Posttraumatic Stress Disorder Research Research Articles

Serum cortisol and neuroticism for post-traumatic stress disorder over 2 years in patients with physical injuries.

This study aimed to explore the relationships between serum cortisol levels, personality traits, and the development of Post-Traumatic Stress Disorder (PTSD) over 2 years among individuals with physical injuries. Participants were consecutively recruited from a trauma center and followed prospectively for 2 years. At baseline, serum cortisol levels were measured, and personality traits were categorized into five dimensions (Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness), using the Big Five Inventory-10. The diagnosis of PTSD during follow-up (at 3, 6, 12, and 24 months post-injury) was determined using the Clinician-Administered PTSD Scale for DSM-5. Binary and multinomial logistic regression analyses were conducted to examine the interactions between cortisol levels, personality traits, and PTSD development. Among 923 patients analyzed, 112 (12.1%) were diagnosed with PTSD at some point during the study period, with prevalence rates decreasing from 8.8% at 3 months to 3.7% at 24 months post-injury. Direct associations between cortisol levels or personality traits and PTSD were not observed. However, a significant interaction between lower cortisol levels and higher Neuroticism in relation to PTSD risk was identified, especially during the early follow-up periods (3 to 6 months), but this association waned from the 12-month follow-up onward. Our findings reveal Neuroticism-dependent associations between serum cortisol levels and PTSD development, exhibiting temporal variations. These results suggest that PTSD development may be influenced by a complex, time-sensitive interplay of biological and psychosocial factors, underscoring the importance of considering individual differences in stress reactivity and personality in PTSD research and treatment.

Neuroimaging of posttraumatic stress disorder in adults and youth: progress over the last decade on three leading questions of the field.

Almost three decades have passed since the first posttraumatic stress disorder (PTSD) neuroimaging study was published. Since then, the field of clinical neuroscience has made advancements in understanding the neural correlates of PTSD to create more efficacious treatment strategies. While gold-standard psychotherapy options are available, many patients do not respond to them, prematurely drop out, or never initiate treatment. Therefore, elucidating the neurobiological mechanisms that define the disorder can help guide clinician decision-making and develop individualized mechanisms-based treatment options. To this end, this narrative review highlights progress made in the last decade in adult and youth samples on three outstanding questions in PTSD research: (1) Which neural alterations serve as predisposing (pre-exposure) risk factors for PTSD development, and which are acquired (post-exposure) alterations? (2) Which neural alterations can predict treatment outcomes and define clinical improvement? and (3) Can neuroimaging measures be used to define brain-based biotypes of PTSD? While the studies highlighted in this review have made progress in answering the three questions, the field still has much to do before implementing these findings into clinical practice. Overall, to better answer these questions, we suggest that future neuroimaging studies of PTSD should (A) utilize prospective longitudinal designs, collecting brain measures before experiencing trauma and at multiple follow-up time points post-trauma, taking advantage of multi-site collaborations/consortiums; (B) collect two scans to explore changes in brain alterations from pre-to-post treatment and compare changes in neural activation between treatment groups, including longitudinal follow up assessments; and (C) replicate brain-based biotypes of PTSD. By synthesizing recent findings, this narrative review will pave the way for personalized treatment approaches grounded in neurobiological evidence.

An examination of the potential core symptoms of posttraumatic stress disorder: What is integral after removing general psychopathology & distress?

