with a known association to PTSD symptoms, theoretically may mediate this PTSD-anger relationship. We conducted a mediational model using self-report measures of PTSD symptoms, rumination, and anger reactions from a nonclinical, trauma-exposed sample (N = 339) through Amazon's Mechanical Turk. Rumination mediated overall PTSD symptoms and anger reactions, controlling for age and gender identity. Further analyses examined this mediating role between PTSD subscale scores and anger. Rumination mediated all PTSD subscales and anger when modeled separately. After adjusting for other PTSD symptoms, only 2 subscales' relationship with anger remained mediated by rumination: negative alterations in cognitions/mood and physiological arousal. Rumination should be assessed in the context of PTSD and anger symptoms, specifically physiological arousal and negative moods/cognitions symptoms in PTSD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

4286 The Relationship Between Tinnitus-Related Distress and PTSD Symptoms Among Post 9/11 Veterans with Posttraumatic Headache

4286 The Relationship Between Tinnitus-Related Distress and PTSD Symptoms Among Post 9/11 Veterans with Posttraumatic Headache

0651 Longitudinal Effects of CPAP Adherence on Changes in PTSD Symptoms and Subscales: The Importance of Hyperarousal on Adherence and Outcomes

Abstract Introduction Comorbidity of posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) is staggeringly high, with rates of 75.7% when using criteria of apnea/hyponea index (AHI) &amp;gt; 5. Continuous positive airway pressure (CPAP) therapy can decrease PTSD symptoms, however, no study has used advanced mixed-modeling to examine which cluster of PTSD CPAP therapy effects. Methods Participants were 59 veterans with PTSD and undiagnosed OSA. Apnea/Hypopnea index (AHI) was scored according to AASM criteria. Auto-titration CPAP devices were prescribed with pressures empirically selected by the sleep physician based on BMI, overall AHI, and dominant event type; maximum pressures was set at 20cm H2O. Analyses used hierarchical linear modeling to examine changes in PTSD symptoms clusters as a function of CPAP use over 6-months. Measures include PTSD checklist (PCL) and clusters (reexperiencing, avoidance, and hyperarousal), percentage of nights CPAP used, weight, and BMI. Results Baseline scores were high: PCL (M=60.02; SD=15.03) and AHI (M=28.18 per hour; SD=20.35). Average number of nights CPAP use in the last 6-months was 59.3%, with 3.5 hours each night with clear adherent and non-adherent groups emerging. The adherent group showed a 15-point drop in PCL scores and the non-adherent group had a 3-point drop. More days of CPAP use in the last 6-months predicted larger decreases in hyperarousal (d=0.56) and re-experiencing (d=0.47) clusters, but not avoidance. The intercept was significant in the hyperarousal analyses suggesting individuals with higher hyperarousal at baseline had less CPAP adherence. Conclusion The need for PTSD clinicians to screen and refer for OSA is necessary, but may not be sufficient, in treating PTSD. Change in hyperarousal symptoms accounted for most of the effects from CPAP use. Higher hyperarousal symptoms at baseline predict lower CPAP adherence, suggesting a higher clinical need to address these individuals as they will get the most positive effects from CPAP. Support This work is supported by a VA RR&amp;D CDA (1lK2Rx002120-01) to Peter Colvonen.

Accelerated Resolution Therapy: Randomized Controlled Trial of a Complicated Grief Intervention.

