Posttraumatic Symptom Severity Research Articles

Grande précarité, psycho-traumatisme, souffrance narcissique : résultats d’une recherche-action à méthodologie quantitative et qualitative intégrée

In the context of a multi-annual research project, aiming at exploring the relations between traumatic biographic events since childhood and the structural functioning of personality at adult age, the results of a cross-sectional study with people living in great precariousness (n=105) are discussed. Context of the studyThis research project was implemented according to a sequential design: An exploratory study with n=206 people suffering from exclusion and marginalization was based on the exploration of the links between a semi-structured biographical interview and the assessment of current personality functioning with psychometric and projective tests. A theoretical modelization was constructed with the help of multidimensional statistical procedures. In a second stage, this modelization was tested by means of a confirmatory study with a new sample of n=195 people. The third stage of the research project was focused on the assessment of arts psychotherapeutic interventions with people of the two samples suffering from severe posttraumatic symptoms (not developed in this article). Clinical and theoretical backgroundThe clinical and theoretical background of the project was, on the one side, the traumatogenic hypothesis of borderline functioning, on the other side, the current discussion on broadening the definitions of posttraumatic states and adjustment disorders. According to the criteria of DSM-IV and ICD-10, the posttraumatic syndromes we encounter in our research population comprehend the Posttraumatic Stress Disorder (PTSD) and the Adjustment Disorder (AD) with Anxiety and/or Depression. More recently identified syndromes, relevant for clinical reality, could be the Complex Posttraumatic Stress Disorder (CPSD) with dissociation and the Posttraumatic Embitterment Disorder (PED). This article is focused on the exploration of the above mentioned research questions in the subgroup of people living in great precariousness. Our data are drawn from the confirmatory stage of the study. The research population was encountered in shelters for homeless people. State-of-the-artsThe international research literature tends to demonstrate, by means of retrospective studies, the great amount of disastrous events in the biography of homeless people (breaks of human bonds, attachment problems, multiple interruptions of life course, violence, negligence, humiliations, etc). On the other side, the situation of exclusion and marginalization itself acts as a permanent psychic stressor. Recent research objectives are focused on the neuro-psychological effects of long-term homelessness, as well as on the interaction between personality traits and the exterior stressors, leading to the distinction between protective and harmful personality traits. MethodsThe cross-sectional study with n=105 people living in great precariousness adopted an integrated qualitative and quantitative research methodology, combining a semi-structured biographical interview, the auto-reported questionnaire HADS and the semi-projective Sentences Completion Test by Rotter. The data of the Rotter Test are analyzed with the help of original rating scales allowing to move from qualitative analysis to quantification and the application of appropriate non parametric statistical procedures. Research resultsIn our sample, the prevalence of traumatic biographic events since childhood is much higher than in the general population. It is also higher than in the other subgroups participating to the same research project (refugees and asylum seekers, drug addicted prisoners). The data of the Rotter test make also appear the prevalence of borderline functioning, defined according to structural psychopathology and operationalized by the scores on the dimensions of archaic aggressiveness, anaclitical objectal relationship and pathological narcissism in the Rotter test. The dissociative tendencies of participants are explored by means of the Rotter test and the HADS. According to the rating scales for the Rotter test, the comparison beween the answers in the first person and the answers in the third person revealed many discrepancies between the conscious and unconscious expression of needs and emotions, pointing towards defense mechanisms of splitting, scotomization and rationalization. The investigation of the pathology of the Ego Ideal (in the sense of hypertrophy or underdevelopment) also highlights the opposition between the conscious and unconscious representation of oneself. In the HADS, the types defined by a discrepancy between anxiety and depression occur with a frequency superior to the theoretical expectancies, according to the results of the Configural Frequency Analysis. These results of the confirmatory study concord with the data of the exploratory stage and confirm the theoretical modelization. Discussion and conclusionThe discussion is focused on the pertinence of the results of this study in the context of the current literature related to psycho-trauma and great precariousness, taking into account some recent proposals of conceptual enlargement (CPSD and PED).

