Posttraumatic Stress Disorder Symptom Patterns Research Articles

Couple-Level Manifestations of Posttraumatic Stress and Maternal and Paternal Postpartum Relationship Functioning

Objective. Posttraumatic stress disorder (PTSD) is linked with impaired intimate relationships in postpartum women, yet less is known about couple-level manifestations of posttraumatic psychopathology and potential associations with relationship functioning for mothers and fathers during this critical time. Method. In a predominately low-to-middle income sample of 867 mother-father couple dyads assessed six months following the birth of a child, two analytic methods—a data-driven dyadic latent profile analysis and hypothesis-driven a priori categorization approach—evaluated whether discrete subgroups of couples could be identified based on both partners’ PTSD symptoms. Structural equation models then tested associations between identified subgroups with (1) self-reported relationship quality and (2) interviewer-rated relationship stress. Results. Three couple-level PTSD symptom groupings were common to both methods: both low, mother low-father high, and mother high-father low. Dyad-level PTSD symptom patterns were differentially related to relationship dysfunction for mothers and fathers, although mixed findings emerged across methods regarding the relevance of which partner had elevated symptoms for relationship functioning in PTSD symptom-discordant couples. Individuals in dyads characterized by at least one partner with elevated PTSD symptoms consistently exhibited greater relationship dysfunction—indexed both subjectively and objectively—compared to dyads where both partners had low symptoms. Conclusions. Couple-level typologies of PTSD symptoms can be identified using data- and hypothesis-driven approaches, with generally concordant results. Dyadic patterns of PTSD symptoms are relevant to relationship functioning for both mothers and fathers during the postpartum period and may help to inform more targeted intervention efforts to support couples who are parenting.

Evolution of the network pattern of posttraumatic stress symptoms among children and adolescents exposed to a disaster

Growing network approach analyses of posttraumatic stress disorder (PTSD) have enhanced the knowledge of PTSD symptomatology. This study aims to explore changes in network patterns of PTSD symptoms among youth survivors following the Zhouqu debris flow through a network approach. A two-year longitudinal study was conducted to follow 1460 children and adolescents at 3, 15, and 27 months after the disaster. Symptoms with high centrality varied at different time points. Sleep problems and nightmares exhibited high centrality at 3 months, and their centrality decreased over time, while the centrality of physiological cue reactivity and flashbacks increased over time and reached a high level at 27 months. The global connectivity of the network was stronger at 27 months than at 3 and 15 months. These findings provide novel insights into youths’ PTSD symptom evolution. Temporal differences in PTSD symptoms merit more attention from researchers. Different core symptoms in acute and chronic PTSD structures should be treated as targets at different stages following trauma in clinical practice.

Predicting treatment dropout among veterans receiving prolonged exposure therapy.

To examine whether dropout from prolonged exposure (PE) therapy can be predicted from demographic and outcomes data that would typically be available to clinicians. Dropout was examined in 2,606 patients treated by clinicians in the U.S. Veterans Health Administration PE Training Program. PE typically consists of 8-15 sessions, with 8 sessions being considered a minimum therapeutic dose for most patients. Logistic regression was used to assess the impact of demographics, depression, trauma history, and PE target trauma on risk for dropout. Growth mixture modeling was used to study how posttraumatic stress disorder symptom patterns during the first 5 treatment encounters predicted dropout. In total, 782 patients (30.0%) completed fewer than 8 sessions of PE. Younger veterans were more likely to drop out of PE; odds ratio (OR) per year of age = 0.97, p < .01. Controlling for other factors, veterans who focused on childhood trauma were less likely to drop out than those focusing on combat trauma (OR = 0.51, p < .05). Dropout was unrelated to symptom course or symptom worsening between sessions. Nevertheless, clinicians attributed dropout to distress or avoidance in 45% of the patients who dropped out, citing other factors in 37% of dropout cases. Treatment dropout was predicted by age but not by initial symptom severity or symptom course early in treatment. Symptom exacerbation was rare and did not increase risk of dropout. Nonetheless, clinicians often attributed dropout to patients not tolerating PE. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Alcohol and Marijuana Polysubstance Use: Comparison of PTSD Symptom Endorsement and Severity Patterns.

