Predictors Of Posttraumatic Stress Disorder Symptoms Research Articles

Post-traumatic stress disorder symptoms in healthcare workers: a ten-year systematic review.

Background and aims:Healthcare workers (HCWs) employed in hospital settings frequently experience many occupational stressors leading to post-traumatic stress disorder (PTSD) symptoms. Literature has increasingly highlighted PTSD as a major issue that involves both staff and healthcare organizations; the consequences of PTSD may include medication errors and lower standards of care. The current COVID-19 pandemic poses the need for preventing PTSD in HCWs working closely with COVID-19 patients. The purpose of this systematic review was to analyze the latest developments in assessing and managing the occupational risk of PTSD symptoms in hospital HCWs.Methods:We searched for publications in MEDLINE/Pubmed using selected keywords. Each article was reviewed and categorized into one or more of the following four categories based on its subject matter: risk assessment, risk management and occurrence rates.Results:Our search resulted in a total of 32 publications that matched our inclusion criteria. Increased years of service, older age, previous year exposure to violence, personality traits (i.e. neuroticism), history of mental disorders, being non-graduates, were found to be workers’ pre-trauma factors predicting PTSD symptoms.Conclusions:The findings suggest the need to prioritize preventative interventions aimed to anticipate the effects of traumatic exposure by training HCWs in evidence based anticipatory methods of coping with stressful events. With regard to the current COVID-19 pandemic, we found evidence of the need to strength social support and training targeted at psychological skills of medical staff who treated COVID-19 patients. (www.actabiomedica.it)

Incidence and predictors of post-traumatic stress symptoms in a cohort of patients with intracerebral hemorrhage

ObjectivesExamine the incidence and predictors of PTSD symptoms in a cohort of patients with ICH. Patients and MethodsThis study uses a prospective cohort of 108 patients with complete follow-up data including a questionnaire regarding stress symptoms (PCL-S: PTSD checklist specific for a stressor) at 3, 6, and 12 months. ResultsThe incidence of novel stress symptoms following ICH was approximately 6.5%. Age was negatively associated with PTSD symptoms with only trend-level significance (3 months: OR = 0.83, p = 0.087; 6 months: OR = 0.70, p = 0.015; 12 months: OR = 0.88, p = 0.087). Gender did not affect PTSD symptom development, (t = 1.34, p = 0.18). Pre-morbid functioning, initial stroke prognosis, total number of complications, and length of hospital/ICU stay were not associated with PTSD symptoms; however, each was significantly correlated with poorer functional outcomes. Yet, poorer functional outcomes were observed in those with higher reports of PTSD symptoms (r = 0.24, p = 0.01). ConclusionFunctional outcomes in ICH are correlated with PTSD symptoms, however the mechanism and relationship are difficult to elucidate. Further research is needed to determine possible mechanisms by which a stroke patient may develop PTSD.

Event centrality, transitional impact and symptoms of posttraumatic stress in a clinical sample

ABSTRACTBackground and Objectives: There is growing research indicating that event centrality strongly predicts posttraumatic stress disorder (PTSD). However, there is not much research on what makes a traumatic event central to one’s life story. One reason a traumatic memory becomes a reference point for one’s life story is that it brings about significant changes in one’s life. This study investigated the relationships between transitional impact of an event, event centrality, and PTSD symptoms. Specifically, it tested whether higher negative changes were associated with higher levels of event centrality and PTSD symptoms. It also investigated whether event centrality mediated the relationship between transitional impact and PTSD severity.Methods: 101 individuals diagnosed with PTSD completed the Transitional Impact Scale (TIS), Centrality of Event Scale, and Impact of Event Scale-Revised regarding their traumatic experiences. Furthermore, they responded to the Posttraumatic Stress Disorder Symptom Scale-Self Report (PSS-SR), Traumatic Events Checklist (TELC), and Beck Anxiety Inventory (BAI).Results and Conclusions: Results indicate that (a) the TIS had valid and reliable psychometric properties in a PTSD sample, (b) most of the traumatic events received high negative psychological and material change scores, and (c) event centrality mediated the relationship between transitional impact and PTSD severity.