Diagnostic mistakes in Post-Traumatic Stress Disorder. The problem of symptom overlap with Depression

The overlap between symptoms of PTSD and MDD is substantial. PTSD symptoms arise after a traumatic experience and the trauma is present in all of the diagnostic clusters. In individuals who have experienced a trauma a long time before, it is difficult to establish the exact moment of onset of their symptoms in relation to the trauma suffered. We proposed to raise awareness among operators who may encounter this problem, with the aim of providing them with valuable help in order to achieve a correct differential diagnosis. A sample of subjects suffering from PTSD without comorbidity was assessed to confirm the diagnosis and the severity of post-traumatic symptoms. The Kruskal-Wallis test was used to compare any modifications in the parameters analyzed through the Davidson Trauma Scale with the presence and severity of depressive symptoms as evaluated by the Hamilton-D scale. Half of the PSTD patients recruited showed values of HAM-D > 18, although an active Major Depressive Episode was clinically excluded. Symptom of "numbing", despite being different from the apathy experienced in depression, is identified as a depressive symptom by the HAM-D. Giving prevalence to depressive symptoms may be misleading for diagnosis and may ultimately result in inappropriate treatment.

The relationship between post-traumatic symptom severity and object relations deficits in persons with schizophrenia

The aim of this study was to determine if object relations deficits in people with schizophrenia spectrum disorders (i.e., schizophrenia and schizoaffective disorder) are related to co-morbid post-traumatic stress disorder (PTSD). Cross-sectional and correlational. Positive and Negative Syndrome Scale, Post-Traumatic Stress Disorder Checklist, and Bell Object Relations Inventory were administered to 60 people with schizophrenia in an outpatient setting. With four hierarchical regressions, we hypothesized that, controlling for schizophrenia symptoms, diagnosis type, and potential demographic features, PTSD symptoms would correlate with each of the four types of object relations deficits. All participants reported experiencing at least one traumatic experience. As predicted, PTSD symptoms were a significant predictor of alienation, insecure attachment, and egocentricity controlling for schizophrenia symptoms, diagnosis type, and demographic features. Against prediction, PTSD was not associated with Social Incompetence. If PTSD symptoms contribute to object relations deficits in persons with schizophrenia spectrum disorders, then interventions such as psychotherapy need to be developed to address PTSD symptoms in the treatment of these interpersonal deficits.

Comorbid depressive symptoms in treatment-seeking PTSD outpatients affect multiple domains of quality of life

PurposeNo study has examined the impact of the comorbid Axis I conditions on the quality of life (QoL) of patients with a primary diagnosis of PTSD. Our goal was to investigate the influence of comorbid disorders on the QoL of treatment-seeking outpatients with PTSD. MethodsThe diagnoses of PTSD and of the comorbid disorders were established using the SCID-I. The 54 volunteers also completed the Posttraumatic Stress Disorder Checklist – Civilian Version, the BDI, the BAI, the Trauma History Questionnaire, and a socio-demographic questionnaire. Quality of life was assessed by means of the WHOQOL-BREF, a 26-item self-administered scale that measures four domains of QoL: psychological, physical, social, and environmental. Multiple linear regression models were fitted to investigate the relationship between the severity of post-traumatic, mood, and anxiety symptoms; the presence of specific current comorbid disorders and of psychotic symptoms, the number of current comorbid conditions, and a history of child abuse for each of the four domains of QoL, after adjusting for the effect of socio-demographic characteristics. ResultsThe severity of PTSD symptoms impacted negatively on the psychological and physical domains. The severity of depressive symptoms correlated negatively with QoL in all domains, independently of sex, age, occupation, and marital status. The psychotic symptoms impacted negatively on the environmental domain. A history of child abuse was negatively associated with the psychological and the social domains. ConclusionsThe severity of comorbid depressive symptoms is one of the most important factors in the determination of the QoL in patients with PTSD.

Chinese My Trauma Recovery, A Web-Based Intervention for Traumatized Persons in Two Parallel Samples: Randomized Controlled Trial

