Risk For PTSD Research Articles

Psychological assistance at disaster in Bulgaria - contemporary policies for health risk management

Abstract Issue Health risk management (HRM) in Bulgaria is provided to citizens in emergencies, disasters, accidents and catastrophes (E&DAC). According to the legislation in the country, this is a part of the mandatory package of medical provision for the injured population (MPIP) and concerns any acute life-threatening condition (LTC). In the dynamically changing environment of E&DAC, a special form of health consequences among survivors are related to mental health (MeH). Description of the problem In practice, any serious E&DAC has a direct or indirect psychological impact. It can manifest itself acutely or remotely over time, puts the victims in temporary or permanent disability and is followed by serious social effects. A strategy has been proposed for inclusion in the obligatory package of MPIP in case of significant E&DAC and primary psychological assistance (PPA) for every citizen who has survived. Results In the country, PPАs to citizens for decades is an on-demand service provided mainly by the private sector. Within the BRC, a group has been formed to provide PPA with a modest resource capacity. The emotional citizens culture in the country is far from active demand for PPA in general and severely limited in resources and the MeH is not a priority. This system of public health care, based on withdrawal from the MeH, also exposes to increased risk of psycho-somatic and distress-provoked physical illnesses (PSDPPhI). Lessons Carrying out timely PPA for those in need changes the range of adverse mental effects, reducing them. Provides a better adaptive response to reduced risk of PTSD and PSDPPhI. A volume of preventive measures organized in stages over time gives a greater chance to a larger number of victims. Key messages The health of the nation is a complex program for controlling both the acute health problems at E&DAC and the protection of MeH. To provide modern sustainable policies for the implication of PPA in everyone who has seriously experienced E&DAC is resulted in good health practices.

Drugs age-of-onset as a signal of later post-traumatic stress disorder: Bayesian analysis of a census protocol

Individuals with PTSD have an increased risk of drug use disorders. Conversely, we aim to evaluate how early onset of alcohol, tobacco and psychoactive drugs use are associated with PTSD later in life. 2,193 brazilian young adults completed modularized assessments: The Trauma History Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C, transformed to PCL-5 through a crosswalk procedure), the Barratt Impulsivity Scale; and a survey on drug use with self-report questions about first use, current use, frequency, quantity, and interpersonal consequences. Bayesian inference and multivariate regression models were used to examine the effects on the risk of PTSD, considering different assumptions of information flow. Raw and unbiased (multivariate) estimates consistently revealed that earlier age of onset of alcohol and tobacco use increased risk for PTSD (Odds-ratios between 2.39 and 3.19 (Alcohol) and 1.82 to 2.05 (Tobacco). Among those who had PTSD (310), 10.3% (32) were very precocious at the onset age (12 to 18 years) of alcohol consumption (No-PTSD: 89 out 1883, 4.7%). Data supports a model in which age of onset effects are partially mediated by the number of trauma exposures. Early intoxication might suggest vulnerability for qualifying trauma events, or it may increase chances of exposure. Also, PTSD may be more likely to occur among trauma-exposed individuals with early intoxicating experiences due to alcohol or drug self-administration. The last possibility resonates with the idea that early intoxication might disrupt adolescent brain development, with a subsequent reduction in resilience when qualifying trauma events occur.

Attachment Style Moderates Polygenic Risk for Incident Posttraumatic Stress in U.S. Military Veterans: A 7-Year, Nationally Representative, Prospective Cohort Study

BackgroundPosttraumatic stress disorder (PTSD) develops consequent to complex gene-by-environment interactions beyond the precipitating trauma. To date, however, no known study has used a prospective design to examine how polygenic risk scores (PRSs) interact with social-environmental factors such as attachment style to predict PTSD development. MethodsPRSs were derived from a genome-wide association study of PTSD symptoms (N = 186,689; Million Veteran Program cohort). We evaluated combined effects of PRS and attachment style in predicting incident PTSD in a 7-year, nationally representative cohort of trauma-exposed, European-American U.S. military veterans without PTSD (N = 1083). We also conducted multivariate gene-by-environment interaction and drug repositioning analyses to identify loci that interact with multiple environmental factors and potential pharmacotherapies that may be repurposed for this disorder. ResultsVeterans with higher PTSD PRS were more likely to have an incident-positive screen for PTSD over 7 years. A gene-by-environment interaction was also observed, such that higher PRS only predicted incident PTSD in veterans with an insecure attachment style and not those with a secure attachment style. At an individual locus level, the strongest gene-by-environment interaction was observed for the rs4702 variant of the FURIN gene with cumulative lifetime trauma burden. Drug repositioning revealed that genes implicated in PRS are perturbated by the drug doxylamine. ConclusionsAttachment style moderates polygenic risk for the development of PTSD in European-American veterans. These findings may inform PTSD prevention and treatment for veterans with high polygenic risk for PTSD and suggest a potential pharmacotherapeutic target for risk genes moderated by social-environmental factors.

