Posttraumatic Stress Disorder Scale Research Articles

Criticality is Associated with Future Psychotherapy Response in Patients with Post-Traumatic Stress Disorder—A Pilot Study

Background Trauma-focused psychotherapy is treatment of choice for post-traumatic stress disorder (PTSD). However, about half of patients do not respond. Recently, there is increased interest in brain criticality, which assesses the phase transition between order and disorder in brain activity. Operating close to this borderline is theorized to facilitate optimal information processing. We studied if brain criticality is related to future response to treatment, hypothesizing that treatment responders’ brains function closer to criticality. Methods Functional magnetic resonance imaging resting-state scans were acquired from 46 male veterans with PTSD around the start of treatment. Psychotherapy consisted of trauma-focused cognitive behavioral therapy, eye movement desensitization and reprocessing, or a combination thereof. Treatment response was assessed using the Clinician-Administered PTSD Scale, and criticality was assessed using an Ising temperature approach for seven canonical brain networks (ie, the visual, somatomotor, dorsal attention, ventral attention, limbic, frontoparietal and default mode networks) to measure distance to criticality. Results The brains of prospective treatment responders were closer to criticality than nonresponders (P = 0.017), while no significant interaction effect between group and brain network was observed (P = 0.486). In addition, average criticality across networks correlated with future treatment response (P = 0.028). Conclusion These results show that the brains of prospective PTSD psychotherapy treatment responders operate closer to criticality than nonresponders, and this occurs across the entire brain instead of in separate canonical brain networks. These results suggest that effective psychotherapy is mediated by brains operating closer to criticality.

Childhood-related PTSD: the role of cognitions in EMDR and imagery rescripting

ABSTRACT Background: The relationship between trauma-related negative cognitions and post-traumatic stress disorder (PTSD) symptoms has been studied frequently. Several studies found a mediating effect of trauma-related negative cognitions on symptom reduction in studies on different psychotherapeutic treatments, however, this relationship has never been studied in imagery rescripting (ImRs) or eye movement desensitization and reprocessing (EMDR). Objective: To analyse the role of trauma-related negative cognitions in the treatment of PTSD due to childhood trauma with EMDR and ImRs. Method: N = 155 patients with PTSD due to childhood trauma aged between 18 and 65 (M = 38.54) participated in a randomized clinical trial and were treated with either EMDR or ImRs in Australia, Germany, and the Netherlands between October 2014 and June 2019. We analysed the relationship between PTSD symptoms (Clinician-administered PTSD Scale for DSM-5, CAPS-5 and Impact of Event Scale revised; IES-R, completed twice for index trauma and for all other traumas) and trauma-related negative cognitions (Post-Traumatic Cognitions Inventory, PTCI) using Granger Causality analyses with linear mixed models on person-centered variables. Assessments were conducted pre-treatment, post-treatment (12 sessions in 6 weeks), eight weeks post-treatment, and one year after the pre-treatment assessment. Results: Changes in negative cognitions (PTCI) preceded changes in PTSD symptoms (unidirectional) as measured by the CAPS and the IES-R for index trauma. For the IES-R related to all other traumas, a unidirectional relationship was found in which changes in PTSD symptoms preceded changes in negative cognitions. No moderating effect of treatment was found. On the level of PTCI subscales only changes in cognitions about oneself preceeded changes in PTSD symptoms. Conclusions: The results support the idea of a general role of trauma-related negative cognitions in the treatment of PTSD. The analyses should be replicated with a higher frequency of assessments.

Trauma-focused and personality disorder treatment for posttraumatic stress disorder and comorbid cluster C personality disorder: a randomized clinical trial

