Posttraumatic Stress Disorder Reexperiencing Symptoms Research Articles

Childbirth self-efficacy and birth related PTSD symptoms: an online childbirth education randomised controlled trial for mothers

BackgroundThis study evaluated an online childbirth education course on childbirth self-efficacy and, subsequent birth related posttraumatic stress disorder (PTSD) symptoms and mother-infant relationship quality.MethodThree group (intervention, passive control, active control) parallel randomised controlled trial. Groups were assigned using computer generated random allocation. For the passive control group participants were instructed to carry on with whatever they were currently undertaking with their pregnancy, while the active control group were asked to read a booklet comprised of twelve birth stories. The purpose of the active control was to check if the act of having an activity to complete would influence outcomes. For the online course group (intervention) participants were asked to complete the online version of a birthing course designed by She Births®. One hundred and twenty-five women residing in Australia between 12 and 24 weeks pregnant were recruited online. Participants were asked to complete their required activity between 24 and 36 weeks pregnant. Childbirth self-efficacy scores were tested pre and post intervention (time one and time 2), PTSD symptoms and mother-infant relationship quality were tested at six weeks and six months postnatal.ResultsThere was no significant interaction by group for childbirth self-efficacy scores. Mean difference scores at time one (pre-intervention) and time two (post-intervention) for each group indicated a trend in the online group towards higher childbirth self-efficacy compared with the two control groups. The main effect of group on birth related PTSD scores was not statically significant at six weeks postnatal or at six months postnatal. The main effect of group on mother-infant relationship scores was not statically significant at six weeks postnatal or six months postnatal.ConclusionsTrends showed childbirth self-efficacy scores to be higher in the intervention group compared with the two control groups, demonstrating effectiveness for the intervention. Paradoxically, PTSD scores were higher in the intervention group compared with the two control groups and therefore also reported poorer mother-infant relationship quality. External factors may be more important than childbirth self-efficacy highlighting the need for a holistic approach that addresses systemic and socio-political influences to improve communication, autonomy, and respectful maternity care.Trial RegistrationThis trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry number: ACTRN12624000241538 on March 11, 2024.

Understanding Intensive Care Unit Family Caregivers' Vulnerability to Post-Traumatic Stress Disorder: The Impact of Neurotic Personality Traits, Emotional Suppression, and Perceptions of Unexpected Death.

Rationale: Family members of patients who die in an intensive care unit (ICU) are at heightened risk of post-traumatic stress disorder (PTSD) symptoms. Not all surrogates develop these symptoms and heterogeneity exists in PTSD symptom clusters. Objectives: The study tested a personality model of PTSD symptoms in bereaved family caregivers of ICU patients. It was hypothesized that family members endorsing higher levels of neurotic personality traits would report higher levels of PTSD symptom clusters and that these associations would be explained by tendencies to view the patient's death as unexpected and to cope by suppressing their emotions. Methods: Participants were family members of ICU patients at an urban, academic medical center who either died or were discharged to an inpatient hospice unit. Participants were contacted for participation at least six months after the patient's death. Participants completed measures of personality, emotion regulation, and PTSD symptoms. Data were analyzed using path analysis. Results: Approximately one-third (35%) of the sample of 162 caregivers endorsed at-risk levels of PTSD. Individuals reporting higher levels of neurotic personality traits reported more PTSD symptoms (r = 0.53, p < 0.001). Perceptions that the patient death was unexpected partially explained the association of neuroticism with the intrusive re-experiencing PTSD symptoms (B = 0.45, p = 0.031). In contrast, emotional suppression partially explained the association of neuroticism with avoidance (B = 0.70, p = 0.010) and hyperarousal symptom clusters (B = 0.37, p = 0.041). Conclusions: Family vulnerability to PTSD after an ICU death can be conceptualized based on neurotic personality traits. Tendencies to view the patient's death as unexpected may contribute to intrusive thoughts and memories of the ICU experience. Individuals may avoid reminders and remain at heightened levels of arousal when they suppress their emotional experiences. Key Message: Family members who experience the death of a loved one following ICU treatment are vulnerable to PTSD symptoms. These reactions to ICU-related losses may be shaped by family members' personalities, expectations, and emotion regulation styles. Understanding these characteristics could inform family screening and intervention efforts in the ICU.