Interactive effects of PTSD and substance use on suicidal ideation and behavior in military personnel: Increased risk from marijuana use.

The current study examines the unique and interactive effects of posttraumatic stress disorder (PTSD) symptoms and days using alcohol, opioids, and marijuana on PTSD symptoms, suicidal ideation, and suicidal behavior up to 1 year, later in a high-risk sample of military personnel not active in mental health treatment. Current and former military personnel at risk for suicide (N = 545; M age = 31.91 years, standard deviation = 7.27; 88.2% male) completed self-report measures of PTSD symptoms, past 30 days heavy alcohol use, opioid use, marijuana use, and current suicidal ideation via telephone at baseline and 1, 3, 6, and 12 months later. PTSD symptoms and the substance use variables (and relevant covariates) were entered as predictors of changes in PTSD symptoms, the likelihood of suicidal ideation, suicidal ideation severity, and the likelihood of suicidal behavior during the 11-month follow-up period. PTSD symptoms predicted PTSD symptoms 1 month later. PTSD symptoms and marijuana use predicted the likelihood of suicidal ideation 1 month later and suicidal behavior during the 11-month follow-up period. The interaction between PTSD symptoms and marijuana use significantly predicted increased PTSD symptoms over time and suicidal behavior. At high, but not low levels of PTSD symptoms, more days using marijuana predicted increased PTSD symptoms over time and the likelihood of suicidal behavior. Results suggest marijuana, especially for military personnel experiencing elevated PTSD symptoms may negatively impact suicidal thoughts and behavior. These results are relevant to suggestions that medical marijuana could be used in treating or augmenting treatment for PTSD.

Validity of Attention Bias Variability Indices for Posttraumatic Stress Disorder Research: Evidence From Patient Data.

Although initial findings indicated that threat-related attention bias variability (ABV), an index designed to capture dynamic shifts in threat-related attention over time, was positively correlated with the severity of posttraumatic stress disorder (PTSD) symptoms, a recent study relying on simulated data has raised questions regarding the validity and empirical utility of ABV. Specifically, the simulations suggested that core features of reaction time data distinct from threat-related attention bias, such as the reaction time standard deviation and mean, could explicate the reported elevated ABV among samples with PTSD. In the present study, we evaluated these suggestions in 95 PTSD-diagnosed participants. The results showed that ABV significantly and uniquely predicted PTSD symptom severity beyond the predictive value of core reaction time features, ΔR2 = .05-.23. Some of the predictions stemming from the simulated results were replicated, whereas others were not. Contrary to the conclusion drawn from the simulated data, the results from the current study suggest that ABV is a valid and replicable correlate of PTSD symptom severity.

The Perpetration of Violence and the Experience of Trauma: Exploring Predictors of PTSD Symptoms in Male Violent Offenders

Incarcerated offenders are more likely to experience Posttraumatic Stress Disorder (PTSD) and associated symptoms than the general population. PTSD may develop from a variety of events, including being a victim of violence, witnessing violence, or from committing a violent offense. This study examined symptoms and predictors of PTSD in 150 male violent offenders. Participants recalled acts of reactive and instrumental violence, poorly recalled violence, and subjectively disturbing events (e.g., victim of violence), and rated each event for symptoms of PTSD using the Impact of Events Scale (IES). Subjectively disturbing events were associated with higher IES scores than the acts of violence. Hierarchical linear modeling showed that more recent events were associated with a greater number of trauma symptoms and peritraumatic dissociation was positively associated with trauma symptoms. As well, trauma symptoms were more likely to develop if the victim was a family member or a friend, as compared to a stranger or acquaintance. These results support the need for trauma-informed assessment and treatment for offenders. Knowing more about the predictors of trauma symptoms is a first step in effectively treating PTSD in this population.