BackgroundGuided self-help interventions for PTSD (post-traumatic stress disorder) are a promising tool for the dissemination of contemporary psychological treatment.ObjectiveThis study investigated the efficacy of the Chinese version of the My Trauma Recovery (CMTR) website.MethodsIn an urban context, 90 survivors of different trauma types were recruited via Internet advertisements and allocated to a randomized controlled trial (RCT) with a waiting list control condition. In addition, in a rural context, 93 survivors mainly of the 2008 Sichuan earthquake were recruited in-person for a parallel RCT in which the website intervention was conducted in a counseling center and guided by volunteers. Assessment was completed online on a professional Chinese survey website. The primary outcome measure was the Post-traumatic Diagnostic Scale (PDS); secondary outcome measures were Symptom Checklist 90-Depression (SCL-D), Trauma Coping Self-Efficacy Scale (CSE), Post-traumatic Cognitive Changes (PCC), and Social Functioning Impairment (SFI) questionnaires adopted from the My Trauma Recovery website.ResultsFor the urban sample, findings indicated a significant group×time interaction in post-traumatic symptom severity (F 1,88=7.65, P=.007). CMTR reduced post-traumatic symptoms significantly with high effect size after one month of treatment (F 1,45=15.13, Cohen’s d=0.81, P<.001) and the reduction was sustained over a 3-month follow-up (F 1,45=17.29, Cohen’s d=0.87, P<.001). In the rural sample, the group×time interaction was also significant in post-traumatic symptom severity (F 1,91=5.35, P=.02). Post-traumatic symptoms decreased significantly after treatment (F 1,48=43.97, Cohen’s d=1.34, P<.001) and during the follow-up period (F 1,48=24.22, Cohen’s d=0.99, P<.001). Additional outcome measures (post-traumatic cognitive changes, depression) indicated a range of positive effects, in particular in the urban sample (group×time interactions: F 1,88=5.32-8.37, all Ps<.03), contributing to the positive evidence for self-help interventions. Differences in the effects in the two RCTs are exploratorily explained by sociodemographic, motivational, and setting feature differences between the two samples.ConclusionsThese findings give support for the short-term efficacy of CMTR in the two Chinese populations and contribute to the literature that self-help Web-based programs can be used to provide mental health help for traumatized persons.Trial RegistrationAustralia New Zealand Clinical Trials Registry (ANZCTR): ACTRN12611000951954; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000951954 (Archived by WebCite at http://www.webcitation.org/6G7WyNODk).

Stress-Related Psychological Symptoms Are Associated with Increased Attentional Capture by Visually Salient Distractors

Research has shown that attention can be abnormally drawn to salient threat- or trauma-related information in individuals with posttraumatic stress and related psychological symptoms. The nature of this attentional bias is thought to derive from capture of attention toward potential threat overpowering the volitional, goal-directed attentional system. However, it is unclear whether this pattern of attentional dysregulation generalizes to salient, but non-emotional types of information. Using a well-established and sensitive measure of attentional capture, the current study demonstrates that posttraumatic psychological symptom severity is associated with the capture of attention by visually salient, non-emotional distractors. Specifically, during visual search for a unique shape, the presence of a task-irrelevant but salient color singleton disrupted search efficiency, and this disruption was correlated with both posttraumatic stress disorder (PTSD) and depression symptom severity as assessed by self-report. These findings suggest that posttraumatic stress and depression may be characterized as involving a general alteration of the balance between salience-based and goal-directed attentional systems.

EMDR Individual Protocol for Paraprofessional Use: A Randomized Controlled Trial With First Responders

The eye movement desensitization and reprocessing (EMDR) individual protocol for paraprofessional use in acute trauma situations (EMDR-PROPARA) is part of a project developed at the initiative of Dr. Francine Shapiro. This randomized clinical trial examined the effectiveness of the protocol administered by experienced EMDR therapists. There were 39 traumatized first responders on active duty randomly assigned to receive two 90-min sessions of either EMDR-PROPARA or of supportive counseling. Participants in the EMDR-PROPARA group showed benefits immediately after treatment, with their scores on the Short PTSD Rating Interview (SPRINT) showing further decreases at 3-month follow-up. In comparison, supportive counseling participants experienced a nonsignificant decrease after treatment and an increase in the SPRINT scores at the second follow-up. The significant difference between the two treatments provides preliminary support for EMDR-PROPARA’s effectiveness in reducing severity of posttraumatic symptoms and subjective global improvement. More controlled research is recommended to evaluate further the efficacy of this intervention.

