Posttraumatic Stress Responses Research Articles

Impact of COVID-19 outbreak on posttraumatic stress in patients with psychiatric illness

The present study aimed to examine the prevalence of posttraumatic stress response in reaction to the COVID-19, including posttraumatic-stress-disorder-like symptoms (PTSD-like symptoms) and depressive symptoms, among patients with pre-existing psychiatric illness. The socio-demographic and psychological correlates of PTSD-like symptoms were also examined. A total of 193 participants were recruited. More than 45% of the respondents reported significant PTSD-like symptoms related to the COVID-19; this group of patients also had a high level of pandemic-related depressive symptoms. High level of PTSD-like symptoms were predicted by rumination on concerns about the outbreak of COVID-19 and feeling of social isolation. They were also associated with hypervigilance to cues related to the pandemic. Our results suggested that the pandemic had taken a psychological toll on people living with psychiatric illness. Further research is needed to understand the development and mechanism of traumatic stress reaction in response to a prolonged infectious disease outbreak among this vulnerable population. Clinical attention is also called to mitigate the psychiatric sequalae of the pandemic in this vulnerable group of people.

The mediating role of rumination in the relation between self-compassion, posttraumatic stress disorder, and posttraumatic growth among adolescents after the Jiuzhaigou earthquake

Previous studies indicated that self-compassion can alleviate posttraumatic stress disorder (PTSD) and promote posttraumatic growth (PTG). Rumination is a cognitive process in which individuals repeatedly think about traumatic events and their consequences, which includes invasive rumination (IR) and deliberate rumination (DR). IR is a process of thoughts over traumatic event that invades the cognitive world in an undesired state, whereas DR is an individual’s conscious and repeated thinking on events. IR and DR have also been shown to have effects on PTSD and PTG. Studies have examined the relationship between self-compassion, IR, deliberate rumination DR, PTSD, and PTG, respectively, but only a few studies have examined their combined roles in PTSD and PTG among adolescents who have experienced an earthquake. In addition, recent studies have shown that the positive and negative components of self-compassion have different effects on post-traumatic stress responses, but few studies have explored the mechanisms of positive and negative self-compassion on PTSD and PTG in adolescents who experience earthquakes. This study examines the mediating roles of rumination in the relationship between self-compassion, PTSD and PTG among Chinese adolescents after the Jiuzhaigou earthquake. Ten months after the Jiuzhaigou earthquake, a questionnaire survey was conducted among 621 middle school students in Jiuzhaigou county. The participants were assessed by using the following systems: Trauma Exposure Questionnaire, Self-Compassion Scale, Event-Related Rumination Inventory, PTSD Checklist for DSM-5, and Posttraumatic Growth Inventory. When we controlled for the gender, age, and trauma exposure in the direct effect model, positive self-compassion (PSC) had a negative effect on PTSD and a positive effect on PTG. Moreover, negative self-compassion (NSC) had a positive effect on PTSD, but the effect on PTG was nonsignificant. In the indirect model, PSC had an indirect and positive effect on PTSD and PTG via deliberate rumination (DR). NSC had an indirect and positive effect on PTSD and PTG via invasive rumination (IR), whereas NSC also had an indirect and negative effect on PTSD and PTG, as well as via an indirect path from IR to DR on PTSD and PTG. Findings indicated that increased PSC may reduce PTSD and be beneficial for PTG. NSC may exacerbate PTSD. Rumination plays a significant mediating role between self-compassion, PTSD, and PTG.

Understanding Post-Traumatic Stress Responses among Military Chaplains: Implications for Military Behavioral Health

Introduction: Military chaplains play a vital role in helping the military accomplish their missions. These chaplains can be exposed to traumatic experiences during their deployments with some of them developing posttraumatic stress disorder (PTSD). Method: Using in-depth interviews with 17 former and active-duty chaplains who have been diagnosed with PTSD, this study employs classical grounded theory to formulate a conceptual model explaining key factors that contribute to their trauma resiliency. Results: The conceptual model derived from grounded theory analysis of the interviews theorizes that chaplains with PTSD who have a greater number of overall and religious/spiritual protective factors and fewer overall and religious/spiritual risk factors are more resilient to military-related trauma experiences. Alternatively, chaplains who have more overall and religious/spiritual risk factors and fewer of these protective factors demonstrate decreased resiliency. Key risk factors included high levels of guilt, perceived weakness and stigma associated with symptoms, heavy work demands during deployments, competitive work environments, isolation, and unhelpful leadership responses. Discussion: Implications for military behavioral health to support military chaplains are highlighted. They include recommendations for increased and targeted psychoeducation efforts, expanded use of camaraderie-based approaches/fostering informal support, incorporation of chaplain’s faith/spirituality, increased use of narrative and cognitive interventions, and advocating for chaplains.