Stranger Harassment and PTSD Symptoms: Roles of Self-Blame, Shame, Fear, Feminine Norms, and Feminism

Stranger harassment is a prevalent experience for many women but is often trivialized as a social problem (Kearl 2014; Vera-Gray 2016). As a result, there is a lack of knowledge related to understanding women’s lived experiences of stranger harassment. Our study attends to this gap in the literature by examining the relation between experiences of stranger/street harassment and posttraumatic stress disorder (PTSD) symptom severity among 367 young adult U.S. women. We also examined novel explanatory (i.e., self-blame, shame, and fear of rape), risk (adherence to traditional feminine norms of sweet and nice and sexual fidelity), and resiliency (feminist identification) factors in predicting PTSD symptom severity via a moderated mediation model. We found that stranger harassment was both directly and indirectly related to PTSD symptom severity via more self-blame, greater shame, and more fear of rape along three dimensions—taking rape precautions, fear of men, and safety concerns. In addition, we found a significant conditional indirect effect, in which the indirect effect of stranger harassment on PTSD symptom severity via shame was stronger among women with higher levels of sexual fidelity. Furthermore, the conditional indirect effect of stranger harassment on PTSD symptom severity via self-blame was contingent on feminist identification such that these relations were stronger among women with lower levels of feminist identification. Our results underscore the potential negative impact of stranger harassment experiences on women’s mental health and the importance of targeting self-blame, shame, fear, gender-related norms, and feminist attitudes in intervention strategies.

Event Centrality: Factor Structure and Links to Posttraumatic Stress Disorder Symptom Clusters

Event centrality is defined as the extent to which traumatic events are perceived to be integral to one's life. However, there are discrepancies regarding the factor structure of event centrality, as the factor structure may differ depending on the nature of the trauma. Event centrality has predicted posttraumatic stress disorder (PTSD); yet, few studies have taken into account other key cognitive predictors of PTSD, such as posttraumatic cognitions. The PTSD symptom clusters also remain largely unexamined, despite potential specificity in their ties to event centrality. The aims of the current study were to: (a) examine the factor structure of event centrality and whether the structure differs following interpersonal versus noninterpersonal trauma; (b) investigate whether event centrality predicts PTSD symptom clusters beyond posttraumatic cognitions; and (c) determine if the associations between event centrality, posttraumatic cognitions, and PTSD are equivalent between trauma types. The study aims were examined utilizing 263 college students (Mage = 24.54, SD = 6.29; 79.8% female; 58% White). Event centrality was best represented by one factor, which was consistent between groups. Structural equation models indicated that event centrality and posttraumatic cognitions regarding the self predicted each of the PTSD symptom clusters across groups, βs = .27-.58. However, event centrality was more strongly related to avoidance symptoms among individuals who experienced a noninterpersonal trauma. For both the interpersonal and noninterpersonal groups, event centrality had equivalent ties to each cluster. Even after accounting for negative trauma-related beliefs, event centrality appears to be relevant in understanding posttrauma functioning.

PTSD symptoms and suicidal ideation in US female firefighters.

Little is known regarding the mental health of women firefighters. To identify demographic, work-related and mental health characteristics associated with post-traumatic stress disorder (PTSD) symptoms and lifetime suicidal ideation in female firefighters compared with male colleagues. Participants were firefighters (75 women and 2564 men) employed in a large urban fire department in the USA. Chi-square, correlations, t-tests and analyses of variance were conducted to examine the predictors of PTSD symptoms and lifetime suicide ideation in men and women. Approximately 20% of women scored positively for PTSD and 30% reported lifetime suicidal ideation. Women with PTSD symptoms were more likely to be in their mid-career years (11-20) than in their first 10 years (87% versus 44%; χ2 = 8.77, P < 0.05) and to have received counselling (53% versus 14%; χ2 = 8.11, P < 0.01). Being single (73% versus 58%; χ2 = 6.02, P < 0.05), having a second job (68% versus 38%; χ2 = 5.79, P < 0.05) and having received counselling (41% versus 11%; χ2 = 8.51, P < 0.01) predicted suicide ideation. Depression and general stress positively predicted PTSD symptoms and suicide ideation. PTSD also predicted suicide ideation. Compared to male firefighters, women were at high risk for PTSD symptoms and suicide ideation. Particularly for women, few socio-demographic and work-related variables were associated with these outcomes. Mental health variables predicted depression and suicide ideation for both gender groups. Therefore, in screening and intervention efforts, it may be most fruitful to focus on mental health risk correlates of PTSD and suicide ideation.

