Posttraumatic Stress Disorder Symptom Severity Research Articles

Do childhood experiences influence associations between posttraumatic stress disorder symptoms and positive autobiographical memories among military veteran students? An exploratory study

ABSTRACT Background Evidence links posttraumatic stress disorder (PTSD) symptoms and features of positive autobiographical memories (accessibility, vividness, coherence, sharing, emotional intensity, distancing). There is a knowledge gap on how adverse childhood experiences (ACEs) and benevolent childhood experiences (BCEs) may influence these relationships. Objectives The current study explored whether the number ACEs or BCEs moderated associations between PTSD symptom severity and features of positive autobiographical memories. Design and Methods The sample included 124 student military veterans who had experienced a trauma (M age = 33.90; 77.4% male; 75.0% White). Results Path analyses showed more PTSD symptom severity was significantly associated with less positive autobiographical memory vividness (β = −0.26, p = .019, R2 = 0.06). Further, the number of ACEs moderated the relationship between PTSD symptom severity and positive autobiographical memory accessibility (β = −0.25, p = .023, R2 = 0.10) and vividness (β = −0.20, p = .024, R2 = 0.10). Among individuals with more ACEs (1 SD above the mean) compared to those with fewer ACEs (1 SD below the mean), less accessibility and vividness of positive autobiographical memories was associated with greater PTSD symptom severity. The number of BCEs was not a significant moderator. Conclusions Positive memory-based interventions may be particularly useful to address PTSD symptoms among military veterans with a history of childhood adversity.

The prevalence of post-traumatic stress disorder among emergency medical services personnel in Saudi Red Crescent Authority, Riyadh, Saudi Arabia

BackgroundDetermining the prevalence of PTSD and contributing variables among (EMS) specialists was the goal of the current investigation. Furthermore, limited evidence exists regarding the application of PCL-5 for EMT practitioners, and the incidence of PTSD among different age groups and genders in Saudi Arabia.MethodsThis cross-sectional descriptive study includes 211 prehospital care providers of the Saudi Red Crescent Authority stations in Riyadh. The randomization was done using Google Forms into subgroups according to participants’ gender, years of experience, occupations, and average working hours. The presence and severity of PTSD symptoms were evaluated using the 20-item PTSD Checklist for DSM-5 (PCL-5) self-report questionnaire. Data were analyzed using Pearson Chi-Square, Mann-Whitney and Kruskal-Wallis tests. The reliability statistics were calculated using Cronbach’s Alpha for the 20-survey questionnaire.ResultsThe comparison of PCL-5 total scores indicated more PTSD symptomatology among females (1.61 + 0.799) as compared to male workers (1.13 + 0.642). The total score of PTSD demonstrated no statistically significant (P=0.79) differences between our age group classifications. In terms of the participants’ city (Riyadh), the total PTSD score was less than the cutoff point which is 31. PTSD total score may not be affected by working experience as indicated by the non-significant difference in prevalence among EMT practitioners having <5 years, 5-10 years and above 10 years of working experience (P=0.215 with X2 = 3.076). PTSD incidence is affected by the type of occupation as statistically significant differences between groups (P=0.001) were recorded depending on the position and responsibilities of EMS practitioners. PTSD is also affected by average working hours per week, and there were statistically significant differences between groups (P=0.001).ConclusionThe total score of PTSD in the case of emergency service practitioners was found to be 33.7% among all the research participants, which may be regarded as a high prevalence when compared to the general population. Our investigations would contribute to a better understanding of the underlying factors of mental stress in EMS specialists in Saudi Arabia and to the development of adequate mental health practices.

A Pilot Study of a Trauma Resiliency Protocol for Law Enforcement Officers with Posttraumatic Stress Disorder (PTSD) Symptoms.

To test the efficacy of the 22ZERO Trauma Resiliency Protocol (TR-P) on PTSD symptom severity among current and former law enforcement officers. Uses a retrospective, pre/post intervention design to test the effects of the TR-P on measures of self-reported symptom severity. 128 current and former law enforcement officers were exposed to the TR-P treatment. All participants were administered the PCL-5 PTSD Checklist and other psychological assessments before and after exposure. Participants experienced a significant reduction in symptom severity, suggesting that exposure to the TR-P reduced the effects of PTSD in this sample of law enforcement officers. The 22ZERO Trauma Resiliency Protocol may be an efficacious mechanism for reducing PTSD symptom severity among current and former law enforcement officers. It should be tested using a randomized trial and a longer follow-up period.

