Trauma Exposure Severity Research Articles

Modeling the structural relationships between trauma exposure with substance use tendency, depression symptoms, and suicidal thoughts in individuals with earthquake trauma experience: the mediatory role of peritraumatic dissociation and experiential avoidance

BackgroundDespite the fact that studies indicate that earthquake trauma is associated with numerous psychological consequences, the mediating mechanisms leading to these outcomes have not been well-studied. Therefore, this study investigates the relationship between trauma exposure with substance use tendency, depression, and suicidal thoughts, with the mediating role of peritraumatic dissociation and experiential avoidance.MethodsThe descriptive-correlational approach was employed in this study. The participants were people who had experienced the Kermanshah earthquake in 2017. A total of 324 people were selected by convenient sampling method. The Traumatic Exposure Severity Scale, the Peritraumatic Dissociative Experiences Questionnaire, the Acceptance and Action Questionnaire, the Iranian Addiction Potential Scale, Beck’s Depression Inventory [BDI-II], and Beck’s Suicidal Thoughts Scale were used to collect data. The gathered data was analyzed‌ using structural equation modeling in ‌SPSS Ver. 24 and LISREL Ver. 24.ResultsThe study findings indicated that the intensity of the trauma exposure is directly and significantly associated with depression symptoms, peritraumatic dissociation, and experiential avoidance. The severity of exposure to trauma had a significant indirect effect on the tendency to use substances through experiential avoidance. This is while the severity of the trauma experience did not directly correlate with substance use and suicidal thoughts. In addition, peritraumatic dissociation did not act as a mediator in the relationship between the severity of trauma exposure with substance use, depression, and suicidal thoughts.ConclusionsThe severity of exposure to the earthquake was associated with symptoms of depression and these findings indicate the importance of experiential avoidance in predicting the tendency to use drugs. Hence, it is essential to design and implement psychological interventions that target experiential avoidance to prevent drug use tendencies and to establish policies that lower depression symptoms following natural disasters.

A - 73 The Impact of Posttraumatic Stress Disorder on Cognitive Health in 9/11 Responders: the Role of Sleep Disturbances.

PTSD is known to have a long-term impact on cognitive health, specifically executive dysfunction. However, most studies have not tested possible mechanisms underpinning this association. Sleep disturbances have emerged as a potential pathway between PTSD and cognitive functioning. This study aimed to investigate whether sleep disturbances account for the association between PTSD and executive dysfunction in trauma-exposed first responders. Participants consisted of 9/11 WTC responders (N = 452, mean age = 55.22, SD = 8.73, 89% male, 90% White). Data collection occurred across 3 time points, each 1year apart. Measures included self-reported PTSD and insomnia symptoms, two weeks of Ecological Momentary Assessment of sleep duration and sleep quality, and the Trail Making Test part B. Due to high stability across 3years, the present study focused on mean, trait-like variables. Analyses adjusted for demographics, BMI, and trauma exposure severity. PTSD was associated with Trail Making Test part B (r = 0.10, p = 0.03), as well as insomnia (r = 0.63, p < 0.00) and sleep quality (r = -0.45, p < 0.00), but not sleep duration. Mediation analyses revealed that sleep quality fully accounts for the significant association between PTSD and executive functioning (indirect effect β= 0.056, p = 0.041, 95% CI [0.009, 0.108]). The current results highlight the important role that disturbances in sleep may have on cognitive health outcomes. Improving sleep, in the context of PTSD, could attenuate cognitive symptoms, and possibly protect against further decline. Future research conducted in the acute phase of trauma-exposure and PTSD is needed to clarify the directionality of these relationships, with longitudinal analyses that will allow form modeling cognitive decline.

Decision-making for concurrent reward and threat is differentially modulated by trauma exposure and PTSD symptom severity