Nurses' post-traumatic stress symptoms and growth by perceived workplace bullying: An online cross-sectional study.

The aim of this study was to explore the relationship between workplace bullying and mental health, focusing on the indirect effect of post-traumatic stress responses and moderation of nurses' perception of workplace bullying. Post-traumatic stress symptoms frequently result from workplace bullying, but how nurses' individual appraisals relate to negative consequences is unclear. A cross-sectional online survey was conducted with 319 Korean nurses; participants were divided into the perceived and non-perceived workplace bullying groups. Moderated mediation models were tested using structural equation modelling with Stata version 16. Regardless of nurses' appraisals, higher levels of workplace bullying were associated with poor mental health. Post-traumatic stress symptoms indirectly impacted the relationship in both groups, but post-traumatic growth did not. The perceived group showed a partial negative association between post-traumatic growth and mental health. It is necessary to develop systems for early detection of mental health problems to create safe work environments not only for nurses who perceive workplace bullying but also for those who do not. Staff education and institutional support that consider PTSS are recommended for all nurses.

Precision Psychiatry Approach to Posttraumatic Stress Response

Personalized medicine has led to important discoveries and medical innovations. For the successful translation of that progress into precision psychiatry, the complexity of mental illness and its underpinning mechanisms must be considered, and data-driven approaches are needed. Computational approaches such as machine learning are important drivers of innovation and are spurred by recent advances in statistical modeling. [ Psychiatr Ann . 2021;51(1):7–13.]

Child and Family Factors Associated With Posttraumatic Stress Responses Following a Traumatic Medical Event: The Role of Medical Team Support

This study examined the contribution of pretrauma psychosocial factors (child emotional functioning, family resources, family functioning, and social support) and environmental factors (mother's posttraumatic stress symptoms [PTSSs], medical team support [MTS]) to PTSSs of injured or seriously ill children within a pediatric rehabilitation setting. It was hypothesized that psychosocial variables would be strongly associated with child's PTSS; that mother's PTSS and MTS would mediate the association between psychosocial factors and child's PTSS; that mother's report on child's PTSS would mediate the association between mother's PTSS and child's PTSS. Participants were 196 children hospitalized following an injury/illness and assessed M = 47.7 days postevent. Children completed measures of PTSS, mothers completed measures of their own PTSS, child's PTSS, and pretrauma psychosocial factors. Family's therapist completed a MTS measure. Structural equation modeling was employed to evaluate the study hypotheses. Pretrauma family structure and resources were associated with child's self-reported PTSS; each pretrauma variable and mother's report of child's PTSS was significantly associated. Although mother's PTSS was not directly associated with child's PTSS, this relationship was mediated by mother's report of child's PTSS. MTS mediated the relationship between pretrauma social support and mother's PTSS. This study further explicates the utility of a biopsychosocial framework in predicting childhood PTSS. Findings confirm the role of pretrauma factors and environmental factors at the peritrauma period in the development of PTSS following a pediatric injury/illness. Mother's PTSS and MTS may be appropriate targets for prevention and early intervention.

Developing a Screening Tool for Young Children Using an Ecological Framework.

Young children from impoverished backgrounds experience high levels of family and environmental stress, adversely impacting developmental functioning. Early identification provides a pathway to solutions, but many children are never assessed. In addition, the child-serving workforce lacks resources and expertise to use traditional measures. Furthermore, existing measures do not account for the substantial influence of a child's ecology. To bridge these gaps, we developed the Neurodevelopmental Ecological Screening Tool (NEST) and conducted a pilot study (n=60) to test its feasibility for use with caregivers of children ages 3-5 in low-resource settings. We developed an item pool across three domains (child, caregiver, environment), vetted it with experts, and conducted cognitive interviewing with parents (n=15) and case managers (n-10). Simultaneously, we built an online, user-friendly delivery platform. We used a one parameter Item Response Model and a Rasch-based Rating Scale Model (RSM) and fit confirmatory factor analytic (CFA) models to test for unidimensional and construct validity. The results support the feasibility of screening children from low SES populations within low-resource settings using an ecological perspective and supports the work of child-serving paraprofessionals in identifying and addressing risks in the lives of young children.

