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Saenz de Viteri S, Zhang J, Johnson EC, Barr PB, Edenberg HJ, Hesselbrock VM, Nurnberger JI, Pandey AK, Kamarajan C, Kinreich S, Tischfield JA, Plawecki MH, Kramer JR, Lai D, Kuperman S, Chan G, McCutcheon VV, Bucholz KK, Porjesz B, Meyers JL. Genomic risk for post-traumatic stress disorder in families densely affected with alcohol use disorders. Mol Psychiatry 2023; 28:3391-3396. [PMID: 37344610 PMCID: PMC10618091 DOI: 10.1038/s41380-023-02117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023]
Abstract
Recent genome-wide association studies (GWAS) have identified genetic markers of post-traumatic stress disorder (PTSD) in civilian and military populations. However, studies have yet to examine the genetics of PTSD while factoring in risk for alcohol dependence, which commonly co-occur. We examined genome-wide associations for DSM-IV PTSD among 4,978 trauma-exposed participants (31% with alcohol dependence, 50% female, 30% African ancestry) from the Collaborative Study on the Genetics of Alcoholism (COGA). We also examined associations of polygenic risk scores (PRS) derived from the Psychiatric Genomics Consortium (PGC)-PTSD Freeze 2 (N = 3533) and Million Veterans Program GWAS of PTSD (N = 5200) with PTSD and substance dependence in COGA, and moderating effects of sex and alcohol dependence. 7.3% of COGA participants met criteria for PTSD, with higher rates in females (10.1%) and those with alcohol dependence (12.3%). No independent loci met genome-wide significance in the PTSD meta-analysis of European (EA) and African ancestry (AA) participants. The PGC-PTSD PRS was associated with increased risk for PTSD (B = 0.126, p < 0.001), alcohol dependence (B = 0.231, p < 0.001), and cocaine dependence (B = 0.086, p < 0.01) in EA individuals. A significant interaction was observed, such that EA individuals with alcohol dependence and higher polygenic risk for PTSD were more likely to have PTSD (B = 0.090, p < 0.01) than those without alcohol dependence. These results further support the importance of examining substance dependence, specifically alcohol dependence, and PTSD together when investigating genetic influence on these disorders.
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Affiliation(s)
| | - Jian Zhang
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Emma C Johnson
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Peter B Barr
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | | | | | | | - Ashwini K Pandey
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Chella Kamarajan
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sivan Kinreich
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | | | | | - John R Kramer
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Dongbing Lai
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Grace Chan
- University of Connecticut Health Center, Farmington, CT, USA
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Vivia V McCutcheon
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kathleen K Bucholz
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Bernice Porjesz
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jacquelyn L Meyers
- State University of New York Downstate Health Sciences University, Brooklyn, NY, USA
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Fijtman A, Clausen A, Kauer-Sant'Anna M, Morey R. Trauma history in veterans with bipolar disorder and its impact on suicidality. J Psychiatr Res 2023; 157:119-126. [PMID: 36463626 DOI: 10.1016/j.jpsychires.2022.10.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES Veterans are at increased risk for exposure to trauma, developing serious mental illnesses, and death by suicide. History of trauma correlates with worsening outcomes in patients with bipolar disorder. This study investigated associations between trauma exposure (type and timing) and suicide attempt in Veterans with bipolar disorder. METHODS One hundred six Veterans with a diagnosis of bipolar disorder and 815 Veterans with no psychiatric history (age rage = 20-72 years old) completed a clinical questionnaire, the Beck Scale for Suicide Ideation, and the Traumatic Live Events Questionnaire. Multinomial logistic regressions investigated correlations between diagnosis, time of trauma (before, during, or after the military), trauma type (attack, illness, accident, child violence, child sexual abuse, and adult sexual abuse), and suicide attempt. RESULTS Seventy-five Veterans with bipolar disorder had comorbid PTSD. Controlling for PTSD, Veterans with bipolar disorder had a higher prevalence of trauma including physical assault [odds ratio (OR) = 2.85; 95% confidence interval (CI) = 1.39-5.86] and child sexual trauma (OR = 2.89; CI = 1.38-6.05). Veterans with bipolar disorder who endorsed previous suicide attempts (n = 42) had significantly higher levels of exposure to childhood trauma (OR = 5.69; CI = 1.84-17.62). CONCLUSIONS Results support incorporating history of previous trauma exposure when assessing Veterans at risk for bipolar disorder. Especially, trauma characterized as attack and childhood sexual abuse. Particular attention should be given to Veterans with bipolar disorder and exposure to trauma during childhood, which may be associated with increased risk of suicidality.