Complicated grief (CG) is severe, prolonged (>12 months) grieving. Complicated grief disproportionately affects older adults and is associated with negative physical/psychological effects. Although treatment options exist, those which do are time-intensive. We report on a randomized clinical trial (RCT) which examined whether accelerated resolution therapy (ART), a novel mind-body therapy, is effective in treating CG, post-traumatic stress disorder (PTSD), and depression among hospice informal caregivers. Prospective 2 group, wait-listed RCT. All participants were scheduled to receive 4 ART sessions. ≥60 years, inventory of CG >25, and PTSD checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition >33 or Psychiatric Diagnostic Screen Questionnaire PTSD subscale >5. Major psychiatric disorder, other current psychotherapy treatment. Depression was measured by the Center for Epidemiologic Studies Depression. Mean (standard deviation [SD]) age of 54 participants was 68.7 (7.2) years, 85% female, and 93% white. Participants assigned to ART reported significantly greater mean (SD) CG reduction (-22.8 [10.3]) versus Wait-list participants (-4.3 [6.0]). Within-participant effect sizes (ESs) for change from baseline to 8-week post-treatment were CG (ES = 1.96 (95% confidence interval [CI]: 1.45-2.47; P < .0001), PTSD (ES = 2.40 [95% CI: 1.79-3.00]; P < .0001), depression (ES = 1.63 [95% CI: 1.18-2.08; P < .0001). Treatment effects did not substantially differ by baseline symptom levels. Results suggests that ART presents an effective and less time-intensive intervention for CG in older adults. However, it should undergo further effectiveness testing in a larger, more diverse clinical trial with a focus on determining physiological or behavioral mechanisms of action.

Association of Postdisaster Depression and Posttraumatic Stress Disorder With Mortality Among Older Disaster Survivors of the 2011 Great East Japan Earthquake and Tsunami

Depression and posttraumatic stress disorder (PTSD) represent 2 common mental health sequelae of natural disasters. However, to date, no studies have examined whether postdisaster depression and PTSD are associated with increased risk of mortality among community-dwelling survivors of natural disasters. To assess whether postdisaster depression and PTSD were associated with mortality in older disaster survivors. In this cohort study, prospective data were retrieved from older Japanese adults in Iwanuma City, Miyagi Prefecture, which was directly affected by the 2011 Great East Japan Earthquake and Tsunami. The baseline was established 7 months before the disaster (August 2010), and follow-up surveys were conducted approximately 2.5 years afterward (October 1, 2013, to January 31, 2014). Invitations were mailed to every citizen 65 years or older in Iwanuma City. Mortality data were obtained through March 4, 2017. Data analysis was performed from December 1, 2018, to June 30, 2019. Postdisaster depression (Geriatric Depression Scale Short Form score ≥5) and PTSD (Screening Questionnaire for Disaster Mental Health PTSD subscale score ≥4) were measured in 2013. Mortality data were obtained by linkage to the national long-term care insurance database. Cox proportional hazards regression models were adjusted for predisaster sociodemographic characteristics, health behaviors, social cohesion, predisaster depression, and disaster experiences. The response rate for the baseline survey was 59.0% (5058 of 8567 individuals), and the follow-up rate was 82.1% (3594 of 4380 eligible respondents). A total of 2965 individuals (mean [SD] age, 73.4 [6.2] years; 1621 [54.7%] female) participated in the study. The mean (SD) follow-up since the 2013 survey was 3.3 (0.5) years. Overall, 974 (32.8%) reported postdisaster depression and 747 (25.2%) reported PTSD. In adjusted models, depression was associated with more than double the risk of mortality (hazard ratio, 2.29; 95% CI, 1.54-3.42); PTSD was not associated with increased risk of mortality (hazard ratio, 1.10; 95% CI, 0.73-1.64). When evaluating the association of the 4-category comorbid depression and PTSD variable with mortality, survivors with depression only (HR, 2.24; 95% CI, 1.43-3.49) as well as those with comorbid depression and PTSD (HR, 2.54; 95% CI, 1.50-4.27) were at increased risk of death during the follow-up period compared with those with neither depression nor PTSD. Depression, but not PTSD, was associated with mortality during 3.3 years of follow-up among older disaster survivors. These findings suggest that long-term mental health consequences of natural disasters may exist and that treating depression in older survivors of disasters may be beneficial.