Many confirmatory factor analyses (CFA) have examined the structure of posttraumatic stress disorder (PTSD) with some suggesting increased complexity (i.e., 6+ factors), while others suggesting a more refined structure (i.e., 2-factors). These competing PTSD structures may be due to conflation of non-trauma specific symptoms that have been added overtime. However, none of these studies examined if all symptoms being examined are specific to PTSD or potentially more related to general distress and psychopathology. The current study re-evaluated the structure of PTSD using bifactor exploratory factor analysis (EFA) to identify the construct's core symptoms. Data for EFA models were taken from a sample of Veterans (N = 694) attending outpatient therapy for PTSD and were cross-validated using CFA in a sample of 297 Veterans attending residential treatment. Clinician Administered PTSD Scale for DSM-5 (CAPS-5) at pre-treatment was used across sample. Factor analyses resulted in a 2-factor, bifactor model comprised of eight total items. Model fit was robust, RMSEA = 0 [0.000, 0.036]; robust CFI = 1; robust TLI = 1.017. The bifactor analytic approach captured what might be the core structure of PTSD, which were pathognomonic symptoms of PTSD (Factor one). A distinct second factor related to depression was also found. In identifying this structure, the model eliminates redundancies and lesser performing items and differentiates depressive reactions as potentially distinct and separate. Overall, these findings may assist in future research of PTSD by determining the unique elements of the construct within a veteran sample versus associated features, general psychological distress, and comorbid psychopathology.

Concordance of Posttraumatic Stress Disorder Symptoms Assessed via Retrospective Report Versus Experience Sampling Methods in Community Women Experiencing Intimate Partner Violence.

Posttraumatic stress disorder (PTSD) is one of the most prominent negative health consequences that women experiencing intimate partner violence (IPV) may develop. However, research on PTSD among women experiencing IPV has largely relied on retrospective reporting methods, which are vulnerable to bias and may consequently misrepresent PTSD symptoms. This study evaluated the concordance between PTSD symptoms assessed via retrospective self-report and experience sampling methods (ESM), which involve repeated within-day sampling of experiences in near real-time and in natural environments. Community women (N = 134) experiencing IPV (Mage = 40.7, 30.4% Black) responded to ESM surveys three times a day for 30 days and then completed a follow-up interview. Retrospective self-report of PTSD symptoms, which were assessed during the follow-up interview, were compared to ESM reports of PTSD symptoms. Retrospective reports of PTSD symptoms were significantly different from PTSD symptoms reported during the ESM period, but most closely resembled peak PTSD symptoms. Notably, retrospective reports of PTSD symptoms were significantly different, with a very large effect size, from average PTSD symptoms reported during the ESM period. Discordance scores were significantly negatively associated with the number of days on which any IPV occurred, suggesting that as the frequency of IPV experiences increased, differences between retrospective PTSD symptoms and each ESM symptom pattern decreased. This study provides an important contribution to the literature by highlighting meaningful differences in PTSD symptoms assessed via retrospective self-report versus ESM and the role of IPV context. Findings emphasize the importance of utilizing ESM in PTSD research with women experiencing IPV.

Exploring the Perceived Impact of Parental PTSD on Parents and Parenting Behaviours—A Qualitative Study

A considerable number of adults who are currently living with posttraumatic stress disorder (PTSD) are also parents caring for at least one biological child. Evidence suggests that parental PTSD can be associated with impairments to certain parenting behaviours, particularly increasing the use of more negative practices. However, most of the evidence to date has been collected using quantitative methodology, which gives limited insight into why such effects might occur. The current study qualitatively explored study the lived experiences of parents currently living with PTSD, within the United Kingdom. Interviews were conducted with 30 parents (16 mothers, 14 fathers) who were recruited via a PTSD research registry, and who had children living at home under the age of 18 years at the time they experienced their trauma. Three main themes were identified: key impacts of the trauma to the parent personally; negative changes to specific parenting outcomes; impact of these parenting changes on the parent’s sense of parental efficacy; and recovery and coping. These findings provide novel insight into the experiences of both mothers and fathers with PTSD, and highlight the multiple challenges faced by parents living with PTSD that extend beyond impairments to themselves as individuals. Potential implications for the implementation of effective support for parents and their families following trauma exposure are considered.

