Vulnerability Factor For Posttraumatic Stress Disorder Research Articles

Pre-trauma memory contextualization as predictor for PTSD-like behavior in male rats

While many people experience potentially threatening events during their life, only a minority develops posttraumatic stress disorder (PTSD). The identification of individuals at risk among those exposed to trauma is crucial for PTSD prevention in the future. Since re-experiencing trauma elements outside of the original trauma-context is a core feature of PTSD, we investigate if the ability to bind memories to their original encoding context (i.e. memory contextualization) predicts PTSD vulnerability. We hypothesize that pre-trauma neutral memory contextualization (under stress) negatively relates to PTSD-like behavior, in a prospective design using the cut-off behavioral criteria rat model for PTSD. 72 male Sprague Dawley rats were divided in two experimental groups to assess the predictive value of 1) memory contextualization without acute stress (NS-group) and 2) memory contextualization during the recovery phase of the acute stress-response (S-group) for susceptibility to PTSD-like behavior. A powerful extension to regression analysis -path analysis-was used to test this specific hypothesis, together with secondary research questions. Following traumatic predator scent stress, 19.4% of the rats displayed PTSD-like behavior. Results showed a negative relation between pre-trauma memory contextualization and PTSD-like behavior, but only in the NS-group. Pre-trauma memory contextualization was positively related to fear association in the trauma environment, again only in the NS group. If the predictive value of pre-trauma contextualization of neutral information under non-stressful conditions for PTSD susceptibility is replicated in prospective studies in humans, this factor would supplement already known vulnerability factors for PTSD and improve the identification of individuals at risk among the trauma exposed, especially those at high trauma risk such as soldiers deployed on a mission.

Depressive Dysfunctional Attitudes and Post-Traumatic Stress in Victims of Terrorist Attacks

ABSTRACT The DSM-5ʹs new conception of post-traumatic stress disorder (PTSD) includes, as a diagnostic criterion, the presence of persistent and exaggerated negative beliefs, thoughts, or expectations about oneself, others, the world, and one’s guilt. These symptoms increase the symptomatic similarity with major depressive disorder (MDD) and with the negative cognitive triad of Beck’s cognitive theory of depression and allow us to assume that the dysfunctional attitudes that this theory proposes as a vulnerability factor for MDD could also refer to PTSD. This study aims to examine the relationship between depressive dysfunctional attitudes and the symptoms and diagnosis of PTSD. A sample of 378 adult victims of terrorism completed measures of depressive dysfunctional attitudes (DAS-A), DSM-IV post-traumatic stress symptoms (PCL-S), depressive symptoms (BDI-II), and DSM-IV diagnosis of emotional disorders (SCID-I). A significant relationship was found between depressive dysfunctional attitudes and PTSD symptomatology, even after controlling for the effect of depression, sex, age, education level, anxiety, and previous depressive episodes. It was also found that victims with PTSD, with or without MDD, had more depressive dysfunctional attitudes than those without emotional disorders and more achievement-perfectionism attitudes than victims with emotional disorders other than PTSD or MDD. The results suggest that depressive dysfunctional attitudes could be a vulnerability factor for PTSD. The results also suggest the need to refine Beck's cognitive theory proposals about dysfunctional attitudes common and specific to each emotional disorder and identify potential therapeutic targets of cognitive therapies for these disorders.

The brain at war: effects of stress on brain structure in soldiers deployed to a war zone

In search of the neural basis of severe trauma exposure and post-traumatic stress disorder (PTSD), a multitude of cross-sectional studies have been conducted, most of them pointing at structural deficits in the hippocampus and medial prefrontal cortex including the anterior cingulate cortex (ACC) and ventromedial prefrontal cortex (vmPFC). Since cross-sectional studies are silent to causality, the core question remains: which brain structural alterations constitute a risk factor for disease and therewith precede the stressor, and which brain regions may undergo alterations as a consequence of exposure to the stressor. We assessed 121 soldiers before and after deployment to regions of war and 40 soldiers as controls, who were not deployed. Analysis using voxel-based morphometry revealed volumetric reductions in the ACC, vmPFC (region of interest analysis, effect does not survive conservative multiple test correction) and in bilateral thalamus (whole-brain analysis) in the deployment group. Remarkably, the ACC and vmPFC volume decrease was not limited to the period of deployment, but continued over the following 6 months after deployment. Volumetric reductions did not correlate with increases in PTSD symptoms. The volume decreases in medial prefrontal cortex and thalamus seem to be driven by trauma exposure rather than a vulnerability factor for PTSD. However, data indicate that the volume decrease in medial prefrontal cortex surpasses the time period of deployment. This may hint at an initiated pathobiological process below a symptom threshold, potentially paving the way to future mental health problems.

Reexamination of diathesis stress and neurotoxic stress theories: A qualitative review of pre-trauma neurobiology in relation to posttraumatic stress symptoms.