Psychological and physical condition of Japan maritime self-defense force personnel who performed disaster-relief missions after the 2011 great east Japan earthquake

The Great East Japan Earthquake, which occurred on March 11, 2011, was the most powerful earthquake ever recorded in Japan. In the present study, we examine personnel from the Japan Maritime Self-Defense Force who performed disaster relief in the earthquake's aftermath, focusing on the associated psychological and physical impacts. Overall, 8733 personnel were examined. In both July–August 2011 (M1) and July 2012 (M2), these personnel answered the Impact of Events Scale-Revised, the Kessler Psychological Distress Scale, and the Disaster Relief Questionnaire. We also analyzed the sample's physical examination records for the periods before and after the earthquake, using as controls a sample of peers who were not dispatched to the disaster area (N = 32,270). The psychological examinations showed that, in M1, holding the rank of private/sergeant (odds ratio [OR] = 2.13), performing body-recovery duties (OR = 1.94), and having disaster-affected family members (OR = 2.13) were significant risk factors for high post-traumatic stress response (PTSR). In M2, performing body-recovery duties (OR = 1.45) and having disaster-affected family members (OR = 2.60) were significant risk factors for high PTSR. Also, being woman (OR = 2.18) and having disaster-affected family members (OR = 1.68) were significant risk factors for high general psychological distress. For the physical examinations, the mean alanine transaminase in the dispatched group (31.73 ± 25.21) was significantly higher than that in the non-dispatched group (29.56 ± 21.03). These findings suggest that personnel involved in disaster relief experience psychological impacts in the subacute stage, but that these impacts attenuate one year after the event.

The Tokyo subway sarin attack has long-term effects on survivors: A 10-year study started 5 years after the terrorist incident.

ObjectivesThe Tokyo subway sarin attack in 1995 was an unprecedented act of terrorism that killed 13 people and sickened more than 6,000. The long-term somatic and psychological effects on its victims remain unknown.MethodsWe conducted analyses on the self-rating questionnaire collected annually by the Recovery Support Center (RSC) during the period from 2000 to 2009. The RSC is the only organization that has large-scale follow-up data about sarin attack victims. The prevalence of self-reported symptoms was calculated over 10 years. We also evaluated the prevalence of posttraumatic stress response (PTSR), defined as a score ≥ 25 on the Japanese-language version of the Impact of Event Scale–Revised. The multivariate Poisson regression model was applied to estimate the risk ratios of age, gender, and year factor on the prevalence of PTSR.ResultsSubjects were 747 survivors (12% of the total) who responded to the annual questionnaire once or more during the study period. The prevalence of somatic symptoms, especially eye symptoms, was 60–80% and has not decreased. PTSR prevalence was 35.1%, and again there was no change with time. The multivariate Poisson regression model results revealed “old age” and “female” as independent risk factors, but the passage of time did not decrease the risk of PTSR.ConclusionsAlthough symptoms in most victims of the Tokyo subway sarin were transient, this large-scale follow-up data analysis revealed that survivors have been suffering from somatic and psychological long-term effects.

The relationship between stress response after trauma with anxiety and depression levels of syrian children

Witnessing many painful events such as war and systematic violence adversely affects children’s mental health and development. Refugee children are the most at-risk group with the incidence of Post Traumatic Stress Disorder. The aim of this study upon working group of refugee children victims of war was to investigate the relationship between post-traumatic stress responses and anxiety and depression levels of children living in Turkey. This descriptive study was designed according to relational survey model. The sample of the study consists of 224 Syrian children who were randomly selected among the children living in Turkey. In the research, “Revised Child Anxiety and Depression Scales Child Version (RCADS-CV)” and Child The Child Posttraumatic Stress Disorder Reaction Index (CPTS-RI) ”data collection tools were used. To analyze the study data, Pearson Product Moment Correlation coefficients and frequency and percentage were used as descriptive statistical methods. As a result of the study, a positive, high and significant relationship was found between the total post-traumatic stress response levels and anxiety and depression levels of children (p

Increased proliferation of hepatic periportal ductal progenitor cells contributes to persistent hypermetabolism after trauma.

