PTSD Checklist For DSM-5 Scores Research Articles

Implementing group therapy for posttraumatic stress disorder within a primary care setting: A pilot study

BackgroundPosttraumatic stress disorder (PTSD) is associated with comorbid psychiatric and medical conditions and high rates of medical service utilization. Given that PTSD is highly prevalent in the primary care setting, group therapy delivered within this setting has the potential to treat large numbers of patients. To date, few studies have examined the feasibility or effectiveness of group therapy for PTSD within primary care. MethodsA pilot study of a PTSD group therapy intervention based on the Trauma Information Group model was conducted in a Federally Qualified Health Center (FQHC). Across 9 cohorts, 32 individuals with PTSD completed 8–10 group therapy sessions. Self-reported PTSD severity was assessed using the PTSD Checklist for DSM-5 (PCL-5) at baseline and post-treatment. ResultsFifty percent of participants had a PTSD treatment response (PCL-5 score reduction ≥10) following group therapy and paired t-tests demonstrated a statistically significant reduction in PCL-5 scores from pre- to post-treatment. Patient demographic characteristics and psychiatric comorbities were not associated with treatment response. LimitationsThe small sample size, demographic characteristics, and FQHC setting potentially limit the generalizability of these findings. Treatment dropout rates and associated factors also were not examined. ConclusionsThe Trauma Information Group treatment for PTSD was feasible to implement within a low resourced primary care setting and led to improvement in PTSD symptoms in this pilot study. These findings suggest that offering group therapy for PTSD within primary care could improve access to effective treatment and warrant future research to examine feasibility and effectiveness in this setting.

Effect of agreement between clinician-rated and patient-reported PTSD symptoms on intensive outpatient treatment outcomes

The level of agreement between self-reported posttraumatic stress disorder (PTSD) symptom severity, measured with the PTSD Checklist for DSM-5 (PCL-5), and severity measured via a clinician-rated measure, the Clinician Administered PTSD Scale for DSM-5 (CAPS-5), was tested as a predictor of the degree of improvement following a 2-week Intensive Outpatient Treatment Program (IOP). Differences in PTSD severity scores (PCL-5 minus CAPS-5) of US Veterans and service members with PTSD (N = 483) at Intake were used to categorize patients into 3 agreement groups: Congruent reporters, Limited Over-reporters and Extensive Over-reporters. A linear mixed model tested whether agreement group impacted the degree of improvement, measured as reduction in PCL-5 score, from IOP baseline to completion. The mean difference between the PCL-5 and CAPS-5 scores was 17.5 ± 13.1 points. Mean modeled reduction in PCL-5 scores from IOP Baseline to IOP Completion for Limited Over-reporters was -21.3 points (95 %CI -23.6, -19.1), which was significantly less than the reduction for Extensive Over-reporters (-27.6, 95 %CI -32.1, -23.1, p<.001), but not significantly different from Congruent reporters (-18.0, 95 %CI -22.7, -13.3, p=.17). Patients who most over-report their PTSD symptoms compared to trained clinicians show steepest declines in PTSD symptom severity with treatment. Personalizing treatment for PTSD may benefit from understanding the mechanisms contributing to these differences.

Mental health and perceived consequences in a clinical sample of women featured in video-based pornography

ContextSeveral reports have shed light on the potentially traumatic filming conditions, and violence experienced by women featured in pornography (WP). However, there is a scarcity of research on the mental health of these women, as well as the perceived consequences of participation in Video-based Pornography (VbP). MethodsThirty-six women, recruited through collaboration with WP support groups, completed an online questionnaire covering socio-demographics, pre-VbP violence experiences, and perceived consequences of their participation in VbP. Additionally, participants completed the French versions of the post-traumatic stress disorder (PTSD) Checklist for DSM-5 (PCL-5), the Dissociative Experiences Scale (DES-II), and the 13-item Beck Depression Inventory (BDI-13). ResultsThe participants had a mean age of 31.2 years (SD = 7), and the median age at first participation in VbP was 21. A majority (77.8 %) reported a lifetime experience of sexual violence before featuring in VbP. All participants reported at least one negative effect of participating in VbP, with three in four women citing cyberbullying following VbP dissemination. Additionally, participants reported a range of physical consequences such as vaginal lesions and sexually transmitted diseases. Thirty women (83 %) had a PCL-5 score over 33, indicative of probable PTSD, and 28 women (78 %) had a DES-II score of 30 or more, indicating high levels of dissociative symptoms. Furthermore, 19 women (53 %) reported a BDI-13 score over 13, suggesting potential severe depression. ConclusionThis study underscores psychosocial vulnerabilities and the presence of severe psychopathology among WP. It also documents their perceptions of negative consequences of participation in VbP, such as cyberbullying, physical injuries, and emotional distress. Further, large-scale studies are needed to substantiate these results and better understand the scale of the problem, as well as to optimize care interventions.