Trauma exposure, particularly interpersonal violence (IPV) traumas, are significant risk factors for development of mental health disorders, particularly posttraumatic stress disorder (PTSD). Studies attempting to disentangle mechanisms by which trauma confers risk and maintenance of PTSD have often investigated threat or reward learning in isolation. However, real-world decision-making often involves navigating concurrent and conflicting probabilities for threat and reward. We sought to understand how threat and reward learning interact to impact decision-making, and how these processes are modulated by trauma exposure and PTSD symptom severity. 429 adult participants with a range of trauma exposure and symptom severities completed an online version of the two stage Markov task, where participants make a series of decisions towards the goal of obtaining a reward, that embedded an intermediate threat or neutral image along the sequence of decisions to be made. This task design afforded the possibility to differentiate between threat avoidance vs diminished reward learning in the presence of threat, and whether these two processes reflect model-based vs model-free decision-making. Results demonstrated that trauma exposure severity, particularly IPV exposure, was associated with impairment in model-based learning for reward independent of threat, as well as with model-based threat avoidance. PTSD symptom severity was associated with diminished model-based learning for reward in the presence of threat, consistent with a threat-induced impairment in cognitively-demanding strategies for reward learning, but no evidence of heightened threat avoidance. These results highlight the complex interactions between threat and reward learning as a function of trauma exposure and PTSD symptom severity. Findings have potential implications for treatment augmentation and suggest a need for continued research.

Exploring the buffering role of social capital in the development of posttraumatic stress symptoms among Iranian earthquake survivors.

Social capital, or the resources that an individual can draw on through his or her social networks and the value ascribed to these resources by the individual, has been hypothesized to be an important factor in the development of mental health problems following a natural disaster. Nevertheless, little research has been conducted in this area. The present study aimed to evaluate the potential buffering effect of the 2 types of social capital-bonding and bridging social capital-on the association between severity of trauma exposure and posttraumatic stress disorder (PTSD) symptoms in a large sample of earthquake survivors in Iran. Participants were 600 adults who survived the Azarbaijan earthquake in Iran. Participants were selected using a multistage sampling method. PTSD symptoms were reported in 37% of the participants, 95% CI [34%, 41%]. Consistent with prior research, significant differences were found between areas that were highly affected and areas that were less affected by the disaster. Although both bonding and bridging social capitals were negatively related to PTSD symptoms, this buffering effect against PTSD symptoms was about 2 times as large for bridging capital than for bonding social capital. While bridging and bonding social capital are both significant protective factors for mental health outcomes following natural disasters, bridging social capital may be more important. Future directions for this area of research are discussed, as are policy implications for disaster preparedness and postdisaster interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exposure to Violence Variety as a Risk Factor for Cigarette Smoking: Relevance of Sensation-Seeking and Impulsivity as Mediators

Background Prior research has indicated that exposure to violence is a risk factor associated with cigarette smoking. However, the relevance of variety of exposure for predicting this outcome has remained underexplored. This is problematic, as increased variety of exposure may represent a measure of severity of trauma exposure with less recall bias than other measures. Further, related constructs of sensation-seeking and impulsivity have yet to be investigated as mediators of this relationship. It is predicted that increased variety of exposure to violence results in dysfunctional variation in these constructs, leading to increased daily cigarette use. Methods The present study utilizes data from the first three waves of the Pathways to Desistance study to examine these relationships. Generalized structural equation modeling is used to identify direct and indirect effects of interest. A bootstrap resampling process was used to compute normalized standard errors so that indirect effects were not biased. Results Results indicated that lifetime exposure to violence variety prior to baseline predicted increased daily cigarette use at follow-up. Neither sensation-seeking nor impulsivity were significant mediators when both constructs were included in the model, but impulsivity emerged as a significant mediator when separate mediation models were estimated for each construct. Conclusions The findings indicate the potential utility of screening for variety of exposure to violence to determine adolescents who may be at-risk for high frequency cigarette smoking. Programming focused on impulsivity may play a role in addressing cigarette smoking issues stemming from exposure to violence.

Impact of Oxytocin on the neural correlates of fearful face processing in PTSD related to childhood Trauma

ABSTRACT Background: Posttraumatic stress disorder (PTSD) related to exposure to abuse and neglect during childhood is associated with particularly severe and persistent deleterious outcomes. Amygdala hyperreactivity has been observed in childhood trauma survivors and implicated in symptoms of PTSD. Objective: The neuropeptide oxytocin holds promise as a potential treatment for PTSD due to its ability to attenuate amygdala response to threat cues. However, the effect of oxytocin on amygdala reactivity in individuals with childhood trauma-related PTSD has not been investigated. Method: We employed a double-blind, randomized, placebo-controlled crossover design to examine the effects of intranasal oxytocin (24 IU) versus placebo on amygdala reactivity to fearful faces among childhood-trauma exposed individuals with PTSD (n = 17) and without PTSD (control group; n = 16). Results: Region-of-interest based amygdala fMRI signal magnitude did not differ by group, drug, or group x drug interaction. Self-report of childhood trauma exposure severity was negatively associated with the oxytocin-related change in left amygdala response in the PTSD group, but not in the control group. Supplementary and exploratory whole-brain analyses conducted separately in each group revealed that left amygdala reactivity to fearful faces was absent on placebo but increased on oxytocin in the control group. The PTSD group showed right amygdala activation to fearful faces in both the oxytocin and placebo conditions, but the left amygdala response observed in the placebo condition was diminished on oxytocin. Conclusions: Findings extend the literature pertaining to the potential for oxytocin to attenuate neural correlates of PTSD to a childhood trauma-related PTSD sample.