Salivary inflammatory biomarkers as a predictor of post-traumatic stress disorder and depressive symptom severity in trauma patients: A prospective study

BackgroundAlthough post-traumatic stress disorder (PTSD) and depression screening are recommended for traumatic injury patients, routine screening is still uncommon. Salivary inflammatory biomarkers have biological plausibility and potential feasibility and acceptability for screening. This study tested prospective associations between several salivary inflammatory biomarkers (proinflammatory cytokines interleukin-1β, interleukin-6, tumor necrosis factor-α; and C-reactive protein), collected during hospitalization and PTSD and depressive symptoms at 5-month follow-up. MethodsAdult traumatic injury patients (N = 696) at a major urban Level 1 trauma center provided salivary samples and completed PTSD and depressive symptom measures during days 0–13 of inpatient hospitalization. At 5-month follow-up, 368 patients (77 % male, 23 % female) completed the Clinician-Administered PTSD Scale for DSM-IV and the Self-rated Inventory of Depressive Symptomatology. Analyses focused on a latent inflammatory cytokine factor and C-reactive protein at baseline predicting 5-month PTSD and depression symptom outcomes and included baseline symptom levels as covariates. ResultsA latent factor representing proinflammatory cytokines was not related to 5-month PTSD or depressive symptom severity. Higher salivary CRP was related to greater PTSD symptom severity (β = .10, p = .03) at 5-month follow-up and more severity in the following depressive symptoms: changes in weight and appetite, bodily complaints, and constipation/diarrhea (β’s from .14 to .16, p’s from .004 −.03). ConclusionIn a primarily Latine and Black trauma patient sample, salivary CRP measured after traumatic injury was related to greater PTSD symptom severity and severity in several depressive symptom clusters. Our preliminary findings suggest that salivary or systemic CRP may be useful to include in models predicting post-trauma psychopathology.

Trauma exposure across the lifespan among individuals engaged in treatment with medication for opioid use disorder: differences by gender, PTSD status, and chronic pain

BackgroundThere is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD status, and chronic pain.MethodsA cross-sectional study examined baseline data from participants (N = 303) enrolled in a randomized controlled trial of a mind–body intervention as an adjunct to MOUD. All participants were stabilized on MOUD. Measures included the Trauma Life Events Questionnaire (TLEQ), the Brief Pain Inventory (BPI), and the Posttraumatic Stress Disorder Checklist (PCL-5). Analyses involved descriptive statistics, independent sample t-tests, and linear and logistic regression.ResultsParticipants were self-identified as women (n = 157), men (n = 144), and non-binary (n = 2). Fifty-seven percent (n = 172) self-reported chronic pain, and 41% (n = 124) scored above the screening cut-off for PTSD. Women reported significantly more intimate partner violence (85%) vs 73%) and adult sexual assault (57% vs 13%), while men reported more physical assault (81% vs 61%) and witnessing trauma (66% vs 48%). Men and women experienced substantial childhood physical abuse, witnessed intimate partner violence as children, and reported an equivalent exposure to accidents as adults. The number of traumatic events predicted PTSD symptom severity and PTSD diagnostic status. Participants with chronic pain, compared to those without chronic pain, had significantly more traumatic events in childhood (85% vs 75%).ConclusionThe study found a high prevalence of lifetime trauma among people in MOUD. Results highlight the need for comprehensive assessment and mental health services to address trauma among those in MOUD treatment.Trial registrationNCT04082637.

Deep brain stimulation of the amygdala for treatment-resistant combat post-traumatic stress disorder: Long-term results