Behavioral economic analysis of the comorbidity of alcohol problems and posttraumatic stress: Findings from high-risk young adults and general community adults.

A behavioral economic reinforcer pathology model theorizes that alcohol problems are influenced by steep delay discounting, overvaluation of alcohol reinforcement, and low reinforcement from alcohol-free activities. Extending this account to the comorbidity of alcohol problems and posttraumatic stress disorder (PTSD), the present study tested the hypothesis that alcohol problems and PTSD symptom severity would interact and be positively associated with indicators from these three domains. High-risk emerging adults from North America (Study 1, n = 1,311, Mage = 22.13) and general community adults from Canada (Study 2, n = 1,506, Mage = 36.80) completed measures of alcohol problems, PTSD symptoms, delay discounting, alcohol demand, and proportionate alcohol-related reinforcement. Across studies, regression analyses revealed significant main effects of alcohol problems and PTSD symptoms in relation to selected reinforcer pathology indicators, but no significant interactions were present for delay discounting or proportionate alcohol-related reinforcement. Interactions were observed for alcohol consumption at $0 (intensity) and the rate of change in consumption across the demand curve (elasticity; Study 1) and for elasticity and maximum alcohol expenditure (Omax; Study 2), but not in the predicted directions. Higher synergistic severity was associated with lower alcohol reinforcing value in each case. These findings reveal expected relations between reinforcer pathology indicators and both alcohol problems and PTSD symptomatology in general but did not support the hypothesized synergistic relationship. The relation between alcohol problems and PTSD is more complex than predicted by existing extensions of the reinforcer pathology model, warranting further investigation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationship between posttraumatic stress disorder and race-based traumatic stress.

This study examined the relationships between race-based traumatic stress symptoms (RBTSS), posttraumatic stress disorder (PTSD) symptoms, and negative affect (NA) in the past year. Participants were 185 community-based respondents who completed a paper and pencil survey of the race-based traumatic stress symptoms scale (RBTSSS), diagnostic and statistical manual (DSM)-related PTSD symptoms, and negative emotions. Two canonical correlation analyses were conducted for two participant groups: those with no race-based traumatic stress (RBTS) elevations and those with one or more RBTS elevations. Results showed a significant relationship between RBTS symptoms and PTSD symptoms for the no elevation group, and a significant relationship between RBTS symptoms and NA for the race-based stress/traumatic stress group. Notably, RBTS inclusion was not significantly correlated with NA. Those with average-level RBTS symptoms appear to endorse more PTSD criteria, while those with elevated RBTS scores do not. The study, therefore, highlights the need for further investigation of how diagnostic measures of trauma may differentiate from trauma symptoms related to race-based experiences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Systematic Review of Evidence-Based Treatments for Adolescent and Adult Sexual Assault Victims.

Sexual assault (SA) is a serious crime that is a prevalent mental and public health problem. Addressing the needs of SA victims and providing appropriate treatment are essential to reduce potential adverse short- and long-term outcomes. Our team undertook an extensive systematic literature review (published between January 2006 and July 2021) to provide evidence-based mental health intervention recommendations for adolescent and adult victims of SA. Where SA-specific research was limited, the literature and clinical practice guidelines on treatments for trauma-induced post-traumatic stress disorder (PTSD) were reviewed to provide additional information to formulate recommendations. Findings strongly support several primary psychotherapy treatments: cognitive behavioral therapy, cognitive processing therapy, eye movement desensitization and reprocessing, narrative exposure therapy, and prolonged exposure therapy. Complementary (aerobic exercise, art, drama, and music therapy) and pharmacological treatments were explored. Mental health nurses who provide services for victims of SA can utilize this overview to guide recommendations for treatment of SA trauma and related PTSD symptoms to mitigate the short- and long-term negative impacts after a traumatic event. When victims of SA receive optimal mental health treatments, our communities benefit as victims heal and recover.