4.1 RELATIONSHIP BETWEEN ADHD AND PTSD: A SYSTEMATIC REVIEW AND META-ANALYSIS

PTSD is a disorder that occurs after a traumatic experience. Although exposure to trauma is common, few individuals exposed to trauma develop PTSD, suggesting that these individuals have predisposing risk factors. ADHD is one such possible risk factor. The goal of this study was to examine the relationship between ADHD and PTSD by conducting a systematic review and meta-analysis of the literature on the association between ADHD and PTSD. We hypothesized that the literature would show a robust and bidirectional association between ADHD and PTSD. We reviewed literature through PubMed and PsycINFO in the year 2014 utilizing the search (posttraumatic stress disorder OR PTSD) AND (ADHD OR attention deficit hyperactivity disorder OR ADD OR attention deficit disorder OR hyperkinetic syndrome OR minimal brain dysfunction). We included original human research in English that operationalized diagnoses of ADHD and PTSD, evaluated the relationship between the disorders, and included controls. We extracted sample size, age, diagnostic methods, design, referral status, control type, and number of subjects with and without ADHD and PTSD alone and combined. We computed meta-analyses for studies examining ADHD in PTSD and PTSD in ADHD using a random-effects model and meta-analytic regression. We assessed for heterogeneity and publication bias and adjusted for intrastudy clustering. We identified 402 articles; 29 met the criteria for inclusion (14 with adult subjects and 15 with child subjects). The relative risk (RR) for PTSD in individuals with ADHD was 2.9 (p < 0.0005). In samples using only normal controls, the RR was 3.7 (p = 0.001), and in samples using trauma-exposed controls, the RR was 1.6 (p = 0.003). The RR for ADHD in individuals with PTSD was 1.7 (p < 0.0005), and in samples using trauma-exposed controls, the RR was 2.1 (p < 0.0005). All 6 studies examining the temporality of each disorder found earlier ADHD onset than PTSD. All 6 studies examining the correlation between ADHD and PTSD symptoms found a positive and significant correlation. Results indicate a bidirectional association between ADHD and PTSD, suggesting clinical implications and highlighting the need for neurobiological research examining the mechanisms underlying this connection.

6.35 Behavioral and Neural Mechanisms of Trauma Symptomatology in Youth With Autism Spectrum Disorder

Previous research has demonstrated that youth with autism spectrum disorders (ASD) are more likely to experience adverse childhood experiences (ACEs) and may be at greater risk for developing PTSD following such events. Our research aimed to utilize the longitudinal ABCD study to assess the prevalence and underlying mechanisms of increased risk of ACEs, trauma, and PTSD in youth with ASD. Youth with ASD (n = 196) were identified and a typically developing control (CTL) group was established using nearest neighbor propensity score matching on age, sex, MRI scanner, IQ, and socioeconomic status (SES). Using data from the Family Environment Scales, K-SADS, Family History, Short Social Responsiveness Scale, Youth Life Events Scale, and Longitudinal Parent Demographics Survey, we compared the relationship between ACEs and PTSD symptoms between groups using negative binomial regression and moderation analyses of functional connectivity (FC) MRI measures provided by the ABCD consortium seeded in the amygdala. Youth with ASD had significantly more ACEs compared to CTL peers and met DSM-5 criteria for PTSD (per K-SADS-5) at nearly twice the rate (9.9%) of their CTL peers (5.2%, p = 0.020). Poor social skills were associated with more PTSD in CTL compared to ASD and externalizing and internalizing behaviors predicted PTSD above and beyond ACEs differently for the two groups. More positive right amygdala FC with the visual, auditory and sensory-motor hand networks predicted more PTSD symptoms in ASD youth with high ACEs (visual & auditory) or all levels of ACEs (SM hand). This is the first study to examine the prevalence of PTSD in a community sample of youth with ASD who did not come to study attention through clinical interactions and confirmed the higher rate of PTSD in ASD. Alterations in FC in the ASD group suggest underlying ASD-related abnormalities may be risk factors for development of PTSD and that youth with ASD respond differently to ACEs and/or develop different compensatory mechanisms. The differential expression of internalizing and externalizing behaviors associated with PTSD underlines the importance of assessing for ACEs and post-traumatic symptoms in youth with ASD as these youth may have greater difficulty mounting appropriate resiliency responses and therefore need further intervention.