ABSTRACT Background: Posttraumatic stress disorder (PTSD) is associated with high rates of cluster C personality disorders (PD), which may negatively affect PTSD treatment. It is unknown whether concurrent treatment for PTSD and comorbid PD leads to superior treatment effects, compared to standard trauma-focused treatment. Objective: The objective was to test the efficacy of adding personality disorder treatment (group schema therapy; GST) to individual trauma-focused treatment (imagery rescripting; ImRs). Method: A two-arm randomized clinical trial (1:1 allocation ratio) was conducted between 2018 and 2023 at two sites of a mental health institution in the Netherlands. Raters were blind to treatment allocation. Adult outpatients with PTSD and comorbid cluster C personality disorders were randomized to receive either ImRs (12–18 sessions) or ImRs + GST (12–18 ImRs + 52–58 GST). The main outcome was PTSD severity one year after start of treatment measured with the Clinician-Administered PTSD Scale for DSM-5. Results: Of 130 patients (mean [SD] age = 40.6 [11.2], 110 [85%] females), 66 were assigned to ImRs and 64 to ImRs + GST. At 12 months, there were large decreases in PTSD severity (d ImRs = 2.42, 95%CI = 1.97–2.87; d ImRs + GST = 2.44, 95%CI = 1.99–2.90), but there was no significant difference between conditions (d = 0.02, 95%CI = −0.33–0.36, p = .944). Reductions in personality disorder symptoms and all other secondary outcomes were observed in both conditions. There were no significant differences between conditions on any of the secondary outcomes at 12 months. Conclusion: The more intensive concurrent trauma-focused and personality disorder treatment (ImRs + GST) was not superior to trauma-focused treatment alone (ImRs) for patients with PTSD and comorbid CPD. This suggests that trauma-focused treatment is the preferred primary treatment in patients presenting with both internalizing personality disorder and PTSD, reserving the stepping up to more intensive psychotherapy aimed at the personality disorder as a second line of treatment. Trial registration: ClinicalTrials.gov identifier: NCT03833531

Exploring the feasibility and acceptance of huddinge online prolonged exposure therapy (HOPE) for severe and complex PTSD

ABSTRACT Background: Trauma-focused cognitive behavioural therapy such as prolonged exposure is considered firsthand choice for treatment of posttraumatic stress disorder (PTSD) but is seldom available in regular care. Digital therapy is proposed to bridge this gap, but its effectiveness for severe and complex PTSD is uncertain. The primary objective of the current study was to examine the feasibility, acceptability, and preliminary effects of digital therapist-guided prolonged exposure (Huddinge Online Prolonged Exposure; HOPE). Method: Thirty participants with moderate to severe PTSD, with the majority self-reporting complex PTSD symptoms, received HOPE over a ten-week period. Eighty percent of participants had been diagnosed with other psychiatric comorbidity by a mental health professional. Primary outcome was the feasibility and acceptability of treatment. Participants were repeatedly assessed using clinician- and self-rated outcome measures at baseline, during the treatment period, post-treatment, and at 1-month and 6-month follow-ups to estimate preliminary treatment effects. The Clinician Administered PTSD Scale version 5 (CAPS-5), administered by independent assessors, evaluated PTSD symptom severity. Results: HOPE proved feasible and effective, delivering evidence-based treatment content in a psychiatric outpatient setting with reduced therapist time. The treatment was well-tolerated, with no severe adverse events and a 17% dropout rate. Sixty-four percent completed the exposure-based portion of the treatment, and overall satisfaction measured by the Client Satisfaction Questionnaire was moderate. Furthermore, significant reductions in PTSD symptoms as assessed with the CAPS-5 (Cohen's d = 1.30 [95% CI −1.79 to −0.82]) at the primary endpoint 1 month which were sustained at the 6-month follow up. Conclusion: Altogether, this study indicate feasibility of treating severe and complex PTSD through a digital PE intervention, thereby building upon and extending previous research findings. Large-scale controlled trials are needed to further validate the specific effect and long-term benefits of HOPE. Trial registration: ClinicalTrials.gov identifier: NCT05560854.

Trauma-related moderators of associations between sex hormones and PTSD symptoms: a replication-extension

ABSTRACT Background: Post-traumatic stress disorder (PTSD) disproportionately affects women and recent evidence suggests that unique associations between sex hormones (e.g. estradiol and progesterone) and PTSD symptoms may contribute to this difference. In addition, trauma characteristics such as age at trauma and trauma type may influence this association. We aimed to replicate and extend the findings of a prior study that identified trauma characteristics (sexual trauma and age at trauma) as moderators of associations between estradiol and PTSD symptoms. Methods: Sixty-five trauma-exposed individuals assigned female at birth were included (M age = 31.45). Participants provided blood samples for estradiol and progesterone assays. The Clinician Administered PTSD Scale for DSM-5 (CAPS-5) was used to assess trauma characteristics and PTSD symptoms. Results: There were no significant correlations between estradiol, progesterone, and PTSD symptom severity. Regression analyses revealed no moderation effects by sexual trauma or age at trauma for estradiol. However, age at trauma significantly moderated the relationship between progesterone and total PTSD severity. Discussion: Contrary to expectations, our results did not replicate prior research, as estradiol was not associated with PTSD severity in our sample. Progesterone was not directly associated with PTSD symptoms, but this relationship was moderated by age at trauma onset. Our findings suggest that trauma characteristics may influence the relationship between sex hormones and PTSD symptoms. While we didn't replicate previous associations between estradiol and PTSD symptoms, our study emphasizes the importance of considering trauma characteristics in understanding the relationship between sex hormones and PTSD.