A growing body of work links posttraumatic stress disorder (PTSD) symptoms and substance use. Unfortunately, much of the literature has examined associations in isolation (e.g., alcohol only). Failure to account for simultaneous or concurrent substance use may limit conclusions that can be drawn from existing research, including the extent to which specific substances contribute differentially to PTSD symptom patterns. The current study examined differences in PTSD symptom profiles between individuals using one or both of the most commonly co-administered psychoactive substances – alcohol and marijuana. Trauma-exposed participants (N = 533; Mage = 21.15) comprised two mutually-exclusive groups: past-month alcohol-only use (n = 334) or past-month alcohol and marijuana use (n = 199). Cluster-level and symptom-level profile analyses evaluated mean differences and shape (parallelism) of PTSD symptom severity profiles between the groups. Follow-up analyses examined symptom-specific difference in PTSD symptom endorsement and severity. Overall, individuals using marijuana and alcohol evidenced greater PTSD negative cognition (30.8% greater) and hyperarousal (26.4% greater) symptom severity. Alcohol and marijuana users were more likely to endorse, and report greater severity of, mood-related PTSD negative cognition symptoms (e.g., anhedonia, negative affect) and externalizing hyperarousal symptom (e.g., irritability/aggression, risky behaviors) than alcohol-only users. Findings highlight important PTSD differences between individuals that are often lumped into homogenous categories of isolated substance users. Findings provide preliminary support for an ‘additive’ self-medication model between PTSD and polysubstance use. Lastly, findings indicate that mood-related negative cognition symptoms and externalizing hyperarousal symptoms may be important targets for PTSD-polysubstance use intervention.

PTSD Latent Classes and Class Transitions Predicted by Distress and Fear Disorders in Disaster-Exposed Adolescents

This study aimed to determine the population-based typologies of posttraumatic stress disorder (PTSD) symptomatology, the longitudinal patterns of transitions across these typologies, and the predictive effects of distress and fear disorder symptoms on these transitions in a frequently referred but scantly studied population of traumatized youth. A sample of 1,278 Chinese adolescents (54.0% girls) with a mean age of 13.4 years (SD = 0.8, range = 12–16) completed 2-wave surveys 2.5 and 3.5 years after a major disaster. Psychopathological symptoms were assessed with the UCLA PTSD Reaction Index for DSM-IV, the Depression Self-Rating Scale for Children, and the Screen for Child Anxiety Related Emotional Disorders. Latent class analyses identified 4 classes characterized by high, reexperiencing/hypervigilance, dysphoria, and low symptoms, respectively at each time point. Latent transition analyses revealed relatively high levels of temporal stability within low symptom and dysphoria classes but relatively high probabilities of migration from re-experiencing/hypervigilance and high symptom classes into lower symptom classes. Multinomial logistic regression analyses found that some of the between-class movements during the year were predicted by baseline distress or fear disorders. This study provides an initial depiction of both quantitative and qualitative changes in youth’s long-term PTSD symptom patterns over time and gives a further elucidation of other forms of posttrauma psychopathology’s impacts on PTSD course. These findings carry implications for ongoing evaluation and adjustable intervention individually tailored to youth’s PTSD manifestations and comorbidities in the long-term disaster aftermath.