The dynamic brain-network model of PTSD

The brain is a highly complex system whose functioning is critical for our interaction with the world. Neural elements, from single cells to brain systems, constantly fluctuate in their dynamics, accompanying the plethora of possible exchanges between our environment and ourselves. However, sometimes things go awry. An unfortunate example is post-traumatic stress disorder (PTSD), a debilitating clinical condition that can appear after exposure to a threatening life event. In this work, using complexity as a framework, we aim to introduce the dynamic brain network model of PTSD. We hope this model will allow the generation of novel specific hypotheses concerning brain organization and dynamics in PTSD research. We first introduce how the network framework complements the localizationist approach centered in specific brain regions or subsets of brain regions, with a whole brain approach considering brain regions' dynamic relationships. Then, we review key concepts in network neuroscience, focusing on the importance of the network topology and dynamics to understand the organizational principles of the brain, that is, functional segregation and integration. In the third part, we apply this knowledge to describe the possible trajectories conducting a brain system to present PTSD alterations. Accordingly, we introduce the Dynamic Brain Network Model (DBNM) of PTSD, a concrete framework built on the network approach and resilience theory to study the transition of a brain network from state 1 (e.g., before the traumatic event) to state 2 (e.g., after the traumatic event). To conclude, we provide a summary of metrics for quantifying elements on the DBNM and its potential use in computational models of PTSD.

Potential PTSD therapeutics targeting 5-HT<sub>2C</sub> receptors

Post-traumatic stress disorder (PTSD) is often treated by (1) selective serotonin reuptake inhibitors (SSRIs), (2) exposure therapy, or a combination of the two. However, while all treatments have some efficacy, they are not fully effective. It is necessary to elucidate the causes of inadequate efficacy and to direct the development of effective treatments. First, regarding (1), pharmacological studies have indicated that the 5-HT2C receptor is one of the receptor subtypes that interfere with the therapeutic effects of SSRIs. To compensate for nonselective effects in pharmacological manipulations, we replicated pharmacological results using mice deficient in the 5-HT2C receptor gene. However, since either pharmacological blockade or gene knockout of the 5-HT2C receptor could increase locomotor activity, the locomotor-enhancing effects make the interpretations of results difficult. Therefore, we used the conditioned lick suppression test to evaluate fear response using corrected values that consider the effects of differences in locomotor activity, thereby eliminating this possibility. Next, to address (2), we conducted fear conditioning by simultaneously presenting a composite of sound and environmental stimuli and then re-exposing the subjects to the sound and environmental stimuli separately. We found that the fear response to the sound stimuli quickly decreased, while the fear response to the environmental stimuli did not diminish even after repeated exposure. Thus, exposure therapy may exacerbate PTSD, depending on the method used. In this paper, we will introduce the above results and suggest directions for future PTSD research.

MDMA-assisted psychotherapy; Inclusion of transgender and gender diverse people in the frontiers of PTSD treatment trials.

IntroductionTransgender and gender diverse (TGD) people experience stigma, discrimination, trauma, and post-traumatic stress disorder (PTSD) at higher rates compared to the general population; however, TGD people have been underrepresented in PTSD research. Clinical trials of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy demonstrate promising safety and efficacy for the treatment of PTSD. Issues related to equitable access, power imbalances in the therapeutic relationship, and vulnerable states of consciousness occasioned by MDMA are magnified when working with people affected by structural vulnerabilities and health disparities, and community engagement in research planning and implementation is essential. To inform the inclusion and safety of TGD people in future MDMA-assisted psychotherapy research, the aims of the current study were to: characterize TGD experiences with trauma-related mental health care, assess openness of TGD people to participate in experimental PTSD research, and to gather specific feedback on protocol design for conducting MDMA-assisted psychotherapy with TGD people.Materials and methodsWe conducted three virtual focus group discussions (FGDs) with 5–6 participants each (N = 17). Eligible TGD participants had a history of receiving trauma-related mental health care. Each FGD was facilitated by two licensed clinicians who identified as TGD. Qualitative data analysis was conducted via an iterative process of identification of recurrent patterns and themes.ResultsWe have identified several key issues TGD people face when seeking and engaging in trauma-related mental health care, including barriers to receiving adequate gender-affirming and trauma-informed mental health care and frustration with providers lacking cultural humility. Suggested amendments to MDMA-assisted psychotherapy protocols include: routine collection of trans-inclusive gender identity data, implementing an explicit gender-affirming treatment approach, ensuring a culturally safe setting, and diversifying co-therapy dyads.DiscussionThe inclusion of TGD voices in early conversations about emerging experimental PTSD interventions promotes equitable access, in the context of health and healthcare disparities, and helps researchers understand the needs of the community and tailor research to meet those needs. Through an ongoing conversation with the TGD community, we aim to incorporate a gender-affirming approach into existing research protocols and inform future applications of MDMA-assisted psychotherapy in addressing the effects of minority stress and boosting resilience.