Investigation of Psychosocial, Clinical Outcomes of Individuals with Limb Loss After Earthquakes

The purpose of this study is to investigate the severity of symptoms of Post-Traumatic Stress Disorder (PTSD), depression, psychache, and coping styles in individuals who have experienced limb loss or have not sustained any permanent injuries while trapped under rubble following an earthquake. Furthermore, the study aims to explore the differences between groups in terms of sociodemographic and event characteristics. The study included individuals who were trapped under rubble during the earthquake and had a limb amputated, as well as those who were trapped under rubble but did not experience any permanent physical function loss. Semi-structured sociodemographic form, PTSD Checklist for DSM-5 (PCL-5), Psychache Scale, Coping with Earthquake Stress Scale (CESS), and Beck Depression Inventory (BDI) assessment tools were used. A total of 64 participants, 32 with and 32 without limb loss, were included in the study. It was found that the severities of traumatic stress and depressive symptoms and psychache were significantly higher in the earthquake survivors with limb loss than those without limb loss (p < 0.001, p < 0.001, and p = 0.005, respectively). It was found that earthquake survivors with limb loss made fewer positive reappraisals than those without limb loss (p = 0.012). According to the multiple linear regression analysis, having limb loss predicted BDI and PCL-5 scores (β = -12,239, p < 0,001; β = -10,105, p = 0,008, respectively). Additionally, suicidal ideation exacerbates the severity of psychache in individuals who are were trapped under rubble. Identifying the factors related to the mental state of these individuals is useful for determining those who are most likely to need psychological support.

B - 126 Posttraumatic Stress Disorder Symptoms as a Predictor of Invalid Attention-Deficit/Hyperactivity Disorder and General Psychiatric Symptom Reporting among Adult Neuropsychology Referrals

Abstract Objective Diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD) in adulthood is complicated by the nonspecific nature of attention complaints, which overlap with most forms of internalizing psychopathology as well as elevated rates of invalid symptom overreporting. This study assessed the relationship between posttraumatic stress disorder (PTSD) symptoms and overreporting of both ADHD and general psychological symptoms. Method Data from 308 consecutive adults (mean age = 29.0; mean education = 16.09; 57.5% female, 42.5% male; 35% White, 27% Hispanic, 18% Black, 13% Asian, 7% Other) referred for neuropsychological evaluation of possible ADHD were administered the PTSD Checklist for DSM-5 (PCL-5) and embedded symptom validity tests (SVTs) on the Clinical Assessment of Attention Deficit-Adult (CAT-A) and the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Patients were classified as overreporting/no overreporting ADHD and general psychiatric symptoms based on elevations on the CAT-A and MMPI-2-RF overreporting SVTs, respectively. Results Logistic regressions showed that higher PCL-5 scores significantly predicted overreporting of both ADHD symptoms on CAT-A (X2 = 7.47, p = 0.006; Classification Accuracy = 85.1%; Nagelkerke R2 = 0.04; B.025; p = 0.007) and psychiatric symptoms on MMPI-2-RF (X2 = 58.76, p &amp;lt; 0.001; Classification Accuracy = 71.4%; Nagelkerke R2 = 0.35; B = -1.92; p &amp;lt; 0.001), with significantly greater variance predicted for overreporting of psychiatric symptoms. Conclusions Higher PTSD symptoms predicted overreporting of ADHD symptoms (CAT-A) and, more significantly, broad psychopathology (MMPI-2-RF). Findings reinforce the necessity of SVTs when evaluating ADHD among adults, particularly in the context of elevated PTSD symptoms, and also indicate that neuropsychologists should consider routinely assessing patients’ trauma history/symptomatology during ADHD evaluations to improve diagnostic accuracy.

Assessing the utility of the PC-PTSD-5 as a screening tool among a cancer survivor sample.