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Affiliation(s)
- Adam Fijtman
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, 3643 N. Roxboro St, Durham, NC, 27704, USA.
| | - Ashley Clausen
- St. Vincent Hospital, Department of Behavioral Health, 2900 12th Ave N, Billings, MT, 59101, USA.
| | - Marcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-002, Brazil.
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- Durham VA Medical Center, 508 Fulton St. Durham, NC. 27705, USA
| | - Rajendra Morey
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, 3643 N. Roxboro St, Durham, NC, 27704, USA; Durham VA Medical Center, 508 Fulton St. Durham, NC. 27705, USA.
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Birnbaum HJ, Dittmann AG, Stephens NM, Reinhart EC, Carey RM, Markus HR. Personal harm from the Covid-19 pandemic predicts advocacy for equality. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2022; 104:104400. [PMID: 36032507 PMCID: PMC9395294 DOI: 10.1016/j.jesp.2022.104400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022]
Abstract
The Covid-19 pandemic has laid bare the vast amount of economic inequality in the U.S. Yet, has it influenced Americans' attitudes and behaviors toward equality? With a three-wave longitudinal survey, the current research provides evidence that experiencing personal harm (e.g., contracting Covid-19, losing jobs, or psychological distress) from the pandemic predicts an increase in people's attitudinal and behavioral advocacy for equality. Specifically, we find that experiencing greater personal harm in the early stages of the pandemic (i.e., May 2020) is associated with increased advocacy for equality one year later (i.e., May 2021; e.g., contacting a public official to express support for reducing inequality). Furthermore, we find that this increase in advocacy for equality is explained, in part, by people's greater endorsement of the external factors (e.g., bad luck, discrimination, etc.) that contribute to inequality. Our work provides evidence that the extent to which people experience harm from the Covid-19 pandemic predicts both their increased understanding of external sources of inequality, as well as their efforts to combat this inequality (e.g., by advocating for policies that combat structural contributors to inequality).
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Affiliation(s)
- Hannah J Birnbaum
- Organizational Behavior Area, Olin Business School, Washington University in St. Louis, USA
| | - Andrea G Dittmann
- Organization and Management, Goizueta Business School, Emory University, USA
| | - Nicole M Stephens
- Management and Organizations, Kellogg School of Management, Northwestern University, USA
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Nöthling J, Abrahams N, Jewkes R, Mhlongo S, Lombard C, Hemmings SMJ, Seedat S. Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape. J Affect Disord 2022; 309:151-164. [PMID: 35427719 DOI: 10.1016/j.jad.2022.04.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The prevalence of posttraumatic stress disorder (PTSD) in rape survivors is considerably higher than the prevalence in non-sexual trauma survivors. Few studies have investigated risk and protective factors in survivors early-after-rape in a prospective longitudinal design. METHODS In a sample of 639 rape-exposed women who were assessed within 20 days of rape and over 6 months, baseline data were used to predict PTSD symptom severity scores up to 6 months post-rape. RESULTS The incidence of PTSD at 3 months was 48.5% and the cumulative incidence at 6 months post-rape was 54.8%. Baseline experience of rape stigma (guilt, shame, self-blame, social devaluation and discredit) and depression were significant predictors of PTSD symptom scores over time, in mixed linear regression models. Higher levels of depression and rape stigma were associated with higher PTSD scores. Assault-related factors were not associated with PTSD scores. LIMITATIONS We could not measure PTSD symptom trajectories in all rape survivors, some of who may be at greater risk for PTSD e.g. non-disclosing rape survivors, those who declined participation and those who were extremely distressed at the time of recruitment. CONCLUSION Addressing internalised and externalised stigma and resultant mental health effects on women who present to rape clinics may reduce the long-term adverse effects of rape on mental health outcomes, such as PTSD. Rape survivors who present with high levels of depression soon after a rape should be carefully monitored and appropriately treated in order to reduce PTSD severity.