Self-reported mindfulness and soldier health following a combat deployment.

Combat exposure has been linked to health-related challenges associated with postcombat adjustment, including mental health symptoms, behavior-related problems, physical pain, and functional impairment. Mindfulness, or acceptance of the present moment without reactivity or judgment, may be associated with better mental health following a combat deployment. This study examined whether self-reported mindfulness predicted soldier health outcomes over the course of the postdeployment period. U.S. soldiers (n = 627) were surveyed 4 months after a deployment to Afghanistan (T1) and again 3 months later (T2). Mindfulness was assessed using the nonreactivity to inner experience subscale of the Five-Facet Mindfulness Questionnaire. Hierarchical linear regressions examined how mindfulness (T1) moderated the impact of combat exposure (T1) on outcomes at T2. Controlling for rank, the interaction between combat exposure and mindfulness significantly predicted posttraumatic stress disorder (PTSD) symptoms, depression symptoms, risk-taking behaviors, pain symptoms, and functional impairment. The interaction term explained 1% to 2% of the variance in these health outcomes. Simple slopes analyses revealed that combat exposure was associated with more PTSD symptoms, depression symptoms, risk-taking behaviors, pain symptoms, and functional impairment when soldiers reported low levels of mindfulness. There was no effect for alcohol misuse, sleep difficulties, or aggressive behaviors. Nonreactivity to inner experience may mitigate the detrimental effects of high-levels of combat exposure on both mental and physical health outcomes. These findings indicate that mindfulness strategies such as nonreactivity may be particularly useful for employees facing potentially traumatic stressors in a high-risk occupational context. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

S24. Characterizing the Association of Mobile Skin Conductance and Ambulatory Heart Rate on PTSD Symptom Clusters

Increased psychophysiological reactivity to stress is a defining feature of Post-Traumatic Stress Disorder (PTSD). While various stress-inducing tasks are available, they can be time-consuming and difficult to implement in the resource-constrained settings often found in low-and middle-income countries. Thus, the aim of this study was to evaluate the feasibility of using ambulatory heart rate (HR) and mobile skin conductance level (SCL) during a standard trauma interview (STI) in predicting PTSD symptom severity among Vietnamese young men who have sex with men (YMSM).