Characteristics of pro- and anti-inflammatory cytokines alteration in PTSD patients exposed to a deadly earthquake

BackgroundMany studies have shown that the disturbance of pro-inflammatory and/or anti-inflammatory cytokines is involved in the modulation of traumatic stress and related psychiatric disorders, typically posttraumatic stress disorder (PTSD). However, the specific immune alterations associated with PTSD symptoms are still unclear. The present study compared levels of pro- and anti-inflammatory cytokines between PTSD and non-PTSD controls, and investigated the relationships of immune changes with PTSD symptomatology. MethodsIn this study, 51 earthquake-exposed PTSD patients and 136 earthquake-exposed healthy controls were recruited. We assessed trauma exposure, PTSD and depression severity, and quantified a panel of pro- inflammatory cytokines, including interleukin (IL)-1β, IL-2, IL-6, IL-8, tumor necrosis factor alpha (TNF-α), interferon ϒ (IFNϒ), and anti-inflammatory cytokines, including IL-4, IL-10 and IL-13 with enzyme-linked immunosorbent assays. Additionally, total pro-inflammatory cytokines score and total anti-inflammatory cytokines score were calculated to reflect the status of two balance system. ResultsBehavioral data showed that the PTSD group had greater severity of depression, as well as total symptoms and every symptom cluster in the seven-factor model of PTSD compared to the non-PTSD control group. Immune data showed that PTSD subjects had higher levels of IL-1β and TNFα, as well as total pro-inflammatory cytokine scores compared to controls, suggesting an increase of inflammatory activity in PTSD. In all subjects, the IL-1β levels were correlated with PCL scores, after controlling for covariates, including age, education, marital status and gender, trauma exposure severity and depression. LimitationsThe current study did not include a non-traumatized healthy control group, and PTSD was assessed using a self-reported measure. ConclusionsThus, by including a control group comprised entirely of earthquake-exposed individuals as means to discriminate specific alterations of cytokine levels in PTSD, these findings suggest that the increased inflammatory cytokines, especially IL-1β, may play a role in the pathophysiology of PTSD.

Interactive effects of insomnia symptoms and trauma exposure on PTSD: Examination of symptom specificity.

Although symptoms of posttraumatic stress disorder (PTSD) are common following exposure to a traumatic event, most people who experience trauma do not develop PTSD. Thus, the identification of risk factors that may interact with trauma exposure to confer vulnerability for the development of PTSD may highlight important targets for prevention and treatment. Recent research suggests that sleep disturbance amplifies the effect of maladaptive emotional processes on PTSD symptom severity. However, no study to date has examined the impact of sleep disturbance, such as insomnia symptoms, on the relationship between trauma exposure severity and specific PTSD symptom clusters. The present study examined insomnia symptoms as a potential moderator of the relationship between trauma exposure severity and specific PTSD symptom clusters among combat exposed veterans (N = 72). Results revealed large associations between insomnia symptoms and PTSD symptom clusters, small to moderate associations between combat trauma severity and PTSD symptom clusters, and a significant interaction between insomnia symptoms and combat exposure to predict reexperiencing, but not avoidance or arousal, symptoms of PTSD. These findings suggest that poor sleep may be one risk context in which trauma exposure results in the development of reexperiencing symptoms of PTSD. The implications of these findings for the development and maintenance of reexperiencing symptoms of PTSD are discussed. (PsycINFO Database Record

Workplace belongingness, distress, and resilience in emergency service workers.