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Affiliation(s)
- Jani Nöthling
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa.
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Carl Lombard
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Biostatistics Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
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Nöthling J, Abrahams N, Toikumo S, Suderman M, Mhlongo S, Lombard C, Seedat S, Hemmings SMJ. Genome-wide differentially methylated genes associated with posttraumatic stress disorder and longitudinal change in methylation in rape survivors. Transl Psychiatry 2021; 11:594. [PMID: 34799556 PMCID: PMC8604994 DOI: 10.1038/s41398-021-01608-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 08/01/2021] [Accepted: 09/02/2021] [Indexed: 12/24/2022] Open
Abstract
Rape is associated with a high risk for posttraumatic stress disorder (PTSD). DNA methylation changes may confer risk or protection for PTSD following rape by regulating the expression of genes implicated in pathways affected by PTSD. We aimed to: (1) identify epigenome-wide differences in methylation profiles between rape-exposed women with and without PTSD at 3-months post-rape, in a demographically and ethnically similar group, drawn from a low-income setting; (2) validate and replicate the findings of the epigenome-wide analysis in selected genes (BRSK2 and ADCYAP1); and (3) investigate baseline and longitudinal changes in BRSK2 and ADCYAP1 methylation over six months in relation to change in PTSD symptom scores over 6 months, in the combined discovery/validation and replication samples (n = 96). Rape-exposed women (n = 852) were recruited from rape clinics in the Rape Impact Cohort Evaluation (RICE) umbrella study. Epigenome-wide differentially methylated CpG sites between rape-exposed women with (n = 24) and without (n = 24) PTSD at 3-months post-rape were investigated using the Illumina EPIC BeadChip in a discovery cohort (n = 48). Validation (n = 47) and replication (n = 49) of BRSK2 and ADCYAP1 methylation findings were investigated using EpiTYPER technology. Longitudinal change in BRSK2 and ADCYAP1 was also investigated using EpiTYPER technology in the combined sample (n = 96). In the discovery sample, after adjustment for multiple comparisons, one differentially methylated CpG site (chr10: 61385771/ cg01700569, p = 0.049) and thirty-four differentially methylated regions were associated with PTSD status at 3-months post-rape. Decreased BRSK2 and ADCYAP1 methylation at 3-months and 6-months post-rape were associated with increased PTSD scores at the same time points, but these findings did not remain significant in adjusted models. In conclusion, decreased methylation of BRSK2 may result in abnormal neuronal polarization, synaptic development, vesicle formation, and disrupted neurotransmission in individuals with PTSD. PTSD symptoms may also be mediated by differential methylation of the ADCYAP1 gene which is involved in stress regulation. Replication of these findings is required to determine whether ADCYAP1 and BRSK2 are biomarkers of PTSD and potential therapeutic targets.
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Affiliation(s)
- Jani Nöthling
- Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch University, Cape Town, South Africa.
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa.
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Stellenbosch University, Cape Town, South Africa.