Decreased Cardiac Vagal Control in Drug-Naïve Patients with Posttraumatic Stress Disorder

ObjectiveDecreased cardiac vagal control (CVC) has been proposed in posttraumatic stress disorder (PTSD), but the results are mixed. Analyses with larger sample sizes and better methodology are needed.MethodsThirty-two drug-naïve survivors with current PTSD, 32 survivors without PTSD and 192 matched controls were recruited for a case-control analysis. We used the PTSD checklist-civilian version (PCL-C) to assess posttraumatic symptoms severity. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters. Frequency-domain indices of HRV were obtained. The obtained results were evaluated in association with personality traits assessed by the Tridimensional Personality Questionnaire (TPQ).ResultsPTSD patients exhibited decreased LF-HRV and HF-HRV as compared to survivors without PTSD and to matched controls. The PTSD symptoms severity was associated with reduced mean RR intervals, Var-HRV, LF-HRV and HF-HRV. The harm avoidance score (which has been suggested to be associated with serotonergic activity) was negatively correlated with Var-HRV, LF-HRV and HF-HRV.ConclusionThese data suggest that PTSD is accompanied by decreased CVC, highlighting the importance of assessing HRV in PTSD patients. In view of the increased risk for cardiovascular diseases in these vulnerable individuals, one might consider the treatment to restore their autonomic function while reducing PTSD symptoms.

The contribution of personal and exposure characteristics to the adjustment of adolescents following war

The study examined the unique contribution of both personal characteristics and several types of exposure variables to the adjustment of Israeli adolescents following the Second Lebanon War. Two thousand three hundred and fourteen adolescents, who lived in areas that were the target of multiple missile attacks, completed self-report questionnaires assessing personal characteristics of gender and early traumatic events, subjective exposure (i.e., measures of fear and shortage of basic necessities during the war), objective exposure (i.e., exposure to missile attacks, knowing someone who was wounded or killed) and media exposure. Fifteen percent of the adolescents reported moderate or severe post-traumatic symptoms. Girls and adolescents who experienced earlier traumatic events were at higher risk for distress. While the level of direct exposure contributed to greater distress, the contribution of subjective exposure was significantly stronger. The discussion deals with the unique contribution of both subjective and objective characteristics to post-war adjustment.

Posttraumatic stress and depression symptoms as correlates of deliberate self-harm among community women experiencing intimate partnerviolence

Deliberate self-harm (DSH) among women in the general population is correlated separately with posttraumatic stress, depression, and abuse during childhood and adulthood. The prevalence of these DSH correlates is particularly high among women exposed to intimate partner violence (IPV), yet few studies have examined DSH among this high-risk population and none have examined these correlates simultaneously. Two hundred and twelve IPV-victimized women in the community participated in a 2-h retrospective interview. One-third reported current or past DSH. Discriminant analysis was used to examine which posttraumatic stress and depression symptoms and types of current IPV and childhood abuse were uniquely associated with current DSH. Findings show that women who currently use DSH reported greater severity of posttraumatic stress numbing symptoms and more severe sexual IPV compared to women who used DSH only in the past. Examining factors that are associated with women's current DSH in this population is critical so that a focus on DSH can be integrated into the treatment plans of women who are receiving mental health care, but also so that women who are not receiving such care can be referred to adequate mental health services.

Early Altered Resting-State Functional Connectivity Predicts the Severity of Post-Traumatic Stress Disorder Symptoms in Acutely Traumatized Subjects

The goal of this study was to investigate the relationship between resting-state functional connectivity and the severity of post-traumatic stress disorder (PTSD) symptoms in 15 people who developed PTSD following recent trauma. Fifteen participants who experienced acute traumatic events underwent a 7.3-min resting functional magnetic resonance imaging scan within 2 days post-event. All the patients were diagnosed with PTSD within 1 to 6 months after trauma. Brain areas in which activity was correlated with that of the posterior cingulate cortex (PCC) were assessed. To assess the relationship between the severity of PTSD symptoms and PCC connectivity, contrast images representing areas positively correlated with the PCC were correlated with the subject’s Clinician-Administered PTSD Scale scores (CAPS) when they were diagnosed. Furthermore, the PCC, medial prefrontal cortex and bilateral amygdala were selected to assess the correlation of the strength of functional connectivity with the CAPS. Resting state connectivity with the PCC was negatively correlated with CAPS scores in the left superior temporal gyrus and right hippocampus/amygdala. Furthermore, the strength of connectivity between the PCC and bilateral amygdala, and even between the bilateral amygdala could predict the severity of PTSD symptoms later. These results suggest that early altered resting-state functional connectivity of the PCC with the left superior temporal gyrus, right hippocampus and amygdala could predict the severity of the disease and may be a major risk factor that predisposes patients to develop PTSD.

