Posttraumatic Stress Disorder Symptom Clusters Research Articles

The Posttraumatic Cognitions Inventory (PTCI): Psychometric evaluation in veteran men and women with trauma exposure.

The Posttraumatic Cognitions Inventory (PTCI) is a self-report measure of negative posttraumatic cognitions, which is an important construct in the development and maintenance of posttraumatic stress disorder (PTSD). Evidence for the most appropriate PTCI item and factor structure is mixed, and this measure has not been extensively studied in veterans. The present study examined the psychometric properties of the PTCI in two national samples of veteran men and women. Participants in Sample 1 (veterans from all service eras) and Sample 2 (recently separated veterans) completed the PTCI and additional measures of mental health symptoms. Confirmatory factor analyses indicated that a brief version of the PTCI (PTCI-9; 3-factor, nine-item) was a superior fit relative to other examined factor structures. Consistent with the original conceptualization of the measure, these factors were labeled: Negative cognitions about self, negative cognitions about the world, and self-blame. Scores on the PTCI-9 were differentially associated with the PTSD symptom clusters and with scores on self-report measures of external comorbidities. PTCI-9 scores were higher among individuals with trauma exposure and with a probable PTSD diagnosis. There was evidence of full (Sample 1) and partial (Sample 2) scalar invariance across men and women. Overall, the present study supports the use of the PTCI-9 as a measure of negative cognitions; however, scores may not be specific to PTSD and may represent a global negative thinking style. Even so, the PTCI-9 appears to be a suitable and abbreviated measure that could be used with veterans in research and clinical practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining the bidirectional relationship between posttraumatic stress disorder symptom clusters and PAP adherence.

Obstructive sleep apnea (OSA) is a common sleep disturbance in individuals with posttraumatic stress disorder (PTSD), with an emerging literature showing that treating OSA with positive airway pressure (PAP) therapy has a moderate effect on decreasing PTSD severity. Unfortunately, PAP adherence among individuals with PTSD is low. Our study examined how baseline PTSD cluster subscores predict 6-month PAP adherence and how PAP adherence predicts change in PTSD cluster subscores over time. We examined PTSD and PAP adherence in 41 veterans with PTSD newly diagnosed with OSA over 6 months of PAP use (mean age = 50.27 years; 73.7% White; 13.6% female). The Posttraumatic Stress Disorder Checklist-Specific (PCL-S) was used to examine PTSD and subscales (re-experiencing, avoidance, and hyperarousal). We used longitudinal analyses to examine PTSD subscores on PAP adherence and PAP adherence predicting changes in PTSD subscores at 6-month follow-up. Among veterans with PTSD, higher levels of re-experiencing and hyperarousal, but not avoidance, predicted lower PAP use. Overall, the high-adherent group showed a 14.36-point decrease on the PCL-S, while the low-adherent group averaged just a 3.66-point decrease. More days of PAP use were associated with greater improvement in hyperarousal and avoidance subscores but not re-experiencing. Our findings reaffirm the importance of PAP use among patients with comorbid PTSD and sleep apnea, as well as the difficulty in achieving adherent PAP use in this population. Directly addressing heightened re-experiencing and hyperarousal in PTSD may increase PAP adherence among veterans with PTSD and requires future research. Colvonen PJ, Goldstein LA, Sarmiento KF. Examining the bidirectional relationship between posttraumatic stress disorder symptom clusters and PAP adherence. J Clin Sleep Med. 2023;19(5):857-863.

The underlying mechanisms by which PTSD symptoms are associated with cardiovascular health in male UK military personnel: The ADVANCE cohort study