Deep brain stimulation (DBS) holds promise for neuropsychiatric conditions where imbalance in network activity contributes to symptoms. Treatment-resistant Combat post-traumatic stress disorder (TR-PTSD) is a highly morbid condition and 50% of PTSD sufferers fail to recover despite psychotherapy or pharmacotherapy. Reminder-triggered symptoms may arise from inadequate top-down ventromedial prefrontal cortex (vmPFC) control of amygdala reactivity. Here, we report long-term data on two TR-PTSD participants from an investigation utilizing high-frequency amygdala DBS. The two combat veterans were implanted bilaterally with quadripolar electrodes targeting the basolateral amygdala. Following a randomized staggered onset, patients received stimulation with adjustments based on PTSD symptom severity for four years while psychiatric and neuropsychiatric symptoms, neuropsychological performance, and electroencephalography were systematically monitored. Evaluation of vmPFC-Amygdala network engagement was assessed with 18FDG positron emission tomography (PET). CAPS-IV scores varied over time, but improved 55% from 119 at baseline to 53 at 4-year study endpoint in participant 1; and 44%, from 68 to 38 in participant 2. Thereafter, during 5 and 1.5 years of subsequent clinical care respectively, long-term bilateral amygdala DBS was associated with additional, clinically significant symptomatic and functional improvement. There were no serious stimulation-related adverse psychiatric, neuropsychiatric, neuropsychological, neurological, or neurosurgical effects. In one subject, symptomatic improvement was associated with an intensity-dependent reduction in amygdala theta frequency power. In our two participants, FDG-PET findings were inconclusive regarding the hypothesized mechanism of suppression of amygdala hyperactivity. Our findings encourage further research to confirm and extend our preliminary observations.

Subtypes of childhood maltreatment and posttraumatic stress disorder symptoms in an adult trauma sample: The mechanistic role of sleep.

Childhood maltreatment is indisputably linked to adverse mental health outcomes, including an increased risk to develop posttraumatic stress disorder (PTSD) in adulthood. The role of childhood maltreatment in the context of recovery from a trauma later in adulthood is not well understood. A variable related to both childhood maltreatment and PTSD symptoms, and a potential link between the two, is sleep. The current study aimed to understand how sleep disturbances may play a mechanistic role in the effect of subtypes of childhood maltreatment on PTSD symptom severity in an adult trauma sample. 160 adults (90 women; Mage = 33.73, SD = 10.86) were recruited from the emergency department at a Level-1 trauma center in southeastern Wisconsin after experiencing a traumatic injury. Experiences of childhood maltreatment and sleep were self-reported at 2-week and 3-month posttrauma, respectively. PTSD symptoms were clinically assessed 6 months later. Sleep disturbances 3-month posttrauma mediated the effect of emotional abuse, physical neglect, and emotional neglect on PTSD symptom 6 months after the traumatic injury. The effect of sexual and physical abuse on PTSD symptoms was not significantly mediated by sleep disturbances. These findings highlight the differential impact of subtypes of childhood maltreatment on PTSD symptoms, the mechanistic role of sleep, and the need to consider early life adversity when assessing adult posttrauma experiences. These results also suggest that interventions aimed at improving sleep quality might improve PTSD symptoms in those who have experienced childhood maltreatment and a subsequent traumatic injury in adulthood. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

0925 A Multilevel Time-lagged Mediation of Nightmare and PTSD Symptom Severity Across Time in a Combined Treatment

0925 A Multilevel Time-lagged Mediation of Nightmare and PTSD Symptom Severity Across Time in a Combined Treatment

Posttraumatic stress disorder (PTSD) and complex PTSD in eating disorder treatment-seekers: Prevalence and associations with symptom severity.

Although childhood trauma and posttraumatic stress disorder (PTSD) have been well-researched in eating disorder epidemiology, prevalence rates are unavailable for complex PTSD (CPTSD). Under recently introduced ICD-11 criteria, individuals with CPTSD have both PTSD symptoms and additional disturbances in self-organization (DSO). Using ICD-11 criteria, this study aimed to determine the prevalence of PTSD and DSO symptoms, diagnostic rates of PTSD and CPTSD, and childhood trauma exposure in eating disorder treatment-seekers. Participants (N = 217) were individuals attending residential, partial hospitalization, and outpatient services who completed measures of eating disorder- and trauma-related symptoms and childhood adverse experiences. One third of participants reported PTSD symptoms, and over half reported DSO symptoms, with probable ICD-11 diagnostic rates of 3.8% for PTSD and 28.4% for CPTSD. CPTSD was significantly more prevalent than PTSD and more common in higher levels of care. Both PTSD and DSO symptom severity were positively correlated with eating disorder symptoms and impairment, rs =.285-.642. DSO symptom severity was a significant and unique explanatory factor of eating disorder severity and impairment. The findings highlight the prevalence of CPTSD in eating disorder populations and the association between DSO symptoms and eating psychopathology independent of PTSD symptoms. Implications are discussed for adjunct treatment approaches for individuals with comorbid eating disorders and PTSD or CPTSD.