A Protocol for the Induction of Posttraumatic Stress-Disorder (PTSD)-like Behavior in Mice.

Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition that precipitates in ~10% of individuals exposed to a traumatic event (TE). Symptoms include recurrent and intrusive thoughts, sleep disturbance, hypervigilance, exaggerated startle, and reckless or destructive behavior. Given the complex and heterogeneous nature of the disease, animal models for PTSD-like symptomatology are of increasing interest to the field of PTSD research. Because resilience to PTSD-like symptomatology is an important epidemiologic aspect of PTSD, animal models that resolve vulnerable and resilient animals are of particular value. Due to the complex nature of the PTSD phenotype and the potential overlaps between PTSD-like behavior and behaviors associated with other stress-induced psychopathologies such as anxiety or depression, animal models that utilize multiple readouts for PTSD-like behavior are also of increasing value. We utilize a paradigm developed by Lebow et al. 2012 for the induction and identification of PTSD-like symptomatology in mice. This paradigm utilizes inescapable electric foot shock, administered in two decontextualized sessions over two consecutive days. Stressed mice perform four behavioral tests - dark/light transfer, marble burying, acoustic startle, and home cage activity - to generate five behavioral readouts of PTSD-like behavior: % risk assessment (%RA), % marbles buried (%MB), % prepulse inhibition (%PPI), latency to peak startle amplitude (LPSA), and % light phase activity (%LPA). PTSD-like symptomatology is characterized by decreased %RA, increased %MB, decreased %PPI, decreased LPSA, and increased %LPA. The 20% of animals displaying the most PTSD-like behavior in each test are awarded a certain number of points depending on the test, and animals scoring sufficient points are designated as PTSD-like, while animals scoring no points are designated PTSD-resilient. This paradigm identifies PTSD-like behavior in ~15% of animals, a rate comparable to that observed in humans. This protocol represents a robust and reproducible paradigm for the induction of PTSD-like behavior in mice.

The Need for a Diagnostic Instrument to Assess Post-Traumatic Stress Disorder in People with Dementia: Findings from a Delphi Study.

Cognitive and behavioral aspects may mask posttraumatic stress disorder (PTSD) in people with dementia. PTSD severely lowers quality of life in people with dementia. Proper recognition of PTSD is essential to ensure adequate treatment. However, a valid diagnostic tool for PTSD in dementia is lacking. A Delphi study was conducted among 20 Dutch and 6 international experts in the field of PTSD and dementia care or research. The aim was to reach consensus in 3 rounds on the added value, form, content, and application for developing such an instrument. The first round confirmed the need for a new diagnostic tool for research and clinical practice. Consensus was reached on 23 statements regarding the support base and 19 related to content of the instrument. In the third round, opinions on several conceptual problems were gathered. Based on the experts' opinions, a draft version of an instrument, the TRAuma and DEmentia-interview (TRADE-interview), was developed. Clinical and research implications of this new measure are discussed.