Psychometrics of the PTSD and Depression Screener for Bereaved Youth

ABSTRACTInterventions for bereaved children and families range from supportive counseling, designed to promote social connectedness and expression of feelings and thoughts about the deceased, to intensive trauma/grief-specific therapy, designed to ameliorate symptoms of posttraumatic stress disorder (PTSD) and depression. That said, professionals have few brief assessment instruments to match response and functioning to appropriate interventions. To expedite the screening and referral process for bereaved families, Brown, Goodman, and Swiecicki (2008) developed the PTSD and Depression Screener for Bereaved Youth, a 19-item measure of bereavement-related history and symptoms of PTSD and depression. The current study is a psychometric evaluation of the Screener for Bereaved Youth. Data were collected from 284 bereaved children, 6–17 years of age (M = 12.4; SD = 2.9). A factor analysis revealed distinct subscales for PTSD (eight items) and depression (four items). The PTSD and depression subscales showed both concurrent and discriminant validity. Endorsement of four items on either subscale was associated with meeting full criteria on more extensive measures of PTSD and depression. These findings are discussed with specific consideration to the multiple systems in which the measure could be used and applications to clinical services.

Lifetime PTSD and geriatric depression symptomatology relate to altered dorsomedial frontal and amygdala morphometry

Posttraumatic stress disorder (PTSD) affects a large portion of combat deployed Veterans. Moreover, many individuals also suffer from comorbid late life depression (geriatric depression; GD). While a great deal of research has begun to characterize the morphometric features of PTSD and depression individually, few studies have investigated the interacting effect of these two disorders, specifically in a Veteran population. The current study used cortical and subcortical surface-based morphometry (SBM) in combination with psychological assessments of PTSD and GD symptom severity to examine morphometric alterations in Vietnam War Veterans. Our results indicated that increased GD severity, PTSD symptomatology, and their interaction, was related to decreased grey matter volume (GMV) in the left dorsomedial prefrontal cortex (dmPFC). Furthermore, increased symptomatology in the PTSD subscales of reexperiencing and hyperarousal were additionally found to be related to decreased GMV in this same dmPFC region. Subcortically, the interacting effect between PTSD and GD was also significantly related to regional shape variation in the left amygdala. These results suggest that morphometry of cortical (dmPFC) and non-neocortical regions (amygdala) putatively underlying emotional reactivity and the emotional components of memory is altered in PTSD and GD.

Relationships Between Latent Factors of Posttraumatic Stress Disorder and Posttraumatic Growth.

In the present study, we examined posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) responses among a nonclinical sample of 202 participants. Instruments included the PTSD Checklist for the DSM-5 (fifth edition of the Diagnostic and Statistical Manual of Mental Disorders) and Posttraumatic Growth Inventory. Confirmatory factor analysis demonstrated the most support for the 6-factor DSM-5 PTSD model and 5-factor PTG model, previously supported in the literature. Canonical correlation analysis evidenced a strong relationship between PTSD and PTG subscales. Path analysis results demonstrated that PTSD's re-experiencing subscale was related to PTG's appreciation for life subscale. Posttraumatic stress disorder's avoidance was related to PTG's personal strength subscale. We also tested curvilinear relationships between PTSD and PTG subscales. Results and implications are discussed in the context of the constructs of PTSD and PTG.

Long-Term Fluctuations in Traumatic Symptoms of High School Girls Who Survived from the 2011 Japan Tsunami: Series of Questionnaire-Based Cross-Sectional Surveys.

