Posttraumatic Stress Disorder Symptomology Research Articles

Posttraumatic stress disorder symptomology as measured by PCL-5 and its relationships to resilience, hostility and stress among paramedics and social professionals.

This survey study aimed to contribute to the extensive debate on the dimensionality of the Posttraumatic Stress Disorder Checklist for the DSM-5 (PCL-5) questionnaire by examining the psychometric properties and construct validity of its Hungarian version and relying on the inspection of a conceptual network of related variables, that is, perceived stress, hostility, and resilience. Confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and path analysis were applied on data collected from 177 paramedics and 66 professionals from the social field (58.4% male; Mage=43.5±9.96years). Despite the acceptable fit indices gained with CFA when testing the original four-factor DSM-5 model of PCL-5, strong associations (r=0.69-0.90) between subscales were found. Thus, ESEM was applied and as a result a new, three-factor version of the DSM-5 model of PCL-5 was proposed due to significant crossloadings that was theoretically also supported. The Reexperiencing and Avoidance subscales were merged and named Difficulty with Assimilation of Experience (DAE). In the path analysis only two of the tested associations were not significant using the new factor structure, in which stress fully mediated the relationship between resilience and DAE, and resilience and Hyperarousal. Overall, the hypothesised pathways between variables fit the collected data well. (weighted least squares mean-and variance-adjusted χ2=503.750 (df=270), comparative fit index=0.948, Tucker-Lewis index=0.939, root mean square error of approximation (90% confidence interval)=0.064 (0.055-0.073), weighted root mean square residual=1.024). Our analysis of the Hungarian version of PCL-5 contributes to the testing of a DSM-5-based questionnaire measuring posttraumatic stress disorder symptomology.

Evaluation of Posttraumatic Stress Disorder Screening Measures of Emergency Medical Services Clinicians in Urban and Suburban New York During the Coronavirus Disease 2019 Pandemic

ObjectiveThe objective of this study was to assess the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on the self-reported rates of posttraumatic stress disorder (PTSD) among emergency medical services (EMS) clinicians in urban and suburban settings that were one of the primary epicenters during the first wave of the COVID-19 pandemic. MethodsAnonymous surveys containing the PTSD Checklist–Specific (PCL-S) were sent electronically between November 2020 and April 2021 to EMS clinicians working in 2 EMS agencies. A threshold score ≥ 36 was considered a positive screen for PTSD symptomology; a score ≥ 44 was considered a presumptive PTSD diagnosis. ResultsOf the 214 surveys sent, 107 responses were returned. The total PCL-S scores suggested PTSD symptoms were present in 33% of responding EMS clinicians (95% confidence interval [CI], 24.1%-42.5%), and 25% (95% CI, 17.6%-34.7%) met the criteria for a presumptive diagnosis of PTSD. Regression revealed increasing PCL-S scores were associated with thoughts of job resignation (+3.8; 95% CI, 1.1-6.4; P = .006), whereas lower PCL-S scores were related to the degree that respondents believed emotional support was available at their institution (−3.6; 95% CI, −6.8 to −0.4; P = .03). ConclusionSixth months after the first wave of the COVID-19 pandemic, one third of participating EMS clinicians screened positive for PTSD symptoms. Pandemic planning must address the mental health of EMS clinicians to reduce subsequent burnout and maintain a healthy workforce.

Systematic Review of Dispositional Mindfulness and Posttraumatic Stress Disorder Symptomology: A Targeted Examination of Avoidance.