Birth related PTSD and its association with the mother-infant relationship: A meta-analysis

ObjectiveThere is a growing body of research showing that birth related posttraumatic stress disorder (PTSD) symptoms may impact the mother-infant relationship. The present study assessed the strength of the association between birth related PTSD symptoms and the mother-infant relationship. MethodA total of twelve studies (5,572 participants) were included based on database searches using PubMed, EBSCO and ProQuest. ResultsThe findings showed that greater levels of birth related PTSD symptoms were associated with poorer mother-infant relationship, r = −0.36, 95% CI: [−0.43 - −0.28], random effects model. The outcomes appeared to be heterogeneous (Q(11) = 81.63, p <.001, tau2 = 0.0123, I2 = 80.73%), despite all outcomes being in the same direction as the overall outcome. ConclusionsThe results indicated that birth related PTSD symptoms are negatively associated with the mother-infant relationship. Further investigation into the prevention of birth related trauma is suggested. Improving birthing experiences for mothers is likely to contribute to improved infant mental health, thereby reducing overall social and economic costs.

Not all traumas are created equal: Phenotypic heterogeneity of PTSD symptoms in relation to index traumas in U.S. military veterans

Posttraumatic stress disorder (PTSD) is prevalent in military veterans. Although exposure to trauma is subsumed under the diagnostic criteria for PTSD, there is great variability in index traumatic events, and the clinical presentation of PTSD may vary in individuals depending on the type of event experienced. We examined the relationship between different index traumas and PTSD symptoms in 3507 trauma-exposed U.S. military veterans who participated in the National Health and Resilience in Veterans Study. Results showed that interpersonal violence and combat/captivity was associated with greater overall severity of PTSD symptoms relative to illness/injury and disaster/accident. Interpersonal violence and combat/captivity were also associated with greater severity of intrusive, avoidance, negative affect, anhedonia, externalizing behaviors, and anxious and dysphoric arousal symptoms, relative to the other two categories. Implications of these findings for tailoring treatment approaches for PTSD in veterans are discussed.

Association of systemic inflammation with posttraumatic stress disorder after a myocardial infarction

BackgroundAdverse mental health conditions including depression, posttraumatic stress disorder (PTSD), and anxiety are prevalent among patients who survive myocardial infarctions (MI) and are associated with adverse outcomes. The mechanisms underlying these associations, however, are not well understood. Inflammatory pathways may mediate the cardiovascular outcomes of patients with mental health disorders. We examined the bidirectional association between PTSD symptoms and inflammatory biomarkers in a young/middle-aged post MI population. We further examined how this association may differ between women and men as well as between Black and non-Black individuals. MethodsParticipants included individuals with early onset MI between the ages 25 and 60. Mental health scores for depression, PTSD, perceived stress, and anxiety as well as inflammatory biomarkers, interleukin-6 (IL-6) and high sensitivity C-reactive protein (hsCRP), were collected at baseline and at six-month follow up. We examined the bidirectional changes in mental health symptoms and inflammatory biomarkers between baseline and follow-up. ResultsAmong 244 patients in the study (mean age: 50.8, 48.4% female, 64.3% Black), the geometric means for IL-6 level and hsCRP at rest were 1.7 pg/mL and 2.76 mg/L, respectively. Mental health scores at baseline did not consistently predict changes in inflammatory biomarkers at follow-up. However, baseline levels of both IL-6 and hsCRP were robustly associated with an increase in re-experiencing PTSD symptoms at 6 months: in adjusted linear mixed models, there was a 1.58-point increase in re-experiencing PTSD symptoms per unit of baseline hsCRP (p = 0.01) and 2.59-point increase per unit of baseline IL-6 (p = 0.02). Once the analysis was stratified by race, the association was only noted in Black individuals. Baseline inflammation was not associated with change in any of the other mental health symptom scores. ConclusionMarkers of inflammation are associated with an increase in post-event PTSD symptoms in younger or middle-aged patients who experienced an MI, especially Black patients. These results suggest a mechanistic link between inflammation and the development of PTSD among individuals with cardiovascular disease.

Transtorno de estresse pós-traumático e anomalias congênitas no pré-natal

Abstract Objective: to assess post-traumatic stress disorder (PTSD) symptoms in pregnant women diagnosed with congenital anomaly. Methods: his is a quantitative and cross-correlational study. The sample consisted of 111 pregnant women diagnosed with congenital anomaly between 2013 and 2014. We used a semi-structured questionnaire and the Impact of Events Scale - Revised (IES-R). For statistical analysis, the chi-square test, Student’s t test or Mann-Whitney test, Cronbach Alpha coefficients, Pearson’s correlation and simple linear regression models. Results: viable congenital anomalies corresponded to 66.6%, and non-viable, to 33.3%. The average of all areas of IES-R, as well as the sum of matters concerning IES-R, were high in all pregnant women diagnosed with congenital anomaly. Using a cut of 5.6 units in the IES-Rtotal score, we found that 46.8% of pregnant women diagnosed with a congenital anomaly showed PTSD symptoms; however, symptoms were more frequent among pregnant women diagnosed with non-viable congenital anomaly (64.9%). The IES-R intrusion and hyperstimulation dimensions were more correlated. We observed a decreasing connection with PTSD symptoms in relation to the time of the notification of congenital anomaly diagnosis. Conclusions: PTSD symptoms were more frequent in pregnant women diagnosed with non-viable congenital anomaly.