Prolonged and persistent hypermetabolism and excessive inflammatory response after severe trauma is detrimental and associated with poor outcome. The predisposing pathology or signals mediating this complex response are essentially unknown. As the liver is the central organ mediating the systemic metabolic responses and considering that adult hepatic stem cells are on top of the hierarchy of cell differentiation and may pass epigenetic information to their progeny, we asked whether liver progenitor cells are activated, signal hypermetabolism upon post‐traumatic cellular stress responses, and pass this to differentiated progeny. We generated Sox9CreERT2: ROSA26 EYFP mice to lineage‐trace the periportal ductal progenitor cells (PDPCs) and verify the fate of these cells post‐burn. We observed increased proliferation of PDPCs and their progeny peaking around two weeks post‐burn, concomitant with the hepatomegaly and the cellular stress responses. We then sorted out PDPCs, PDPC‐derived hepatocytes and mature hepatocytes, compared their transcriptome and showed that PDPCs and their progeny present a significant up‐regulation in signalling pathways associated with inflammation and metabolic activation, contributing to persistent hypermetabolic and hyper‐inflammatory state. Furthermore, concomitant down‐regulation of LXR signalling in PDPCs and their progeny implicates the therapeutic potential of early and short‐term administration of LXR agonists in ameliorating such persistent hypermetabolism.

Cardiac autonomic functioning and post-traumatic stress: A preliminary study in youth at-risk for PTSD

The identification of robust, psychophysiological markers of trauma-related distress is critical for developing comprehensive, trauma-informed, mental health assessments for youth. Thus, the present study examined the clinical utility of cardiac autonomic balance (CAB) and cardiac autonomic regulation (CAR), two composite indices of the sympathetic and parasympathetic nervous system. We hypothesized that CAB/CAR would more reliably index post-traumatic stress (PTS) responses compared to measuring the parasympathetic (i.e., respiratory sinus arrhythmia; RSA) and sympathetic (i.e., pre-ejection period; PEP) nervous systems in isolation. Our sample was comprised of 88 diverse, low-income youth (40.9% African-American and 36.4% White; 60.5% girls; Mage = 12.05 years; SDage = 1.57) who are at increased risk for adversity-exposure. RSA and PEP were measured during a 5-minute baseline period and 5-minute parent-child conflict discussion task. Adolescent-caregiver dyads completed a clinician-administered measure of the youth's lifetime trauma-exposure and current PTS. CAB represented the difference between RSA and PEP, while CAR was the summation of RSA and PEP. Analyses revealed that sympathetically-oriented CAB reactivity uniquely (a) indexed PTS, especially in the context of elevated trauma, and (b) distinguished between those with and without PTSD. Findings highlight the translational promise of using physiological markers that account for the balance between the parasympathetic and sympathetic nervous system.

Trajectories of PTSD symptoms among children who survived the Lushan earthquake: A four-year longitudinal study

BackgroundThis study aimed to explore the trajectories of posttraumatic stress disorder (PTSD) symptoms among child survivors of the Lushan earthquake by using latent category growth analysis. MethodsIn total, 304 students from a school located in Lushan County were assessed by UCLA PTSD-RI at 1.5, 6, 12, 24 and 48 months after the earthquake. The children ages ranged from 9 to 17 years old at the time of the first assessment, and the sample included 140 males and 164 females. ResultsFour trajectories of PTSD symptoms were found, namely, resilience (53.8%), low symptoms (32.6%), recovery (7.0%), and chronic dysfunction (6.6%). Then, a logistic regression analysis that controlled for gender and grade showed that compared with the resilience group, children with an injury or probable acute stress disorder (ASD) were likely to be in the recovery group, children with probable ASD were more likely to be in the low-symptoms group, and children with a bad relationship with their father were more likely to be in the chronic group. LimitationsThe participants were selected by convenience principle. All children received an intervention after the earthquake. ConclusionsThese findings suggest that increasing children's social support may relieve children's PTSD symptoms. We should consider both perceived threat and object exposure in future studies. The posttraumatic stress response was very high and was unstable during the first month after the earthquake, which suggests that psychological first aid is necessary in posttraumatic events.

Psychosocial Predictors of Adjustment to Disability Among Patients With Breast Cancer: A Cross-Sectional Descriptive Study.

Acceptance of disability relates to the process of adaptation, which reflects how the values of a patient change over time to accept herself or himself as an intrinsically worthy person. Acceptance of disability (AOD) plays an important role in the adjustment of persons with physical disability to their environment. However, no studies on the level of AOD in patients with breast cancer are available in the literature. The aim of this study was to explore the significant factors that influence disability acceptance in Chinese women with breast cancer. A cross-sectional study was conducted on 292 patients with breast cancer between January and April 2017. Participants were assessed using the Acceptance of Disability Scale-Revised, Medical Coping Modes Questionnaire, Sense of Coherence Scale, Social Relational Quality Scale, and general information questionnaire. Multiple regression analysis was used to determine the factors associated with the level of disability acceptance. The mean score for AOD was 79.14 and ranged from 32 to 128. Multiple regression analysis indicated that family intimacy, friendships, confrontation, manageability, family commitment, marital status, surgery, and acceptance-resignation significantly affected disability acceptance, explaining 49.1% of the total variance in disability acceptance. The participants had a moderate level of disability acceptance. Disability acceptance is an important factor in the psychosocial adaptation to cancer. Healthcare staff should pay special attention to low scores for this factor and explore the potential of psychological interventions to effectively reduce the posttraumatic stress response, encourage the adoption of positive coping strategies, and hasten disability acceptance and return to society.