Impact of an intensive care unit diary on psychological distress in patients and relatives*

To assess the impact of an intensive care unit diary on the psychological well-being of patients and relatives 3 and 12 months after intensive care unit discharge. Prospective single-center study with an intervention period between two control periods. Medical-surgical intensive care unit in a 460-bed tertiary hospital. Consecutive patients from May 2008 to November 2009 and their relatives. Study inclusion occurred after the fourth day in the intensive care unit. A diary written by both the patient's relatives and the intensive care unit staff. Patients and relatives completed the Hospital Anxiety and Depression Scale and Peritraumatic Dissociative Experiences Questionnaire 3 months after intensive care unit discharge, and completed the Impact of Events Scale assessing posttraumatic stress-related symptoms 12 months after intensive care unit discharge. Of the 378 patients admitted during the study period, 143 were included (48 in the prediary period, 49 in the diary period, and 46 in the postdiary period). In relatives, severe posttraumatic stress-related symptoms after 12 months varied significantly across periods (prediary 80%, diary 31.7%, postdiary 67.6%; p<.0001). Similar results were obtained in the posttraumatic stress-related symptom score after 12 months in the surviving patients (prediary 34.6 ± 15.9, diary 21 ± 12.2, and postdiary 29.8 ± 15.9; p = .02). The intensive care unit diary significantly affected posttraumatic stress-related symptoms in relatives and surviving patients 12 months after intensive care unit discharge.

Chronic Idiopathic Urticaria, Psychological Co-morbidity and Posttraumatic Stress: The Impact of Alexithymia and Repression

The objective of this study was to investigate the interrelationship between chronic idiopathic urticaria (CIU), psychological co-morbidity, posttraumatic stress, repression and alexithymia. 89 participants with CIU and 105 without CIU responded to an online questionnaire. Both groups completed the general health questionnaire-12, the perceived stress scale, the posttraumatic stress diagnostic scale and the Toronto alexithymia scale-20 and were categorised into four defence mechanism groups (repressive, defensive, high-anxious, low-anxious). CIU participants also completed the Skindex-17 and a self-report severity measure. CIU participants reported higher levels of alexithymia than the control group and their defence mechanism was most likely to be categorised as defensive, with conscious self-image management reported alongside high manifest anxiety. Partial least squares analysis revealed significant paths between posttraumatic stress and CIU severity and psychological co-morbidity. Posttraumatic stress was associated with alexithymia and type of defence mechanism. Only being in the high-anxious group partially mediated the relationship between posttraumatic stress and CIU severity. In conclusion, there is evidence for a relationship between CIU and trauma. The severity of posttraumatic symptoms varies depending upon alexithymic traits and defence mechanisms used. Disease severity and psychological co-morbidity are differentially influenced by the relationships between trauma, alexithymic traits and defence mechanisms.

P-298 - Psychosocial assistance project decreased severity of posttraumatic stress disorder symptoms and and depressivenes amongst school adolescents in post-war bosnia herzegovina

Aim To estimate whether psychosocial support of the School Project UHD “Prijateljice-Friends” positively affect on reducing of posttraumatic sequel in Bosnia-Herzegovina among school adolescents, after the war period 1992–1995. Methods The stratified sample of 507 students, aged of 13.7±1.0 (10 to16) years, in primary and secondary schools, involved in psychosocial support, compared with 78 randomly selected peers from the same schools, not involved in this project. Data were collected in February 2010 and in May 2010. The Children Depression Inventory and DSM III R questionnaire for posttraumatic stress disorder (PTSD) were utilized. Results All adolescents reported experience of (mean±standard deviation=5.4±2.7) without significant differences between observed and control group (F = 0.001, P = 0.980, ANOVA). Symptoms of PTSD and depressiveness among students involved in the School Project, significantly reduced from (mean±standard deviation=6.5±3.3 to 4.9±3.5; 7.1±4.5 to 5.8±5.2, respectively) (t = 8.524, P Conclusions Adolescents in this study reported surviving of multiple traumas. Psychosocial support within the School Project resulted with significant reduction of PTSD symptoms severity and severity of depressiveness amongst involved students compared to controls. Schools and other institutions ought to envisage as many as possible projects to be implemented in schools and out-of-schools in order to assist youth to easier overcome consequences of no favorable war in their development.

How Disorder-Specific are Depressive Attributions? A Comparison of Individuals with Depression, Post-Traumatic Stress Disorder and Healthy Controls.