Alone on the frontline: The first report of PTSD prevalence and risk in de-occupied Ukrainian villages.

The ongoing Russian invasion of Ukraine marks a critical juncture in a series of events posing severe threat to the health of Ukrainian citizens. While recent reports reveal higher rates of PTSD in Ukrainian refugees following Russia's invasion - data for Ukrainians remaining at the warfront is inherently difficult to access. A primarily elderly demographic, Ukrainians in previously Russian-occupied areas near the front (UPROANF) are at particular risk. Data was sourced from screening questionnaires administered between March 2022 and July 2023 by mobile health clinics providing services to UPROANF. Previously occupied villages in Eastern and Southern Ukraine. UPROANF attending clinics completed voluntary self-report surveys reporting demographics, prior health diagnoses, and PTSD symptom severity (n = 450; Meanage = 53.66; 72.0% female). Participants were exposed to Russian occupation of Ukrainian villages. The PTSD Checklist for the DSM-V (PCL-5) with recommended diagnostic threshold (i.e. 31) was utilized to assess PTSD prevalence and symptom severity. ANCOVA was used to examine hypothesized positive associations between (1) HTN and (2) loneliness and PTSD symptoms (cumulative and by symptom cluster). Between 47.8% and 51.33% screened positive for PTSD. Though cumulative PTSD symptoms did not differ based on HTN diagnostic status, those with HTN reported significantly higher PTSD re-experiencing symptoms (b = 1.25, SE = 0.60, p = .046). Loneliness was significantly associated with more severe cumulative PTSD symptoms (b = 1.29, SE = 0.31, p < .001), re-experiencing (b = 0.47, SE = 0.12, p < .001), avoidance (b = .18, SE = 0.08, p = .038), and hypervigilance (b = 0.29, SE = 0.13, p = .036). PTSD prevalence was higher than other war-exposed populations. Findings highlight the urgent mental health burden among UPROANF, emphasizing the need for integrated care models addressing both trauma and physical health. Given the significance of loneliness as a risk factor, findings suggest the potential for group-based, mind-body interventions to holistically address the physical, mental, and social needs of this highly traumatized, underserved population.

The burden of anxiety, depression, and stress, along with the prevalence of symptoms of PTSD, and perceptions of the drivers of psychological harms, as perceived by doctors and nurses working in ICUs in Nepal during the COVID-19 pandemic; a mixed method evaluation.

The COVID-19 pandemic resulted in significant physical and psychological impacts for survivors, and for the healthcare professionals caring for patients. Nurses and doctors in critical care faced longer working hours, increased burden of patients, and limited resources, all in the context of personal social isolation and uncertainties regarding cross-infection. We evaluated the burden of anxiety, depression, stress, post-traumatic stress disorder (PTSD), and alcohol dependence among doctors and nurses working in intensive care units (ICUs) in Nepal and explored the individual and social drivers for these impacts. We conducted a mixed-methods study in Nepal, using an online survey to assess psychological well-being and semi-structured interviews to explore perceptions as to the drivers of anxiety, stress, and depression. Participants were recruited from existing national critical care professional organisations in Nepal and using a snowball technique. The online survey comprised of validated assessment tools for anxiety, depression, stress, PTSD, and alcohol dependence; all tools were analysed using published guidelines. Interviews were analysed using rapid appraisal techniques, and themes regarding the drivers for psychological distress were explored. 134 respondents (113 nurses, 21 doctors) completed the online survey. Twenty-eight (21%) participants experienced moderate to severe symptoms of depression; 67 (50%) experienced moderate or severe symptoms of anxiety; 114 (85%) had scores indicative of moderate to high levels of stress; 46 out of 100 reported symptoms of PTSD. Compared to doctors, nurses experienced more severe symptoms of depression, anxiety, and PTSD, whereas doctors experienced higher levels of stress than nurses. Most (95%) participants had scores indicative of low risk of alcohol dependence. Twenty participants were followed up in interviews. Social stigmatism, physical and emotional safety, enforced role change and the absence of organisational support were perceived drivers for poor psychological well-being. Nurses and doctors working in ICU during the COVID-19 pandemic sustained psychological impacts, manifesting as stress, anxiety, and for some, symptoms of PTSD. Nurses were more vulnerable. Individual characteristics and professional inequalities in healthcare may be potential modifiable factors for policy makers seeking to mitigate risks for healthcare providers.