Hematopoietic stem cell transplantation (HCT) is an intensive and invasive procedure used in cancer treatment that can lead to posttraumatic stress disorder (PTSD) symptoms. These symptoms are frequently overlooked in oncology and general health care settings. The suitability and utility of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) within the cancer population remains uncertain. This study aims to evaluate its performance as a brief (five-item) case-finding screening alternative to the longer (20-item) PTSD Checklist for DSM-5 (PCL-5) in survivors who received an HCT 1 to 5 years ago. A total of 817 cancer survivors completed the PC-PTSD-5 and PCL-5 during recruitment for a randomized clinical trial. Optimal cut scores for identifying probable PTSD and item performance were determined using indices correcting for chance and item response theory analyses. Of the HCT sample, 10.4% screened as positive for probable DSM-5 PTSD using the PCL-5. The PC-PTSD-5 exhibited strong internal consistency and significant associations with PCL-5 scores (total, r=.82; items, rs=.56-.61). A cutoff score of 2 provided optimal sensitivity for screening (κ[Se]=.95), whereas a cut score of 4 demonstrated the highest efficiency for detecting a probable DSM-5 PTSD diagnosis on the PCL-5 (κ[Eff]=.39). Item response theory analyses indicated that item 4 (numbing) of the PC-PTSD-5 yielded the most informative data, with other items potentially lacking incremental utility. Although not an instrument validation study, these findings offer efficient evidence for using the PC-PTSD-5 as a succinct screening tool among cancer survivors in a clinical context. ClinicalTrials.gov, NCT04058795, registered 8/16/2019.

Stress-induced increase in heart-rate during sleep as an indicator of PTSD risk among combat soldiers.

Discerning the differential contribution of sleep behavior and sleep physiology to the subsequent development of posttraumatic-stress-disorder (PTSD) symptoms following military operational service among combat soldiers. Longitudinal design with three measurement time points: during basic training week (T1), during intensive stressed training week (T2), and following military operational service (T3). Participating soldiers were all from the same unit, ensuring equivalent training schedules and stress exposures. During measurement weeks soldiers completed the Depression Anxiety and Stress Scale (DASS) and the PTSD Checklist for DSM-5 (PCL-5). Sleep physiology (sleep heart-rate) and sleep behavior (duration, efficiency) were monitored continuously in natural settings during T1 and T2 weeks using wearable sensors. Repeated measures ANOVA revealed a progressive increase in PCL-5 scores from T1 and T2 to T3, suggesting an escalation in PTSD symptom severity following operational service. Hierarchical linear regression analysis uncovered a significant relation between the change in DASS stress scores from T1 to T2 and subsequent PCL-5 scores at T3. Incorporating participants' sleep heart-rate markedly enhanced the predictive accuracy of the model, with increased sleep heart-rate from T1 to T2 emerging as a significant predictor of elevated PTSD symptoms at T3, above and beyond the contribution of DASS stress scores. Sleep behavior did not add to the accuracy of the model. Findings underscore the critical role of sleep physiology, specifically elevated sleep heart-rate following stressful military training, in indicating subsequent PTSD risk following operational service among combat soldiers. These findings may contribute to PTSD prediction and prevention efforts.

Cluster-based analysis of PTSD-Checklist for DSM-5 (PCL-5) in civilians with post-concussive cognitive changes

ABSTRACT Objective This study explores the relationship between PTSD symptoms and cognition in patients with persistent post-concussive symptoms (PPCS). Methods Adults with PPCS presenting to a specialized brain injury clinic provided demographic and injury information and completed the PTSD checklist for DSM-5, Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The Montreal Cognitive Assessment (MoCA) was used to screen for possible cognitive concerns. Multiple regression analysis (MLR) adjusting for age, sex, mechanism of injury, psychiatric history, number of previous concussions, months since most recent injury, and mental health questionnaire scores was used to determine associations between PTSD and cognition. Binomial logistic regression explored the relationship between domains of the MoCA and PCL-5 scores. Results We found a negative correlation between MoCA scores, PCL-5 (ρ=-0.211, p = 0.009) and PHQ-9 (ρ=-0.187, p = 0.021) in patients with PPCS and collinearity of PCL-5 and PHQ-9 scores. Significantly higher Arousal and Reactivity cluster scores within the PCL-5 were associated with poorer scores on naming and abstract tasks on the MoCA. Conclusion The association between specific PCL-5 clusters and lower MoCA scores may represent a viable target for psychotherapeutic and psychopharmacologic intervention in patients with cognitive changes associated with PPCS.

Towards predicting PTSD symptom severity using portable EEG-derived biomarkers.