Psychological Status of Nepalese Young Adults During The End of First Wave of COVID-19 Pandemic.

Psychological problems increased during the period of COVID-19. Lockdown" is adopted in many countries of the world. It has also been seen that COVID-19 has led not only to an increase of infection and death but also vast change in the lifestyles of every individual especially in young adults causing various mental health issues. However, in Nepal, there are limited studies to address this issue. The main objective of this study is to generate evidence on the prevalence of symptoms of post-traumatic stress disorder, anxiety, and depression among young adults and the factors contributing to these outcomes in Nepal. Cross-sectional methods were employed using an online structured questionnaire in January 2021, among 1229 participants. Three logistic regression models were performed to examine the significant COVID-19 factors. The prevalence of Depression, Anxiety and post-traumatic stress disorder related symptoms in this study were 255(20.4%), 240(19.2%)and 162(13.2%) respectively relate.COVID-19 diagnosis, COVID-related stress and exposure was significantly related to depression. Similarly, COVID-19 diagnosis, change in income during COVID-19, being exposed to 4 or more exposure factors had high chances of getting anxiety. Also, income change during COVID-19 and stressors during COVID-19 were related to post-traumatic stress disorder. This research shows that various COVID-19 related factors have contributed to the high prevalence of these outcomes.

Shorter Telomeres Related to Posttraumatic Stress Disorder Re-experiencing Symptoms in Sexually Assaulted Civilian Women.

Telomeres are short tandem repeats of “TTAGGG” that protect the chromosome ends from deterioration or fusion of chromosomes. Their repeat length shortens with cell division acting as a biomarker of cellular aging. Traumatic stress events during adulthood or childhood have been associated with posttraumatic stress disorder (PTSD) and short leukocyte telomere length (LTL). This study investigated whether LTL was associated with PTSD in a Brazilian sample of sexually assaulted civilian women at two time points: baseline and 1-year follow-up. At baseline, we assessed 64 women with PTSD following sexual assault (cases) and 60 women with no previous history of sexual trauma or mental disorders (healthy controls – HC). At follow-up visit, 13 persistent PTSD cases, 11 HCs, and 11 PTSD remitters patients were evaluated. PTSD diagnosis and severity were assessed using Mini International Neuropsychiatric Interview (Diagnostic and Statistical Manual of Mental Disorders III/IV criteria) and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), respectively. LTL was measured using multiplex real-time polymerase chain reaction (PCR). In the baseline analysis, we observed that LTL was associated with re-experiencing symptoms (B = −0.16; confidence interval (CI) 95% = −0.027—−0.005; Bonferroni-adjusted p-value = 0.02), but no association was observed between other PTSD symptoms and LTL. In the longitudinal analysis, telomere shortening was no longer observed in patients with PTSD and PTSD remitters. In conclusion, our findings indicate that shorter baseline LTL is associated with early stage of PTSD re-experiencing symptoms in recently sexually assaulted women.

The Impact of Service Dogs on Military Veterans and (Ex) First Aid Responders With Post-traumatic Stress Disorder.

Due to its novelty and lack of empirical study it remains unclear if a service dog truly mitigates the burden of post-traumatic stress disorder (PTSD) symptoms. To cross sectionally investigate the effect of service dogs on veterans and first aid responders with PTSD, we studied subjective and physiological parameters in 65 individuals divided over four groups. These groups were: veterans and first aid responders with PTSD and a service dog (n = 20), with PTSD and a companion dog (n = 10), with PTSD without a dog (n = 12) and a group without PTSD (n = 23). We found that veterans and first aid responders with PTSD who had a service dog showed significantly less PTSD related symptoms, better sleep quality, and better wellbeing experience, than those with a companion dog. Those with a service dog additionally experienced fewer PTSD related symptoms than those without a service dog and tended to walk more than individuals without PTSD. No differences were found in cortisol levels between groups though and changes in both salivary cortisol and activity were not linked to improved welfare experience. Though the use of physiological measurement methods thus warrants more research, our study indicates that the subjective experience of wellbeing, sleep quality and PTSD related symptoms is improved by the presence of a service dog.