Depressed individuals tend to assign internal, stable, and global causes to negative events. The present study investigated the specificity of this effect to depression and compared depressive attributional styles of individuals with major depression (MD), post-traumatic stress disorder (PTSD), and healthy controls. We indexed attributional style using the depressive attributions questionnaire in 164 participants. Additionally, we assessed appraisals characteristic of PTSD using the post-traumatic cognitions inventory (PTCI), depressive rumination, trauma history, and depression and PTSD symptom severity. Individuals with MD endorsed a depressive attributional style to a greater extent than both individuals with PTSD, who were not depressed, and healthy controls. Depressive attributional style was associated with the severity of depressive and PTSD symptoms, number and distress of traumatic experiences, frequency of rumination, and post-traumatic cognitions. Depressive attributions and PTCI appraisals independently predicted MD and PTSD symptom severity. They may thus be useful in predicting MD and PTSD, and should be targeted in psychological treatments of these conditions.

Posttraumatic stress reactions as a disruption in anxiety-buffer functioning: Dissociation and responses to mortality salience as predictors of severity of posttraumatic symptoms.

Posttraumatic stress reactions as a disruption in anxiety-buffer functioning: Dissociation and responses to mortality salience as predictors of severity of posttraumatic symptoms.

Integration and organization of trauma memories and posttraumatic symptoms

To examine the connection between trauma memory integration in personal memory, memory organization, and posttraumatic symptom severity, 47 trauma-exposed adults undertook an event-cuing task for their trauma memory and for a memorable nontraumatic negative event. Measures of integration provided by self-endorsement, rated by naïve judges, or calculated from the language of the memories, did not significantly predict posttraumatic stress disorder symptom severity after adjusting for age, time since the event, anxiety when disclosing, familiarity of the memory, and integration of nontrauma memory. Less use of casual connectives in the trauma memory narrative was associated with higher trauma-related avoidance (r = .33; p = .03), whereas self-rating of the trauma memory as disorganized was associated with higher overall symptom severity (r = .42; p = .006).

Childhood adversity, mental ill-health and aggressive behavior in an African orphanage: Changes in response to trauma-focused therapy and the implementation of a new instructional system

BackgroundThe number of orphans in Sub-Saharan Africa is constantly rising. While it is known that family or community care is preferable over institutional care of African orphans, little is known about the quality of care in orphanages and possibilities of improvement.Study 1MethodsExposure to traumatic stress, experiences of violence in the home, school and orphanage, as well as mental ill-health and aggression of 38 children (mean age of M = 8.64 years) living in an orphanage in rural Tanzania were assessed at two time points. The severity of post-traumatic stress disorder symptoms (PTSD), depressive symptoms, and internalizing and externalizing problems were used as indicators of mental ill-health.ResultsViolence experienced in the orphanage correlated more strongly with all indicators of mental ill-health than violence in the former home, school or neighborhood at time point 1. Additionally, violence experienced in the orphanage had a positive relationship with the aggressive behavior of the children at time point 2.Study 2MethodsWith the help of the pre-post assessment of Study 1, the implementation of a new instructional system and psychotherapeutic treatment (KIDNET) for trauma-related illness were evaluated.ResultsIn response to both, a change in the instructional system and psychotherapeutic treatment of PTSD, a massive decline in experienced violence and in the severity of PTSD-symptoms was found, whereas depressive symptoms and internalizing and externalizing problems exhibited little change.ConclusionsThese studies show that violence, especially in the orphanage, can severely contribute to mental ill-health in orphans and that mental health can be improved by implementing a new instructional system and psychotherapeutic treatment in an orphanage. Moreover, the results indicate that the experience of violence in an orphanage also plays a crucial role in aggressive behavior of the orphans.

Predictors of suicidal ideation in veterans with PTSD related to military sexual trauma

Predictors of suicidal ideation (SI) were examined in a sample of veterans (N = 128) diagnosed with posttraumatic stress disorder (PTSD) related to military sexual trauma. Suicidal ideation was predicted by both depressive symptom severity and posttraumatic symptom severity in separate correlation analyses. When controlling for the effects of depressive and posttraumatic symptom severity on one another in the prediction of SI in a single multiple regression model, however, only depressive symptoms independently predicted SI. These analyses suggest that the contribution of PTSD symptom severity to the prediction of SI is reduced by adding depressive symptoms. Hyperarousal symptom severity, however, was found in a separate multiple regression model to contribute independently to the prediction of SI controlling for depressive symptom severity.

Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans

Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R2 = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.