Pathway from Childhood Maltreatment to Perceived Parental Competence and Intimate Partner Violence Among Expecting Fathers: The Role of PTSD Symptoms

ABSTRACT Men who have a history of childhood maltreatment may be at risk of experiencing significant challenges during the transition to parenthood, which might be explained by the presence of post-traumatic stress disorder (PTSD) symptoms. Using a nonclinical community sample of 230 expecting fathers, the aims of the current study were as follows (1) to investigate, during the prenatal period, associations between childhood maltreatment and perceived parental competence as well as between childhood maltreatment and intimate partner violence, and (2) to evaluate whether PTSD symptoms contributed to explaining these associations. A structural equation model showed that the severity of childhood maltreatment predicted more severe PTSD symptoms, which in turn predicted higher levels of intimate partner violence as well as a lower perceived parental competence. No direct associations between childhood maltreatment and both perceived parental competence and intimate partner violence were observed. Implications for interventions and future research are discussed.

Graph theory-based analysis reveals neural anatomical network alterations in chronic post-traumatic stress disorder

Abstract Multimodal imaging using network connectivity techniques shows promise for investigating neuropathology influencing Post-Traumatic Stress Disorder (PTSD) symptom maintenance and course. We recruited World Trade Center (WTC) responders who continued to suffer from chronic PTSD into a diffusion tensor neuroimaging protocol (n=100), along with nine unexposed controls without PTSD from other sources. Using a graph theory approach to probe network alterations in brain diffusion images, we calculated weighted characteristics path length as a surrogate marker for the effective neuroanatomical distance between anatomical nodes. The sample (N=109; 47 with chronic PTSD) was in their mid-fifties, and the majority were male. Responders were matched in terms of cognitive performance, occupation, and demographics. The anatomical connectivity graph was constructed for each participant using deterministic diffusion tractography. We identified a significant difference in weighted Characteristic Path Length (wCPL) between trauma-exposed WTC responders (Cohen’s d = 0.42, P&amp;lt;0.001) that was highest in people with PTSD, and not explained by WTC exposure severity or duration. We also found that wCPL was associated with PTSD symptom severity in responders with PTSD. In the largest study to date to examine the relationship between chronic PTSD and anatomy, we examined the anatomical topography of neural connections and found that wCPL differed between the PTSD+ and PTSD- diagnostic categories.

Posttraumatic cognitions about the self are associated with depression symptoms in veterans endorsing a history of assaultive military sexual trauma.

Depressive symptoms are a commonly observed yet understudied mental health sequalae of military sexual trauma (MST). Prior research supports the relationship between negative posttraumatic cognitions (NPCs) and the onset and course of trauma symptoms more broadly. We hypothesized that NPCs would be associated with depression symptoms in veterans endorsing a history of MST, specifically assaultive type MST. Our clinical sample included veterans presenting for treatment related to assaultive MST (N = 158; 70.9% female, 65.2% White, 27.8% Black). Participants completed self-report measures of posttraumatic stress disorder (PTSD), depression, and NPCs during intake at a Veteran's Affairs specialty trauma clinic. Linear regressions were used to analyze the association between NPCs and depression symptoms controlling for PTSD symptom severity. PTSD severity and NPCs about the self were significantly associated with depression symptoms, explaining 46% of the variance severity, F(4, 153) = 33.16, R² = .46, p < .001. These findings newly demonstrate a relationship between NPCs about the self and depression in veterans with a history of MST. Clinicians may benefit from incorporating cognitive interventions into preexisting depression treatments to directly address NPCs in this population. Future study is needed to determine how these results may extend to other forms of MST or trauma types. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Predictors of veteran attendance in an intimate partner violence intervention.

This study examined session attendance data from 2,754 veterans who participated in a national implementation of a trauma-informed intimate partner violence intervention, Strength at Home, across the Veterans Affairs Healthcare System. Potential correlates of attendance were demographic characteristics, posttraumatic stress disorder (PTSD) symptom severity, alcohol use, court involvement, current military involvement, and intervention modality (in-person vs. virtual). Given the trauma-informed nature of the intervention, it was expected that trauma-relevant risk factors, specifically PTSD symptom severity and racial minority status, would be less strongly associated with attendance than barriers related to other demographic variables and higher alcohol use, intervention modality, and court involvement. Results indicated that age, education level, employment status, retirement status, PTSD symptom severity, alcohol use, and court involvement were associated with session attendance in the expected direction at the bivariate level. Only education level, employment status, retirement status, alcohol use, and court involvement emerged as unique predictors of attendance such that more educated, employed, retired, and court-mandated veterans with less alcohol use attended more sessions. These findings suggest the importance of a trauma-informed, coordinated community response to intimate partner violence intervention and integration of motivational components surrounding problematic alcohol use to enhance compliance and mitigate barriers to attendance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