It Is Not What Happens to You But How You React to It That Matters: PTSD as a Moderator of the Association Between Trauma and Impulsive Behaviors.

We examined the moderating role of posttraumatic stress disorder (PTSD) in the association between trauma and impulsive behaviors. Adult women ( N = 97) with a history of childhood sexual abuse (CSA; n = 26), rape in adulthood ( n = 21), both CSA and adult rape ( n = 25), or no history of sexual trauma ( n = 25) completed self-report questionnaires. PTSD symptoms were positively associated with self-harm and with stealing and accident proneness, but not with sexual impulsivity. Trauma group had no independent associations with impulsive behaviors. PTSD reexperiencing symptoms interacted with trauma group such that reexperiencing symptoms were positively associated with self-harm for the two trauma groups that included CSA but not for the control and adult rape-only groups. Overall, results indicate that PTSD symptoms-more so than the occurrence of trauma itself-associate with impulsive behavior. Results highlight the importance of assessing posttraumatic symptomatology, and not just trauma occurrence, when aiming to prevent or treat impulsive behaviors.

Prospective examination of pre-trauma anhedonia as a risk factor for post-traumatic stress symptoms

ABSTRACT Background Anhedonia, the reduction of pleasure and reward-seeking behaviour, is a transdiagnostic symptom with well-described neural circuit mediators. Although typically observed during disease state, extant hypotheses suggest that anhedonia may also be an early risk factor for development of psychopathology. Understanding the contribution of anhedonia to the trauma-response trajectory may bolster inferences about biological mechanisms contributing to pre-trauma risk versus trauma-related symptom expression, knowledge of which could aid in targeted interventions. Objective Using a prospective, longitudinal design in a population at risk for trauma disorders, we tested the hypothesis that anhedonia may be a pre-trauma risk factor for post-traumatic stress disorder (PTSD) symptoms. Methods Adult male participants from the Marine Resilience Study (N = 2,593) were assessed across three time-points (pre-deployment, 3-month and 6-month post-deployment). An anhedonia factor was extracted from self-report instruments pre-trauma and tested for its relationship with development of PTSD re-experiencing symptoms after deployment. Results Higher pre-deployment anhedonia predicted increased PTSD intrusive re-experiencing symptoms at 3- and 6-months post-deployment when controlling for pre-trauma PTSD and depression symptoms. Depression symptoms were not significant predictors of subsequent PTSD intrusive re-experiencing symptoms. Anhedonia at 3 mo also robustly predicted maintenance of PTSD intrusive re-experiencing symptoms at the 6 mo time point. Conclusions Pre-deployment anhedonia may be a pre-trauma risk factor for PTSD, not simply a state-dependent effect of trauma exposure and PTSD symptom expression. Anhedonia may contribute to persistence and/or chronicity of re-experiencing symptoms after the emergence of PTSD symptoms.

Exploring Predictors of Sleep State Misperception in Women with Posttraumatic Stress Disorder

ABSTRACT Objectives Insomnia is a common symptom of posttraumatic stress disorder (PTSD) that is resistant to first-line cognitive behavioral interventions. However, research suggests that, among individuals with PTSD, self-reported sleep impairment is typically more severe than what is objectively observed, a phenomenon termed sleep state misperception. Relatively little research has examined which individuals with PTSD are most likely to exhibit sleep state misperception. This study explored clinical predictors of sleep state misperception in a sample of 43 women with PTSD and clinically significant sleep impairment. Method During a baseline assessment, participants’ PTSD symptoms were assessed using a clinical interview and their sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI). Objective sleep, self-reported sleep, and PTSD symptoms were then assessed over a 1-week period using actigraphy and daily diaries. Results Consistent with previous research, women in the study exhibited total sleep time (TST), sleep efficiency (SE), and sleep onset latency (SOL) sleep state misperception. For TST and SE, but not SOL, discrepancies between actigraphy and the PSQI were associated with each clinician-rated PTSD symptom cluster, whereas discrepancies between actigraphy and daily diary were only associated with clinician-rated reexperiencing symptoms. The only self-reported PTSD symptom that was uniquely associated with sleep state misperception was nightmares. This association was no longer significant after controlling for sleep-related anxiety. Conclusions Results suggest that women with more severe reexperiencing symptoms of PTSD, particularly nightmares, may be more likely to exhibit TST and SE sleep state misperception, perhaps due to associated sleep-related anxiety.