Post-Traumatic Stress Disorder (PTSD) has been identified as an independent risk factor for cardiovascular disease, but the mechanisms of this relationship are not well understood. This study investigates the associations between PTSD symptom clusters (hyperarousal, intrusive thoughts, avoidance behaviours and emotional numbing) and mechanisms of cardiovascular disease including cardiometabolic effects, inflammation, and haemodynamic functioning. In the ADVANCE study cohort of UK male military personnel, 1111 participants were assessed for PTSD via questionnaire and cardiovascular risk via venous blood sampling, pulse wave analysis and dual energy x-ray absorptiometry between 2015 and 2020. Variable selection procedures were conducted to assess which of the symptom clusters if any were associated with cardiovascular risk outcomes. Associations were confirmed via robust regression modelling. Avoidance behaviours were associated with greater systolic Blood Pressure (BP) (Adjusted Coefficient (AC) 0.640 (95% Confidence Interval (CI) 0.065, 1.149). Emotional numbing was associated with greater estimated glucose disposal rate (AC -0.021 (95%CI -0.036, −0.005). Hyperarousal was associated with greater levels of (log)triglycerides (exponentiated-AC 1.009 (95%CI 1.002, 1.017). Intrusive thoughts were associated with greater visceral adipose tissue (AC 0.574 (95%CI 0.020, 1.250). Nonlinear relationships were observed between emotional numbing with heart rate and intrusive thoughts with systolic BP. Limited evidence is present for symptom associations with lipoproteins and pulse wave velocity. No associations were observed between PTSD symptom clusters and high sensitivity c-reactive protein, diastolic BP, total cholesterol, or haemoglobin fasting glucose. In conclusion, symptom clusters of PTSD were associated with increased cardiovascular risk via cardiometabolic and haemodynamic functioning mechanisms, but not inflammation.

An examination of the heterogeneity of the relationships between posttraumatic stress disorder, self-compassion and gratitude.

Previous research has found both self-compassion and gratitude to be protective against overall posttraumatic stress disorder (PTSD) symptom severity. PTSD is a highly heterogeneous disorder; however, it is unclear if these protective constructs are differentially associated with each cluster of PTSD. The present study examined differences in the association of self-compassion and gratitude with the four clusters of PTSD as indicated by the DSM-5. Participants were 1424 trauma-exposed individuals recruited via Amazon's Mechanical Turk. The mean age of participants was 31.49 (SD = 11.25) years old, and 55.3% of the sample identified as female. A structural equation model (SEM) approach was used to examine relationships between factors of gratitude, self-compassion and the four PTSD symptom clusters. A two-factor model of self-compassion best fits the data. Both the self-compassion and gratitude factors were significantly associated with all symptom clusters of PTSD. Wald chi-square tests indicated self-compassion and gratitude to have the strongest association with negative alterations in cognitions and mood (NACM) PTSD symptoms. These findings may have important implications for treatment targets to reduce specific symptoms of PTSD, particularly in PTSD symptoms related to negative affect.

Characteristics and Prevalence of Posttraumatic Stress Disorder and Posttraumatic Stress Symptoms Among Adults with Hemophilia a and B

Background: Studies show that the prevalence of illness-induced Posttraumatic Stress Disorder (PTSD) ranges from 12-25%, but little is known about the prevalence of PTSD or Posttraumatic Stress Symptoms (PTSS) among adults with hemophilia. We hypothesized that persons with hemophilia (PWH) would be particularly at risk for PTSD and PTSS given their bleeding diathesis, bleeding disorder treatment and prophylaxis requirements, and history of viral contamination of their treatments. After experiencing a traumatic event, symptoms of PTSD include intrusive memories, avoidance of reminders of the traumatic event, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity. Aims:Determine the prevalence of PTSD and PTSS among PWH.Characterize the traumatic experiences of PWHs. Methods: Using REDCap, a self-administered survey tool was offered to all adult PWH aged 20+ at the time of their annual comprehensive visit to their Hemophilia Treatment Center (HTC). Three large academic HTCs (Boston Hemophilia Center, MA; Mount Sinai Hemophilia Center, NY; M Health Fairview Center for Bleeding and Clotting Disorders, MN) participated in the study. The tool for this study had two components: (i) Participant Characteristics was used to collect demographic information and specifics about participants’ hemophilia and comorbidities. Participants were also given the opportunity to provide a description of any hemophilia-related traumatic experience. The second component of the tool was the (ii) PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 (PCL-5): The PCL-5 is a validated, 20-item, self-report questionnaire that assesses the four DSM-5 symptom clusters of PTSD and their severity. In this study, it was used to screen for PTSS and/or provide a provisional diagnosis of PTSD based on their identified hemophilia-related trauma. Results: 178 participants were included in the analysis. Total scores on the PCL-5 ranged from 0-66 with a median of 8. 11.8% of participants (n=21) met criteria for a provisional PTSD diagnosis based on either PCL-5 score ≥ 31 or if the participant endorsed each PTSD symptom cluster. This included 6 participants (31.6%) with a self-reported established PTSD diagnosis. 101 participants (56.7%) identified a traumatic event related to living with hemophilia. The following themes of trauma emerged from their subjective trauma descriptions: non-infectious medical events, psychosocial, pain, hepatitis, and HIV/AIDS. 63 participants (35.4%) endorsed at least one Posttraumatic Stress Symptom (PTSS) by reporting a traumatic event and meeting clinical diagnostic criteria for at least one PTSD symptom cluster. Intrusion symptoms were experienced most frequently by participants (32%). A higher burden of PTSD symptomatology was significantly associated with lower education levels (p = 0.003), being unemployed (p = 0.003), having a history of previous hospitalization (p<0.001) and having two or more previously identified mental health disorders (p<0.001). Age (p = 0.18), sex (p = 0.14), comorbidities (p=0.16) and severity of hemophilia (p = 0.67) were not significantly associated with PTSD symptomatology or PTSS. Conclusion: PTSD and PTSS are commonly experienced by PWH regardless of disease severity and appear to exist at a higher rate than among the general population. These findings warrant the need for routine trauma screening, trauma informed care, and further investigation into trauma prevention. This research was supported by the 2021 National Hemophilia Foundation's Social Work Excellence Fellowship Award.