失独父母创伤后应激障碍的症状结构、特征及预测因素

<p id="C2">The Chinese culture regards death as a taboo subject that is often avoided in daily conversations. Moreover, the death of a family member is a family affair that is inappropriate to share with others. Thus, the bereavement experience of the Chinese is a particularly mysterious territory that provides limited information. Among all types of bereavement, the death of a child is the most significant stressor that a parent could experience. In particular, an only child’s death is the ultimate trauma that any parent could ever encounter. However, China’s one-child policy, which has been implemented since the late 1970s, has the number of bereft parents who lost their only child to illness, accident, and other causes reaching millions. For <italic>shidu</italic> parents, the death of their only child may be the most significant source of traumatic stress, coupled with financial difficulties, thereby possibly leading to a state of stress and even severe post-traumatic stress disorder (PTSD). Therefore, research on PTSD symptoms in <italic>shidu</italic> parents is critical. This study attempts to analyze the symptom characteristics and predictive factors of PTSD in <italic>shidu</italic> parents <p id="C2-1">The study investigated 463 <italic>shidu</italic> parents (mean age = 60.20 years, <italic>SD</italic> = 7.58) from March 2017 to December 2017 by using convenience sampling. The subjects completed the Parents Themselves and Their Children’s Basic Information Questionnaire and PTSD Checklist—Civilian Version (PCL-C). The survey results indicated that (1) the five-factor dysphoric arousal model entailing intrusion, avoidance, emotional numbing, dysphoric arousal, and anxious arousal was verified in the sample group of <italic>shidu</italic> parents. (2) The PTSD prevalence in the sample group was 71.9%. Among them, the incidence of PTSD, intrusion, avoidance, dysphoric arousal, emotional numbing, and anxious arousal increased. Repeated stress events; memory of past events (children), ideas, and the pain; and attempt to avoid stress factor (children’s death events) memory are the symptoms with the highest positive rates. (3) PTSD symptoms are significantly correlated with the duration of the loss and age of the <italic>shidu</italic> parents. Significant differences in PTSD symptoms were demonstrated in terms gender, home location, and family income status. The variables were incorporated into a regression equation and the three factors (i.e., gender, home location, and age) can be used to predict the PTSD symptoms <p id="C2-2">This research has theoretical and practical significance. First, this research enriched the study of PTSD symptom structure by verifying Elhai’s five-factor dysphoric arousal model. Second, this study determined that the three main factors, namely, gender, home location, and age, can be used to predict PTSD symptoms. This finding is beneficial for scholars to study the mechanism for PTSD emergence and development. Lastly, this research will enable the development of effective intervention methods for Chinese <italic>shidu</italic> PTSD. In the process of psychosocially assisting <italic>shidu</italic> parents, patients with high risk of PTSD should be screened in five aspects: intrusion, avoidance, emotional numbing, dysphoric arousal, and anxious arousal, particularly intrusion and avoidance. Furthermore, <italic>shidu</italic> patients should be distinguished in terms of age, home location, and gender to be able to implement effective approaches to alleviate the symptoms of PTSD.

Symptoms of Posttraumatic Stress Disorder and Associated Risk Factors in Patients With Lung Cancer: A Longitudinal Observational Study.

Purpose. This study aimed to measure symptoms of posttraumatic stress disorder (PTSD) in Chinese patients following a new diagnosis of lung cancer. Secondary aims were to explore factors at diagnosis that may predict PTSD symptoms at 6 months. Methods. This was a prospective longitudinal observational study that included 93 patients with newly diagnosed lung cancer. PTSD symptomology was assessed using the PTSD Checklist Civilian Version (PCL-C) and health-related quality of life (HRQoL) was assessed with the European Organisation for the Research and Treatment of Cancer questionnaire. Measures were completed at diagnosis and 6 months. Results. No patient had PTSD at baseline or 6 months as measured by a score of ⩾50 in the PCL-C. However, at diagnosis, 44% of patients had “mild” symptoms of PTSD. At 6 months, 64% of patients had “mild” and 8% had “moderate” PTSD symptoms. PTSD symptom scores significantly worsened over 6 months (mean difference [95% CI] = 7.2 [5.4 to 9.0]). Six months after diagnosis, higher PTSD scores were seen in people who at diagnosis were younger (P = .003), had a lower smoking pack history (P = .012), displayed less sedentary behavior (P < .005), or initially had worse cancer symptoms, including fatigue (P = .001) and poorer HRQoL (P = .004). Conclusions. Mild PTSD symptoms are common in patients with lung cancer 6 months after treatment; however, a full diagnosis of PTSD is uncommon. Screening for PTSD symptoms may be considered for at-risk patients with newly diagnosed lung cancer.

Cognitive Flexibility Predicts PTSD Symptoms: Observational and Interventional Studies.