50.10 PTSD and Prenatal Maternal Psychopathology in Times of Hurricane MarIa

Poor maternal mental health is associated with adverse effects in child development. Traumatic exposure to a natural disaster, such as Hurricane Maria, could increase the risk of PTSD and other psychopathologies. Children of mothers with disaster-related PTSD and depression have been shown to be more reactive, anxious, and depressed. This study aims to describe prenatal psychopathologies in the context of posthurricane PTSD.

Adaptation to Limb Loss: Heterogeneous Trajectories of Resilience and Depression Predict Posttraumatic Stress

<h3>Research Objectives</h3> To identify longitudinal trajectories of depression in the first six months following amputation and to explore baseline predictors of these trajectories. A secondary aim was to utilize trajectories as predictors of PTSD as a 6-month distal outcome. <h3>Design</h3> Archival data from two inception cohort studies of persons with new onset limb loss. Participants completed assessments at initial, -3 and 6-month follow-ups. <h3>Setting</h3> hospitalized care, acute rehabilitation, ambulatory care, and community. <h3>Participants</h3> Individuals with new limb loss were recruited from consecutive cases within a large metropolitan hospital system over a four-year period (2002-2007). Final sample (n = 203) was predominantly male (78.8%) and white (83.3%) with an average age of 49.4 years (SD = 14.58) at the time of amputation. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Patient Health Questionnaire-9 (PHQ-9); PTSD checklist – Civilian Version (PCL-C). <h3>Results</h3> Using Latent Growth Mixture Modeling, four trajectories of depression were identified: resilience (73.2%), recovery (6.7%), emerging depression (8.9%), and chronic depression (11.2%). Pain intensity was a significant baseline predictor of trajectory membership, whereas demographic covariates were non-significant. In distal outcome analyses, trajectory membership significantly predicted PTSD at 6-months. Pairwise comparisons revealed significantly elevated PTSD in the chronic-depression trajectory versus all other classes; the resilient class had significantly fewer PTSD symptoms than the emerging depression class but did not differentiate from the recovery trajectory. <h3>Conclusions</h3> Findings support the conclusion that the course of depression post-amputation is heterogeneous, with varying profiles of symptom development and remission. Although the majority of individuals were classified as resilient, average depression was mildly elevated in the resilient class immediately post-amputation, underscoring the challenging nature of acute recovery. Further, a substantial minority of individuals (8.9%) developed clinically significant depression between 3 and 6-months, suggesting that early screening during acute care may be insufficient for the detection of emerging depression. The derivation of latent classes of depression in longitudinal data may prove useful as a clinical tool for the early identification of those at risk for PTSD, a diagnosis with unique time-course requirements. <h3>Author(s) Disclosuress</h3> None

The role of inhibitory processes in the relationship between subsyndromal PTSD symptoms and aggressive behaviour

The issue of aggressive behaviours among military populations is important for a number of reasons, including the potential associated occupational, social and functional impacts. Controlled aggressive behaviour is an adaptive requirement of some military roles, however, this aggression can become maladaptive when uncontrolled, or contextually inappropriate. Elevated aggression among deployed veterans has been identified in a number of studies, although the reasons for it are not well understood. Deployed populations have elevated levels of stress and trauma exposure, have higher rates of childhood and other lifetime trauma exposures and have a heightened risk for subsyndromal or full PTSD. Both trauma exposure and PTSD have been found to be associated with executive function deficits, and increased anger and aggressive behaviours. The purpose of this paper was to explore the contribution of both early PTSD symptoms and cognitive disinhibition in predicting increased aggressive behaviour following deployment in a healthy active serving cohort. After controlling for pre-deployment PTSD symptoms and cognitive function, there were significant main effects of both PTSD symptoms and cognitive function on increased aggression at post-deployment. Furthermore, the positive association between PTSD symptoms and post-deployment aggression was moderated by response inhibition deficits in the domains of false positive errors as well as faster reaction times. Subsidiary analyses showed that the effects of increased reaction time in particular increased the likelihood of PTSD symptoms being coupled with increased aggression. These findings highlight the potential effects of repeated occupational stress exposure and point to possible cognitive adaptations and long-term risk for disorder.

Religion, spirituality, and risk for incident posttraumatic stress disorder, suicidal ideation, and hazardous drinking in U.S. military veterans: A 7-year, nationally representative, prospective cohort study

While religion and spirituality (R/S) have been linked to positive mental health outcomes, most studies have employed cross-sectional designs, which do not allow one to evaluate the utility of R/S in predicting these outcomes. To address this gap, this study analyzed data from a 7-year nationally representative, prospective cohort study of U.S. military veterans to examine the effects of R/S on the development of incident mental health outcomes in this population. Specifically, we examined the association between organizational religious activity (ORA), non-organizational religious activity (NORA), and intrinsic religiosity (IR), and the risk of incident PTSD, suicidal ideation (SI), and hazardous drinking (HD). Multivariable logistic regression analyses revealed that ORA predicted a lower incidence of PTSD and SI; NORA a greater risk of developing HD; and IR a lower risk of developing HD. These results suggest that religion and spirituality, assessed in a nationally representative sample of military veterans, predict risk of developing PTSD, SI, and HD, over and above sociodemographic factors and perceived social support. Clinical implications and strategies for incorporating R/S into mental health assessment and interventions in this population are discussed.

Prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria: a cross-sectional study

BackgroundLittle is known about the prevalence of and factors associated with PTSD among adult females in Nigeria, particularly those who live in slums. PTSD is a mental health condition that develops among some individuals who experience or witness a traumatic event. Several other factors could place individuals at heightened risk of PTSD including stress and comorbid mental disorders. Therefore, this study aimed to examine the prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria.MethodsWe conducted a cross sectional survey using multistage sampling of 550 women aged 18 and above from selected slums. Interviewer administered questionnaires were used to elicit information on experience of childhood trauma, recent stressors, intimate partner violence, other mental disorders, sociodemographic characteristics and PTSD. PTSD was measured using the Harvard Trauma Questionnaire (HTQ) which is based on DSM IV. A multivariable linear regression model was built to test associations between PTSD and independent variables.ResultsThe prevalence for PTSD was found to be 4.18% and the mean PTSD score was 5.80 ± 7.11. Sexual abuse in childhood, past year intimate partner violence and anxiety were significantly associated with higher PTSD scores. PTSD was not significantly associated with a history of recent stressors. Education, employment and marital status were not associated with PTSD however, age and wealth index showed marginal association with PTSD.ConclusionThe prevalence of PTSD among women living in Ibadan slums was relatively low. Both child sexual abuse and intimate partner violence can be prevented. We also recommend longitudinal studies to better understand risk and protective factors.

Posttraumatic Stress Disorder among Patients at an Anxiety Clinic in Puerto Rico

Specialized evidence-based clinics are available for psychological trauma treatment. Data from patients in these clinics must be analyzed in order to better understand this population. In this study, we described the sociodemographic and clinical profile of patients from an evidence-based, anxiety disorder treatment/research center, located in the metropolitan area of Puerto Rico: The Center for the study of Fear and Anxiety (known by its Spanish acronym, CETMA). We performed a secondary data analysis of CETMA database, with data from the multidimensional evaluation, performed at the initial screening interview. We identified 35 patients with a preliminary diagnosis of PTSD. Patients with PTSD were mostly women, between 19-30 years, single, employed, with a completed bachelor’s degree. Also, they had 2-4 diagnoses, the most common comorbidity was generalized anxiety disorder. They reported a previous psychiatric history of PTSD, depression, and panic attacks. On average, patients received 1-15 therapeutic sessions. Findings highlight the need for educating and disseminating these services to the public, a population with an increased risk for PTSD.

Anxiety, PTSD, and stressors in medical students during the initial peak of the COVID-19 pandemic.

To assess psychological effects of the initial peak phase of the COVID-19 pandemic on United States (US) medical students in clinical training to anticipate sequelae and prepare for future outbreaks. Authors emailed a cross-sectional survey in April-May, 2020 to students in clinical training years at six US medical schools which included validated General Anxiety Disorder (GAD-7) and Primary Care-PTSD (PC-PTSD-5) screening tools, and asked students about pandemic-related stress and specific concerns. Authors used quantitative and thematic analysis to present results. Of 2511 eligible students, 741 responded (29.5%). Most students (84.1%) reported at least "somewhat" increased levels of stress and anxiety related to the pandemic. On the GAD-7, 34.3% showed mild, 16.1% moderate, and 9.5% severe anxiety symptoms, with 39.6% demonstrating no/minimal symptoms. One quarter (25.4%) screened positive for PTSD risk symptoms. Top concerns of students chosen from a pre-populated list included inadequate COVID-19 testing, undiagnosed or asymptomatic spread and racial or other disparities in the pandemic. In thematic analysis, students' reactions to removal from clinical learning included: understanding the need to conserve PPE (32.2%), a desire to help (27.7%), worry over infectious risk to others (25.4%) and self (21.2%), and lost learning opportunities (22.5%). Female students were significantly more likely to report anxiety and PTSD risk symptoms. Asian students had a greater risk of moderate anxiety and those underrepresented in medicine (UIM) had greater risk of moderate and severe anxiety symptoms compared to white students. During the initial peak phase of COVID-19, over 60% of US medical students screened positive for pandemic-related anxiety and one quarter were at risk for PTSD. Female and UIM students were significantly more affected. Medical schools should consider broad support of students, and targeted outreach to female and UIM students.

Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population

ObjectiveTo test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity.DesignPopulation-based cross-sectional study.SettingIceland.ParticipantsA total of 22...

Associations of trauma and posttraumatic stress disorder with aldosterone in women

BackgroundPosttraumatic stress disorder (PTSD) has been associated with increased cardiovascular risk, however, underlying mechanisms have not been fully specified. PTSD is associated with stress-related hormones, including dysregulated glucocorticoid activity. Dysregulation of aldosterone, a mineralocorticoid activated by psychological stress and implicated in cardiovascular damage, may be a relevant pathway linking PTSD and cardiovascular risk. Few studies to date have evaluated the association between PTSD and aldosterone, none with repeated measures of aldosterone. We examined if trauma and PTSD were associated with altered aldosterone levels relative to women unexposed to trauma. MethodsThe association of trauma exposure and chronic PTSD with plasma aldosterone levels was investigated in 521 middle-aged women in the Nurses’ Health Study II. Aldosterone was assessed at two time points, 10–16 years apart, and trauma exposure and PTSD were also ascertained for both time points. Regarding exposure assessment, women were characterized based on a structured diagnostic interview as: having chronic PTSD (PTSD at both time points; n = 174); being trauma-exposed (trauma exposure at first time point but no PTSD; n = 174); and being unexposed (no trauma exposure at either time point; reference group for all analyses; n = 173). Linear mixed models examined associations of trauma and PTSD status with log-transformed aldosterone levels, adjusting for covariates and health-related variables that may confound or lie on the pathway between PTSD and altered aldosterone levels. ResultsAcross the sample, mean aldosterone concentration decreased over time. Adjusting for covariates, women with chronic PTSD had significantly lower aldosterone levels averaged over time, compared to women unexposed to trauma (β = − 0.08, p = 0.04). Interactions between trauma/PTSD group and time were not significant, indicating change in aldosterone over time did not differ by trauma/PTSD status. Post-hoc exploratory analyses suggested that menopausal status partially mediated the relationship between chronic PTSD status and aldosterone level, such that postmenopausal status explained 7% of the effect of PTSD on aldosterone. ConclusionsThese findings indicate that PTSD is associated with lower levels of aldosterone. Further work is needed to understand implications of this type of dysregulation in a key biological stress system for cardiovascular and other health outcomes previously linked with PTSD.

Traumatic Effects of the COVID-19 Outbreak in Middle School Students and Caregivers.

Objective To investigate the traumatic effects of the COVID-19 pandemic on middle-school students and their parents. Methods This epidemiological cross-sectional study was conducted with middle-school students in Denizli. A questionnaire consisting of the IES-R, CRIES-13 and a sociodemographic data form was delivered online. A total of 1059 participants who fully completed the questionnaire were included for analysis. Results The IES-R total and subdimension scores and the CRIES-13 scores were found to be significantly higher in families with an income level of ≤2,500 TL. The CRIES-13 scores of children were found to be significantly higher in divorced families. No statistically significant difference was determined between the IES-R total and subdimension scores of the parents who were healthcare workers and the CRIES-13 scale scores of their children. Conclusion A statistically significant, positive, moderate relationship was found between the IES-R scale total and subdimension scores of parents and the CRIES-13 scale scores of children. A low socioeconomic level was seen to increase the prevalence of anxiety in adults and adolescents. The children of divorced families were found to be at higher risk of PTSD. Successful management of mental health symptoms in parents will reflect positively on the mental health status of their children.

A national survey on depressive and anxiety disorders in Afghanistan: A highly traumatized population

BackgroundThis survey attempts to measure at a national level, exposures to major traumas and the prevalence of common mental health disorders in a low-income dangerous country, highly affected by conflicts: Afghanistan.MethodsTrans-sectional probability survey in general population by multistage sampling in 8 provinces, represented nationwide: 4445 adults (4433 weighted),15 years or older, 81% participation rate. Face to face interviews used specific scales for measuring lifetime exposure (LEC 5 Life Events Checklist) and Post Traumatic Stress Disorder (PTSD Check List), a diagnostic standardized interview: Composite International Diagnostic Interview (Short Form) for.Major Depressive Episode and Generalized Anxiety Disorder, plus scales for suicidal thoughts and attempts and psychological distress (MH5 and RE from SF36).Results52.62% of the population is illiterate, 84,61% of the women do not have any source of income; 70.92% of the population lives in rural areas, 60.62% are below 35 years, 80% lives in very dangerous areas. 64.67% of the Afghan population had personally experienced at least one traumatic event; 78.48% had witnessed one such event. 60.77% of the sample experienced collective violence in relation to war and 48.76% reported four or more events; this very much differs across regions and levels of danger; women are less at risk for trauma except sexual violence, 35 years and above are more at risk than younger. 12-month PTSD prevalence reaches a high rate: 5.34% as MDE 11,71%, whereas GAD 2.78%; suicidal thoughts 2.26%, lifetime suicidal attempts 3.50% are close to reported in other countries. Women have more risk for PTSD (0R = 1.93) and suicidal behaviours (attempts OR = 1.92) than men; the number of events increases risk for MDE, PTSD and suicidal attempts, whereas education is protective. Exposure to different war events produced different mental health effects. People suffering from PTSD have higher risk to report 12-months suicidal ideations and lifetime suicidal attempts.ConclusionOur findings highlight the need to map the extent and the types of mental disorders post conflict; this would help maximise the help to be offered in guiding proper choice of interventions, including education.

Integrative Functional Genomic Analysis of Human PTSD Molecular Pathology and Risk

PTSD is a multigenic and multifactorial disorder occurring in the aftermath of significant trauma exposure. Recent GWAS have identified many high confidence loci as risk factors for PTSD, which have shed some light on impaired mechanisms. However, there are still fundamental gaps in our understanding of how these risk genes and pathways are interrelated in causing PTSD but are likely reflected in cell type-specific transcriptomic and epigenetic changes in the brain. Therefore, it is necessary to uncover the individual cell type contribution to the molecular pathology of PTSD.

The impact of life hardiness, attachment style and personality profile on ptsd vulnerability manifestation in breast cancer patients undergone successful surgical treatment