Ambulance personnel provide emergency medical services to the community, often attending to highly challenging and traumatic scenes in complex and chaotic circumstances. Currently, the assessment of predictors of psychological well-being remains limited. The current study investigated whether workplace belongingness was significant in predicting psychological distress as well as the presence of resilience in ambulance personnel while controlling for more routinely examined factors. Australian ambulance officers (N = 740) completed a survey battery including the Kessler 10, Brief Resilience Scale, and Psychological Sense of Organizational Membership scale. Controlling for more commonly examined factors such as severity of trauma exposure and length of service, hierarchical multiple regression analyses demonstrated that workplace belongingness was significantly associated with reduced distress levels and enhanced resilience levels. Results suggest that strategies to enhance a sense of workplace belongingness in emergency service organizations could promote the well-being of emergency workers despite routine exposure to potentially traumatic events. (PsycINFO Database Record

Distinct behavioral and immunoendocrine parameters during crack cocaine abstinence in women reporting childhood abuse and neglect

AimTo assess plasma levels of cortisol and cytokines between cocaine-dependent women with and without childhood maltreatment (CM) history during cocaine detoxification treatment. MethodWe assessed immunoendocrine and clinical parameters of 108 crack cocaine female users during 3 weeks of inpatient detoxification treatment, and 24 healthy women to obtain reference values. Women with (CM+, n=53) or without (CM-, n=55) CM history were identified answering the Childhood Trauma Questionnaire (CTQ). Blood samples and clinical assessment were collected before lunch during the first, second and third week post-treatment admission. Flow cytometry was used to assess TNF-α, IFN-γ, IL-2, IL-4, IL-6, IL-10, IL-17A plasma levels and ELISA assay was used to measure plasma cortisol levels. ResultsAt baseline, lower Th1 and Th17-related cytokines levels and higher Th2 cytokines levels were observed in crack cocaine users compared with reference values. Cytokines levels of cocaine dependents gradually became closer to reference values along detoxification treatment. However, when CM+ and CM- groups were compared, increased levels of IL-6, IL-4 and TNF-α across time were observed in CM+ group only. Additionally, a Th1/Th2 immune imbalance was observed within CM+ group, which was negatively correlated with the severity of the crack withdrawal. Finally, loading trauma exposure severity, immunoendocrine and clinical parameters in factor analysis, we identified three clusters of observed variables during detoxification: (1) systemic immunity and trauma exposure, (2) pro-inflammatory immunity and (3) behavior ConclusionOur results suggest the existence of an immunological phenotype variant associated with CM exposure during crack cocaine detoxification of women.

Balanced and less traumatized: Balanced time perspective mediates the relationship between temperament and severity of PTSD syndrome in motor vehicle accident survivor sample

Posttraumatic stress disorder (PTSD) symptoms describe a common chronic and disabling reaction of individuals exposed to extreme stress. The negative influence of PTSD on people's functioning justifies researchers' efforts to define predictors of the disorder and the factors that can prevent the development of PTSD. Existing research exposes a pronounced role of temperamental traits, in addition to the severity of trauma exposure. Experience of the traumatic event and subjective assessment of its consequences may also be influenced by individual differences in the time perspective profile, particularly the indicator of temporal adaptation referred to as balanced time perspective (BTP). The aim of the present research was to establish the relationship between time perspective, trauma exposure and temperament and its influence on the level of PTSD symptoms. The regression analyses showed that briskness, emotional reactivity, BTP and trauma severity were significant predictors of PTSD symptoms and that BTP mediated the relationship between temperament and PTSD. People exposed to more severe trauma who were prone to strong emotional reactions and were less flexible in coping with trauma revealed a negatively biased time perspective, which resulted in the development of PTSD symptoms.

Posttraumatic Growth in Relation to the Frequency and Severity of Traumatic Experiences Among Police Officers in Small to Midsize Departments.

The Critical Incident History Questionnaire (CIHQ) measures, through multiple measurement methods, the severity and frequency of traumatic events experienced by law enforcement officers. We, however, found no studies utilizing the CIHQ to examine posttraumatic growth (PTG) as measured by the Posttraumatic Growth Inventory. The purpose of this brief report was to assess the strength and direction of the relationships between PTG with trauma frequency, trauma severity, and health variables, including subjective traumatic stress, relationship stress, nontraumatic work stress, posttraumatic stress disorder (PTSD) symptoms, depression, and alcohol use among law enforcement officers (N = 193) from small and midsize agencies. In addition, we sought to explore differences between cognitive and behavioral PTG. Based on results from bivariate and multivariate analyses, we found that an idiosyncratic view of trauma severity shaped by personal experience demonstrated the strongest relationship with PTG among the frequency and severity variables and that increased PTG was not associated with reduced psychological distress. Alcohol use, a variable that is assessed primarily through behaviors compared with cognitions, was not significantly associated with PTG. Overall, the findings of this study demonstrate the importance for future research to consider both the frequency and severity of trauma exposure in the development of PTG and its impact on health outcomes.