Introduction: Post-Traumatic Stress Disorder (PTSD) is a prevalent, severe and tenacious psychopathological consequence of traumatic events. Neurobehavioral mechanisms underlying PTSD pathogenesis have been identified, and may serve as risk-resilience factors during the early aftermath of trauma exposure. Longitudinally documenting the neurobehavioral dimensions of early responses to trauma may help characterize survivors at risk and inform mechanism-based interventions. We present two independent longitudinal studies that repeatedly probed clinical symptoms and neurocognitive domains in recent trauma survivors. We hypothesized that better neurocognitive functioning shortly after trauma will be associated with less severe PTSD symptoms a year later, and that an early neurocognitive intervention will improve cognitive functioning and reduce PTSD symptoms.Methods: Participants in both studies were adult survivors of traumatic events admitted to two general hospitals’ emergency departments (EDs) in Israel. The studies used identical clinical and neurocognitive tools, which included assessment of PTSD symptoms and diagnosis, and a battery of neurocognitive tests. The first study evaluated 181 trauma-exposed individuals one-, six-, and 14 months following trauma exposure. The second study evaluated 97 trauma survivors 1 month after trauma exposure, randomly allocated to 30 days of web-based neurocognitive intervention (n = 50) or control tasks (n = 47), and re-evaluated all subjects three- and 6 months after trauma exposure.Results: In the first study, individuals with better cognitive flexibility at 1 month post-trauma showed significantly less severe PTSD symptoms after 13 months (p = 0.002). In the second study, the neurocognitive training group showed more improvement in cognitive flexibility post-intervention (p = 0.019), and lower PTSD symptoms 6 months post-trauma (p = 0.017), compared with controls. Intervention- induced improvement in cognitive flexibility positively correlated with clinical improvement (p = 0.002).Discussion: Cognitive flexibility, shortly after trauma exposure, emerged as a significant predictor of PTSD symptom severity. It was also ameliorated by a neurocognitive intervention and associated with a better treatment outcome. These findings support further research into the implementation of mechanism-driven neurocognitive preventive interventions for PTSD.

Predictors of Outcome and Residual Symptoms Following Trauma-Focused Psychotherapy in Police Officers With Posttraumatic Stress Disorder.

Police officers exposed to potentially traumatic events (PTE) are at a heightened risk of developing posttraumatic stress disorder (PTSD). Little is known about trauma-focused psychotherapy outcomes in the police. In this naturalistic study, we evaluated whether PTE exposure and baseline clinical characteristics predicted PTSD symptom reduction during treatment and residual PTSD symptoms posttreatment. In consecutive referrals to a specialized mental health service for police officers (N = 665), PTSD was measured pre- and posttreatment using structured clinical interviews. Treatment consisted of brief eclectic psychotherapy for PTSD. We grouped PTE as follows: injury/maltreatment, loss (colleague or private), other job-related, other private traumatic events. Data were analyzed multivariably using structural equation modeling and logistic regression. Treatment effect size was large, d = 3.6, 95% CI [3.4, 3.8]. Police officers who reported more injury/maltreatment or private traumatic had more baseline PTSD symptoms as well as larger symptom reduction during treatment; police officers who reported more losses of loved ones showed smaller PTSD symptom reduction. Concentration problems persisted in 17.7% of police officers posttreatment, and these were predicted by baseline PTSD symptoms and loss of loved ones. Proportions of variance explained by the multivariable models ranged from 0.08 to 0.14. Our findings increase insight into the type of PTE and clinical characteristics of police officers with PTSD who benefit most from trauma-focused treatment. Because loss of loved ones can be presumed to have a profound impact on social and interpersonal functioning, a more specific treatment focus on grief processes may further enhance efficacy.

Subjective Age as a Moderator in the Reciprocal Effects Between Posttraumatic Stress Disorder Symptoms and Self-Rated Physical Functioning.