501 Maternal PTSD and Child Brain Function During Implicit Emotion Regulation

OBJECTIVES/GOALS: Maternal mental health, such as post-traumatic stress disorder (PTSD), is closely linked to child mental health. PTSD in mothers is associated with their children’s emotional responses. We examined associations between maternal PTSD and child brain function during emotion regulation. METHODS/STUDY POPULATION: Eight children ages 10-12 years, whose mothers had trauma histories, performed the Emotional N-Back task during functional MRI scanning. Mothers and children each reported on their trauma exposure and PTSD symptom severity. BOLD response to fearful faces during the Emotional N-Back was extracted from two specific brain regions of interest, amygdala and anterior cingulate cortex. These regions are involved in emotional response and attentional control, which are processes intrinsic to emotion regulation. An independent samples t-test was conducted on children’s BOLD response to fearful faces, with maternal PTSD symptom severity (high, low) as the independent variable. A parallel analysis was conducted with child PTSD symptom severity (high, low) as the independent variable. RESULTS/ANTICIPATED RESULTS: We found a main effect of maternal PTSD within brain regions of relevance to implicit emotion regulation. Compared to children whose mothers reported low PTSD symptom severity (n=4), children whose mothers reported high PTSD symptom severity (n=4) showed greater responsiveness to fearful faces in anterior cingulate cortex (t=2.04, p=.09,d=1.44) and amygdala (t=2.44, p=.05, d=1.72) at trending significance. A parallel analysis with child PTSD symptom severity showed no differences in brain function by this factor (ps=.55-.61). DISCUSSION/SIGNIFICANCE: Our pilot study is the first, to our knowledge, to examine associations between maternal PTSD and brain function during emotion regulation in their children. This study lays a foundation for future work; our goal is to explore dysfunction in emotion regulation neurocircuitry as one mechanism linking maternal PTSD to their children’s mental health.

Less is more: Smaller hippocampal subfield volumes predict greater improvements in posttraumatic stress disorder symptoms over 2 years.

Posttraumatic stress disorder (PTSD) is a heterogeneous disorder, and symptom severity varies over time. Neurobiological factors that predict PTSD symptoms and their chronicity remain unclear. This study investigated whether the volume of the hippocampus and its subfields, particularly cornu ammonis (CA) 1, CA3, and dentate gyrus, are associated with current PTSD symptoms and whether they predict PTSD symptom changes over 2 years. We examined clinical and structural magnetic resonance imaging measures from 252 trauma-exposed post-9/11 veterans (159 with Time 1 PTSD diagnosis) during assessments approximately 2 years apart. Automated hippocampal subfield segmentation was performed with FreeSurfer Version 7.1, producing 19 bilateral subfields. PTSD symptoms were measured at each assessment using the Clinician-Administered PTSD Scale-IV (CAPS). All models included total intracranial volume as a covariate. First, similar to previous reports, we showed that smaller overall hippocampal volume was associated with greater PTSD symptom severity at Time 1. Notably, when examining regions of interest (CA1, CA3, dentate gyrus), we found that smaller Time 1 hippocampal volumes in the bilateral CA1-body and CA2/3-body predicted decreased PTSD symptom severity at Time 2. These findings were not accounted for by combat exposure or treatment history. Additionally, both Time 1 CA1-body and CA2/3-body volume showed unique associations with changes in avoidance/numbing, but not with changes in reexperiencing or hyperarousal symptoms. This supports a more complex and nuanced relationship between hippocampal structure and PTSD symptoms, where during the posttrauma years bigger may not always mean better, and suggests that the CA1-body and CA2/3-body are important factors in the maintenance of PTSD symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reducing posttraumatic stress disorder symptom severity among depressed women with childhood sexual abuse histories in interpersonal psychotherapy-trauma: The role of improved social functioning.