Resting-state EEG functional connectivity predicts post-traumatic stress disorder subtypes in veterans

Objective. Post-traumatic stress disorder (PTSD) is highly heterogeneous, and identification of quantifiable biomarkers that could pave the way for targeted treatment remains a challenge. Most previous electroencephalography (EEG) studies on PTSD have been limited to specific handpicked features, and their findings have been highly variable and inconsistent. Therefore, to disentangle the role of promising EEG biomarkers, we developed a machine learning framework to investigate a wide range of commonly used EEG biomarkers in order to identify which features or combinations of features are capable of characterizing PTSD and potential subtypes. Approach. We recorded 5 min of eyes-closed and 5 min of eyes-open resting-state EEG from 202 combat-exposed veterans (53% with probable PTSD and 47% combat-exposed controls). Multiple spectral, temporal, and connectivity features were computed and logistic regression, random forest, and support vector machines with feature selection methods were employed to classify PTSD. To obtain robust results, we performed repeated two-layer cross-validation to test on an entirely unseen test set. Main results. Our classifiers obtained a balanced test accuracy of up to 62.9% for predicting PTSD patients. In addition, we identified two subtypes within PTSD: one where EEG patterns were similar to those of the combat-exposed controls, and another that were characterized by increased global functional connectivity. Our classifier obtained a balanced test accuracy of 79.4% when classifying this PTSD subtype from controls, a clear improvement compared to predicting the whole PTSD group. Interestingly, alpha connectivity in the dorsal and ventral attention network was particularly important for the prediction, and these connections were positively correlated with arousal symptom scores, a central symptom cluster of PTSD. Significance. Taken together, the novel framework presented here demonstrates how unsupervised subtyping can delineate heterogeneity and improve machine learning prediction of PTSD, and may pave the way for better identification of quantifiable biomarkers.

PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations

This study investigated the associations between momentary emotion dynamics and posttraumatic stress disorder (PTSD) symptoms. Using a sample of 61 couples (N = 122 individuals) in which all individuals were trauma exposed and at least one partner screened positive for PTSD, we examined the intra- and interpersonal regulation of vocally encoded emotional arousal (fundamental frequency [f0]) and how these momentary emotion regulatory patterns relate to specific PTSD symptoms during two couple conversations: one designed to elicit conflict and one to elicit intimacy. PTSD symptoms were assessed using a gold standard clinical interview. In both conversations, higher reexperiencing symptoms were associated with greater emotional inertia (i.e., more resistance to change in emotional state following deviation from one’s emotional equilibrium), and higher avoidance symptoms were associated with less emotional inertia (i.e., quicker return to emotional equilibrium). In the intimacy conversations, individuals also responded to their partners’ arousal. Furthermore, individuals whose partners exhibited higher emotional numbing symptoms exhibited more emotional inertia, suggesting that emotion regulation may be a function of both one’s own and one’s partner’s PTSD symptoms. Attending to the interpersonal context of emotion dynamics during PTSD treatment may enhance outcomes.

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.

The facilitated sensemaking model as a framework for nursing intervention on family members of mechanically ventilated patients in the intensive care unit.