High rates of nonresponse to evidence-based treatment for posttraumatic stress disorder (PTSD) have fueled the search for improved intervention. Evidence suggests that improvements in dispositional mindfulness (i.e., tendency to attend to the present with nonjudgment and nonreactivity) may help reduce PTSD symptoms. While some research suggests that transdiagnostic mindfulness-based interventions particularly target avoidance symptoms, the association between dispositional mindfulness and avoidance has yet to be systematically examined. To address this gap, we examined peer-reviewed studies that reported quantitative associations between avoidance and dispositional mindfulness among trauma-exposed adults, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Sixteen studies were identified for final review from PsycINFO and PubMed databases. Results suggest that mindfulness has a weak relationship with effortful avoidance. This weak relationship may be obscured in studies where effortful avoidance is measured among other symptoms (e.g., anhedonia). Mindfulness appeared to have stronger associations with symptoms of hyperarousal and negative alterations in cognition and mood. An important clinical implication is that high effortful avoidance may manifest among patients who report strong mindfulness skills. It may be helpful for clinicians to carefully assess how mindfulness is being used to cope.

Flexible emotional regulation typology: associations with PTSD symptomology and trait resilience

BackgroundMultiple factors influence posttraumatic stress disorder (PTSD) risk in trauma exposed individuals. An established association exists between trait resilience and decreased PTSD distress and between emotion regulation (ER) ability/flexibility and trait resilience. Typologies in ER ability/flexibility, associated with trait resilience and PTSD experience, could explain the difference in risk. This study aimed to explore the relationship between ER ability, ER flexibility, context sensitivity, resilience, and PTSD.MethodsData from N = 563 trauma exposed UK residents was used in a latent profile analysis (LPA) and membership in the resultant profiles was explored in a logistic regression of sociodemographics, resilience, and PTSD symptomology.ResultsAnalysis showed 2 latent profiles (High Flexibility, Low Flexibility) typified by emotion regulation ability and context sensitivity. Members of the Low Flexibility profile were more likely to be younger, male, endorsing less trait resilience, and experiencing negative cognition/mood and hyperarousal PTSD symptomology.ConclusionsDifficulties in ER ability and flexibility could be improved with targeted learning in a therapeutic or home setting, potentially increasing trait resilience after trauma exposure and reducing PTSD distress.

Interactive relationship between alexithymia, psychological distress and posttraumatic stress disorder symptomology across time

ABSTRACT Alexithymia, psychological distress, and posttraumatic stress disorder (PTSD) are highly related constructs. The ongoing debate about the nature and relationship between these constructs is perpetuated by an overreliance on cross-sectional research. We examined the longitudinal interactive relationship between alexithymia, psychological distress, and PTSD. We hypothesised that there is an interactive relationship between the three constructs. Military personnel (N = 1871) completed the Toronto Alexithymia Scale, the Kessler 10 and a PTSD Checklist (PCL-C) at pre-deployment, post-deployment, and at 3–4 years following the post-deployment assessment. We initially tested whether psychological distress is either a moderator or mediator in the relationship between alexithymia and PTSD across the time points. General psychological distress was a partial mediator of total PTSD severity and hyperarousal symptomology at all three time points. Psychological distress fully mediated re-experiencing and avoidance symptomology at all three time points. Our results suggest that those with alexithymia are at longitudinal risk of developing more severe PTSD symptomology and experiencing hyperarousal irrespective of temporal proximity to traumatic exposure. Further, vulnerability to the emergence of re-experiencing and avoidance symptomology for those with alexithymia is increased when one experiences greater distress. Our results show that alexithymia is a persistent risk factor for PTSD symptomology.

78 The Effects of Hypertension and Obstructive Sleep Apnea on Auditory Learning and Memory in Veterans with PTSD Symptomology

Objective:Obstructive sleep apnea (OSA) has been associated with cognitive deficits as evidenced by neuropsychological testing in the domains of attention/working memory, verbal memory, processing speed, and executive function. OSA is often comorbid with hypertension and has been considered a risk factor for hypertension (Kareem et al., 2018; Tietjens et al., 2019). Both hypertension and OSA have been shown to be independent predictors of memory (Kinoshita et al., 2012). OSA and posttraumatic stress disorder (PTSD) are also frequently co-occurring, especially among veterans. In a group of veterans with a history of PTSD, we seek to explore the effects of sleep apnea and hypertension on cognitive functioning, particularly auditory learning/memory.Participants and Methods:One hundred and three male and female participants with comorbid OSA and PTSD symptomology were screened as part of a larger VA Palo Alto Health Care System study. Participants (age: x=56.3, a=13.8, 24-81 years; education: x=14.6, a=2.3, 8-20 years; 9.6% female, 89.6% male) completed a neuropsychological battery, including the CVLT-II and WMS-IV Logical Memory. Presence or absence of hypertension was dichotomously coded and AHI severity was categorically coded. An auditory learning/memory composite variable was created using the z-score transformation method (Dodge et al., 2020). Variables and covariates were entered into a hierarchical regression.Results:The initial regression model revealed hypertension and OSA severity to be independent predictors of performance on auditory learning/memory (hypertension: ß= -0.71, p<0.01; OSA: ß= -0.42, p<0.01), where presence of hypertension or increased severity of OSA resulted in worse performance on the auditory learning/memory composite.Conclusions:Results suggest that hypertension and OSA may independently and negatively affect performance on measures of auditory learning/memory in veterans with PTSD symptomology and OSA. Such findings underscore the importance of assessing and treating both hypertension and OSA among veterans with PTSD to improve not only physical health, but also cognitive health. Further research demonstrating similar findings is recommended along with studies investigating whether or not the treatment of hypertension and OSA can improve auditory learning/memory.

6 Trauma Exposure as a Predictor for Score Profiles on Structured and Unstructured Tasks of Verbal Memory in a Community Sample

Objective:Evidence suggests that the most consistent cognitive impairment found in individuals experiencing posttraumatic stress disorder symptomology is verbal memory impairment (Johnsen & Asbjornsen, 2008). More specifically, research has shown that patients with PTSD perform poorer on verbal memory tasks relating to logical (story) memory than on word memory tasks, such as CVLT-III (Barrera-Valencia et al., 2017). While recent literature accounts for memory impairments related to PTSD, less is known about this relationship for individuals with mere trauma exposure compared to individuals without trauma exposure. The present research aims to determine if there is a significant impact on WMS-LM when compared to CVLT-III for individuals in a community sample that have been exposed to a traumatic event in their lifetime.Participants and Methods:One hundred nineteen patients presented to a community-based practice for neuropsychological evaluation. Patients were screened for trauma exposure during a clinical interview. Immediate and long delay trials of Wechsler Memory Scale IV Logical Memory (WMS-LM) were used to examine structured learning and memory and the California Verbal Learning Test (CVLT-II) immediate and long delay recalls were used to examine unstructured learning and memory. Out of the 119 patients, 36 patients reported trauma exposure. Twenty-five were diagnosed as “normal,” 62 were diagnosed with mild cognitive impairment, and 32 were diagnosed with dementia. A one-way MANOVA was conducted to examine the relationship across the multiple dependent variables.Results:There was a statistically significant difference in immediate recall in memory based on exposure to trauma, F (2, 116) = 3.28, p < .05; Wilk’s A = 0.947, partial n2 = .53, such that individuals with trauma exposure performed better. For long delay recall performance, there was a similar trend though it did not reach statistical significance F (2, 114) = 3.03, p = .052; Wilk’s A = 0.949, partial n2 = .51.Conclusions:Data showed that patients who reported trauma exposure scored significantly higher on immediate recall performance on CVLT and WMS-LM than those who did not report trauma exposure. Although research suggests that patients who were exposed to trauma often experience cognitive deficits on verbal memory tasks, evidence also shows that trauma exposure can lead to higher immediate recall performance in memory related to attentional allocation modeling (Hayes et al., 2012).

Post traumatic stress disorder in African American men exposed to violent trauma

Research has shown strong association between exposures to violence resulting in post traumatic stress symptoms. Despite the high lifetime prevalence of post traumatic stress disorder (PTSD) and exposure to violence among African American men, research outcomes are limited and inconsistent. African American youth who live in low-income urban areas routinely face various contextual specific risks factors that leave them susceptible to loss and trauma in their lifetime resulting in persistent PTSD over time. Personas of resilience found in African American men exposed to chronic violence often mask trauma symptoms raising concerns on the evaluation of PTSD symptomology among African American men as well as the process of resilience and coping methods within this population. Limitations to research include convenience sampling limited to specific cities and exclusion of incarcerated African American men. In addition, there is a lack of longitudinal studies detailing the physiological and psychological course of PTSD and rates of recovery in African Americans. Health care systems and providers must be equipped, informed, and prepared to responding to mental health needs of African American men. The understanding of the expression and presence of PTSD among African American men will result in improvements of healthcare professionals' ability to evaluate, diagnose, and provide treatment for PTSD among this group whose symptoms of trauma may be misinterpreted or overlooked.

Burns and posttraumatic stress disorder: What's being done

Burn injuries can be a life-shattering event causing significant physical impairment. Burn survivors suffer from changes in appearance and body function. The perception of burn injuries has transformed from permanent disability to now rehabilitative. Through ever-evolving technology coupled with enhanced clinical assessments, burn injuries are seen through the lens of being more than physical. This article aims to keep non-burn experts abreast of what is being done to address the psychological effects of burn injuries. This article discusses different screening and diagnostic instrumentation for assessing posttraumatic stress disorder as well as treatment options for clinicians encountering burn survivors. Early detection of posttraumatic stress disorder symptomology and aggressive treatment are essential in improving the quality of life of those who have suffered a burn trauma.

Burnout Among Service Providers for People Living with HIV: Factors Related to Coping and Resilience.

Individuals who provide services for people living with HIV (PLWH) face numerous work-related challenges, including psychosocial and structural factors affecting the quality of care that they provide. Little is known about the factors that relate to burnout among service providers for PLWH. The current study seeks to examine the factors associated with burnout and the role of resilience and coping in the context of burnout. Via convenience sampling, data was collected from 28 professionals (e.g., peer counselors, HIV testers, case managers/case workers, group facilitators, or social workers) serving PLWH in the USA. Participants completed quantitative measures on sociodemographics, organizational factors, discrimination, trauma, depression, and burnout. A sub-sample of 19 participants provided in-depth qualitative data via semi-structured interviews on burnout, coping, and resilience as a buffer against the effects of burnout. Thematic content analysis revealed themes on the factors related to burnout (e.g., discrimination, limited financial and housing resources, and COVID-19), rejuvenating factors, coping with burnout, and intervention strategies. Additionally, Pearson's product moment correlations revealed significant associations between mental health variables such as depressive and posttraumatic stress disorder symptomology with (a) discrimination and microaggressions and (b) burnout. The current study highlights challenges to providing HIV care, including structural barriers and discrimination that are doubly impactful to the professionals in this sample who share identities with the PLWH whom they serve. These findings may inform the development of an intervention targeting burnout among individuals providing services to PLWH and motivate change to remove structural barriers and improve quality of care for PLWH.

Was it me? The Role of Attributions and Shame in Posttraumatic Stress Disorder (PTSD): A Systematic Review

AbstractShame has been identified as a key emotional response to trauma exposure and is implicated in the development and maintenance of PTSD. Despite this, there is a lack of empirical research explaining how and why shame emerges following trauma exposure. Current theoretical models of shame converge on the idea that shame is elicited through internal, stable, and global attributions about the precipitating event. A systematic review was conducted to assess the relationship between causal attributions, shame, and PTSD symptomology. A database search of PsycINFO, PubMED, Medline, EMBASE and PTSDPubs identified articles published between 1980 to 2022 that enabled examination of the relationship between attributions, shame, and PTSD. A total of eight articles met inclusion criteria for this review. There were cross-sectional relationships between internal attributions, shame, and PTSD symptoms, with shame demonstrating the strongest relationship with PTSD symptoms. Significant indirect effects were found between internal attributions, shame, and PTSD. Concerns surrounding reliability of measurements and sampling bias made it difficult to draw definitive conclusions. The current evidence is too preliminary to offer strong support for the mediation hypothesis. However, it does offer important avenues for future research that will have important clinical applications.

Mind-body exercise interventions for prevention of post-traumatic stress disorder in trauma-exposed populations: a systematic review and meta-analysis

ObjectiveMind-body exercise (MBE) interventions, such as yoga, are increasingly recognised as an adjunct treatment for trauma-related mental disorders but less is known about their efficacy as a preventative intervention. We...

The Role of Coping Behaviors and Intoxication in Trauma Symptomology Subsequent to Sexual Victimization

ABSTRACT College women are at an elevated risk for sexual victimization (SV) and secondary physical and psychological consequences. While some women experience negative outcomes such as posttraumatic stress disorder (PTSD), others experience reduced or complete absence of distress following SV. The variation in outcomes may be associated with the victim’s level of intoxication, which may in turn affect their processing of and coping with the event. We examined the effects of SV severity on PTSD via coping and intoxication using a moderated mediation analysis among female college students (N = 375). Results demonstrate that coping mediates the association between SV severity and PTSD symptomology; however, intoxication did not moderate these associations. Results suggest that regardless of intoxication, SV severity influences various coping styles and plays an important role in a victim’s adjustment post-victimization.

Exacerbated PTSD symptoms among older U.S. military veterans during the COVID-19 pandemic: Results from the national health and resilience in veterans study

Research has demonstrated that the impact of the coronavirus 2019 (COVID-19) pandemic on the mental health of United States (U.S.) veterans was less negative than originally anticipated. However, U.S. veterans are susceptible to exacerbation of post-traumatic stress disorder (PTSD) symptomology in late life. The aims of this study were to examine the extent to which older U.S. veterans experienced an exacerbation of PTSD symptoms during the COVID-19 pandemic, and to identify pre- and peri-pandemic factors that conferred risk for symptom exacerbation. Participants were U.S. military veterans aged 60 and older who completed three waves of the 2019–2022 National Health and Resilience in Veterans Study (NHRVS) (n=1858). PTSD symptoms were measured at all waves using the PTSD Checklist for DSM-5, and a latent growth mixture model was conducted to compute latent slopes of change of PTSD symptoms over the 3-year period. 159 (8.3%) participants experienced a worsening of PTSD symptomology over the pandemic period. Factors related to PTSD exacerbation were incident trauma exposure between Waves 1 and 2, more medical conditions with onset prior to the pandemic, and peri-pandemic social restriction stress. Number of incident traumas moderated the relationship between both number of pre-pandemic medical conditions and pre-pandemic social connectedness, and exacerbated PTSD symptoms. These results suggest that the pandemic did not confer additional risk for PTSD exacerbation than would be expected over a 3-year period for older veterans. Those who experience incident trauma exposure should be monitored for symptom exacerbation.

Occupational exposure to traumatic evidence and posttraumatic stress symptoms in forensic science professionals: Prevalence and patterns.

Forensic science professionals are routinely exposed to potentially traumatizing evidence. This study aimed to estimate the prevalence of occupational posttraumatic stress disorder (PTSD) among forensic science professionals, identify job-related correlates of PTSD symptoms, and examine the role of social support in mitigating PTSD symptomology. In response to recruitment through the American Academy of Forensic Sciences, the American Society of Crime Laboratory Directors, and Evidence Technology Magazine, 449 forensic science professionals participated in the current study. Results found that 73.5% (n = 330) of the overall sample experienced at least one work-related traumatic event consistent with meeting Criterion A for PTSD, and these rates were higher for field-based respondents (n = 203, 87.9%). The prevalence of past-month provisional PTSD was 21.6% for the full sample. Disaggregated PTSD rates were 29.0% and 14.5% for field-based and non-field-based respondents, respectively. These rates were 6- to 8-fold higher than the past-year prevalence of PTSD in the general US population, estimated to be 3.5%, and were found to be at least as high as those observed in prior epidemiological research with non-treatment seeking members of the US military deployed to war zones in Iraq and Afghanistan. Results further showed that social support was protective against PTSD symptomology. The high rates of occupational exposure to trauma and consequent PTSD symptomology observed in this large sample of forensic science professionals highlight the under-acknowledged psychological risks of these occupations and the need for enhanced attention to mental health resources for these professionals.

Predictors of alcohol and substance use among people with post-traumatic stress disorder (PTSD): findings from the NESARC-III study

PurposeThe self-medication hypothesis suggests people may develop Alcohol Use Disorder (AUD) or Non-Alcohol Substance Use Disorder (NA-SUD) following PTSD as a maladaptive way of coping with PTSD symptoms. Given that an accumulation of trauma experiences and interpersonal trauma increase the likelihood and severity of PTSD, we sought to determine whether the number and type of traumas additionally predict AUD and NA-SUD following PTSD.MethodsWe analysed data from 36,309 adult participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) study (M = 45.63 years, SD = 17.53, 56.3% female) who were administered semi-structured diagnostic interviews of trauma exposure and PTSD, AUD and NA-SUD symptoms.ResultsIndividuals with PTSD were more likely to have an AUD or NA-SUD than those without PTSD. Endorsement of a greater number of traumas was associated with greater odds of having PTSD, AUD, or NA-SUD. Experience of interpersonal trauma was related to greater odds of having PTSD and subsequent AUD or NA-SUD than not experiencing interpersonal trauma. Multiple experiences of interpersonal trauma compared to one interpersonal trauma exposure also increased the odds of having PTSD followed by AUD or NA-SUD.ConclusionsInterpersonal trauma and multiple experiences of interpersonal trauma may result in individuals turning to alcohol and substances as a way to alleviate intolerable PTSD symptomology, aligning with the self-medication hypothesis. Our findings highlight the importance of ensuring services and support for interpersonal trauma survivors and for those who have experienced multiple traumas given their increased for unfavourable outcomes.

Relationship between Posttraumatic Stress Disorder and Sleep Disturbances in Syrian Refugees in the United States.

Background Posttraumatic stress disorder (PTSD) is associated with disturbed sleep. However, the impact of sleep disturbances and PTSD symptomology in refugee populations is not well known. This study examined how PTSD-related sleep symptoms and overall sleep quality were impacted by previous and current traumatic and stressful experiences. Methods Adult Syrian refugees living in Southeast Michigan were assessed via scheduled in-home interviews. Overall sleep quality was measured using the Pittsburgh Sleep Quality Index. PTSD-related sleep disturbances were measured using the Pittsburgh Sleep Quality Index Addendum. The presence of PTSD symptomatology was assessed via self-report using the Posttraumatic Stress Disorder Checklist. The Life Events Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-5 screened for prior traumatic events experienced and the Postmigration Living Difficulties Questionnaire was assessed for postmigration stressors. Correlational analysis was conducted between overall sleep quality, PTSD symptom severity, and previous trauma experienced. A stepwise linear regression analysis was conducted to examine the role of overall sleep quality, PTSD-specific sleep disturbances, current living difficulties, and the number of preimmigration traumatic events directly experienced or witnessed due to the presence of overall PTSD symptomology. Results A total of 53 adults completed the study. PTSD-disturbed sleep was found to be positively associated with overall poor sleep quality ( r = 0.42, p < 0.01), PTSD symptomology ( r = 0.65, p < 0.01), and current living difficulties ( r = 0.37, p < 0.05). The PTSD-related sleep disturbances (B = 0.66, p < 0.01) and postmigration living difficulties (B = 0.44, p < 0.01) were found to be the strongest predictors of PTSD symptoms. Conclusion Disturbed sleep is strongly associated with current stressful experiences and PTSD symptomology among Syrian refugees.

Moral Injury as a Social Phenomenon: Looking at the Unique Relationship with System Justification

ABSTRACT Moral Injury (MI) and Posttraumatic Stress Disorder (PTSD) are potential outcomes following combat military service which exposes veterans to a range of potentially morally injurious events (PMIEs). Given the hypothesized social nature of MI symptoms, it was predicted that System Justification, the tendency to defend and justify systems, even when they may be disadvantageous, would be uniquely related to MI, compared to PTSD. A total of 146 male combat veterans filled in questionnaires relating to PMIEs (MIES), MI (EMIS-short), PTSD symptoms (PCL-5) and System Justification (GSJS). PMIEs (self, other and betrayal related) were all related to higher levels of MI. A parallel mediation model was conducted and demonstrated that PMIEs (self) were associated with higher levels of MI and PTSD symptoms and that MI symptoms mediated the relationship between PMIEs (self) and lower System Justification. There was no mediation effect of PTSD symptoms. This relationship was strongest when veterans did not perform reserve duty and thus were not affiliated with the military. The findings support the theory that MI symptomology, as opposed to PTSD symptomology, has a greater relationship with worldviews such as the relationship to societal systems and that this is greatest when transitioned to civilian life.

The Implementation of Narrative Exposure Therapy (NET) for Transgender and Gender Diverse Adolescents and Young Adults

PurposeThere is limited information available regarding the use of trauma modalities within the transgender and gender diverse community (TGD) to address gender-based trauma, including discrimination and invalidation, particularly for adolescents and young adults (AYA). The purpose of this paper is to describe a novel treatment approach to addressing post-traumatic stress disorder (PTSD) symptoms within TGD AYA, inclusive of gender-based trauma.MethodsNarrative Exposure Therapy (NET) was implemented as a brief intervention for TGD AYA who had a positive screening for PTSD symptomatology. Measures were used to assess PTSD symptoms, as well as changes in self-perceived resilience and positive well-being. Two case vignettes are provided to demonstrate the adaptations made to be responsive to the unique needs of TGD AYA for trauma processing.ResultsPreliminary outcomes from two case studies indicate the strength of NET when working with TGD AYA who face multiple traumatic events and continue to experience invalidation.ConclusionNET shows promise as an effective brief intervention to reduce PTSD symptomology and increase resiliency in TGD AYA.

Abstract WP61: Impact Of Post-stroke Post Traumatic Stress Disorder On Quality Of Life

Introduction: After an ischemic stroke or transient ischemic attack (TIA), patients may have post-event anxiety and re-experience transient neurological symptoms. However, some stroke patients develop persistent and disabling symptoms of post-traumatic stress disorder (PTSD). Data on post-stroke post-traumatic stress disorder (PS-PTSD) is sparse. Methods: We conducted a single-center observational pilot study of 20 adult patients diagnosed with stroke or TIA in the previous 31 days to 1 year. Patients completed the PTSD Check List-5 (PCL-5), Patient Health Questionnaire-9 (PHQ-9), stroke specific Quality of Life Scale-12 (SS-QOL-12), modified Rankin Scale of disability, and the National Institutes of Health Stroke Scale. The PCL-5 is a 20 item self-report score assessing symptoms of re-experiencing (Criterion B), avoidance (Criterion C), negative alterations in cognition or mood (Criterion D), and hyperarousal (Criterion E). Subjects were classified as having PS-PTSD with PCL-5 score ≥33 or endorsement of moderate symptoms in at least one B item, one C item, two D items, and two E items. Results: Twenty patients completed the PCL-5 and 19 completed the follow up scales. Seven patients (35%) were found to have PS-PTSD. Higher PCL-5 scores were significantly correlated with lower SS-QOL12 scores indicating worsened quality of life (r= -0.709, P=.001) and higher PHQ9 scores representing more depressive symptoms (r= 0.727, P&lt;0.001). The effect was most prominent in the SS-QOL-12 domains of mood, language, upper extremity function, and family roles (Table 1). Conclusion: PS-PTSD was found to be prevalent after stroke and TIA with 35% of patients having significant PTSD symptomology. These patients were also more likely to have concurrent depressive symptoms and worsened quality of life.