PTSD symptom presentation among people with alcohol and drug use disorders: Comparisons by substance of abuse

Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) commonly co-occur, and there is some evidence to suggest that PTSD symptom clusters are differentially related to various substances of abuse. However, few studies to date have compared PTSD symptom patterns across people with different types of SUDs, and fewer still have accounted for the presence of comorbidity across types of SUDs in understanding symptom patterns. Thus, in the current study, we use a treatment-seeking sample of people with elevated symptoms of PTSD and problem alcohol use to explore differential associations between past-year SUDs with active use and PTSD symptoms, while accounting for the presence of multiple SUDs. When comparing alcohol and drug use disorders, avoidance symptoms were elevated in those with alcohol use disorder, and hyperarousal symptoms were elevated in those who had a drug use disorder. In the subsample with alcohol use disorder, hyperarousal symptoms were elevated in people with co-occurring cocaine use disorders and numbing symptoms were elevated in people with co-occurring sedative/hypnotic/anxiolytic use disorder. These findings provide evidence for different symptom cluster patterns between PTSD and various types of SUDs and highlight the importance of examining the functional relationship between specific substances of abuse when understanding the interplay between PTSD and SUDs.

A Preliminary Study of DSM–5 PTSD Symptom Patterns in Veterans by Trauma Type

Posttraumatic stress disorder (PTSD) has a primary etiology in experiencing psychological trauma and the subsequent psychological sequelae (American Psychiatric Association, 2013). There are multiple trauma types that may serve as the index trauma in PTSD. This exploratory study compared DSM–5 PTSD symptoms for 3 types of trauma in veterans: combat trauma (n = 36), sexual trauma (n = 21), and civilian trauma (n = 21). Results indicated that veterans with combat trauma were likely to experience diminished interest and detachment and estrangement from others. Veterans with sexual trauma were likely to experience detachment and estrangement from others, sleep disturbances, and problems with concentration. Veterans with civilian traumas were less likely to meet criteria for PTSD and were less likely to experience a number of PTSD symptoms. Results of this preliminary study suggest that PTSD is not a unitary disorder, but a disorder characterized by different subtypes based on the precipitating trauma.

Posttraumatic Stress Disorder Patients and Results of Violent Behavior

AIM: High levels of anger and aggression in post-traumatic stress disorder lead to unfavorable social, legal, physical and economic results to family members and the other social layers as much as patients. In this study, it is aimed to investigate the relation between both alcohol-cigarette consumption ratios and anger levels, characteristics of aggressive behaviors and the judicial outcome in cases diagnosed post-traumatic stress disorder due to armed conflict. METHODS: 38 cases diagnosed as post-traumatic stress disorder were included to the study. Pre- and post-traumatic alcohol/cigarette consumption amounts and aggressive behaviors are determined. Impact of Events Scale (Revised) (IES-R) was used for evaluating post-traumatic stress disorder symptom patterns and severity, Buss Perry Aggression Questionnaire was used for measuring anger and aggression levels, and Taylor’s Violence Rating Scale was used for evaluating the judicial outcome of aggression. RESULTS: 23 of cases (60.6%) were married with children, 13 of cases (34.25) were single and 2 of cases (5.2%) were divorced.18 of cases (47.4%) were graduate. IES-R total score was 66,9 ± 12,7, Buss Perry total score was 111,3 ± 20,5, and Taylor’s Violence Rate was 2,5 ± 1,0. When the pre- and post-traumatic aggressive behaviors were compared; physical violence to the partner was increased more than ten times, Physical and verbal violence to social individuals were increased more than four and seven times, respectively. And also it is observed that inflicting damage to property was increased 17 times, reckless driving was increased 11 times, and self-mutilation was increased 5 times. Alcohol consumption was determined as 0 (0 - 126) g/day for pre-trauma cases and 16.5 (0 - 294) g/day for post-trauma cases. Cigarette smoking was determined as 5 (0 – 40) cigarette/day for pre-trauma cases and 30 (0 -60) cigarette/day for post-trauma cases. CONCLUSION: Post-traumatic stress disorder associated with high levels of anger and aggression and alcohol can cause familial-marital problems, breaking up a family, increase in judicial problems and arrest, increase in ratios of self-mutilation and severe bodily injuries, physical violence to patterns and children, progressing of post-traumatic stress disorder, severe mental situations such as depression and suicide. For these reasons, careful detecting of alcohol-drug abuse and overstimulation symptoms as anger/aggression in post-traumatic stress disorder, and rapid target-driven psychopharmacologic and psychotherapeutic interventions Become more of an issue.