Machine Learning for Prediction of Posttraumatic Stress and Resilience Following Trauma: An Overview of Basic Concepts and Recent Advances.

Posttraumatic stress responses are characterized by a heterogeneity in clinical appearance and etiology. This heterogeneity impacts the field's ability to characterize, predict, and remediate maladaptive responses to trauma. Machine learning (ML) approaches are increasingly utilized to overcome this foundational problem in characterization, prediction, and treatment selection across branches of medicine that have struggled with similar clinical realities of heterogeneity in etiology and outcome, such as oncology. In this article, we review and evaluate ML approaches and applications utilized in the areas of posttraumatic stress, stress pathology, and resilience research, and present didactic information and examples to aid researchers interested in the relevance of ML to their own research. The examined studies exemplify the high potential of ML approaches to build accurate predictive and diagnostic models of posttraumatic stress and stress pathology risk based on diverse sources of available information. The use of ML approaches to integrate high-dimensional data demonstrates substantial gains in risk prediction even when the sources of data are the same as those used in traditional predictive models. This area of research will greatly benefit from collaboration and data sharing among researchers of posttraumatic stress disorder, stress pathology, and resilience.

Media Coverage, Forecasted Posttraumatic Stress Symptoms, and Psychological Responses Before and After an Approaching Hurricane

Exposure to disaster-related media coverage is associated with negative mental health outcomes. However, risk factors that render individuals vulnerable to this exposure are unknown. Hurricane-associated media exposure was expected to explain the association between forecasted posttraumatic stress (PTS) and adjustment after the hurricane. To examine forecasted PTS responses and media coverage as risk factors for negative mental health outcomes in the context of media coverage of an approaching disaster (Hurricane Irma). In a representative probability community sample of 1637 adults from Florida, respondents completed 2 online surveys: the first during the 60 hours before Hurricane Irma's landfall (wave 1; September 8-11, 2017) and the second approximately 1 month later (wave 2; October 12-29, 2017). Poststratification weights were applied to facilitate population-based inferences. Data were analyzed from October 19 through 31, 2018. Posttraumatic stress responses, psychological distress, functional impairment, and worry about future events. The wave 1 survey included 1637 participants (57.0% response rate); 1478 participants were retained at the wave 2 follow-up (90.3% retention) (weighted proportion of women, 62.2%; mean [SD] age, 59.1 [15.2] years). The final weighted sample closely approximated US Census benchmarks for the state of Florida. Data analyses using structural equation modeling revealed that exposure to media coverage of the hurricane (β = 0.21; 95% CI, 0.11-0.31; P < .001) and forecasted PTS (β = 0.44; 95% CI, 0.35-0.52; P < .001) were significantly associated with adjustment after the hurricane. In addition, a significant indirect path from forecasted PTS to adjustment after the storm occurred through exposure to hurricane-related media coverage (β = 0.07; 95% CI, 0.05-0.08; P < .001). Covariates included demographics, mental health diagnoses before the storm, perceived evacuation zone status, and degree of hurricane exposure. Results of this study provide a more thorough understanding of how psychological factors before hurricanes are associated with adjustment after hurricanes via media consumption. The findings may also demonstrate the importance of considering prestorm psychological factors when assessing poststorm outcomes, with implications for the media and public health efforts.

Longitudinal Factors Associated With Increased Alcohol and Tobacco Use in Fukushima Nuclear Power Plant Workers 32 Months After the Nuclear Disaster: The Fukushima News Project Study.