IntroductionPTSD manifestation is determined by facing extreme life threatening experience going beyond our stress coping skills. The diagnosis of the serious illness like cancer or SARS-2 COVID 19 can be considered as one of the PTSD risk factors. In our clinical practice we have to distinguish the patients groups vulnerable to comorbid PTSD as well as define the psychological factors like good life hardiness, adaptive internal illness image or specific personality profile that can help to cope with disease stress and should be strengthen with psychosocial interventions.ObjectivesAfter screening with PTSD Trauma Screening Questionnaire and an expert clinical interview aimed to verify the PTSD diagnosis according to ICD-10 criteria 97 breast cancer patients were enrolled in the study, 46 with comorbid PTSD, 51 well coped with stressMethodsSemi-structured interview, Hardiness Survey questionnaire,Experiences in Close Relationships-Revised (ECR-R) Adult Attachment questionnaire,Impact of Event Scale-R – IES-R, the questionnaire of the internal disease model, Ego-structure test by G. Ammon(ISTA),.ResultsThe correlation analysis revealed negative correlation between PTSD diagnosis and hardiness, especially its Involvement, Control, Risk acceptance sub-scales and with the Traumatic event impact score. Deficient-destructive ISTA personality profile had a positive correlation with PTSD and traumatic Impact scores, the strongest correlation were with deficient aggression(r=0,698, p=0.01), destructive anxiety (r=0,674, p=0,01), and deficient internal and external demarcation (r=0,678, p=0,01). The adaptive internal illness image types had a negative correlation with PTSDConclusionsHardiness, maladaptive illness images types and destructive-deficient personality dimension should be the main targets for psychotherapy in comorbid PTSD treatment and preventionKeywordlife hardiness ptsd breast cancer internal image of the illness construct anxiety social support

The Role of Military Service and Childhood Adversity in US Law Enforcement Officer Health and Wellness

This study is the first attempt to systematically examine the impact of prior military service and childhood adversity on physical and psychological health outcomes during subsequent law enforcement employment. Given that at least one in five US law enforcement officers (LEOs) is a military veteran, and many law enforcement agencies provide preferential status for veterans in the hiring process, understanding the effects of prior military service on LEO physical and psychological well-being is important for supporting officer safety and wellness. Using nationally representative data, we examine the interrelationships between prior military service, combat deployments, childhood adversity, and three health outcomes during subsequent LE employment—PTSD, sleep problems, and suicidality. Contrary to prior research and our hypotheses, we found that prior military service and combat experience were not associated with an increased risk of PTSD, sleep problems, or suicidality. Furthermore, while greater exposure to adverse childhood experiences (ACEs) among non-veteran LEOs was linked with increased odds of PTSD, among veteran LEOs, greater ACE exposure was significantly linked with reduced odds of PTSD. We offer several possible explanations to account for these findings.

68415 Neural Impact of Neighborhood Disadvantage in Traumatically-Injured Adults: a Multi-Modal Investigation

ABSTRACT IMPACT: Neighborhood disadvantage was significantly associated with brain structure and function in trauma-exposed adults, providing evidence that contextual factors should be assessed in mental health research, particularly in high-risk populations. OBJECTIVES/GOALS: Over 13 percent of Americans live in a socioeconomically disadvantaged neighborhood. Previous work has linked lower individual socioeconomic position to alterations in brain structure and function. However, the neural effects of area-level socioeconomic factors, such as neighborhood disadvantage, are unclear. METHODS/STUDY POPULATION: We recruited two-hundred and fifteen traumatically-injured participants from an Emergency Department in southeastern Wisconsin. An Area Deprivation Index (ADI) score, a national measure of neighborhood socioeconomic disadvantage, was derived from each participant’s home address. Two-weeks post-trauma, participants underwent a battery of self-report measures and functional magnetic resonance imaging (fMRI) scans. Using a multi-modal approach, we investigated the impact of ADI on brain structure as well as neural activation during rest and during an emotional uncertainty task. We sought to disentangle the relationship between neighborhood and individual socioeconomic position and neural activity in the context of trauma. RESULTS/ANTICIPATED RESULTS: We demonstrated that neighborhood disadvantage is associated with decreased volume and alterations of resting state functional connectivity of structures implicated in affect processing, including the hippocampus, amygdala, and ventromedial prefrontal cortex. These results held even after controlling for relevant individual variables, including acute post-traumatic stress symptoms and years of education. Moreover, individuals from disadvantaged neighborhoods exhibited heighted activation of these same structures in response to aversive stimuli. Thus, brain regions critical for recognizing and processing negative stimuli are susceptible to the effects of area-level socioeconomic factors. DISCUSSION/SIGNIFICANCE OF FINDINGS: The results offer additional evidence that neurobiological mechanisms clarify how stress ‘gets under the skin’. Changes to key brain regions may explain why those living in disadvantaged neighborhoods are at a heighted risk of PTSD. Broadly, these findings should inform future policies and community-driven interventions aimed at reducing poverty.