Maternal Trauma and Children’s Functioning: The Role of Kinship Social Support

ABSTRACTAlthough research has documented the detrimental effects of maternal trauma on child behavior (Lambert, Holzer, & Hasbun, 2014), the role of extended family support in potentially mitigating the effects of intergenerational transmission of trauma is not clearly understood. With a diverse community sample of 52 trauma-exposed mothers and their children between the ages of 7 and 12, we investigated relationships between kinship social support, maternal trauma exposure severity, maternal posttraumatic stress disorder (PTSD) symptom severity, and child behavioral problems. Results showed that kinship social support was negatively related to maternal trauma exposure severity, maternal PTSD symptom severity, child internalizing behaviors, and child externalizing behaviors. Additionally, kinship social support moderated the relationship between maternal trauma exposure severity and child internalizing behaviors. These results have implications in the implementation of interventions aimed at supporting diverse families facing trauma that incorporate extended family networks.

Distress Tolerance: Associations With Posttraumatic Stress Disorder Symptoms Among Trauma-Exposed, Cocaine-Dependent Adults.

The present investigation examined associations between distress tolerance and posttraumatic stress disorder (PTSD) symptoms in a cocaine-dependent sample. Participants were comprised of 138 cocaine-dependent adults (Mage = 45.4, SD = 9.9; 81% male; 76.3% African American) who endorsed trauma exposure, defined according to Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) PTSD Criterion A. Participants were administered interview-based measures and completed a series of self-report questionnaires. Results indicated that distress tolerance was significantly, incrementally (negatively) associated with PTSD symptom severity, contributing 6.8% of unique variance to the model (p < .001); notably, the overall model explained 44.8% of variance in PTSD symptomatology. Distress tolerance also contributed between 2.7% and 6.8% of unique variance across each of the PTSD symptom clusters (ps < .05). Incremental effects were documented, after accounting for the variance explained by theoretically relevant covariates (i.e., gender, cocaine-use severity, depressive symptoms, trauma-exposure severity). Theoretical and clinical implications are discussed.

Critical incident history questionnaire replication: frequency and severity of trauma exposure among officers from small and midsize police agencies.

Frequency and severity of trauma exposure are thought to influence posttraumatic reactions. Weiss et al.'s Critical Incident History Questionnaire (CIHQ; 2010) measures these variables among law enforcement officers; they reported findings using a sample of officers from large urban departments. We noted the need for replication studies utilizing samples from smaller and rural police agencies. The purpose of this study was to replicate the CIHQ findings from Weiss et al. using a sample (N = 193) of officers from small and midsize police departments and officers whose duties include policing rural and isolated jurisdictions. Frequency and severity findings were similar to those reported by Weiss et al. (). Regarding frequency, the present study found the critical incident exposure mean score was 188.5, compared to 168.5 from Weiss et al. (). Making a mistake that kills or injures a colleague had the highest mean nomothetic severity rating in both studies. Among the various variables examined in this study, PTSD symptoms demonstrated the strongest association with the exposure indices, based on Spearman rank correlations (r = .26-.46).

Mindfulness Skills, Anxiety Sensitivity, and Cognitive Reactivity in Patients with Posttraumatic Stress Disorder

In trauma-exposed individuals, those with relatively high levels of mindfulness skills tend to have lower levels of symptoms. Mindfulness has also been associated with decreased anxiety sensitivity and cognitive reactivity, and vulnerability factors related to posttraumatic and depressive symptom severity. In this cross-sectional study, our aim was to further investigate the associations among mindfulness skills, anxiety sensitivity, cognitive reactivity, and symptom severity in patients with posttraumatic stress disorder (PTSD). Outpatients with PTSD (N = 101) filled out questionnaires. All facets of mindfulness correlated negatively with reactivity measures and with symptom severity, except for the facet observe. In hierarchical multiple regression analysis, describe, non-judgment, and non-reactivity predicted PTSD symptom severity above and beyond anxiety sensitivity and trauma exposure severity. Describe, act with awareness, and non-judgment also predicted depressive symptom severity above and beyond cognitive reactivity and number of experienced traumatic events. In conclusion, mindfulness skills were indeed uniquely related to symptom severity and cognitive reactivity measures. Our results furthermore support a five-facet model of mindfulness. In addition, the outcomes are a cross-cultural contribution to research on the relevance of mindfulness skills in the treatment of PTSD.