Posttraumatic Stress Disorder (PTSD) is a heterogeneous mental health disorder that occurs following traumatic experience. Understanding its neurobiological basis is crucial to advance early diagnosis and treatment. Electroencephalography (EEG) can be used to explore the neurobiological basis of PTSD. However, only limited research has explored mobile EEG, which is important for scalability. This proof-of-concept study delves into mobile EEG-derived biomarkers for PTSD and their potential implications. Over four weeks, we measured PTSD symptoms using the PTSD checklist for DSM-5 (PCL-5) at multiple timepoints, and we recorded multiple EEG sessions from 21 individuals using a mobile EEG device. In total, we captured 38 EEG sessions, each comprising two recordings that lasted approximately 180 seconds, to evaluate reproducibility. Next, we extracted Shannon entropy, as a measure of the randomness or unpredictability of the signal and spectral power for the fronto-temporal regions of interest, including electrodes at AF3, AF4, T7, and T8 for each EEG recording session. We calculated the partial correlation between the EEG variables and PCL-5 measured closest to the EEG session, using age, sex, and the grouping variable 'batch' as covariates. We observed a significant negative correlation between Shannon entropy in fronto-temporal regions and PCL-5 scores. Specifically, this association was evident in the AF3 (r = -0.456, FDR-corrected p = 0.01), AF4 (r = -0.362, FDR-corrected p = 0.04), and T7 (r = -0.472, FDR-corrected p = 0.01) regions. Additionally, we found a significant negative association between the alpha power estimated from AF4 and PCL-5 (r=-0.429, FDR-corrected p=0.04). Our findings suggest that EEG data acquired using a mobile EEG device is associated with PTSD symptom severity, offering valuable insights into the neurobiological mechanisms underlying PTSD.

Applying the PTSD Checklist-Civilian and PTSD Checklist for DSM-5 crosswalk in a traumatic brain injury sample: A veterans affairs traumatic brain injury model systems study.

This study evaluates the use of the crosswalk between the PTSD Checklist-Civilian (PCL-C) and PTSD Checklist for DSM-5 (PCL-5) designed by Moshier et al. (2019) in a sample of service members and veterans (SM/V; N = 298) who had sustained a traumatic brain injury (TBI) and were receiving inpatient rehabilitation. The PCL-C and PCL-5 were completed at the same time. Predicted PCL-5 scores for the sample were obtained according to the crosswalk developed by Moshier et al. We used three measures of agreement: intraclass correlation coefficient (ICC), mean difference between predicted and observed scores, and Cohen's κ to determine the performance of the crosswalk in this sample. Subgroups relevant to those who have sustained a TBI, such as TBI severity, were also examined. There was strong agreement between the predicted and observed PCL-5 scores (ICC = .95). The overall mean difference between predicted and observed PCL-5 scores was 0.07 and not statistically significant (SD = 8.29, p = .89). Significant mean differences between predicted and observed PCL-5 scores calculated between subgroups were seen in Black participants (MD = -4.09, SD = 8.41, p = .01) and those in the Year 5 follow-up group (MD = 1.77, SD = 7.14, p = .03). Cohen's κ across subgroups had a mean of κ = 0.76 (.57-1.0), suggesting that there was moderate to almost perfect diagnostic agreement. Our results suggest the crosswalk created by Moshier et al. can be applied to SM/V who have suffered a TBI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of veteran-led peer mentorship on posttraumatic stress disorder.

Peer mentorship shows promise as a strategy to support veteran mental health. A community-academic partnership involving a veteran-led nonprofit organization and institutions of higher education evaluated a collaboratively developed peer mentor intervention. We assessed posttraumatic stress disorder (PTSD), postdeployment experiences, social functioning, and psychological strengths at baseline, midpoint, and 12-week discharge using the PTSD Checklist for DSM-5 (PCL-5), Deployment Risk and Resilience Inventory-2, Social Adaptation Self-evaluation Scale, and Values in Action Survey. Brief weekly check-in surveys reinforced mentor contact and assessed retention. The sample included 307 veterans who were served by 17 veteran peer mentors. Mixed-effects linear models found a modest effect for PTSD symptom change, with a mean PCL-5 score reduction of 4.04 points, 95% CI [-6.44, -1.64], d = 0.44. More symptomatic veterans showed a larger effect, with average reductions of 9.03 points, 95% CI [-12.11, -5.95], d = 0.77. There were no significant findings for other outcome variables. Compared to younger veterans, those aged 32-57 years were less likely to drop out by 6 weeks, aORs = 0.32-0.26. Week-by-week hazard of drop-out was lower with mentors ≥ 35 years old, aHR = 0.62, 95% CI [0.37, 1.05]. Unadjusted survival differed by mentor military branch, p =.028, but the small mentor sample reduced interpretability. Like many community research efforts, this study lacked a control group, limiting the inferences that can be drawn. Continued study of veteran peer mentorship is important as this modality is often viewed as more tolerable than therapy.

Comparing effectiveness of residential versus intensive virtual treatment for veterans with posttraumatic stress disorder.

During the COVID-19 pandemic, restrictions imposed on residential treatment programs necessitated rapid implementation of virtual treatment delivery. Posttraumatic stress disorder (PTSD) Residential Rehabilitation Treatment Programs (P-RRTP) are a key mental health treatment for Veterans with PTSD who require more intensive interventions than outpatient care. During the pandemic, the W. G. (Bill) Hefner VA Healthcare System developed and implemented a Virtual Intensive Outpatient Program for PTSD (VIOPP) to meet the needs of the Veteran population. The purpose of this analysis was to compare the effectiveness of VIOPP to P-RRTP. Analyses included N = 370 Veterans, n = 193 who completed P-RRTP between January 2018 to April 2020 and n = 177 who completed VIOPP between June 2020 and November 2022 and provided pre- and posttreatment scores. Pre- and posttreatment scores of the PTSD Checklist for DSM-5 (PCL-5) were available for all patients. Pre- and posttreatment depressive symptom scores from the Nine-item Patient Health Questionnaire (PHQ-9) were available for n = 254 Veterans. Paired and independent samples t tests evaluated differences in change scores overall and by treatment modality (residential vs. virtual). Results indicated a significant decrease in PCL-5 scores regardless of treatment modality, p < .001. Despite beginning VIOPP with significantly higher PCL-5 scores than P-RRTP, there were no significant differences in PCL-5 change scores between virtual (M = -16.94) and residential treatment (M = -17.10), p = .910. PHQ-9 scores also decreased significantly for both treatment groups. These analyses suggest that intensive virtual treatment has similar effectiveness to residential treatment for PTSD. This supports the development of intensive virtual interventions as viable alternatives to residential treatments and a valuable component within the continuum of PTSD care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study

BackgroundPosttraumatic stress disorder (PTSD) after a stay in the intensive care unit (ICU) can affect one in five ICU survivors. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, admission to the ICU for COVID-19 was stressful due to the severity of this disease. This study assessed whether admission to the ICU for COVID-19 was associated with a higher prevalence of PTSD compared with other causes of ICU admission after adjustment for pre-ICU psychological factors.MethodsThis prospective observational comparative cohort study included 31 ICUs. Eligible patients were adult ICU survivors hospitalized during the first wave of COVID-19 pandemic in France, regardless of the reason for admission. The prevalence of presumptive diagnosis of PTSD at 6 months was assessed using the PTSD Checklist for DSM-5 (PCL-5). Sociodemographics, clinical data, history of childhood trauma (Childhood Trauma Questionnaire [CTQ]), and exposure to potentially traumatic events (Life Events Checklist for DSM-5 [LEC-5]) were assessed.ResultsOf the 778 ICU survivors included during the first wave of COVID-19 pandemic in France, 417 and 361 were assigned to the COVID-19 and non-COVID-19 cohorts, respectively. Fourteen (4.9%) and 11 (4.9%), respectively, presented with presumptive diagnosis of PTSD at 6 months (p = 0.976). After adjusting for age, sex, severity score at admission, use of invasive mechanical ventilation, ICU duration, CTQ and LEC-5, COVID-19 status was not associated with presumptive diagnosis of PTSD using the PCL-5. Only female sex was associated with presumptive diagnosis of PTSD. However, COVID-19 patients reported significantly more intrusion and avoidance symptoms than non-COVID patients (39% vs. 29%, p = 0.015 and 27% vs. 19%, p = 0.030), respectively. The median PCL-5 score was higher in the COVID-19 than non-COVID-19 cohort (9 [3, 20] vs. 4 [2, 16], p = 0.034).ConclusionAdmission to the ICU for COVID-19 was not associated with a higher prevalence of PTSD compared with admission for another cause during the first wave of the COVID-19 pandemic in France. However, intrusion and avoidance symptoms were more frequent in COVID-19 patients than in non-COVID-19 patients.Trial Registration: Clinicaltrials.gov Identifier NCT03991611, registered on June 19, 2019.

Chronotype influences on posttraumatic stress disorder induced by the twin earthquakes in Turkey: A cross-sectional study among medical students

ABSTRACT This study aimed to investigate the correlation between chronotypes and posttraumatic stress disorder (PTSD) symptoms in medical students affected by earthquakes in Kahramanmaraş, Turkey, while elucidating if the PTSD manifestation varies among different chronotypes four months post-disaster. The study encompassed 193 medical students, subjected to the sociodemographic data form, the Morningness-Eveningness Questionnaire (MEQ) and the PTSD Checklist for DSM-5 (PCL-5). The results indicated that students identified as “evening types” reported significantly elevated PCL-5 scores (p < 0.001) relative to “morning” and “intermediate” types. According to PCL-5 scores, 43.5% of the participants exhibited PTSD, with a higher occurrence among the evening types. Multivariable linear regression analysis revealed that lower MEQ scores independently correlated with elevated PTSD symptoms (β = -0.1389 [95% CI = -0.273 ˗ −0.0048], p = 0.042), suggesting the potential of eveningness as a risk factor for PTSD post-disaster. These findings could enhance our understanding of PTSD, aid the development of preventive strategies, and underscore the importance of considering chronotypes. Further expansive, population-based studies with a longitudinal design are necessary to better understand the relationship between PTSD and the circadian system.

Improved Post-Traumatic Stress Disorder Symptoms and Related Sleep Disturbances after Initiation of Medical Marijuana Use: Evidence from a Prospective Single Arm Pilot Study

Introduction: Post-traumatic stress disorder (PTSD) is a debilitating disorder experienced by a subgroup of individuals following a life-threatening trauma. Several US states have passed laws permitting the medical use of marijuana (MMJ) by individuals with PTSD, despite very little scientific indication on the appropriateness of marijuana as a therapy for PTSD. This prospective pilot study of adults with confirmed PTSD in Florida (FL) investigated whether PTSD symptoms, sleep quality, affect, and general physical and mental health/well-being improved post-initiation of MMJ treatment. Methods: Participants, N = 15, were recruited from two MMJ clinics in Gainesville and Jacksonville, FL. To be eligible, participants had to be 18 years of age or older, not currently on MMJ, and willing to abstain from recreational marijuana, if using any, until the State Medical Cannabis Card was obtained, screen positive for PTSD. Participants were assessed at baseline (pre-MMJ initiation) and 30 and 70 days post-MMJ initiation using the Pittsburgh Sleep Quality Index (PSQI), PTSD Checklist for DSM-5 (PCL-5), Positive and Negative Affect Schedule (PANAS), PROMIS Global Health V1.2, and semi-structured marijuana and other substance use assessment. Results: PTSD symptom severity as measured by total PCL-5 score improved significantly at 30- and 70-day follow-ups. Similarly, statistically significant reductions in nightmares were reported at 30- and 70-day follow-ups. Corresponding improvements in sleep were noticed with participants reporting increased duration of sleep hours, sleep quality, sleep efficiency, and total PSQI score. Likewise, negative affect and global mental health improved significantly at follow-up. According to the post hoc analyses, the most statistically significant changes occurred between baseline and 30-day follow-up. The exception to this pattern was nightmares, which did not show significant improvement until day 70. Conclusion: The findings of this study highlight the potential of MMJ in improving patient outcomes for those with PTSD, particularly concerning sleep disturbances, which often do not respond to currently available treatments.

Self-rated personality disorder symptoms do not predict treatment outcome for posttraumatic stress disorder in routine clinical care.

To test the hypothesis that self-rated personality disorder (PD) symptoms are a significant and clinically relevant predictor of treatment outcomes in a naturalistic treatment setting specialized in trauma-focused treatment using a single-group pretest-posttest design. Treatment-seeking patients reporting clinical levels of posttraumatic stress disorder (PTSD) symptoms filled out questionnaires at intake and after treatment. The primary outcome was change in PTSD severity after treatment, measured by the PTSD Checklist for DSM-5 (PCL-5). PD symptoms were measured with the Structured Clinical Interview for DSM-5 Screening Personality Questionnaire (SCID-5-SPQ). Secondary outcomes were general mental health problems, treatment response, number of sessions and dropout. N =1174 patients (59% female, baseline PCL-5 score M [SD] = 53.0 [10.8]) were included for the primary analysis. Regression analysis revealed that PD symptoms explained 0.4% of variance in PTSD symptom change (p = .066). After controlling for baseline PTSD symptoms, PD symptoms explained 0.0% of variance (p = .311). The fully adjusted model including baseline PTSD symptom severity, age, gender, cumulative exposure to potentially traumatic experiences, PD symptoms, and number of sessions together explained 5% of the observed variance in PTSD symptom change. Baseline PTSD severity was the only significant predictor and negatively predicted outcome. Sensitivity analyses with imputed data from N = 2694 cases yielded comparable results. Finally, secondary analyses showed that PD symptoms did not predict significant or clinically relevant changes in treatment response status, general mental health problems, dropout rates or number of sessions. The findings provide no evidence that self-rated PD symptoms predict treatment outcomes for patients suffering from clinical levels of PTSD symptoms in a naturalistic treatment setting specializing in trauma-focused treatment. Self-report screening for these symptoms to inform clinicians about expected effects of PTSD treatment is not supported by the evidence.

The effects of Access Bars on depression, anxiety, and stress in police officers: A case series.

You are here: Home › Abstracts › Abstracts – Volume 15, Number 2, November 2023 › The Effects of Access Bars on Depression, Anxiety, and Stress inPolice Officers doi 10.9769/EPJ.2023.15.2.TH Terrie Hope, Houston, Texas, USA Hope, T. (2023). The effects of Access Bars on depression, anxiety, and stress in police officers: A case series. Energy Psychology: Theory, Research, and Treatment, 15(2), 33–42. Abstract: Police officers in the United Kingdom (UK) have clinical levels of anxiety and depression and comorbid presentations of major depression and anxiety, at rates significantly higher than reported in the general population. Risk of stress is significant and posttraumatic stress disorder (PTSD) among police officers is now at a crisis level in the UK, affecting one in five officers. Complex PTSD (the result of chronic exposure to trauma) affects 12% of the working police population, resulting in a diminishing number of working officers. Access Bars, a noninvasive energy technique was evaluated for its effects on depression, anxiety, stress, and PTSD, presented either singularly or in a comorbid state using subjective self-report measures. Methods: This case series included participants (n = 4) aged between 36 and 52 years who were police officers referred for treatment with a clinical diagnosis of one or more of depression, anxiety, stress, or PTSD. All participants had been previously treated with standardized methods and continued to present with mild to severe symptoms. Treatments were provided by a licensed Access Bars Facilitator at a naturopathic clinic in Hampshire, UK. The primary measure was the standardized self-report method, the Depression Anxiety Stress Scale–21 (DASS-21), with the addition of the Beck Anxiety Inventory (BAI) and the PTSD Checklist for DSM-5 (PCL-5) to evaluate PTSD in one participant. All were evaluated prior to receiving seven 60-minute sessions over seven weeks, with post evaluations upon completion of the last session. Results: All methods of evaluation showed a decrease in scores for all post measurements. DASS-21 depression scores had the highest pre scores, with 75% in the extremely severe category. Mean scores declined from 31 to 7.5 (75%, p = 0.02). Mean anxiety scores decreased from 20 to 12 (59%, p = 0.007) and mean stress scores declined from 24 to 8.5 (64%, p = 0.002). A secondary classification of a single participant classified as “acute needs” (AN; n = 1) had additional psychometric evaluations using BAI and PCL-5. BAI scores decreased from 26 to 16 (38%, p = 0.001) and PCL-5 scores declined from 38 to 18 (20 points or 51%, p &lt; 0.001). An 18-point decrease for PCL-5 is considered a clinically significant change. Conclusion: Treatment with Access Bars showed a significant decrease in depression, anxiety, and stress in police officers where significant symptoms remained after standardized treatments. Simultaneous improvement was demonstrated in comorbid anxiety, depression, and stress. These results suggest that Access Bars shows promise as a treatment for depression, anxiety, and stress and may contribute to clinical improvement in PTSD. Keywords: Access Bars, depression, anxiety, stress, police officers, PTSD, trauma

Minimal important difference metrics and test-retest reliability of the PTSD Checklist for DSM-5 with a primary care sample.

The PTSD Checklist for DSM-5 (PCL-5) is a measure of posttraumatic stress disorder (PTSD) symptom severity that is widely used for clinical and research purposes. Although previous work has examined metrics of minimal important difference (MID) of the PCL-5 in veteran samples, no work has identified PCL-5 MID metrics among adults in primary care in the United States. In this secondary analysis, data were evaluated from primary care patients (N = 971) who screened positive for PTSD and participated in a large clinical trial in federally qualified health centers in three U.S. states. Participants primarily self-identified as women (70.2%) and White (70.3%). We calculated test-retest reliability using clinic registry data and multiple distribution- and anchor-based metrics of MID using baseline and follow-up survey data. Test-retest reliability (Pearson's r, Spearman's ρ, intraclass correlation coefficient) ranged from adequate to excellent (.79-.94), with the shortest time lag demonstrating the highest reliability estimate. The MID for the PCL-5 was estimated using multiple approaches. Distribution-based approaches indicated an MID range of 8.5-12.5, and anchor-based approaches indicated an MID range of 9.8-11.7. Taken together, the MID metrics indicate that PCL-5 change scores of 9-12 likely reflect real change in PTSD symptoms and indicate at least an MID for patients, whereas PCL-5 change scores of 5 or less likely are not reliable. These findings can help inform clinicians using the PCL-5 in similar populations to track patient responses to treatment and help researchers interpret PCL-5 score changes in clinical trials.

A - 129 An Examination of the Relationship between Posttraumatic Stress Disorder Symptom Severity and Cognitive Test Performance in a Veteran Sample.

This study examined the relationship between Posttraumatic Stress Disorder (PTSD) symptom severity and cognitive test performance in veterans, hypothesizing that PTSD Checklist for DSM-5 (PCL-5) scores would be correlated with test performance on commonly used neuropsychological measures. Clinically-referred veterans without a neurocognitive disorder who passed the Test of Memory Malingering (TOMM), completed the PCL-5, and completed Weschler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Digit Span or Coding, Weschler Memory Scale-Fourth Edition (WMS-IV) Logical Memory (LMI/LMII), letter fluency (FAS), or Trail Making Test (Parts A and B) were included. The sample included 38 veterans (81.6% male); mean age = 58.79 (SD = 14.71; range 22-80) and mean education level = 13.97years (SD = 2.42, range 6-20). Primary diagnoses included PTSD (47.4%), depression (21.1%), and no diagnosis (23.7%). Pearson, Spearman, and partial correlations were calculated. Moderate negative correlations were found between PCL-5 and FAS raw scores (r = -0.41, p = 0.014; 95%CI [-0.654,-0.089]) and LMI raw scores (r = -0.453, p = 0.02; 95%CI [-0.715,-0.080]). After controlling for age and education, moderate negative correlations remained for FAS (r = -0.46, p = 0.004) and LMI (r = -0.43, p = 0.018) and a weak, non-significant correlation with LMII (r = -0.297, p = 0.079). In veterans with valid cognitive test performance and no neurocognitive disorder, PTSD symptom severity negatively correlated with FAS and WMS-IV LM performance. This suggests PTSD symptoms may influence performance on phonemic fluency and story recall task. Assessing and addressing PTSD symptoms may result in more accurate diagnoses and improved cognitive functioning. Understanding the PTSD-cognition relationship can inform interventions and support strategies to enhance veterans' quality of life.

A - 125 Posttraumatic Stress Disorder Symptom Severity and its Relationship to Performance on the Test of Memory Malingering in a Veteran Sample.

To examine relationships between Posttraumatic Stress Disorder (PTSD) symptom severity and performance on the Test of Memory Malingering (TOMM) trials in veterans without a diagnosis of neurocognitive disorder. A sample of 47 clinically-referred veterans (80.9% male; Mage = 57.47, SD = 14.83; Medu = 13.91, SD = 2.5) who did not meet criteria for a neurocognitive disorder completed the PTSD Checklist for DSM-5 (PCL-5) and the TOMM. Primary diagnoses included PTSD (48.9%), no diagnosis (23.4%), and depression (19.1%). A cutoff of 45 was used for each trial; 47 completed Trial 1 (TOMM-T1), 17 completed Trial 2 (TOMM-T2), and 10 completed Retention Trial (TOMM-Ret). Nine participants (19.1%) failed the TOMM. Analyses included Pearson correlation, Spearman correlation, and independent-samples t-tests. Age was negatively correlated with PCL-5 and positively correlated with TOMM-T1; therefore, relevant partial correlations were conducted. TOMM-T1 demonstrated a moderate, negative correlation with PCL-5, rs(45) = -0.469, p < 0.001, 95%CI(-0.688,-0.248). A moderate non-significant correlation was found between TOMM-T2 and PCL-5, rs(15) = -0.405, p = 0.053, 95%CI(-0.775,0.014). PCL-5 and TOMM-Ret were not correlated. Controlling for age, the correlation between PCL-5 and TOMM-T1 remained significant (rs[44] = -0.426, p = 0.002). Those who passed TOMM (M = 38.45, SD = 16.48) had significantly lower PCL-5 scores compared to those who failed (M = 57.67, SD = 13.83), t(45) = -3.231, p = 0.001, Cohen's D = 16.04. Among veterans, PTSD symptom severity was related to TOMM scores and/or failure. Findings highlight a need to consider the role PTSD symptoms may play in neuropsychological assessment. Findings further support recommendations for trauma-focused treatment before formal neuropsychological testing, as psychiatric symptoms may interfere with obtaining a valid assessment of cognition.