ObjectiveAssociations of neurobiological differences with posttraumatic stress disorder (PTSD) have generated interest in their temporal relation. Support has been voiced for the neurotoxic stress theory (NST) in which neurobiological differences develop following exposure and PTSD development. In contrast, the diathesis stress theory (DST) posits that neurobiological differences existed prior to exposure and may be vulnerability factors for PTSD. Studies in the first wave of neurobiological PTSD research were all cross sectional, but a second wave of research followed which used prospective repeated‐measures designs that measured neurobiology prior to trauma exposure experiences, allowing greater causal inference.MethodsThis study reviewed the second‐wave studies in hopes of developing a preliminary consensus to support either the NST or the DST based on this more powerful prospective, repeated‐measures study design.ResultsTwenty‐five second‐wave studies were located that measured neurobiology prior to traumatic experiences. Nineteen studies supported the DST. Of 10 studies that were capable of testing the NST, only 3 were supportive.ConclusionThe implications of the NST versus the DST have profound implications for understanding the fragility of the human brain and possible paths forward for future research on assessment, treatment, and social policy.

Failure of Attentional Control is a Vulnerability Factor for PTSD: An Identical Twin Study

Posttraumatic stress disorder (PTSD) is an often-debilitating psychiatric disorder that emerges in some people after experiencing a traumatic event such as sexual assault, natural disaster, or combat. Attention-related symptoms such as "hypervigilance" and "problems with concentration" are considered in the DSM-5 to reflect symptoms that begin or worsen after the traumatic event. However, an important question is whether these disruptions are triggered by the experience of trauma or if they are actually a premorbid vulnerability factor.

Increased risk of alcohol dependency in a cohort of National Guard troops with PTSD: A longitudinal study

Studies show high rates of co-morbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) but there is no consensus on the causal direction of the relationship. Some theories suggest AUD develops as a coping mechanism to manage PTSD symptoms and others that AUD is a vulnerability factor for PTSD. A third hypothesis posits independent developmental pathways stemming from a shared etiology, such as the trauma exposure itself. We examined these hypotheses using longitudinal data on 922 National Guard soldiers, representing a subsample (56%) of a larger pre- and post-deployment cross-sectional study of New Jersey National Guard soldiers deployed to Iraq. Measures included the PTSD Checklist (PCL), DSM-IV-based measures of alcohol use/misuse from the National Household Survey of Drug Use and Health and other concurrent mental health, military and demographic measures. Results showed no effect of pre-deployment alcohol status on subsequent positive screens for new onset PTSD. However, in multivariate models, baseline PTSD symptoms significantly increased the risk of screening positive for new onset alcohol dependence (AD), which rose 5% with each unit increase in PCL score (AOR = 1.05; 95% CI = 1.02–1.07). Results also supported the shared etiology hypothesis, with the risk of a positive screen for AD increasing by 9% for every unit increase in combat exposure after controlling for baseline PTSD status (AOR = 1.09; 95% CI = 1.03–1.15) and, in a subsample with PCL scores <34, by 17% for each unit increase in exposure (AOR = 1.17; 95% CI = 1.05–1.31). These findings have implications for prevention, treatment and compensation policies governing co-morbidity in military veterans.

Pre-trauma verbal ability at five years of age and the risk of post-traumatic stress disorder in adult males and females

Previous studies have shown that high cognitive ability, measured in childhood and prior to the experience of traumatic events, is protective of PTSD development. Our aim was to test if the association between pre-trauma verbal ability ascertained at 5 years with DSM-IV lifetime post-traumatic stress disorder (PTSD) at 21 years was subject to effect modification by gender, trauma type or prior behaviour problems. Using a prospective birth cohort of young Australians, we found that both trauma type and behaviour problems did not change the association between cognitive ability and PTSD. During multivariate analysis, testing for the interactive effect of gender revealed that verbal ability was linearly and inversely associated with PTSD in females only, with those in the lowest verbal ability quintile having strongly increased odds of PTSD (OR=3.89: 95% CI; 1.50, 10.10) compared with those in the highest quintile. A graph of the interaction revealed lower verbal ability placed females, but not males, at an increased risk of PTSD. Our results indicate that lower verbal ability in early childhood is a vulnerability factor for PTSD in females but not in males, and may constitute a gender-specific risk factor responsible for part of the increased risk of PTSD found in females compared with males.

Prevalence and Risk Factors of Posttraumatic Stress Disorder in Older Adults

Background: Posttraumatic stress disorder (PTSD) has scarcely been researched in the elderly. There is no population-based information on prevalence and risk factors in older persons. Patients with PTSD are often not recognized or incorrectly diagnosed. As the disorder has great implications for the quality of life, a correct diagnosis and treatment are crucial. Increased knowledge on vulnerability factors for PTSD can facilitate diagnostic procedures and health management in the elderly. Methods: PTSD cases were found following a two-phase sampling procedure: a random selection of 1,721 subjects were screened and in 422 subjects a psychiatric diagnostic interview was administered. Prevalence of PTSD and subthreshold PTSD were calculated. Vulnerability factors regarding demographics, physical health, personality, social factors, recent distress and adverse events in early childhood were assessed. Results: 6-month prevalence of PTSD and of subthreshold PTSD was 0.9 and 13.1%, respectively. The strongest vulnerability factors for both PTSD and subthreshold PTSD were neuroticism and adverse events in early childhood. Conclusions: This is the first population-based study on PTSD in older persons. With a 6-month prevalence of almost 1% the disease is not rare. Comparisons with younger populations suggest some accumulation of cases among older people reflecting the chronic risk factors, which are found in this study: neuroticism and adverse events in early childhood.