The impact of PTSD symptoms on physical and mental health functioning in returning veterans

This study aimed to determine the unique impact of PTSD symptoms, beyond other frequently examined factors on physical and mental health functioning in a sample of returning veterans. Assessments of 168 returning OEF/OIF veterans conducted an average of six months following return from deployment included measures of emotional disorders and the Short Form (36) Health Survey. Hierarchical multiple regressions revealed significant, unique contribution of Clinician-Administered PTSD Scale (CAPS) score above all other predictors in the model (demographics, severity of trauma exposure, physical injury, substance abuse and depressive symptoms), for both the physical (8%) and mental (6%) health aggregate scores, along with significant prediction of physical health (4–10%) and mental health (3–7%) subscale scores. The only other significant predictors were age for physical health scores, and depressive symptoms for mental health scores. PTSD criterion B (re-experiencing) symptoms uniquely predicted reduced physical health functioning and higher experience of bodily pain, while criterion D (hyperarousal) symptoms uniquely predicted lower feelings of energy/vitality and poorer perceptions of emotional health.

Pathological Narcissism and Acute Anxiety Symptoms After Trauma: A Study of Israeli Civilians Exposed to War

Objective: Diathesis-stress models of posttraumatic stress disorder (PTSD) hypothesize that exposure to trauma may interact with individual differences in the development of PTSD. Previous studies have not assessed immediate responses to a proximate stressor, but the current “natural laboratory” study was designed to empirically test the role that individual differences in pathological narcissism may play in the development of acute anxiety symptoms among civilians facing rocket and missile fire. Method: We assessed demographic features, trauma exposure severity, narcissistic personality features, and acute anxiety symptoms (PTSD and General Anxiety Disorder [GAD]) among 342 Israeli female adults during the November 2012 eruption of violence in the Middle East. Results: Results demonstrate an association between exposure severity and acute anxiety symptoms (both PTSD and GAD) for individuals with high levels of pathological narcissism but not for those with low levels of pathological narcissism. These results suggest that individuals with narcissistic personality features are at high risk for the development of acute anxiety symptoms following exposure to uncontrollable and life-threatening mass trauma. Conclusion: The findings underscore the role of intra-personal resources in the immediate psychological aftermath of war by highlighting the increased risk associated with narcissistic personality features. Theoretical and clinical implications of the findings are discussed.

Association of TPH1, TPH2, and 5HTTLPR with PTSD and depressive symptoms

To examine the potential contribution of the serotonin hydroxylase (TPH1 and TPH2) genes, and the serotonin transporter promoter polymorphism (5HTTLPR) to the unique and pleiotropic risk of PTSD symptoms and depressive symptoms. Participants included 200 adults exposed to the 1988 Spitak earthquake from 12 multigenerational families (3 to 5 generations). Severity of trauma exposure, PTSD, and depressive symptoms were assessed using standard psychometric instruments. Pedigree-based variance component analysis was used to assess the association between select genes and the phenotypes. After adjusting for age, sex, exposure and environmental variables, there was a significant association of PTSD symptoms with the 't' allele of TPH1 SNP rs2108977 (p<0.004), explaining 3% of the phenotypic variance. This allele also showed a non-significant trend for an association with depressive symptoms (p=0.08). Also, there was a significant association of PTSD symptoms and the 't' allele of TPH2 SNP rs11178997 (p=0.03), explaining 4% of the variance. Depressive symptoms were significantly associated with the 's' allele of 5HTTLPR (p=0.03), explaining 4% of the variance. Retrospective rating of exposure may have been subject to memory failure leading to misestimation of symptom severities. Second, findings may not be generalizable to other ethnic/racial populations. To our knowledge, this is the first published report showing that variants in TPH1 and TPH2 genes constitute risk factors for PTSD symptoms. Additionally, the TPH1 gene may be associated pleiotropically with PTSD and depressive symptoms. The association of the 's' allele of 5HTTLPR polymorphism with depression adds to similar findings from case/case-control studies.

Recovery from PTSD following Hurricane Katrina.

We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina. A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview. An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD. The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina.