Specific Posttraumatic Stress Disorder Symptoms Research Articles

Cardiometabolic Morbidity (Obesity and Hypertension) in PTSD: A Preliminary Investigation of the Validity of Two Structures of the Impact of Event Scale-Revised.

Background: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69-0.88), high convergent validity (item total correlations r range = 0.39-0.81, and correlations with the IES-R's total score r range = 0.62-0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42-0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12-0.39) and the diagnosis of hypertension (r range = 0.12-0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES-R6, PSS-SR) classified the participants into two clusters according to their BMI (normal weight/low BMI vs. overweight/obese). Meanwhile, only the IES-R, PSS-SR, and IES-R3 dimensions successfully classified participants as having either normal blood pressure or hypertension. Participants in the overweight/obese and hypertensive clusters displayed considerably higher levels of most trauma symptoms. Input variables with the highest predictor importance in the cluster analysis were those variables expressing significant associations in correlations and ROC analyses. However, neither IES-R3 nor IES-R6 contributed to BMI or hypertension either directly or indirectly in the path analysis. Meanwhile, age significantly predicted both health conditions and current smoking. Irritability and numbing were the only IES-R dimensions that significantly contributed to current smoking. Conclusions: The findings emphasize the need for assessing the way through which various PTSD symptoms may implicate cardiometabolic dysfunctions and their risk factors (e.g., smoking and the intake of unhealthy foods) as well as the application of targeted dietary and exercise interventions to lower physical morbidity in PTSD patients. However, the internal and external validity of our tests may be questionable due to the low power of our sample size. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts, is pivotal to validate the results (e.g., in specific groups, such as those with confirmed traumatic exposure and comorbid mood dysfunction).

Which PTSD symptom would mediate the relationship between trauma exposure and depressive symptoms? Preliminary findings from two samples of trauma-exposed middle school students

Recent studies have documented that post-traumatic stress disorder (PTSD) symptoms are robustly associated with depressive symptoms and may mediate the relationship between trauma exposure and depressive symptoms. However, no study has explored the differential mediating effects of four specific PTSD symptom clusters. This study made the first attempt to examine the mediating effects of different PTSD symptom clusters on the linkage between trauma exposure and depressive symptoms. We analyzed data from two large samples of Chinese middle school students (N = 693 and 957) who had experienced the 2013 Ya'an earthquake. Participants completed standardized measures of trauma exposure, PTSD symptoms, and depressive symptoms. The prevalence of probable PTSD was 3.4% and 3.6%, respectively, in the two samples. Mediation analyses revealed that negative alterations in cognitions and mood and alterations in arousal and reactivity were statistically significant mediators in the relationship between trauma exposure during the earthquake and depressive symptoms. The results are very consistent in both samples. The findings suggest that symptom-specific tailored management of these two specific PTSD symptom clusters might have the potential to change the trajectory of developing depressive symptoms among trauma-exposed populations.

Unraveling PTSD: Symptom cluster change during and 1 year after veterans' residential PTSD treatment.

Although treatment of posttraumatic stress disorder (PTSD) is effective in reducing symptom severity, remission rates are low. One potential underlying reason for treatment ineffectiveness is differential response of specific PTSD symptom clusters. Using data from a national Veterans Affairs (VA) residential PTSD treatment cohort, we conducted a longitudinal study to examine changes in Diagnostic and Statistical Manual of Mental Disorders, fifth edition PTSD symptom clusters from admission to 1-year follow-up. PTSD symptom data were analyzed from a national cohort of veterans who completed VA PTSD residential treatment between October 2019 and September 2020 (n = 1,648; 13% women; median age 44.2 years). Endorsement (%) and severity (M[SD]) of PTSD clusters and individual symptoms were compared at admission, discharge, 4-month and 1-year follow-ups. Large magnitude reductions in all four PTSD symptom clusters were observed from admission to discharge and both follow-ups; however, endorsement of all symptom clusters remained high. Intrusions (Cluster B) were the most highly endorsed at discharge and follow-up, whereas avoidance symptoms (Cluster C) were the least highly endorsed. Differential patterns of change were observed among the 20 individual PTSD symptoms; for example, flashbacks decreased during treatment, but increased to near admission levels by 1-year postdischarge. Results suggest that intrusive symptoms may be more resistant to residential treatment for PTSD and contribute to lower likelihood of treatment success. Future work is needed to examine differential treatment response for PTSD clusters, to inform the improvement of current and creation of novel treatment interventions, and to better address intrusive symptoms to maximize PTSD treatment gains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A longitudinal investigation of PTSD symptoms, hazardous drinking, and relationship satisfaction in college student dating relationships

Post-traumatic stress disorder (PTSD) symptoms and hazardous drinking have been linked to lower relationship satisfaction; however, few studies have evaluated these associations over time in a college sample. The current study aimed to examine within-person and between-person longitudinal main and interactive effects of self-reported PTSD symptoms and hazardous drinking on relationship satisfaction in a college sample. We further examined whether individual PTSD symptom clusters (i.e., re-experiencing, avoidance, hyperarousal, and emotional numbing) uniquely predicted relationship satisfaction. College students in current dating relationships ( N = 307; 71% cisgender women) completed online self-report measures assessing relationship satisfaction, PTSD symptoms, and hazardous alcohol use on four occasions across 12 months. Multilevel models revealed that students with more severe PTSD symptoms than average had lower relationship satisfaction (i.e., at the between-person level). Additionally, higher hazardous drinking at the between-person and within-person levels was associated with lower relationship satisfaction. When examining specific PTSD symptom clusters, results indicated only emotional numbing symptoms were negatively associated with relationship satisfaction at the between-person and within-person levels after controlling for other PTSD symptom clusters. Collectively, these results underscore the impact of within- and between-person individual differences in PTSD symptoms and hazardous drinking on romantic relationships in college student populations.

Predicting aggressive behaviors: Examining unique and interactive roles of PTSD and emotion dysregulation in a minority sample.

Aggression is a costly public health problem with severe and multi-faceted negative consequences and thus, identifying factors that contribute to aggression, particularly in understudied populations, is necessary to develop more effective interventions to reduce the public health cost of aggression. The goal this study was to test whether difficulties regulating emotions moderated the association between posttraumatic stress disorder (PTSD) symptoms and aggression in a community sample of predominantly Black females with high levels of trauma exposure. Furthermore, we explored unique relations between PTSD symptom clusters and distinct subscales of difficulties regulating emotions and aggression. The sample included 601 community participants recruited from an urban public hospital. Symptoms were assessed using self-report measures including the Difficulties in Emotion Regulation Scale (DERS) and Behavioral Questionnaire-Short. Regression analyses were conducted using PTSD symptoms and total DERS to test their interaction as predictors for aggression (using BQ-Short). We found that higher levels of PTSD arousal symptoms and difficulty controlling impulses when upset were positively related to aggression. We also conducted an exploratory analysis to examine the association between PTSD symptom clusters using the Alternative Symptom Clusters hybrid model. The results suggest that some PTSD symptoms (externalizing behavior) and some emotion dysregulation processes (difficulties controlling impulses when upset), relate to aggression in independent, rather than multiplicative ways. These results offer insights for new directions of research that focuses on the independent association between specific emotion dysregulation processes and PTSD symptoms on aggression.

Differential Indirect Effects of Military Sexual Trauma on Posttraumatic Stress Disorder Symptom Clusters via Past-Year Intimate Partner Violence Experiences.

Women who serve in the military are at high risk for experiencing military sexual trauma (MST) and intimate partner violence (IPV), both of which are associated with symptoms of posttraumatic stress disorder (PTSD). To improve understanding of the psychological effects of experiencing multiple forms of interpersonal violence, it is important to identify the ways in which recent IPV experiences differentially increase the risk of specific PTSD symptom clusters for women with a history of MST. We aimed to identify if past-year IPV experiences mediate the relation between MST experiences and PTSD symptom clusters (i.e., intrusions, avoidance, negative alterations in cognitions/mood, hyperarousal) using structural equation modeling. A mail survey was administered to a sample of US female veterans at two time points 12 months apart. Among 198 participants, 108 women (54.5%) reported MST at Time 1, and 73 women (36.9%) reported IPV experiences in the past year at Time 2. PTSD symptom severity ranged from asymptomatic to beyond the diagnostic cutoff for a probable PTSD diagnosis. Past-year IPV experiences significantly mediated the association between MST history and PTSD avoidance symptoms, and MST history and PTSD negative alterations in cognitive/mood symptoms. No significant mediating effect was found for intrusion symptoms or hyperarousal symptoms. These findings can inform evidence-based practices for appropriate screening, assessment, detection, and intervention, including primary and secondary prevention efforts to instrumentally reduce future experiences of violence for female survivors of interpersonal violence.

A network analysis of Hurricane Maria-related traumatic stress and substance use among Puerto Rican youth.

Youth exposed to natural disasters are at risk of developing trauma-related symptoms as well as engaging in substance use. Although previous research has established associations between disaster-related stressors and substance use in youth, less has focused on how symptoms of posttraumatic stress disorder (PTSD) may underpin this association. The current study used network analysis to identify specific PTSD symptoms associated with substance use following a natural disaster. Participants were 91,732 youths (Grades 3-12) from across Puerto Rico who completed a needs assessment 5-9 months after Hurricane Maria made landfall in September 2017. We examined associations between PTSD symptoms and substance use, identified clusters of symptoms and bridges between them, and explored age- and binary gender-related differences in associations between specific PTSD symptoms and substance use. Analyses identified two symptom communities: (a) arousal and reactivity, negative alterations in cognition and mood, and substance use, and (b) avoidance and intrusion. Broader findings suggested that substance use was most strongly associated with PTSD-related irritability and angry outbursts among youths. Surrounding nodes explained only 4.1% of the variance in substance use, but this was higher among youths who reported not having a supportive adult, R2 = 8.5; friend, R2 = 7.9; or teacher/counselor, R2 = 7.7, in their life. The bridge symptoms of sleep disruption and physiological reactivity were identified as potentially critical intervention targets for disrupting PTSD symptom networks after a natural disaster. Implications for triaged mental health care following natural disasters and directions for future research are discussed.

Use of substances to cope predicts posttraumatic stress disorder symptom persistence: Investigating patterns of interactions between symptoms and its maintaining mechanisms.

Posttraumatic stress disorder (PTSD) remains a growing public health challenge across the globe and is associated with negative and persistent long-term consequences. The last decades of research have identified different mechanisms associated with the development and persistence of PTSD, including maladaptive coping strategies, cognitive and experiential avoidance, and positive and negative metacognitions. Despite these advances, little is known about how these different processes interact with specific PTSD symptoms, and how they influence each other over time at the within-person level. Leveraging a large (N > 1,800) longitudinal data set representative of the Norwegian population during the COVID-19 pandemic, this preregistered study investigated these symptom-process interactions over four assessment waves spanning an 8-month period. Our panel graphical vector autoregressive network model revealed the dominating role of substance use to cope in predicting higher levels of PTSD symptoms over time and increases in PTSD symptomatology within more proximal time windows (i.e., within 6 weeks). Threat monitoring was associated with increased suicidal ideation, while threat monitoring itself was increasing upon decreased avoidance behavior, greater presence of negative metacognitions, and higher use of substances to cope. Our findings speak to the importance of attending to different coping strategies, particularly the use of substances as a coping behavior in efforts to prevent PTSD chronicity upon symptom onset. We outline future directions for research efforts to better understand the complex interactions and temporal pathways leading up to the development and maintenance of PTSD symptomatology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Using network models to explore the associations between posttraumatic stress disorder symptoms and subjective cognitive functioning

Several studies have identified relationships between posttraumatic stress disorder (PTSD) and cognitive functioning. Here, we aimed to elucidate the nature of this relationship by investigating cross-sectional associations between subjective cognitive functioning (SCF) and 1) the PTSD sum score, 2) symptom domains, and 3) individual symptoms. We also investigated temporal stability by testing whether results replicated over a 3-year period. We estimated partial correlation networks of DSM-5 PTSD symptoms (at baseline) and SCF (at baseline and follow-up, respectively), using data from the National Health and Resilience in Veterans Study (NHRVS; N = 1484; Mdn = 65 years). The PTSD sum score was negatively associated with SCF. SCF was consistently negatively associated with the PTSD symptom domains ‘marked alterations in arousal and reactivity’ and ‘negative alterations in cognitions and mood’, and showed robust relations with the specific symptoms ‘having difficulty concentrating’ and ‘trouble experiencing positive feelings’. Results largely replicated at the 3-year follow-up, suggesting that some PTSD symptoms both temporally precede and are statistically associated with the development or maintenance of reduced SCF. We discuss the importance of examining links between specific PTSD domains and symptoms with SCF—relations obfuscated by focusing on PTSD diagnoses or sum scores—as well as investigating mechanisms underlying these relations.Registration Number: 37069 (https://aspredicted.org/n5sw7.pdf)

Interpersonal and Intimate Violence in Mexican Youth: Drug Use, Depression, Anxiety, and Stress during the COVID-19 Pandemic.

The COVID-19 pandemic may have increased interpersonal and intimate violence, harmful use of alcohol and other drugs (AODs), and mental health problems. This study uses a valid path model to describe relationships between these conditions of young Mexicans during the second year of the pandemic. A sample of 7420 Mexicans ages 18 to 24-two-thirds of whom are women-completed the Life Events Checklist, the Alcohol, Smoking, and Substance Involvement Screening Test, the Major Depressive Episode Checklist, the Generalized Anxiety Scale, and the Post-traumatic Stress Disorder (PTSD) Checklist. Young Mexicans reported higher rates of victimization and perpetration of interpersonal and intimate violence and mental health symptomatology than those noted pre- and in the first year of the pandemic. The harmful use of AOD rates were similar to those reported by adolescents before. The findings suggest asymmetric victimization and perpetration of intimate violence by gender (with women at a higher risk). More men than women have engaged in the harmful use of AODs (except for sedatives, which more women abuse). More women than men were at risk of all mental health conditions. The path model indicates that being a victim of intimate violence predicts the harmful use of tobacco, alcohol, cocaine, and sedatives, depression, anxiety, and specific PTSD symptoms (such as re-experimentation and avoidance symptoms). Being a victim of interpersonal violence resulted in severe PTSD symptoms (including avoidance, negative alterations in cognition-mood, and hyperarousal signs). The harmful use of sedatives predicted depressive symptoms. Men's victimizing intimate violence model contrasted with that of women, which included being the victim of interpersonal violence and severe PTSD symptoms. The high school youth model had three paths: victimizing intimate violence, victimizing interpersonal abuse, and sedative use, which predicted depression. Our findings could serve as the basis for future studies exploring the mechanisms that predict violence to develop cost-effective preventive programs and public policies and to address mental health conditions during community emergencies.

Does age matter in genetics? The role of ADCYAP1R1 in sex-specific risk for posttraumatic stress disorder in trauma-exposed preadolescent children

Following trauma exposure, children are a vulnerable population and at risk for developing posttraumatic stress disorder (PTSD). A large body of research has demonstrated the impactful role of genetics in vulnerability for PTSD in adult samples; yet very little research has examined genetic risk for PTSD in children. It is unknown whether genetic associations identified in adults are true for children; replication of findings from adult samples is needed in child samples. This study investigated an estrogen-responsive variant (ADCYAP1R1) that has been well-established to confer sex-specific risk for PTSD in adult samples, but is hypothesized to function differently in children, potentially due to pubertal changes in the estrogen system. Participants were children (n = 87; 57% female) ages 7 to 11 exposed to a natural disaster. Participants were assessed for trauma exposure and symptoms of PTSD. Participants provided a saliva sample, which was genotyped for the ADCYAP1R1 rs2267735 variant. In girls, the ADCYAP1R1 CC genotype was associated with PTSD (OR = 7.30). In boys, evidence for the opposite effect emerged, with the CC genotype attenuating risk for PTSD (OR = 8.25). When investigating specific PTSD symptom clusters, an association between ADCYAP1R1 and arousal emerged. This study is the first to investigate the relationship between ADCYAP1R1 and PTSD in trauma-exposed children. Findings for girls mirrored prior research on adult women, whereas findings for boys diverged from prior research on adult men. These potential differences between children and adults in genetic vulnerability for PTSD underscore the need for more genetic studies in child samples.

A daily diary study of the romantic partner relationship dynamics associated with anger and other posttraumatic stress disorder symptoms.

Posttraumatic stress disorder (PTSD) is linked to negative relationship outcomes, but the relational processes that link specific PTSD symptoms to these outcomes over granular periods are not well understood. The current study used a daily diary methodology to investigate the associations between specific PTSD symptoms (i.e., anger, avoidance, reexperiencing, hyperarousal, and numbing) and proximal indices of relationship functioning (i.e., accommodation behaviors, disclosure, intimacy). Participants were members of 64 couples, each comprising a male service member (SM) and female romantic partner (RP), who completed daily assessments of PTSD symptoms and indices of relationship functioning for 2 weeks. The results suggest a somewhat unique role of anger on relationship dynamics: Although mean levels of PTSD symptom clusters were associated with negative relationship outcomes at the bivariate level, daily fluctuations in anger were uniquely related to accommodation behaviors and SM- and RP-reported intimacy in multilevel models, Bs = -0.08-0.50). These findings highlight the importance of considering the differential role of specific PTSD symptoms, like anger, in dyadic interventions for PTSD; several strategies for doing so in the context of contemporary evidence-based treatments are discussed.

A Bifactor Model of General and Specific PTSD Symptom Change During Treatment.

Posttraumatic stress disorder (PTSD) consists of four main components in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5): intrusions (INT), avoidance (AV), negative alterations in cognition and mood (NACM), and arousal and reactivity (AAR); however, studies do not always support this four-factor model. A sample of 348 treatment-seeking adults was assessed for PTSD symptoms at baseline (Time 1) and then 12 weeks later (Time 2). Confirmatory factor analysis (CFA) was used to examine the model fit of the DSM-5 four-factor model of PTSD with and without a general factor at both time points, and structural equation modeling allowed for examination of these associations between time points. The four-factor model did not meet the criteria for excellent model fit, and the bifactor model provided improved model fit. The NACM specific factor did not meet the criteria for unique variance above and beyond the general factor. The bifactor model of PTSD symptoms was reliable over time, and both the general factor and the AAR factor significantly predicted subsequent symptom severity.

PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations

This study investigated the associations between momentary emotion dynamics and posttraumatic stress disorder (PTSD) symptoms. Using a sample of 61 couples (N = 122 individuals) in which all individuals were trauma exposed and at least one partner screened positive for PTSD, we examined the intra- and interpersonal regulation of vocally encoded emotional arousal (fundamental frequency [f0]) and how these momentary emotion regulatory patterns relate to specific PTSD symptoms during two couple conversations: one designed to elicit conflict and one to elicit intimacy. PTSD symptoms were assessed using a gold standard clinical interview. In both conversations, higher reexperiencing symptoms were associated with greater emotional inertia (i.e., more resistance to change in emotional state following deviation from one’s emotional equilibrium), and higher avoidance symptoms were associated with less emotional inertia (i.e., quicker return to emotional equilibrium). In the intimacy conversations, individuals also responded to their partners’ arousal. Furthermore, individuals whose partners exhibited higher emotional numbing symptoms exhibited more emotional inertia, suggesting that emotion regulation may be a function of both one’s own and one’s partner’s PTSD symptoms. Attending to the interpersonal context of emotion dynamics during PTSD treatment may enhance outcomes.

The Affective Control Scale: Factor structure and associations with posttraumatic stress symptoms in trauma-exposed male veterans.

Posttraumatic stress disorder (PTSD) is characterized by broad-based difficulties with emotion. However, the extent to which the disorder is associated with fear of particular emotions remains less well understood. The Affective Control Scale (ACS) is a frequently used measure of fear of emotion, but relatively little work has been done to validate this measure, particularly for use in psychiatric research. This study examined the ACS's factor structure and its associations with PTSD symptoms among trauma-exposed male veterans. Participants (N = 347) completed online assessments, including the ACS and the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). The data supported a bifactor structure with 1 general fear of emotion factor and 4 specific fear of emotion factors (i.e., fear of anger, fear of positive affect, fear of depressed mood, and fear of anxiety). Fear of emotion was positively associated with all 4 DSM-5 PTSD symptom clusters. After controlling for general fear of emotion, fear of particular emotion states was associated with some specific PTSD symptoms. Both general and specific fears of emotion were associated with specific PTSD symptoms in trauma-exposed veterans. Despite this, results support the use of a modified ACS total score, capturing general fear of emotion, rather than the subscale scores, capturing fear of specific emotions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations among Intimate Partner Violence, Posttraumatic Stress Disorder Symptoms, and Disordered Eating among Women Intimate Partner Violence Survivors Residing in Shelter.