On March 11, 2011, Japan was struck by a massive earthquake and tsunami. The tsunami caused tremendous damage and traumatized children. We aimed to evaluate and compare the changes in the traumatic symptoms of high school girls 8, 20, 30, and 42months after the 2011 tsunami. The Post-Traumatic Stress Symptoms for Children 15 items (PTSSC-15), a self-rating questionnaire on traumatic symptoms, was administered to 811 high school girls at the above-mentioned intervals. We calculated the total score, post-traumatic stress disorder (PTSD) subscale, and depression subscale of PTSSC-15. The total score was correlated with house damage, evacuation experience, and bereavement experience. The PTSSC-15 total scores of high school girls with traumatic experience were significantly higher than the scores of children without these experiences (all p<0.0001). The PTSSC-15 total score did not decrease significantly over time. Furthermore, the PTSD subscale of the PTSSC-15 did not significantly improved over the study duration. However, the depression subscale of the PTSSC-15 significantly improved at 30months, but significantly worsened at 42months (both p<0.0001). This study demonstrates that the traumatic symptoms of high school girls who survived the massive tsunami fluctuated unpredictably with time. Nonetheless, high school girls continued to suffer depressive symptoms (insomnia, withdrawal, appetite loss, inattention, and physical symptoms) after 42months.

Impact of asylum interviews on the mental health of traumatized asylum seekers

BackgroundAsylum interviews within the asylum procedure are associated with psychological stress for traumatized asylum seekers. This study investigates the impact of asylum interviews on the mental health in a sample of 40 traumatized asylum seekers. The comparison group consisted of refugees (N=10) that had not been invited to an asylum interview. Additionally, the moderating effects of trial-related variables such as perceived justice of the trial, stress of giving testimony, and stress of waiting for the asylum interview were examined.MethodParticipants were assessed on average 10 days before (t1) and 16 days after (t2) the asylum interview. Chi-square tests for dichotomous and categorical variables were used to compare the descriptive statistics of the two groups. To investigate symptom changes from t1 to t2, paired t-tests were calculated. The magnitude of effects was measured by Cohen's effect size d within groups. Hierarchical regression analyses were conducted for demographic and trial variables predicting posttraumatic intrusions, avoidance, and hyperarousal.ResultsData showed a significant increase in posttraumatic intrusions and a significant decrease in posttraumatic avoidance and hyperarousal symptoms from t1 to t2. No significant symptom changes in the posttraumatic stress disorder subscales were found in the comparison group. The results of hierarchical regression analyses revealed perceived justice of the interview to predict the increase of intrusions and the number of experienced traumata and testimony stress to predict posttraumatic avoidance.ConclusionsThe present findings underline the stressful impact of asylum interviews on traumatized refugees. They indicate that the asylum interview might decrease posttraumatic avoidance and trigger posttraumatic intrusions, thus highlight the importance of ensuring that the already vulnerable group of traumatized refugees needs to be treated with empathy during their asylum interview.

The mediating role of anger in the relationship between PTSD symptoms and impulsivity.

Research indicates a significant relationship between posttraumatic stress disorder (PTSD) and anger (Olatunji, Ciesielski, & Tolin, 2010; Orth & Wieland, 2006). Individuals may seek urgent coping to deal with the distress of anger, which is a mobilizing and action-oriented emotion (Novaco & Chemtob, 2002); possibly in the form of impulsive actions consistent with impulsivity's association with anger (Milligan & Waller, 2001; Whiteside & Lynam, 2001). This could be 1 of the explanations for the relationship between PTSD and impulsivity (Kotler, Julian, Efront, & Amir, 2001; Ledgerwood & Petry, 2006). The present study assessed the mediating role of anger between PTSD (overall scores and subscales of arousal and negative alterations in mood/cognitions) and impulsivity, using gender as a covariate of impulsivity. The PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), Dimensions of Anger Reaction scale-5, and the UPPS Impulsivity Scale were administered to a sample of 244 undergraduate students with a trauma history. Results based on 1000 bootstrapped samples indicated significant direct effects of PTSD (overall and 2 subscales) on anger, of anger on impulsivity, and of PTSD (overall and 2 subscales) on impulsivity. Further, anger significantly mediated the relationship between PTSD (overall and 2 subscales) and impulsivity, consistent with the hypothesized models. Results suggest that impulsivity aims at coping with distressing anger, possibly explaining the presence of substance usage, and other impulsive behaviors in people with PTSD. Further, anger probably serves as a mobilizing and action-oriented emotion coupled with PTSD symptoms.