A comparison of PTSD symptom patterns in three types of civilian trauma

Posttraumatic stress disorder (PTSD) is assumed to be an equivalent syndrome regardless of the type of traumatic event that precipitated it. However, the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) and previous research suggest that the clinical presentation of PTSD varies by trauma type. This study compared PTSD symptom profiles in three types of civilian trauma: sexual assault (n = 86), motor vehicle accident (n = 162), and sudden loss of a loved one (n = 185). Groups differed in overall PTSD severity and displayed distinct PTSD symptom patterns. Results suggest that different trauma types lead to unique variants of the PTSD syndrome, which may result from different etiological factors and may require different treatment approaches.

When the killer suffers: Post‐traumatic stress reactions following homicide

Objectives. The present study aimed to consider the extent to which post‐traumatic stress disorder (PTSD) occurs after homicide and to examine characteristics of the offence and the offender which contribute to the development of these symptoms. It was proposed that type of violence (reactive versus instrumental) would be related to PTSD symptoms. Using Blackburn's typology of violent offenders, it was also hypothesized that primary and secondary psychopath, controlled and inhibited types would demonstrate differing forms of violence, prevalences and patterns of post‐traumatic stress symptoms following the homicide.Method. Eighty homicide perpetrators were allocated equally to the four offender types based on their profiles on the Special Hospitals Assessment of Personality and Socialisation (SHAPS). Each offender completed the Post‐Traumatic Stress Disorder Interview and the violence displayed during the index offence was classified as either reactive or instrumental.Results. Of the total sample, 52% met criteria for current PTSD. Reactive violence and reporting that the offence was traumatic were related to a current diagnosis of PTSD. Differing prevalences and patterns of PTSD symptoms were noted for Blackburn's offender types. Primary psychopaths showed instrumental violence and were the least traumatized. Secondary psychopaths were the most symptomatic, but not necessarily due to involvement in the homicide. Controlled and inhibited types both typically displayed reactive violence and had higher levels of current PTSD symptoms related to involvement in the offence itself.Conclusions. The extent to which PTSD follows homicide is a function of both personality type and form of violence. The results can be understood in terms of the cognitive model of Meichenbaum (1996) and also the defining dimensions of Blackburn's typology.

Individual differences in posttraumatic stress disorder symptom profiles in Holocaust survivors in concentration camps or in hiding

AbstractSymptom patterns were compared between Holocaust survivors in concentration camp (n = 70) and those who were in “hiding” (n = 30) during the war. The impact of age at the time of the trauma, gender, and cumulative lifetime stress, and the effect of each of these variables controlling for the others, on posttraumatic stress disorder (PTSD) symptoms were also evaluated. A significant negative relationship between age at the time of the trauma and symptoms of psychogenic amnesia, hypervigilence and emotional detachment, and a positive correlation between age and intrusive thoughts, were observed. Cumulative lifetime stress was positively associated with symptoms of avoidance. The study provides the first empirical data regarding the factors that potentially explain individual differences in PTSD symptom patterns in Holocaust survivors.

Individual differences in posttraumatic stress disorder symptom profiles in Holocaust survivors in concentration camps or in hiding.

Symptom patterns were compared between Holocaust survivors in concentration camp (n = 70) and those who were in "hiding" (n = 30) during the war. The impact of age at the time of the trauma, gender, and cumulative lifetime stress, and the effect of each of these variables controlling for the others, on posttraumatic stress disorder (PTSD) symptoms were also evaluated. A significant negative relationship between age at the time of the trauma and symptoms of psychogenic amnesia, hypervigilence and emotional detachment, and a positive correlation between age and intrusive thoughts, were observed. Cumulative lifetime stress was positively associated with symptoms of avoidance. The study provides the first empirical data regarding the factors that potentially explain individual differences in PTSD symptom patterns in Holocaust survivors.