It is now widely acknowledged that physical decline may increase among middle-aged and older adults who suffer from posttraumatic stress disorder (PTSD). Much less is known about the temporal sequencing of PTSD and physical decline relationship over time. While PTSD can lead to physical decline, physical decline may preserve or augment existing PTSD symptoms. Both problems can also mutually affect each other forming a vicious cycle. Additionally, it is important to address variables that can mitigate these longitudinal effects. Following the recovery capital framework, we consider how the existence or lack of capital in the form of young age identity may affect the recovery process. Therefore, the current study aimed to examine the reciprocal effects of PTSD symptoms and self-rated physical functioning and further test whether one’s subjective age moderates these effects. Using in-region random digit dialing, we collected a stratified sample of community dwelling older adult residing in south Israel. Of that sample (N at T1 = 339), 132 older adults (age range = 51–88, mean age = 66.90, SD = 9.14) were interviewed 4 months after the 2014 Israel–Gaza conflict (T2) and 1 year later (T3). Participants responded to PTSD symptoms scale, and reported their physical functioning and subjective age. PTSD symptoms and self-rated physical functioning were tested as both predictors and outcomes in a cross-lagged model. The moderating effect of subjective age was assessed by examining whether T2 variables interacted with subjective age in predicting T3 outcomes. Results showed that higher PTSD symptoms at T2 were associated with subsequent lower self-rated physical functioning at T3, yet self-rated physical functioning at T2 did not predict PTSD symptoms at T3, thereby highlighting the PTSD self-rated physical function direction. Moreover, subjective age moderated this latter association, so that this relationship was significant only for those who felt relatively older. In addition to clarifying the temporal sequencing of the PTSD self-rated physical functioning association, the study further suggests that an older subjective age (i.e., lack of recovery capital) could render middle-aged and older adults more susceptible to physical decline following PTSD symptoms. We therefore propose to develop interventions aimed at coping with an older age identity and facilitating a younger age identity among traumatized older individuals.

Cumulative effects of the Gulf oil spill and other disasters on mental health among reproductive-aged women: The Gulf Resilience on Women's Health study.

To test whether effects of multiple (up to 5) disasters on mental health responses were cumulative (additive effects), or whether an earlier disaster produced sensitization (higher) or habituation (lower) responses to a later one. The Gulf Resilience on Women's Health study interviewed 1,366 southern Louisiana women regarding their exposure to Hurricanes Katrina, Rita, Gustav, and Ike and the Gulf oil spill (measured several ways), and administered validated measures of symptoms of depression and posttraumatic stress disorder (PTSD). Multiple linear and logistic regression with disaster exposures entered singly, combined, and as an interaction were used to model mental health. Both exposure to the oil spill and hurricane disaster were associated with likely depression and PTSD, consistent with a cumulative model, but we did not find statistical interactions that would suggest sensitization or habituation. When results were examined with continuous symptom measures of depression and PTSD, they were similar, with the exception that exposure to the oil spill and experiencing illness or injury because of the hurricane disaster showed a significant interaction (p < .05) in a manner consistent with a sensitization effect when predicting PTSD symptoms. The results of this study point mainly to a cumulative risk for the mental health effects of multiple disasters, although some indication of sensitization occurred among those with particularly severe experiences. There was no evidence for habituation. These findings may guide efforts to assist those in regions experiencing multiple disasters that occur in close sequence. (PsycINFO Database Record

Alterations in positive affect: Relationship to symptoms, traumatic experiences, and affect ratings.

Intrusive negative affect and concurrent deficits in positive affect are hallmarks of posttraumatic stress disorder (PTSD). We sought to further extend the extant literature by exploring the experience of negative affect intrusion upon potentially positive situations (here termed, "negative affect interference," NAI). Two studies with adults endorsing at least 1 traumatic event (Study 1, N = 294; Study 2, N = 286) examined how NAI and more general hedonic deficits (HD) relate to psychopathology, trauma exposure characteristics, and ratings of normed visual stimuli. Study 1 found that NAI and HD were positively correlated with PTSD symptoms and childhood trauma, and NAI incremented over depressive symptoms in predicting PTSD severity. Study 2 results indicated additional strong positive correlations between NAI and HD and anhedonia, affect regulation problems, negative affect, and neuroticism. NAI and HD were found to increment over trait NA in predicting PTSD symptoms. Individuals endorsing elevated NAI and HD rated positively valenced pictures (including food and erotic images) as less arousing, although not more negative. These findings expand conceptualizations of anhedonia and emotional numbing by drawing attention to negative affect in otherwise positive contexts. (PsycINFO Database Record

Symptoms of PTSD in Frontline Journalists: A Retrospective Examination of 18 Years of War and Conflict.

The objective of the current study was to determine the frequency and severity of symptoms of posttraumatic stress disorder (PTSD) in journalists covering conflict. PTSD data (Impact of Event Scale-Revised) collected over an 18-year period from 684 conflict journalists were analyzed retrospectively for frequency and severity of reexperiencing, avoidance, and arousal symptoms. Conflicts covered were civil wars in the Balkans ( n = 140 journalists), 9/11 attack in New York City ( n = 46), Iraq war ( n = 84), Mexico drug wars ( n = 104), civil war in Syria ( n = 59), Kenya election violence/Al-Shabab terror ( n = 57), state-sanctioned media intimidation in Iran ( n = 114), and the current migration crisis in Europe ( n = 80). The mean age of the sample was 38.59 (SD = 8.35) years, 461 (67%) journalists were men, and the mean duration of conflict work was 13.42 (SD = 7.74) years. The 5 most frequently endorsed symptoms were in the reexperiencing/intrusion category. Mean intrusion (1.31, SD = 0.97), avoidance (1.08, SD = 0.89), and arousal (1.07, SD = 0.96) scores for the entire sample were in the mild range. Being female and less educated independently predicted PTSD symptoms. PTSD phenomenology in a group of conflict journalists with well over a decade of frontline experience is dominated by reexperiencing symptoms. While symptom severity is for the most part mild, group means can obscure those individuals with significantly more severe difficulties.

Posttraumatic stress and depressive symptoms in children after the Wenchuan earthquake

ABSTRACTBackground: Many studies have reported the comorbidity of posttraumatic stress disorder (PTSD) and depression in children. However, the underlying relationship between PTSD and depression remains unclear.Objective: This study examines the relationship between PTSD and depressive symptoms in children who survived the Wenchuan earthquake in China.Methods: In total, 301 children were assessed at four months and then followed up at 29, 40 and 52 months after the disaster. The ages of the children ranged from 9.6–14.6 years old, and the sample included 157 males and 144 females. The children were assessed by using the University of California at Los Angeles PTSD reaction index for DSM-IV for PTSD symptoms and the Children’s Depression Inventory for depressive symptoms.Results: Comorbid PTSD and depressive symptoms were prevalent in 4.0, 3.3, 3.7 and 5.1% of the participants at times 1, 2, 3 and 4, respectively. The cross-lagged analysis indicated that PTSD symptoms at time 1 predicted depressive symptoms at time 2; depressive symptoms at time 1 predicted PTSD symptoms at time 2; depressive symptoms at time 2 predicted PTSD symptoms at time 3; and depressive symptoms at time 3 predicted PTSD symptoms at time 4. The findings also showed that being female, poor parental relationships and trauma exposure were risk factors for PTSD or depressive symptoms.Conclusions: The results suggest that the causal relationship between PTSD and depressive symptoms changes over time; the effects of PTSD symptoms tend to decrease, while those of depressive symptoms tend to increase. Two stages of the relationship between PTSD and depressive symptoms were observed, namely, that PTSD and depressive symptoms first influenced each other and then that depressive symptoms predicted PTSD. The results of our study also suggest that females with poor parental relationships and a high degree of trauma exposure are more likely to require intervention.