Adverse psychological outcomes are prevalent among family members of intensive care unit (ICU) patients. The facilitated sensemaking model (FSM) provides a framework for understanding how intensive care nurses can help these family members overcome situations in which a loved one is critically ill, and reduce adverse psychological outcomes through the facilitated sensemaking process. This study aimed to implement FSM-based research performed by ICU nurses and patients' family members to investigate the impact of the facilitated sensemaking intervention on the psychological status of ICU families. The intervention was performed by nurses on 80 family members of mechanically ventilated patients, 40 in the control group and 40 in the experimental group. The control group only received routine medical services, while the experimental group received the nursing intervention based on FSM in addition to routine medical services. Anxiety, depression, and post-traumatic stress disorder (PTSD) were measured with the Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Post-Traumatic Stress Disorder Check-List-Civilian Version (PCL-C), respectively. SPSS version 25.0 was applied to analyze the data; what is more, some statistical methods, including descriptive statistical analysis, chi-square test and t-test were further adopted. Before the intervention, there were no significant differences in anxiety, depression, and PTSD of family members of ICU mechanical ventilation patients between the two groups (p > .05). After the intervention, the score of anxiety, depression, and PTSD of family members in the control group and the experimental group were 41.50 ± 5.738 versus 36.50 ± 4.385, p < .001; 45.28 ± 8.089 versus 42.13 ± 5.725, p < .05; and 30.55 ± 7.595 versus 27.55 ± 4.696, p < .05, respectively. The nursing intervention based on FSM significantly alleviated anxiety, depression, and PTSD of mechanical ventilation patients' family members. The nursing intervention based on FSM significantly alleviated anxiety, depression, and PTSD of mechanical ventilation patients' family members. However, there was only a statistically significant difference in the avoidance and numbness symptom cluster of PTSD via the PCL-C. Therefore, the observation time after the implementation of the FSM intervention needs to be extended in the future to clarify the effect of the intervention. Further efforts by advanced practice nurses and the cooperation of patients' families are required to incorporate this intervention into ICU practice.

A systematic examination of cognitive emotion regulation strategies, global emotion dysregulation, and cognitive insight in relation to posttraumatic stress disorder symptoms among trauma exposed patients with early nonaffective psychosis.

Previous research has shown that emotion dysregulation after trauma is associated with increased posttraumatic stress disorder (PTSD) severity. However, it remains unclear how different dimensions of emotion dysregulation and cognitive insight may interact to predict Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) PTSD symptoms in early psychosis. The present study systematically examines cognitive emotion regulation strategies, global emotion dysregulation, and cognitive insight in relation to DSM-5 PTSD symptoms among trauma-exposed patients with early nonaffective psychosis. A total of 150 outpatients with early nonaffective psychosis were screened for trauma exposure on the Stressful Life Events Questionnaire. Participants (N = 79; 52.6%) who met the DSM-5 Criterion A subsequently completed the PTSD Checklist for DSM-5, Cognitive Emotion Regulation Questionnaire, Difficulties With Emotion Regulation Questionnaire, and Beck Cognitive Insight Scale. Severity of psychotic and depressive symptoms were rated on the Brief Psychiatric Rating Scale. Multivariate regression models adjusting for age, gender, psychotic and depressive symptoms revealed that PTSD symptom clusters were associated with more maladaptive cognitive emotion regulation strategies (catastrophic thinking, rumination, and other blame) and less adaptive cognitive emotion regulation strategies (cognitive reappraisal and planning; Cohen's f² = 1.50-3.17). Further moderation analyses revealed a negative interaction between global emotion dysregulation and self-reflection on intrusive symptoms such that for patients with low self-reflectivity, global emotion dysregulation was associated with increased severity of intrusive symptoms (f² = 0.96). Our findings suggest that addressing emotion dysregulation and cognitive insight may improve intrusive symptoms, and this may prevent the development of full PTSD in patients with early nonaffective psychosis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

An initial investigation of the association between DSM-5 posttraumatic stress disorder symptoms and nonsuicidal self-injury functions.

Despite the well-established link between posttraumatic stress disorder (PTSD) and nonsuicidal self-injury (NSSI), little is known about factors that may lead to self-injury among trauma-exposed individuals. Moreover, no research to date has examined these relations in the context of the newly revised Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) PTSD criteria. Thus, the purpose of the current study was to explore the associations between DSM-5 PTSD symptom clusters (i.e., intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity) and self-injury functions using a small sample of college students. Participants (N = 81) were recruited for a lifetime history of NSSI and trauma exposure. Findings revealed a statistically significant path from PTSD avoidance symptoms to NSSI social functions and from PTSD negative alterations in cognitions and mood symptoms to NSSI intrapersonal functions, even after controlling for relevant covariates. Results of the current study highlight the importance of assessing for NSSI among trauma-exposed individuals. Considering that NSSI is a risk factor for suicidal behavior and potentially a clinically distinct diagnosis, future research should continue to explore these associations using larger, more diverse clinical samples. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations between Post-Traumatic Stress Disorder, Quality of Life and Alcohol Misuse among UK Veterans

Prior research has shown that those with Post-Traumatic Stress Disorder (PTSD) have persistent reductions in quality of life (QoL), and higher rates of alcohol misuse. As such, it is important that we explore QoL and alcohol misuse on PTSD diagnosis. Therefore, the aim of this study was to assess the association between PTSD, QoL and alcohol misuse among United Kingdom (UK) veterans. 163 UK veterans who sought help for a mental health disorder were recruited to take part. Linear regressions were used to assess the association between probable PTSD, QoL and alcohol misuse. Pearson’s correlation analyses were used to assess the relationship between PTSD symptom clusters and QoL domains. We found unadjusted regressions showed evidence that, compared to those without PTSD, those with PTSD had lower QoL scores on physical health, psychosocial, social relationships and environment domains. Adjusting for age, sex, and outcome variables, only associations with the physical health domain and psychosocial domain remained statistically significant. Correlation analyses between PTSD and QoL domains showed the strongest negative correlations between the functional impairment and physical health domain, and between the functional impairment and psychosocial domain. We found that those with probable PTSD had lower QoL and higher alcohol misuse scores.

The Effects of a Multi-Family Group Trauma Intervention on Caregiver Posttraumatic Stress Symptom Clusters.

Strengthening Family Coping Resources (SFCR), a multi-family group intervention tailored to families experiencing traumatic stress, is associated with improved post-traumatic stress disorder (PTSD) symptoms and family functioning. To further SFCR research, we examined (1) SFCR's effects on caregiver PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], alterations in arousal and reactivity); and (2) whether effects differed by caregiver trauma type (interpersonal versus non-interpersonal; intrafamilial versus extrafamilial). Forty-two caregivers of primarily low socioeconomic status reporting trauma histories completed SFCR treatment. Significant decreases in PTSD intrusion, avoidance, and NACM subscale scores emerged from pre- to post-SFCR; there were no differences in subscale score changes by trauma type categorization. Findings support SFCR as a promising treatment for reducing PTSD severity among caregivers reporting diverse traumas.

Validation of the International Trauma Questionnaire—Child and Adolescent Version (ITQ-CA) in a Chinese mental health service seeking adolescent sample

BackgroundThe International Trauma Questionnaire—Child and Adolescent version (ITQ-CA) is a self-report measure that assesses posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) based on the diagnostic formulation of the 11th version of the International Classification of Diseases (ICD-11). This study aimed to provide a Chinese translation and psychometric evaluation of the ITQ-CA using a sample of mental-health service seeking adolescents in Mainland China.MethodsThe ITQ-CA was translated and back-translated from English to simplified Chinese and finalized with consensus from an expert panel. Adolescents ages 12–17 were recruited via convenience sampling from an outpatient psychiatric clinic in Mainland China. Participants completed the ITQ-CA; measures of four criterion variables (depression, anxiety, stress, adverse childhood experiences); and the PTSD Checklist for DSM-5 (PCL-5). Construct validity, concurrent validity, and comparison of PTSD caseness between ICD-11 and DSM-5 measures were assessed.ResultsThe final sample consisted of 111 Chinese adolescents (78% female; mean age of 15.23), all diagnosed with a major depressive disorder. Confirmatory factor analysis indicated the two-factor second-order model provided optimal fit. All criterion variables were positively and significant correlated with the six ITQ-CA symptom cluster summed scores. In the present sample, 69 participants (62.16%) met symptom criteria for ICD-PTSD or CPTSD using the ITQ-CA, and 73 participants (65.77%) met caseness for DSM-5 PTSD using the PCL-5. Rates of PTSD symptom cluster endorsement and caseness deriving from both diagnostic systems were comparable. ConclusionsThe Chinese ITQ-CA has acceptable psychometric properties and confers additional benefits in identifying complex presentations of trauma-related responses in younger people seeking mental health services.

Examining the associations between PTSD symptom clusters and alcohol-related problems in a sample of low-SES treatment-seeking Black/African American adults

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) often co-occur. This comorbidity negatively influences treatment outcomes, functioning, and quality of life. To better understand the relation between PTSD and AUD, research has begun to examine the influence of PTSD symptom clusters on alcohol-related problems. The current study is the first to analyze the associations between PTSD symptom clusters and alcohol consumption and AUD symptom severity in a treatment-seeking sample of Black/African American (AA) adults with co-occurring AUD and PTSD symptoms. Examination of these associations may help to facilitate greater recovery in this underserved population by identifying more precise targets for treatment. PTSD symptom clusters were identified from both the current 4-factor model identified in the DSM-5 and from a recently proposed 7-factor model. Participants were Black/AA adults (50.6% male) who endorsed trauma exposure and were seeking treatment for alcohol misuse. The majority (66%) were unemployed and almost half (45%) reported an income at or lower than $20,000. In the 4-factor model, results showed Cluster D symptoms of PTSD (i.e., negative alterations in cognitions and mood) were independently associated with alcohol consequences. Use of the 7-factor model, which divides Cluster D into symptoms of negative affect and anhedonia, further demonstrated that only anhedonic symptoms were independently associated with alcohol consequences. No symptom clusters were uniquely associated with alcohol consumption. Results suggest the absence of positive emotions, rather than the presence of negative emotions, are primarily associated with alcohol-related problems in a sample of trauma-exposed, Black/AA adults seeking treatment for alcohol misuse.

Peri-Traumatic Dissociation and Tonic Immobility as Severity Predictors of Posttraumatic Stress Disorder After Rape.

Some individuals show abnormal reactions to extreme fear and life-threatening situations, including tonic immobility (TI) and peri-traumatic dissociation (PTD). We aimed to investigate the association of TI and PTD with posttraumatic stress disorder (PTSD) in women who experienced sexual violence and the risk factors for PTD occurrence. We compared PTSD severity in 86 young adult women with PTSD after a sexual violence exposure grouped according to the presence of PTD and TI. In addition, we investigated whether PTD is associated with depression and anxiety symptoms and assessed potential risk factors for PTD reaction. We found a significant positive correlation between PTSD severity and PTD occurrence (R2 = .132; p = .001). PTD was also positively correlated with all clusters of PTSD symptoms except the Clinician-Administered PTSD Scale avoidance cluster (p = .058). PTD was strongly correlated with anxiety (R2 = .619; p < .001) and depressive symptoms (R2 = .547; p < .001). Multiple logistic regression showed that history of physical abuse (odds ratio [OR]: 1.386; p = .011) and sexual abuse (OR: 1.947; p = .004) during childhood were associated with PTD occurrence. Other risk factors for PTD were having less years of study (OR: 0.216; p = .016) and lower income (OR: 7.403; p = .028). TI measures were available for a subsample of 29 women. We found no association between TI and PTSD severity. PTD, but not TI, is significantly associated with more severe PTSD, depressive, and anxiety symptoms. Less-educated women with a history of childhood abuse and a lower income are at risk of PTD occurrence during a sexual violence episode.

Effects of comorbid posttraumatic stress disorder on cognitive dysfunction in Chinese male methamphetamine patients

ObjectivesCognitive dysfunction and posttraumatic stress disorder (PTSD) are common in methamphetamine patients. However, few studies have investigated the cognitive performance of methamphetamine patients with PTSD. The purpose of this study was to investigate the impact of comorbid PTSD on cognitive function in Chinese male methamphetamine patients. MethodsWe analyzed 464 methamphetamine patients and 156 healthy volunteers. The PTSD Screening Scale (PCL-5) was used to assess PTSD and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function. ResultsCompared with healthy controls, methamphetamine patients had more cognitive dysfunction in immediate memory, visuospatial/constructional, language, attention and delayed memory. Moreover, methamphetamine patients with PTSD had less cognitive dysfunction in immediate memory, attention, and delayed memory than methamphetamine patients without PTSD. Further stepwise regression analysis showed that PTSD alterations in arousal and reactivity cluster were risk predictors for language, and PTSD negative alteration in cognition and mood cluster were risk predictors for delayed memory. ConclusionsOur results indicate that methamphetamine patients without PTSD have poorer cognitive dysfunction than those with PTSD. Some demographic and PTSD symptom clusters are protective or risk factors for cognitive dysfunction in methamphetamine patients.

Posttraumatic Stress Disorder Mediates the Association between Traumatic World Trade Center Dust Cloud Exposure and Ongoing Systemic Inflammation in Community Members.

Exposure to World Trade Center (WTC) dust/fumes and traumas on 11 September 2001 has been reported as a risk factor for post-traumatic stress disorder (PTSD) and other mental/physical health symptoms in WTC-affected populations. Increased systemic inflammation and oxidative stress from the exposure and subsequent illnesses have been proposed as contributors to the underlying biological processes. Many blood-based biomarkers of systemic inflammation, including C-reactive protein (CRP), are useful for non-invasive diagnostic and monitoring of disease process, and also potential targets for therapeutic interventions. Twenty years after 9/11, however, the relationships between WTC exposure, chronic PTSD, and systemic inflammation are only beginning to be systematically investigated in the WTC-affected civilian population despite the fact that symptoms of PTSD and systemic inflammation are still common and persistent. This paper aims to address this knowledge gap, using enrollees of the WTC Environmental Health Center (EHC), a federally designated treatment and surveillance program for community members (WTC Survivors) exposed to the 9/11 terrorist attack. We conducted a mediation analysis to investigate the association between acute WTC dust cloud traumatic exposure (WDCTE) on 9/11, chronic PTSD symptoms, and levels of systemic inflammation. The data indicate that the chronic PTSD symptoms and some specific symptom clusters of PTSD significantly mediate the WDCTE on systemic inflammation, as reflected by the CRP levels. As both chronic PTSD and systemic inflammation are long-term risk factors for neurodegeneration and cognitive decline, further research on the implications of this finding is warranted.

Disentangling subjective symptom complaints and objective cognitive performance in veterans: Impact of posttraumatic stress disorder and lifetime traumatic brain injury burden

Self-reported histories of mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) symptoms are prevalent among post-9/11 veterans. Both are associated with subjective and often overlapping symptom complaints, but variably with objective neuropsychological test performances. These outcomes are seldom explored in relation to lifetime mTBI burden. This cross-sectional study examined associations of PTSD and lifetime mTBI with subjective (persistent symptoms after concussion and cognitive complaints) and objective (performances across five cognitive domains) measures among 46 veterans. Within this sample, 20 veterans had Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) confirmed PTSD (PTSD+), whereas 26 demographically-similar participants did not meet criteria (PTSD−). The Boston Assessment of Traumatic Brain Injury-Lifetime (BAT-L) yielded total mTBI scores ranging from 0 to 8. Regressions showed PTSD was associated with increased subjective symptoms/cognitive complaints, along with reduced verbal fluency, visuospatial memory, and processing speed performances. Lifetime mTBI burden was associated with subjective symptoms, but not with objective cognitive test performance, after controlling for PTSD. No significant interactions were observed. Exploratory correlations suggested that all PTSD symptom clusters were generally associated with the subjective and objective measures. However, fewer significant associations emerged within the PTSD+/− groups separately, with each group yielding somewhat different patterns of relationships. PTSD and increasing mTBI burden are consistently associated with negative subjective symptoms, including cognitive complaints. Each condition likely explains some degree of unique variance in symptom reporting. PTSD is associated with poorer objective cognition on some tasks, including processing speed, executive functioning, and learning/memory. Implications are explored.

The Affective Control Scale: Factor structure and associations with posttraumatic stress symptoms in trauma-exposed male veterans.

Posttraumatic stress disorder (PTSD) is characterized by broad-based difficulties with emotion. However, the extent to which the disorder is associated with fear of particular emotions remains less well understood. The Affective Control Scale (ACS) is a frequently used measure of fear of emotion, but relatively little work has been done to validate this measure, particularly for use in psychiatric research. This study examined the ACS's factor structure and its associations with PTSD symptoms among trauma-exposed male veterans. Participants (N = 347) completed online assessments, including the ACS and the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The data supported a bifactor structure with 1 general fear of emotion factor and 4 specific fear of emotion factors (i.e., fear of anger, fear of positive affect, fear of depressed mood, and fear of anxiety). Fear of emotion was positively associated with all 4 DSM-5 PTSD symptom clusters. After controlling for general fear of emotion, fear of particular emotion states was associated with some specific PTSD symptoms. Both general and specific fears of emotion were associated with specific PTSD symptoms in trauma-exposed veterans. Despite this, results support the use of a modified ACS total score, capturing general fear of emotion, rather than the subscale scores, capturing fear of specific emotions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).