Previous research has not assessed the association between intimate partner violence (IPV) and disordered eating (DE), nor the potential indirect effect through posttraumatic stress disorder (PTSD) symptoms, among residents of IPV shelters. Among 212 IPV survivors, this study examined these and the differential associations by PTSD symptom cluster and types of DE. In the current sample, 67.9% met criteria for probable PTSD, 20.3% met criteria for a probable eating disorder, and 18.4% had probable comorbid diagnoses. Consistent with escape theory, there was an indirect effect of IPV on DE through PTSD symptoms. Additionally, there was an indirect effect of IPV on weight/shape concerns and binge symptoms through PTSD symptoms. Although there was a significant total effect of IPV on compensatory behaviors, there was no indirect effect through PTSD symptoms. When PTSD symptom clusters were examined concurrently, the only indirect effect of IPV on weight/shape concerns was via the PTSD symptom cluster of negative alterations in cognition and mood. Although there was an indirect effect of IPV on binge symptoms via PTSD symptoms overall, no specific PTSD symptom cluster drove this association. Implications highlight the need for attention to DE within this population. Consistent with escape theory, survivors' DE might serve to distract from psychological distress.

Post-traumatic stress disorder as moderator of other mental healthconditions.

Post-traumatic stress disorder as moderator of other mental healthconditions.

The role of PTSD symptom clusters and criterion in predicting future high-risk drug and alcohol use among returning veteran men and women.

The prevalence of co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) remains exceptionally high among returning veterans, with numerous studies linking PTSD, but not specific PTSD symptoms, to future SUD risk. Further explication of PTSD symptom effects on future SUD risk will likely promote intervention development and refinement while offsetting SUD risk. Accordingly, In this study we explored the prospective associations between PTSD symptom clusters, symptoms, and future SUD risk and use of specific drug classes. Returning veterans (N = 1,295; Mage = 42.3, SD = 9.89; 51% female; 66.8% White) completed structured diagnostic interviews to assess PTSD symptoms and self-report measures of substance use 14-36 months later (M = 24.59, SD = 2.97). Hyperarousal and reckless/self-destructive symptoms specifically predicted future high-risk drug use and binge drinking behavior, and avoidance of internal stimuli (i.e., of trauma memories, thoughts, and feelings) differentiated individuals classified as high-risk for alcohol use based on their AUDIT total score. Further, negative alterations in cognition and mood predicted future opioid (i.e., nightmares) and stimulant use (i.e., flashbacks), whereas concentration difficulties were inversely associated with future binge drinking. This longitudinal study identified prospective and enduring associations between specific PTSD symptom clusters, symptoms, and future high-risk substance use patterns among returning veterans. Accordingly, careful assessment of specific PTSD criteria and differential motivations for substance use is warranted, along with tailored interventions to offset risk for opioid, stimulant, and alcohol use among returning veterans. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations between moral injury and ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD among help-seeking nurses: a cross-sectional study

ObjectivesThis study aimed to evaluate how moral injury (MI), traumatic experiences and daily stressors were related to the symptoms of post-traumatic stress disorder (PTSD) and International Classification of Diseases 11th...

Are psychological debriefing groups after a potential traumatic event suitable to prevent the symptoms of PTSD?

Psychological debriefing is a psychotherapeutic approach developed for early intervention in civilians and professionals who have to cope with a potential traumatic event (PTE). Although initial works claimed that this approach may decrease symptoms of posttraumatic stress disorder (PTSD), some studies have concluded that the clinical benefits of psychological debriefing were limited. Several methodological variations could explain the discrepancies observed among studies. Among these variations, how the approach is administered to participants should have importance, and clinical evidence suggests that debriefing groups instead of individuals could have a beneficial clinical effect. We conducted a systematic search of the literature investigating the clinical effects of psychological debriefing groups on PTSD symptoms after a PTE according to the PRISMA guidelines. Among the 790 articles found, 11 met our inclusion criteria. Most of these articles did not support any beneficial effect of psychological debriefing groups on PTSD symptoms. A large number of methodological variations that may influence the outcomes of these studies were observed. Psychological debriefing groups did not seem efficient in alleviating PTSD symptoms. Further studies of high methodological quality are needed to elucidate the effect of psychological debriefing groups on specific PTSD symptoms and on nonspecific symptoms.