The aim of this study was to predict increased alcohol and tobacco use in Fukushima nuclear power plant (NPP) workers 3 years after a nuclear disaster. Surveys were conducted in two postdisaster waves (Wave 1: 2 to 3 months; Wave 2: 32 months). Adjusted risk ratio (aRR) was computed to assess the covariates of increased alcohol and tobacco use in Wave 2. Increased alcohol use was associated with age of 29 years or less [aRR (95% confidence interval (95% CI): 1.26 (1.01 to 1.57)], major property loss [1.25 (95% CI 1.02 to 1.55)], and high posttraumatic stress responses (PTSRs) [1.34 (95% CI 1.08 to 1.67)] in Wave 1. Increased tobacco use was associated with age of 29 years or less [1.46 (95% CI 1.12 to 1.90)] and high PTSR [1.62 (95% CI 1.25 to 2.10)] in Wave 1 (P < 0.05). The workers' increased alcohol and tobacco use were predicted by major property loss (alcohol), age of 29 years or less, and high PTSR (alcohol/tobacco) in Wave 1.

The relationship between dispositional empathy, psychological distress, and posttraumatic stress responses among Japanese uniformed disaster workers: a cross-sectional study

BackgroundDisaster workers suffer from psychological distress not only through the direct experience of traumatic situations but also through the indirect process of aiding disaster victims. This distress, called secondary traumatic stress, is linked to dispositional empathy, which is the tendency for individuals to imagine and experience the feelings and experiences of others. However, the association between secondary traumatic stress and dispositional empathy remains understudied.MethodsTo examine the relationship between dispositional empathy and mental health among disaster workers, we collected data from 227 Japan Ground Self-Defense Force personnel who engaged in international disaster relief activities in the Philippines following Typhoon Yolanda in 2013. The Impact of Event Scale-Revised and the Kessler Psychological Distress Scale were used to evaluate posttraumatic stress responses (PTSR) and general psychological distress (GPD), respectively. Dispositional empathy was evaluated through the Interpersonal Reactivity Index, which consists of four subscales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Hierarchial linear regression analyses were performed to identify the variables related to PTSR and GPD.ResultsHigh PTSR was significantly associated with high Fantasy (identification tendency, β = 0.21, p < .01), high Personal Distress (the self-oriented emotional disposition of empathy, β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.15, p < .05). High GPD was associated with high Personal Distress (β = 0.28, p < .001), marital status (married, β = 0.22, p < .01), being female (β = 0.18, p < .01), medical unit (β = 0.18, p < .05), and no experience of disaster relief activities (β = 0.13, p < .05).ConclusionsAmong Japanese uniformed disaster workers, high PTSR was associated with two subtypes of dispositional empathy: the self-oriented emotional disposition of empathy and high identification tendency, whereas high GPD was associated with high identification tendency. Educational interventions that aim to mitigate these tendencies might be able to relieve the psychological distress of disaster workers.

Cognitive Processing and Regulation Modulates Analogue Trauma Symptoms in a Virtual Reality Paradigm

To date, few studies have examined stress responses during or shortly after potentially traumatic events in real-time. In this study, a prospective Virtual Reality analogue trauma paradigm was used to assess peri- and post-traumatic stress responses in healthy individuals (N = 80). Here we compared a range of peri-traumatic psychophysiological responses following analogue trauma to a control condition. Furthermore, we aimed to identify essential regulatory mechanisms in response to an analogue trauma and their effects on subsequent analogue trauma symptoms. Therefore, we examined the impact of subjective and physiological emotional responses, cognitive processing, cognitive regulation and appraisal as well as flexible emotion regulation on analogue trauma symptoms. Results of the hierarchical multiple regression analyses revealed that cognitive processing as well as cognitive regulation and appraisal predicted analogue trauma symptoms beyond psychophysiological responses, while flexible emotion regulation was uniquely predictive only directly afterwards. The findings provide evidence that flexible emotion regulation might be in particular protective directly after trauma exposure and highlight the general importance of peri- and post-traumatic cognitive factors in the development and maintenance of stress-associated psychopathology, thereby supporting cognitive models of PTSD.

F38. Forecasting the Course of Post-Traumatic Stress Following Emergency Room Admission: A Machine Learning Approach

Previous studies identified distinct trajectories of Post-Traumatic Stress Disorder. These studies typically focus on sociodemographic information and severity of potential traumatic brain injury. Moreover, they often investigate these potential predictive factors a long time after the traumatic event took place, thereby limiting the possibility to discern what is a risk factor and what is the consequence of the psychopathology. Thus, there is need to include data comprehensively and to do so immediately after the potentially traumatic event. We examined a broad range of variables in n=338 patients after Emergency Room admission after having experienced a traumatic event. The current work utilizes machine learning to predict post-traumatic stress responses based on biological indicators garnered from electronic medical records including immune markers, heart rate, pulse, along with inter-related endocrine and genetic markers.