Risk For Posttraumatic Disorder Research Articles

Serum adiponectin-levels are predictive of posttraumatic stress disorder in women

BackgroundAccumulative evidence indicates a role for adiponectin, a polypeptide secreted by adipose tissue, in the pathophysiology of posttraumatic disorder (PTSD) via metabolic and inflammatory pathways. This study examined adiponectin as a potential predictive biomarker for PTSD among female rape survivors. MethodsWe evaluated the relationship of baseline serum adiponectin levels to the development of probable PTSD at 3- and 6-months post rape-exposure and compared adiponectin levels between 542 rape-exposed (RE) and 593 rape-unexposed women (RUE). Probable PTSD were defined as a Davidson Trauma Scale score ≥40. Data were analysed using multivariate regression models and a generalized estimating equation (GEE) model. We adjusted for clinically relevant covariates associated with PTSD, as well as adiposity indices. ResultsParticipants who were in the mid-and high adiponectin tertile groups versus the lowest tertile group had a significantly reduced risk of probable PTSD at 6 months follow-up, independent of adiposity(aOR = 0.45[0.22–1.05], p = 0.035; aOR = 0.44[0.22–0.90], p = 0.024). However, there was no effect of group (RE vs. RUE). LimitationsAdiponectin assays were conducted on non-fasting blood samples and information on chronic medication, dietary factors and levels of physical activity were not collected. There was a high attrition rate among rape exposed participants. ConclusionsOur results show that higher serum adiponectin levels are associated with reduced risk of probable PTSD over a 6-month period. This finding supports the hypothesis that serum adiponectin is a potential risk biomarker for PTSD.

Unique Factor Structures Of The Adolescent Dissociative Experiences Scale And Posttraumatic Cognitions Inventory And Their Relation To PTSD Symptom Clusters In Maltreated Youth

ABSTRACT Adolescents who have experienced maltreatment are at enhanced risk for posttraumatic disorder (PTSD) and posttraumatic symptoms (PTS). Two key aspects of PTSD/PTS include dissociation and trauma-related cognitions, and these constructs are often measured via the Adolescent Dissociative Experiences Scale (ADES) and Posttraumatic Cognitions Inventory (PTCI). Unfortunately, little is known regarding the potential unique factor structures of these measures for maltreated youth with PTSD/PTS. Such knowledge would help clinicians develop more targeted assessments and clinical profiles for these youth. The primary aim of the present study was thus to examine the factor structures of the ADES and PTCI in a sample of 279 maltreated youth with PTSD/PTS (Mage = 14.25 years, SD = 1.78). A secondary aim was to identify whether identified factor structures from the present study sample of maltreated youth better predicted key PTSD symptom clusters of reexperiencing, avoidance, and hyperarousal compared to factor structures reported in previous literature. Confirmatory factor analysis revealed factor structures unique to this sample that better met goodness-of-fit criteria compared to other factor structures. These unique factor structures also displayed invariance across gender and age groups. In addition, the unique factor structure of the PTCI but not the ADES was a better predictor of reexperiencing and avoidance symptoms in maltreated youth compared to other factor structures in the literature. The results indicate that assessment protocols for maltreated youth with posttraumatic symptoms should be more closely tailored to the unique aspects of this population.

Can we predict intensive care relatives at risk for posttraumatic stress disorder?

Aims:To identify the relatives of the intensive care unit (ICU) patients at risk for developing symptoms of posttraumatic stress disorders.Setting:A multidisciplinary hospital ICU.Design:Prospective single center observational study.Material and Methods:Relatives of patients admitted in the ICU (May06-Nov06) who consented to answer the questionnaire participated in the study. Anxiety was assessed by using the Hospital Anxiety and Depression Scale (HAD) and vulnerability to posttraumatic disorder (PTSD) by using the Impact of Event Scale Revised (IES-R) which was administered on the fifth day of admission and at two months following discharge or death.Results:During admission, 48% of the relatives had a HAD score >11 and 72% showed IES-R score >26. There was no association of HAD with gender, patient outcome, working status, age of the patient, or mode of payment of the bills. There was significant association of IES-R >26 with trauma admission, HAD score >11 and mode of payment with the relatives of insured being more stressed as compared to those who settled their bills personally. A total of 35% relatives showed symptoms of posttraumatic stress reaction consistent with a high risk of PTSD after two months. Death in the hospital resulted in elevated HAD and IES-R score during admission and at the two month follow-up. Persistence of stress symptoms was more in school drop outs, working relatives, parents and those with initial anxiety score >11.Conclusions:HAD score greater than 11 was the only factor at admission which could statistically predict a higher PTSD score on follow-up. Adequate counseling of this group of relatives may prevent lasting psychological sequelae of an ICU admission in the relatives of critically ill.