Childhood sexual abuse (CSA) increases risk for posttraumatic stress disorder (PTSD), and both CSA and PTSD are strongly associated with impaired social functioning. Interpersonal psychotherapy (IPT) has demonstrated promise for adults with PTSD and has been shown to be effective for women with PTSD and histories of CSA, but the mechanisms by which IPT might improve PTSD are unknown. The current secondary analysis tested whether the ameliorative effect of IPT-trauma (IPT-T) on PTSD, demonstrated in a randomized effectiveness trial, was mediated by improved social function. The randomized effectiveness trial compared IPT-T to clinic psychotherapy in a publicly funded community mental health center. Women with CSA histories and major depression (n = 162; Mage = 36.3; 54% White, 38% Black, 8% other race) were randomly assigned to IPT-T or CP, and 16 free sessions of IPT-T or CP were offered within a 32-week treatment period. Eighty-eight percent of the sample met diagnostic criteria for PTSD. Mediation models confirmed hypotheses, showing that the effect of IPT-T on improved PTSD symptoms at Week 32 (end of treatment) was partially mediated by better social functioning at Week 16 (middle of treatment period; path c¹: B = 12.25, p = .04, 95% confidence interval [.44, 24.05]). Findings support that a non-exposure-based therapy can reduce PTSD symptoms via improved social functioning. Given extensive literature showing the importance of social functioning in mental health generally and PTSD specifically, integrating a focus on social functioning (e.g., building social skills, expanding support networks) into treatments, including exposure-based treatments, may enhance outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Sources of Social Support and Trauma Recovery: Evidence for Bidirectional Associations from a Recently Trauma-Exposed Community Sample.

Although the association between post-traumatic stress disorder (PTSD) and social support is well documented, few studies have tested the causal pathways explaining this association at several points in the acute post-trauma recovery period or examined whether the association varies for different sources of social support. To address these gaps, 151 community individuals (mean age = 37.20 years, 69.5% women) exposed to trauma within the previous 6 months were recruited to complete measures of PTSD and social support from intimate partners, friends, and relatives four times in 1 year. In line with recent recommendations for research on social support and PTSD symptoms, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine dynamic changes between PTSD severity and social support over time. The pattern of RI-CLPM cross-lagged coefficients indicated that positive deviations from one's expected stable level of total social support (across all sources) sped up the recovery of PTSD symptoms at the end of the post-trauma year, and more severe PTSD symptoms than expected based on one's expected stable level of PTSD started eroding social support midway through the assessment year. When specific sources of social support were analyzed separately, the association between within-person increases in social support from friends at any given time point accelerated the recovery from PTSD across the entire year. Among participants with intimate partners (n = 53), intimate partner support did not predict PTSD symptoms, but more severe PTSD symptoms at any given time point predicted less support at the following time point. Results from this longitudinal study provide additional support for the bidirectional relationship between PTSD and social support over time and suggest that perceived social support from friends may be especially helpful during trauma recovery.

Whole-brain correlates of post-traumatic stress disorder in military-related mild traumatic brain injury: A voxel-wise meta-analysis

Resting-state functional magnetic resonance imaging (rs-fMRI) is widely used in studying mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD) among military service personnel (MSP). The risk for PTSD is greater after mTBI than after non-mTBI trauma, and PTSD is associated with worse biological, psychological, and social (biopsychosocial) outcomes after mTBI. Studying the neural correlates of mTBI-related PTSD in this population may provide insights into the pathophysiology of both conditions and help identify MSPs most at risk of developing persistent symptoms. This voxel-wise meta-analysis aimed to examine the current literature on rs-fMRI in mTBI-related PTSD, collect neuroimaging data, and perform a voxel-wise meta-analysis to identify significant nodes of functional connectivity across studies. We searched the literature using PubMed, EMBASE, and ScienceDirect. The database query yielded 1455 articles, narrowed with specified eligibility criteria to a final cohort of 33 studies, with 1521 experiment group participants and 1369 controls. Article quality was assessed using the QUADAS-2 instrument. Our meta-analysis revealed a robust correlation between PTSD-mTBI and increased whole-brain resting-state functional connectivity (rsFC) in the amygdala. Our meta-analysis also showed strong correlations between PTSD-mTBI and decreased whole-brain rsFC across regions implicated in speech and language processing. Our meta-regression highlighted robust correlations between less time after a recent mTBI and increased whole-brain rsFC in posterior regions of the default mode network. Our meta-regression also showed strong correlations between increased PTSD symptom severity, increased connectivity in the amygdala, and decreased connectivity in Broca's area.