The nosographic structure of posttraumatic stress symptoms across trauma types: An exploratory network analysis approach.

The nosographic structure of posttraumatic stress disorder (PTSD) remains unclear, and attempts to determine its symptomatic organization have been unsatisfactory. Several explanations have been suggested, and the impact of trauma type is receiving increasing attention. As little is known about the differential impact trauma type in the nosographic structure of PTSD, we explored the nosology of PTSD and the effect of trauma type on its symptomatic organization. We reanalyzed five cross-sectional psychopathological networks involving different trauma types, encompassing a broad range of traumatic events in veterans, war-related trauma in veterans, sexual abuse, terrorist attacks, and various traumatic events in refugees. The weighted topological overlap was used to estimate the networks and attribute weights to their links. Coexpression differential network analysis was used to identify the common and specific network structures of the connections across different trauma types and to determine the importance of symptoms across the networks. We found a set of symptoms with more common connections with other symptoms, suggesting that these might constitute the prototypical nosographic structure of PTSD. We also found a set of symptoms that had a high number of specific connections with other symptoms; these connections varied according to trauma type. The importance of symptoms across the common and specific networks was ascertained. The present findings offer new insights into the symptomatic organization of PTSD and support previous research on the impact of trauma type on the nosology of this disorder.

Social Robots for Supporting Post-traumatic Stress Disorder Diagnosis and Treatment.

Post-Traumatic Stress Disorder (PTSD) is a severe psychiatric disorder with profound public health impact due to its high prevalence, chronic nature, accompanying functional impairment, and frequently occurring comorbidities. Early PTSD symptoms, often observed shortly after trauma exposure, abate with time in the majority of those who initially express them, yet leave a significant minority with chronic PTSD. While the past several decades of PTSD research have produced substantial knowledge regarding the mechanisms and consequences of this debilitating disorder, the diagnosis of and available treatments for PTSD still face significant challenges. Here, we discuss how novel therapeutic interventions involving social robots can potentially offer meaningful opportunities for overcoming some of the present challenges. As the application of social robotics-based interventions in the treatment of mental disorders is only in its infancy, it is vital that careful, well-controlled research is conducted to evaluate their efficacy, safety, and ethics. Nevertheless, we are hopeful that robotics-based solutions could advance the quality, availability, specificity and scalability of care for PTSD.

Epidemiology of posttraumatic stress disorder: A prospective cohort study based on multiple nationwide Swedish registers of 4.6 million people.

Experiencing exceptionally threatening or horrifying traumas can lead to posttraumatic stress disorder (PTSD). Increasing political unrest/war/natural disasters worldwide could cause more traumatic events and change the population burden of PTSD. Most PTSD research is based on surveys, prone to selection/recall biases with inconsistent results. The aim was therefore, to use register-based data to identify the occurrence of PTSD and contributing factors in the Swedish general population. This register-based cohort study used survival analysis. Individuals born between 1960-1995, aged ≥15 years, registered and living in Sweden, not emigrating, anytime between 1990-2015, not receiving specialized care for PTSD before 2006 were included (N = 4,673,764), and followed from their 15th/16th birth date until first PTSD diagnosis between 2006-2016 or study endpoint (31-December-2016). PTSD cases (ICD-10: F43.1) were identified from the national patient register. Mean follow-up time was 18.8 years. Between 2006-2016, the incidence of specialized healthcare utilization for PTSD nearly doubled, and 0.7% of the study population received such care. The highest risk was observed for refugees [aHR 8.18; 95% CI:7.85-8.51] and for those with depressive disorder [aHR 4.51; 95% CI:3.95-5.14]. Higher PTSD risk was associated with female sex, older age, low education, single parenthood, low household income, urbanicity, and being born to a foreign-born parent. PTSD is more common among refugee migrants, individuals with psychiatric disorders, and the socioeconomically disadvantaged. It is important that provision of services for PTSD are made available, particularly to these higher risk, and often hard-to-reach groups.

PTSD: equity in diagnostic practice

Post-traumatic stress disorder (PTSD) provides a vocabulary to describe the psychological toll all manner of traumatic events can take. However, although most cases of PTSD are not related to combat, more than 90% of PTSD-related US federal legislation introduced between 1989 and 2009 targeted military populations.1 The US Department of Defense and the US Department of Veterans Affairs are leading funders of PTSD research.2 PTSD has been constructed as a predominantly military-related disorder.

Prevalence and Temporal Trends Analysis of Screening and Diagnostic Instruments in Posttraumatic Stress Disorder: Text Mining Study.

BackgroundVarious instruments for patient screening and diagnosis have been developed for and applied in posttraumatic stress disorder (PTSD).ObjectiveThis study comprehensively investigates the prevalence and temporal trends of the most widely used instruments in PTSD-related studies.MethodsA total of 1345 files of registered clinical trials from ClinicalTrials.gov and 9422 abstracts from the PubMed database from 2005 to 2020 were downloaded for this study. The instruments applied in clinical trials were manually annotated, and instruments in abstracts were recognized using exact string matching. The prevalence score of an instrument in a certain period was calculated as the number of studies divided by the number of instances of the instrument. By calculating the yearly prevalence index of each instrument, we conducted a trends analysis and compared the trends in index change between instruments.ResultsA total of 4178 instrument synonyms were annotated, which were mapped to 1423 unique instruments. In the 16 years from 2005 to 2020, only 10 instruments were used more than once per year; the 4 most used instruments were the PTSD Checklist, the Clinician-Administered PTSD Disorder Scale, the Patient Health Questionnaire, and the Beck Depression Inventory. There were 18 instruments whose yearly prevalence index score exceeded 0.1 at least once during the 16 years. The changes in trends and time points of partial instruments in clinical trials and PubMed abstracts were highly consistent. The average time duration of a PTSD-related trial was 1495.5 days or approximately 4 years from submission to ClinicalTrial.gov to publication in a journal.ConclusionsThe application of widely accepted and appropriate instruments can help improve the reliability of research results in PTSD-related clinical studies. With extensive text data obtained from real clinical trials and published articles, we investigated and compared the usage of instruments in the PTSD research community.

Change in Self-compassion, Psychological Inflexibility, and Interpersonal Courage in Intensive PTSD Treatment: A Latent Growth Curve Analysis

Despite numerous advances in the understanding of the development and maintenance of posttraumatic stress disorder (PTSD), current research is often narrowly focused on symptom reduction. Despite this, the impact of PTSD also extends into areas such as interpersonal relationships, pursuit of valued activities, and self-acceptance. These processes appear to be especially relevant in chronic/complex PTSD but are rarely represented in controlled trials. As a result, there is a need to expand the focus of PTSD research beyond symptom reduction to include processes of well-being. Using a latent growth curve analytical approach, this study examined the impact of change in self-compassion, psychological inflexibility, and interpersonal courage on PTSD symptom reduction, trauma-related shame, quality of life, and valued living for participants in an exposure-based PTSD partial hospitalization program (n = 537; 75% White; 83% female; mean age = 36). All key processes assessed except for interpersonal courage showed clinically meaningful change over the course of the program. For the PTSD and valued living three-piece spline model slopes, only the three self-compassion slopes were significant predictors (p < .001). The psychological inflexibility slope predicted the quality of life slope (p < .001), while the interpersonal courage slope predicted the trauma-related shame slope (p < .001). Results supported the importance of broadening the focus of PTSD conceptualization, treatment, and outcome assessment to include processes such as psychological inflexibility, self-compassion, and interpersonal courage.

Sleep Quality Improvements After MDMA-Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder.

Sleep disturbances (SDs) are among the most distressing and commonly reported symptoms in posttraumatic stress disorder (PTSD). Despite increased attention on sleep in clinical PTSD research, SDs remain difficult to treat. In Phase 2 trials, 3,4‐methylenedioxymethamphetamine (MDMA)–assisted psychotherapy has been shown to greatly improve PTSD symptoms. We hypothesized that MDMA‐assisted psychotherapy would improve self‐reported sleep quality (SQ) in individuals with PTSD and be associated with declining PTSD symptoms. Participants in four studies (n = 63) were randomized to receive 2–3 sessions of active MDMA (75–125 mg; n = 47) or placebo/control MDMA (0–40 mg, n = 16) during all‐day psychotherapy sessions. The PSQI was used to assess change in SQ from baseline to the primary endpoint, 1–2 months after the blinded sessions. Additionally, PSQI scores were measured at treatment exit (TE) and 12‐month follow‐up. Symptoms of PTSD were measured using the CAPS‐IV. At the primary endpoint, CAPS‐IV total severity scores dropped more after active MDMA than after placebo/control (−34.0 vs. −12.4), p = .003. Participants in the active dose group showed more improvement in SQ compared to those in the control group (PSQI total score ΔM = −3.5 vs. 0.6), p = .003. Compared to baseline, SQ had improved at TE, p < .001, with further significant gains reported at 12‐month follow‐up (TE to 12‐months ΔM = −1.0), p = .030. Data from these randomized controlled double‐blind studies provide evidence for the beneficial effects of MDMA‐assisted psychotherapy in treating SDs in individuals with PTSD.

Processing of Positive Memories Technique (PPMT) for Posttraumatic Stress Disorder: A Primer.

Despite substantial evidence linking posttraumatic stress disorder (PTSD) and positive memory processes, existing trauma research and clinical work focuses primarily on traumatic memories. In light of this limitation, Contractor and colleagues proposed a conceptual model linking PTSD to positive memories; this provided the backdrop to develop a manualized positive memory therapy protocol for trauma-exposed individuals (Processing of Positive Memories Technique; PPMT). In the current study, we first present justification for developing PPMT by outlining the role of positive memories in trauma theories, as well as empirical evidence and intervention research linking trauma/PTSD to positive memory processes. Next, we provide information on the preliminary PPMT protocol by outlining (1) theoretical foundations; (2) intervention strategies PPMT draws from; (3) objectives; and (4) a session-by-session description of goals, content, and homework assignments. Finally, we end by highlighting some (1) unique features and advantages of PPMT such as integrating well-supported experimental and cognitive psychology research into intervention research, bridging the gap between basic science and applied research, and being tailored to PTSD's unique symptomatology; and (2) directions for future research. The aim of this paper was to provide a primer on PPMT to facilitate its empirical examination and applicability in PTSD research and clinical work.

Using artificial intelligence and longitudinal location data to differentiate persons who develop posttraumatic stress disorder following childhood trauma

Post-traumatic stress disorder (PTSD) is characterized by complex, heterogeneous symptomology, thus detection outside traditional clinical contexts is difficult. Fortunately, advances in mobile technology, passive sensing, and analytics offer promising avenues for research and development. The present study examined the ability to utilize Global Positioning System (GPS) data, derived passively from a smartphone across seven days, to detect PTSD diagnostic status among a cohort (N = 185) of high-risk, previously traumatized women. Using daily time spent away and maximum distance traveled from home as a basis for model feature engineering, the results suggested that diagnostic group status can be predicted out-of-fold with high performance (AUC = 0.816, balanced sensitivity = 0.743, balanced specificity = 0.8, balanced accuracy = 0.771). Results further implicate the potential utility of GPS information as a digital biomarker of the PTSD behavioral repertoire. Future PTSD research will benefit from application of GPS data within larger, more diverse populations.

Mental Time Travel in Post-Traumatic Stress Disorder: Current Gaps and Future Directions.

Mental Time Travel in Post-Traumatic Stress Disorder: Current Gaps and Future Directions.