Brexpiprazole and Sertraline Combination Treatment in Posttraumatic Stress Disorder

New pharmacotherapy options are needed for posttraumatic stress disorder (PTSD). To investigate the efficacy, safety, and tolerability of brexpiprazole and sertraline combination treatment (brexpiprazole + sertraline) compared with sertraline + placebo for PTSD. This was a parallel-design, double-blind, randomized clinical trial conducted from October 2019 to August 2023. The study had a 1-week, placebo run-in period followed by an 11-week, double-blind, randomized, active-controlled, parallel-arm period (with 21-day follow-up) and took place at 86 clinical trial sites in the US. Adult outpatients with PTSD were enrolled (volunteer sample). Oral brexpiprazole 2 to 3 mg per day (flexible dose) + sertraline 150 mg per day or sertraline 150 mg per day + placebo (1:1 ratio) for 11 weeks. The primary end point was change in Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) total score (which measures the severity of 20 PTSD symptoms) from randomization (week 1) to week 10 for brexpiprazole + sertraline vs sertraline + placebo. Safety assessments included adverse events. A total of 1327 individuals were assessed for eligibility. After 878 screen failures, 416 participants (mean [SD] age, 37.4 [11.9] years; 310 female [74.5%]) were randomized. Completion rates were 137 of 214 participants (64.0%) for brexpiprazole + sertraline and 113 of 202 participants (55.9%) for sertraline + placebo. At week 10, brexpiprazole + sertraline demonstrated statistically significant greater improvement in CAPS-5 total score (mean [SD] at randomization, 38.4 [7.2]; LS mean [SE] change, -19.2 [1.2]; n = 148) than sertraline + placebo (randomization, 38.7 [7.8]; change, -13.6 [1.2]; n = 134), with LS mean difference, -5.59 (95% CI, -8.79 to -2.38; P < .001). All key secondary and other efficacy end points were also met. Treatment-emergent adverse events with incidence of 5% or greater for brexpiprazole + sertraline (and corresponding incidences for sertraline + placebo) were nausea (25 of 205 [12.2%] and 23 of 196 [11.7%]), fatigue (14 of 205 [6.8%] and 8 of 196 [4.1%]), weight increase (12 of 205 [5.9%] and 3 of 196 [1.5%]), and somnolence (11 of 205 [5.4%] and 5 of 196 [2.6%]). Discontinuation rates due to adverse events were 8 of 205 participants (3.9%) for brexpiprazole + sertraline and 20 of 196 participants (10.2%) for sertraline + placebo. Results of this randomized clinical trial show that brexpiprazole + sertraline combination treatment statistically significantly improved PTSD symptoms vs sertraline + placebo, indicating its potential as a new efficacious treatment for PTSD. Brexpiprazole + sertraline was tolerated by most participants, with a safety profile consistent with that of brexpiprazole in approved indications. ClinicalTrials.gov Identifier: NCT04124614.

Neurobiological response to trauma-related and general negative words in men firefighters with post-traumatic stress disorder, compared to trauma-exposed and trauma non-exposed controls: A pilot study.

Although firefighters frequently encounter various traumatic incidents, few develop posttraumatic stress disorder (PTSD). In this pilot study, we aimed to examine trauma-specific neurobiological alterations in firefighters with PTSD, distinguishing these characteristics from those of trauma-exposed controls. Twenty-two firefighters (11 firefighters with PTSD and 11 trauma-exposed controls) and 25 trauma non-exposed controls completed psychiatric questionnaires and functional magnetic resonance imaging while engaging in a trauma-specific emotional counting Stroop task for firefighters. In response to general negative words, the firefighter group exhibited increased brain activity in the left and right superior parietal lobes, left cingulate gyrus, and right medial frontal gyrus compared to the trauma non-exposed control group. In response to trauma-related words, the firefighter group displayed increased brain activity in the left and right superior parietal lobes, left and right middle temporal gyri, and precuneus compared to the trauma non-exposed control group. In response to general negative words, firefighters with PTSD exhibited increased brain activity in the right and left middle temporal gyri compared to trauma-exposed controls. In response to trauma-related words, firefighters with PTSD displayed decreased brain activity in the right and left middle frontal gyri compared to trauma-exposed controls. Among firefighters with PTSD, brain activity in the left middle frontal gyrus in response to trauma-related words negatively correlated with the Clinician-Administered PTSD Scale total score. Collectively, firefighters with PTSD demonstrate reduced brain activation within the middle frontal gyrus in response to trauma-related words, indicating a compromised top-down control mechanism.