Prospective association between pro-inflammatory state on admission and posttraumatic stress following acute coronary syndrome

ObjectiveThe traumatic experience of acute coronary syndrome (ACS) may induce symptoms of posttraumatic stress disorder (PTSD). We examined whether the ACS-triggered acute inflammatory response predicts the development of PTSD symptoms. MethodStudy participants were 70 patients (all Caucasian, 80% male, mean age 59 years) with myocardial infarction (MI) during the acute treatment phase. Interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, IL-4, IL-10, and transforming growth factor (TGF)-1β were determined in plasma collected within 48 h of hospital admission. Participants self-assessed the severity of ACS-induced PTSD symptoms with the 17-item Posttraumatic Diagnostic Scale at 12 months. ResultsThere was a significant positive association of the pro-inflammatory index (added standardized z-scores of pro-inflammatory cytokines IL-1β, IL-6, and TNF-α) with total PTSD symptom severity (ΔR2 = 0.050, p = .029) and re-experiencing symptoms (ΔR2 = 0.088, p = .008), but not avoidance/numbing and hyperarousal symptoms. Analyses were adjusted for the anti-inflammatory index (added standardized z-scores of IL-4, IL-10, and TGF-β1), trauma-focused counseling, sex, age, time since pain onset, troponin, body mass index, and distress during MI. Results were robust when the anti-inflammatory index was removed from the model. Additional analyses showed significant associations of both the net-inflammatory index (i.e., pro-inflammatory index minus anti-inflammatory index) and IL-1β with total PTSD symptom severity, re-experiencing, and hyperarousal symptoms (ΔR2 between 0.042 and 0.090) and of IL-1β with avoidance/numbing symptoms (ΔR2 = 0.050). ConclusionsThe findings suggest an association between the pro-inflammatory state launched during ACS and the development of PTSD symptoms. Increased IL-1β may play a particular role in the pathophysiology of ACS-induced PTSD symptoms.

Association between spatial working memory and Re-experiencing symptoms in PTSD

Background and objectivesFew studies have evaluated the link between working memory (WM) and post-traumatic stress disorder (PTSD). Further, it is unknown whether this relationship is accounted for by other relevant variables including negative affect, emotional dysregulation, or general non-WM-related cognitive control deficits, which are associated with PTSD. The purpose of this study was to determine the extent to which a computerized WM task could predict PTSD symptomology incrementally beyond the contribution of other relevant variables associated with PTSD. MethodsThirty veterans were eligible to complete emotional symptom questionnaires, a heart-rate variability measure, and computerized tasks (i.e., emotional Stroop and automated complex span tasks). A three-stage hierarchical regression was conducted with the PCL-5 total score and symptom clusters (i.e., re-experiencing, avoidance, hyperarousal, and negative cognition/mood) as the dependent variable. ResultsResults revealed that only the re-experiencing symptom cluster was significantly predicted by executive, verbal, and visuospatial WM tasks, which explained an additional 29.7% of the variance over and above other relevant variables. Most notably, the visuospatial task was the only WM task that significantly explained PCL-5 re-experiencing symptoms. LimitationsThis study was based on a small sample of veterans with PTSD and causality cannot be determined with this cross-sectional study. ConclusionsOverall, the results suggest that deficits in visuospatial WM are significantly associated with PTSD re-experiencing symptoms after controlling for other relevant variables. Further research should evaluate whether an intervention to improve visuospatial WM capacity can be implemented to reduce re-experiencing symptoms.

A daily diary study of intrusive PTSD symptoms and suicidal ideation among transgender and gender diverse adults.

High rates of trauma exposure and related posttraumatic stress disorder symptoms (PTSS) may partly explain increased suicidal ideation (SI) in transgender and gender diverse (TGD) people. This study examined whether intrusive PTSS are proximally associated with SI among TGD people. Daily diary surveys (n = 836 surveys; 73.3% compliance rate) were collected over 30 days from a sample of 38 TGD people in the Southeastern United States (mean age: 28.63 years; 84.2% non-Hispanic White; varying gender identities). The prevalence of SI and probable diagnosis of posttraumatic stress disorder at baseline was 59.5% and 42.1%, respectively. Of those who met criteria for probable posttraumatic stress disorder (PTSD), 87.5% reported SI at baseline. Multilevel modeling revealed that only depressive symptoms were positively associated with same-day SI. A trend showed a positive association between intrusive PTSS and same-day SI. Prior-day SI and baseline depressive symptoms were the sole correlates of next-day SI. The present study does not support a proximal association between intrusive PTSS and SI beyond depressive symptoms and prior SI among TGD people. These conclusions are preliminary given the small and homogenous sample. Pending additional research, clinicians should assess suicide risk of TGD people with depressive and PTSD symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Interpersonal violence and painful bladder symptoms in community-dwelling midlife to older women

Women are more likely to present with genitourinary complaints immediately after exposure to interpersonal violence, but little is known about the long-term effects of violence on women's urologic health, including their susceptibility to bladder pain and infections. To determine whether lifetime interpersonal violence exposure and current posttraumatic stress disorder (PTSD) symptoms are associated with the prevalence or severity of painful bladder symptoms and a greater lifetime history of antibiotic-treated urinary tract infections in community-dwelling midlife and older women. We examined the cross-sectional data from a multiethnic cohort of community-dwelling women aged 40 to 80 years enrolled in a northern California integrated healthcare system. Women completed structured self-report questionnaires about their past exposure to physical and verbal/emotional intimate partner violence and sexual assault. The symptoms of PTSD were assessed using the PTSD checklist for the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Civilian version. Additional structured self-report measures assessed the current bladder pain, other lower urinary tract symptoms, and the history of antibiotic-treated urinary tract infections. Multivariable logistic regression models examined self-reported interpersonal violence exposure history and current PTSD symptoms in relation to current bladder pain and antibiotic-treated urinary tract infection history. Among 1974 women (39% non-Latina White, 21% Black, 20% Latina, and 19% Asian), 22% reported lifetime interpersonal violence exposure, 22% reported bladder pain, and 60% reported a history of ever having an antibiotic-treated urinary tract infection. Lifetime experiences of sexual assault (odds ratio, 1.39; [95% confidence interval, 1.02-1.88]) and current PTSD symptoms (odds ratio, 1.96; [95% confidence interval, 1.45-2.65]) were associated with current bladder pain. A lifetime experience of physical intimate partner violence was associated with having a urinary tract infection at any time in life previously (odds ratio, 1.38; [95% confidence interval, 1.00-1.86]), as was emotional intimate partner violence (odds ratio, 1.88; [95% confidence interval, 1.43-2.48]), sexual assault (odds ratio, 1.44; [95% confidence interval, 1.09-1.91]), and current PTSD symptoms (odds ratio, 1.54; [95% confidence interval, 1.16-2.03]). In this ethnically diverse, community-based cohort, lifetime interpersonal violence exposures and current PTSD symptoms were independently associated with current bladder pain and the lifetime history of antibiotic-treated urinary tract infections in midlife to older women. The findings suggest that interpersonal violence and PTSD symptoms may be underrecognized markers of risk for urologic pain and infections in women, highlighting a need for trauma-informed care of these issues.

Cardiorespiratory fitness as protection against the development of memory intrusions: A prospective trauma analogue study

Intrusive and distressing memories are at the core of post-traumatic stress disorder (PTSD). Since cardiorespiratory fitness (CRF) has been linked with improved mental health, emotion regulation, and memory function, CRF may, by promoting these capabilities, protect against the development of intrusions after trauma. We investigated the CRF-intrusion relationship and its potential mediators in 115 healthy individuals, using a trauma film to induce intrusions. As potential mediators, we assessed indices of pre-trauma mental health such as heart rate variability, subjective and psychobiological peri-traumatic responses, and memory. Critically, results showed that higher CRF was related to fewer intrusions, but no mediators emerged for the CRF-intrusion relationship. These results indicate that individuals displaying higher CRF are less prone to develop traumatic memory intrusions. Future studies may want to investigate whether promoting fitness prior to possible trauma exposure can boost resilience against the development of debilitating re-experiencing symptoms of PTSD.