A novel prolonged exposure therapy protocol for improving therapy session attendance and PTSD symptoms among adults receiving buprenorphine or methadone treatment

BackgroundAmong individuals with opioid use disorder (OUD), the prevalence of posttraumatic stress disorder (PTSD) is higher than in the general population. Prolonged exposure (PE) therapy is highly efficacious for improving PTSD symptoms. However, few studies have evaluated PE in individuals receiving medications for OUD (MOUD) and treatment completion rates have been low. This randomized trial evaluated the efficacy of a novel protocol for improving PE attendance and PTSD symptoms among adults receiving buprenorphine or methadone treatment. MethodsEligible participants (n=52) were randomized to one of three 12-week experimental conditions: (a) continued MOUD treatment as usual (TAU; n=17), (b) Prolonged Exposure Therapy (PE; n=17), or (c) PE with financial incentives contingent upon PE session attendance (PE+; n=18). Primary outcomes included percent of PE sessions attended and Clinician Administered PTSD Scale for DSM-5 (CAPS-5). ResultsPE+ participants attended significantly more therapy sessions than PE participants (88 % vs 33 %; p<.001). All three groups reported significant (p<.05) improvements in CAPS-5 scores between intake and week 12, with no significant group differences. However, PE+ participants achieved significantly greater improvements in self-reported PTSD symptoms (p=.02) than TAU participants, as well as higher rates of diagnostic remission compared to TAU and PE participants (p<.001). Participants in the two PE groups did not exhibit an increase in non-prescribed drug use. ConclusionsIn this study of adults receiving MOUD treatment, PE+ was efficacious for increasing PE attendance. Our findings also provide promising support for the efficacy of PE+ for improving PTSD symptoms without exacerbating substance use. Clinical trial numberNCT04104022

Mature brain-derived neurotrophic factor (BDNF) levels in serum correlate with symptom severity in post-traumatic stress disorder (PTSD)

BackgroundPost-traumatic stress disorder (PTSD) is characterised by pervasive and persistent symptoms that negatively impact quality-of-life. A relationship between brain-derived neurotrophic factor (BDNF) and PTSD symptom severity has been investigated with mixed results. This study aimed to systematically investigate BDNF and PTSD symptom severity in a PTSD cohort (n = 43). MethodsBDNF levels were determined from both serum and plasma using two BDNF assays (targeting general BDNF and mature BDNF specifically). BDNF levels were compared to PTSD symptom severity scores determined by clinical interview using the Clinician-Administered PTSD Scale (CAPS-5) for DSM-5 and the self-rated Posttraumatic Stress Disorder checklist (PCL-5) for DSM-5. ResultsOnly mature BDNF levels from serum revealed a significant negative correlation to both CAPS-5 and PCL-5 scores. Additionally, when the study cohort was defined by the CAPS-5 criteria for PTSD, the BDNF to symptom severity correlation was stronger than when the cohort was defined by the PCL-5 criteria. LimitationsThis study acknowledges that limited numbers of PTSD participants with complex co-morbidities and multiple test comparisons requires caution in overinterpretation of results. ConclusionsOverall, this study found that decreasing levels of mature BDNF from serum was associated with increasing symptom severity and that the type of sample, the specificity of the BDNF assay and the PTSD evaluation method all impacted whether a relationship between BDNF and PTSD symptom severity could be detected.

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

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

Cross-cultural validation of the Clinician-Administered PTSD scale for DSM-5, child and adolescent version in Japan

ABSTRACT Background: The establishment of a formal diagnosis of post-traumatic stress disorder (PTSD) for children and adolescents is the foundation for advancing pertinent clinical research and formulating proper treatment and management. However, a validated diagnostic tool for PTSD in children and adolescents is lacking in Japan. Objective: To examine the cross-cultural validity and reliability of the Japanese Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), child and adolescent version (CAPS-CA-5-J). Method: Overall, 73 children who had experienced potentially traumatic events were recruited from three medical facilities. The linguistically validated CAPS-CA-5-J was conducted by trained psychiatrists and psychologists. Additionally, children and their caretakers completed questionnaires such as the UCLA PTSD reaction index for DSM-5 (PTSD-RI-5), Depression Self-Rating Scale for Children (DSRDC), and Strength and Difficulties Questionnaire (SDQ); 16 participants were randomly selected for the inter-rater reliability assessment. Results: Owing to missing values in the CAPS-CA-5-J and PTSD-RI-5, 68 children were included in the final analysis. Regarding reliability, the CAPS-CA-5-J showed excellent internal consistency (Cronbach’s alpha coefficient = 0.90) and interrater agreement (kappa coefficient = 0.88). Convergent validity was supported by a strong correlation between the total severity scale of the CAPS-CA-5-J and the PTSD-RI-5 scores (Pearson’s correlation coefficient = 0.82). Divergent validity was indicated by a moderate correlation between the CAPS-CA-5-J and DSRDC, and no correlation was found with the SDQ scores. Conclusions: This study is the first to validate a structured clinical interview for children and adolescents with PTSD in Japan. The psychometric properties of the CAPS-CA-5-J were good enough and comparable to those reported in previous validation studies. Therefore, the CAPS-CA-5-J can be considered reliable and valid for use in Japan.

Impact of surgery after injury on SDNN and posttraumatic stress disorder development over two years

This study examined the modifying effects of surgery status on the association between the Standard Deviation of NN Intervals (SDNN) of the heart rate variability and the post-traumatic stress disorder (PTSD) development. Participants with physical injury were recruited from a trauma center and followed for two years. Baseline assessment included SDNN and surgery status. Socio-demographic and clinical covariates were collected. PTSD was diagnosed at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5. Logistic regression analyses were performed. Among 538 participants, 58 (10.8%) developed PTSD during the study, with prevalence rates of 8.4% at 3 months, 6.5% at 6 months, 4.7% at 12 months, and 2.5% at 24 months. A significant modifying effect was found that lower SDNN were significantly associated with PTSD in non-surgical patients but not in surgical patients, with significant interaction terms. This pattern was observed from 3 to 12 months but not at 24 months. Surgery-dependent associations between SDNN and PTSD development were observed, highlighting the need for tailored PTSD prevention strategies considering SDNN and surgery status.

Interplay of serum BDNF levels and childhood adversity in predicting earlier-onset post-traumatic stress disorder: A two-year longitudinal study

This longitudinal study explored the intricate relationships between serum Brain-Derived Neurotrophic Factor (sBDNF) levels, exposure to childhood adversities, and the subsequent development of Post-Traumatic Stress Disorder (PTSD), distinguishing between earlier- and delayed-onset forms over a two-year follow-up period in individuals sustaining physical injuries. We recruited patients presenting with moderate to severe physical injuries at a trauma center, conducting baseline assessments of sBDNF levels and childhood adversities through the Adverse Childhood Experiences (ACE) questionnaire. Additionally, detailed socio-demographic and clinical data were compiled. The Clinician-Administered PTSD Scale for DSM-5 was employed to diagnose PTSD at 3, 6, 12, and 24 months post-injury. Binary and multinomial logistic regression analyses were applied to elucidate the interactions between sBDNF levels, childhood adversities, and PTSD onset patterns. Among 895 participants, PTSD was diagnosed in 107 individuals (11.9 %), with 76 (8.4 %) exhibiting symptoms indicative of earlier-onset PTSD and 31 (3.5 %) demonstrating delayed-onset PTSD. Significantly, lower sBDNF levels were associated with a higher risk of earlier-onset PTSD specifically in the context of childhood adversities. This association was not observed in individuals without childhood adversities or in those with delayed-onset PTSD. The findings suggest a complex and critical interplay between neurobiological factors, specifically sBDNF levels, and early life adversities in influencing the timing of PTSD onset, potentially deepening the understanding of PTSD etiology.

Efficacy and safety of balovaptan for posttraumatic stress disorder: A randomized, placebo-controlled trial.

Posttraumatic stress disorder (PTSD) has a significant impact on quality of life and affects more than 13 million individuals in the United States, with limited treatments available. EXUVIA (NCT05401565) was a Phase 2, randomized, placebo-controlled, double-blind trial, conducted across eight sites in the United States. The study aimed to assess the efficacy, safety, and pharmacokinetics of balovaptan, a highly selective vasopressin 1a receptor antagonist, in adults with PTSD. Between August 2022 and October 2023, a total of 57 adult participants (aged 18-60 years) were screened, and 29 participants were randomly allocated (1:1) to receive either balovaptan (13/29 [44.8%]) or placebo (16/29 [55.2%]). No meaningful differences were observed for balovaptan (-17.2 [± 10.7]) versus placebo (-15.6 [± 10.7]) as measured by the primary endpoint of change from baseline at Week 12 in Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition total symptom severity score. No meaningful differences for balovaptan versus placebo were observed at Week 12 for any secondary endpoints. Balovaptan was well tolerated with no new safety findings. The number of participants with at least one adverse event of any intensity was 9/13 (69.2%) in the balovaptan group and 7/16 (43.8%) in the placebo group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effect of mindfulness-based cognitive therapy on PTSD and depression symptoms in trauma-exposed black adults: Pilot randomized controlled trial results

Low-income, urban-dwelling Black adults are disproportionately affected by traumatic experiences, posttraumatic stress disorder (PTSD), and depression and encounter inequities in treatment access. In addition to the benefits Mindfulness-Based Cognitive Therapy (MBCT) for depression, there is preliminary evidence of successful symptom reduction in PTSD via MBCT across two prior pilot studies in veterans. Studies examining the effects of MBCT among trauma-exposed Black adults remains limited, and examination of effects across specific PTSD clusters is almost nonexistent. We examined the preliminary efficacy of adapted MBCT versus waitlist control (WLC) on PTSD and depression symptoms in a pilot randomized controlled trial (RCT). Black adults (N = 80; 86.10 % women) with repeated trauma exposure, who screened positive for PTSD and depression, were recruited from an urban public hospital and randomized to 8-week adapted MBCT or WLC. Symptoms were measured pretreatment and posttreatment with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and the Beck Depression Inventory-II (BDI-II). Mixed model analyses were conducted with an intent-to-treat approach, examining change in PTSD and depression scores between MBCT and WLC over time. There was no significant difference in total PTSD and depression symptom change between MBCT and WLC. CAPS-5 avoidance symptoms showed a nominally significant decrease in the MBCT group (F[1, 68.10] = 5.98, p = .017; t[71.60] = 3.61, p < .001). Findings suggest MBCT might be helpful for addressing avoidance symptoms among Black adults with comorbid PTSD and depression. Although lacking power to draw final conclusions about treatment efficacy, this study provides preliminary data suggesting the importance of future fully powered trials.

Post-traumatic stress disorder in mother’s of children hospitalized in the neonatal intensive care

Background: The progress of neonatal intensive care units has notably enhanced the chances of survival for infants. Despite this, post-traumatic stress disorder (PTSD) in mothers of neonates receiving care in the Neonatal Intensive Care Units (NICU) remains a widely underestimated issue. Aims and objectives: Our objective was to pinpoint the possible risk factors contributing to the development of post-traumatic stress disorder in mothers of neonates receiving care in the NICU. Methods: A prospective, descriptive study was carried out at the Mohamed V Moroccan Military teaching hospital over a 1-year period from January 1st, 2023, to December 31st, 2023, concentrating on neonatal medicine and resuscitation. Mothers were interviewed, and the presence of PTSD after preterm birth and NICU admission was assessed using the Clinician Administered PTSD Scale (CAPS) at 28–30 days following NICU admission or at the time of discharge. Results: The findings revealed that mothers of premature infants displayed more stress symptoms compared to mothers of full-term newborns. Through multivariate analysis, we observed that the gestational age of newborns admitted to the NICU significantly ( p = 0.001) influenced the occurrence of PTSD. Conclusion: Post-traumatic stress disorder in mothers of preterm newborns is a pathological condition that demands proper management from the very first days after birth. The NICU environment remains a significant risk factor for PTSD.

A Study on the Relationship Between Post-Traumatic Stress Disorder, Depression and Anxiety Symptoms and the Quality of Life of Syrian Refugees: Case Study for the Province of Kayseri.

The aim of this study is to investigate the factors related to post-traumatic stress disorder (PTSD), depression and anxiety mental disorders, as well as the quality of life of Syrian refugees and to examine the relationships between mental health disorders and the quality of life of Syrian refugees. Data were collected via face-to-face surveys with 613 adult Syrian refugees in an urban setting. Brislin's methodology was used for translating scale items, involving initial translation, back-translation and review by another professional translator. The study utilised the PTSD Scale, Beck Anxiety Scale, Depression Scale and Quality of Life Scale (QOLS). Descriptive, correlational and multivariate regression analysis were applied. Findings of correlational analysis indicate that PTSD levels among Syrian refugees are significantly related to gender, income level and employment. Depression levels are significantly associated with trauma history, healthcare service use, marital status and employment. Anxiety levels are significantly related to gender, trauma history, healthcare service use, employment and income. According to the findings of the regression analyses, the relationships between depression, quality of life and PTSD are complex. Meanwhile, anxiety decreases quality of life and increases PTSD. Quality of life moderates the relationship between depression and PTSD, as well as between anxiety and PTSD. The study concludes that the mental disorder levels of Syrian refugees, in terms of PTSD, depression and anxiety, are linked to their socio-demographic characteristics. These results highlight the importance of social, economic and cultural factors, healthcare and social services and the socio-demographic characteristics of the region where refugees have settled after displacement.

Educational Level Modifies the Relationship between Standard Deviation of NN Intervals and Post-traumatic Stress Disorder Development over Two-years.

This study investigated how educational levels modify the relationship between the standard deviation of NN intervals (SDNN) of heart rate variability and the development of post-traumatic stress disorder (PTSD). Participants with physical injuries were enrolled from a trauma center and monitored over two years. Initial assessments included SDNN and educational attainment, along with socio-demographic and clinical variables. PTSD diagnoses were made at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5. Logistic regression analyses were conducted. Of the 538 participants, 58 (10.8%) developed PTSD during the follow-up period. A significant interaction effect was observed: lower SDNN was significantly linked to PTSD in individuals with higher education, but not in those with lower education. The study identified education-dependent associations between SDNN and PTSD development, emphasizing the importance of tailored PTSD prevention strategies that consider both SDNN and educational levels.

MDMA-assisted psychotherapy for the treatment of PTSD: A systematic review and meta-analysis of randomized controlled trials (RCTs).

Post-traumatic stress disorder (PTSD) is a mental health disorder resulting from exposure to traumatic events, manifesting in various debilitating symptoms. Despite available treatments, many individuals experience inadequate response or significant side effects. Previous reviews suggest promising outcomes with MDMA-assisted psychotherapy (MDMA-AT), but limitations prompt the need for a comprehensive evaluation. We searched various online databases and registries such as MEDLINE (via PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov to retrieve RCTs that fit our inclusion criteria. We performed meta-analyses using Review Manager by applying a random-effects model. Dichotomous and continuous outcomes were pooled as risk ratios (RR) and standard mean difference (SMD), respectively. Nine studies with a total of 297 participants with PTSD were included in our meta-analysis. The control group consisted of inactive doses of MDMA (25-40 mg) or placebo. Our meta-analysis showed that MDMA-AT led to a significant reduction in the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) severity scores as compared to the control group (SMD -1.10, 95% CI: -1.62 to -0.59). More patients in the MDMA-AT group exhibited significant response (RR 1.59, 95% CI: 1.22, 2.08) and remission (RR 2.32, 95% CI: 1.47 to 3.66) as compared to patients in the control group. There was no significant difference regarding the incidence of ≥1 treatment-emergent adverse events (TEAE), ≥1 severe TEAE, and suicidal ideation between the two groups. MDMA-AT demonstrates significant efficacy in improving PTSD symptoms, enhancing both response and remission rates in individuals with chronic, treatment-resistant PTSD, while maintaining a favorable safety profile.

Risk and Protective Factors of Psychosocial Functioning inSurvivors of Childhood Cancer: Results of the DCCSS-LATER Study.

This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS). CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963-2001) part 2 (age≥18years, diagnosed < 18years, ≥ 5years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self-Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self-Rating Scale for Post-Traumatic Stress Disorder, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and Short Form-36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p< 0.004). A total of 1382 CCS participated, all diagnosed ≥ 15years ago. The mean age of participating CCS was 36years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self-esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self-esteem (10×), and perceived burden (9×). Self-esteem (all β≤ 0.47) and perceived burden (all β≤ 0.38) demonstrated strongest associations of medium/large size. Perceptions of childhood cancer, illness cognitions, self-esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio-demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self-esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.