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sylvanus Toikumo
- Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Stellenbosch University, Cape Town, South Africa
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Stellenbosch University, Cape Town, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Stellenbosch University, Cape Town, South Africa
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Subbie-Saenz de Viteri S, Pandey A, Pandey G, Kamarajan C, Smith R, Anokhin A, Bauer L, Bender A, Chan G, Dick D, Edenberg H, Kinreich S, Kramer J, Schuckit M, Zang Y, McCutcheon V, Bucholz K, Porjesz B, Meyers JL. Pathways to post-traumatic stress disorder and alcohol dependence: Trauma, executive functioning, and family history of alcoholism in adolescents and young adults. Brain Behav 2020; 10:e01789. [PMID: 32990406 PMCID: PMC7667345 DOI: 10.1002/brb3.1789] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Family history (FH) of alcohol dependence is likely to increase the risk of trauma exposure, post-traumatic stress disorder (PTSD), and alcohol dependence. FH of alcohol dependence and trauma has been separately shown to adversely affect planning/problem-solving aspects of executive function. However, few studies have examined these risk factors in an integrated model. METHODS Using data from trauma-exposed individuals from the Collaborative Study on the Genetics of Alcoholism prospective cohort (N = 1,860), comprising offspring from alcohol-dependent high-risk and comparison families (mean age [SE] = 21.9 [4.2]), we investigated associations of trauma (nonsexual assaultive, nonassaultive, sexual assaultive) with DSM-IV PTSD and alcohol dependence symptom counts, and planning/problem-solving abilities assessed using the Tower of London Test (TOLT). Moderating effects of family history density of alcohol use disorder (FHD) on these associations and sex differences were explored. RESULTS Family history density was positively associated with PTSD in female participants who endorsed a sexual assaultive trauma. Exposure to nonsexual assaultive trauma was associated with more excess moves made on the TOLT. CONCLUSION Findings from this study demonstrate associations with PTSD and alcohol dependence symptom counts, as well as poor problem-solving ability in trauma-exposed individuals from families densely affected with alcohol dependence, depending on trauma type, FHD, and sex. This suggests that having a FH of alcohol dependence and exposure to trauma during adolescence may be associated with more PTSD and alcohol dependence symptoms, and poor problem-solving abilities in adulthood.
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Affiliation(s)
| | - Ashwini Pandey
- State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Gayathri Pandey
- State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Chella Kamarajan
- State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Rebecca Smith
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - Andrey Anokhin
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lance Bauer
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Annah Bender
- University of Missouri, St. Louis, Missouri, USA
| | - Grace Chan
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Danielle Dick
- Virginia Commonwealth University, Richmond, Virginia, USA
| | - Howard Edenberg
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sivan Kinreich
- State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | | | | | - Yong Zang
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Vivia McCutcheon
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kathleen Bucholz
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bernice Porjesz
- State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Jacquelyn L Meyers
- State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
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Potentially Traumatic Events and Job Satisfaction: A Prospective Population-Based Comparative Study. J Occup Environ Med 2019; 60:e126-e133. [PMID: 29200186 DOI: 10.1097/jom.0000000000001237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effects of potentially traumatic events (PTEs), posttraumatic stress symptoms (PTSS), and coping self-efficacy (CSE) on post-event job satisfaction. METHODS Repeated analysis of variance (ANOVA) was used to assess differences in the course of job satisfaction during 1 year between population-based samples of affected and nonaffected workers. Multivariate regression analyses were conducted with pre-event health, job satisfaction and insecurity, and postevent PTSS and CSE as predictors. RESULTS About 16% of the affected workers had probable PTSD. The course of job satisfaction between affected (n = 123) and nonaffected workers (n = 644) did not differ significantly. PTSS and CSE did not independently predict post-event satisfaction, in contrast to pre-event job satisfaction. CONCLUSION Findings suggest that when needed social support is provided, concerns about the negative effects of potentially traumatic events on job satisfaction could be somewhat relaxed.
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Carvalho JN, Renner AM, Donat JC, de Moura TC, Fonseca RP, Kristensen CH. Executive functions and clinical symptoms in children exposed to maltreatment. APPLIED NEUROPSYCHOLOGY-CHILD 2018; 9:1-12. [PMID: 30295547 DOI: 10.1080/21622965.2018.1497989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
There is evidence of an association between childhood maltreatment and lifelong cognitive impairment. Few studies investigate cognitive functioning in maltreated children. The objective of this study was to investigate whether there are differences in executive processing between maltreated and nonmaltreated children. Additionally, clinical symptoms were compared between groups and possible associations between clinical symptoms, and deficits in executive functions were investigated. The sample consisted of 55 children (8-12 years), 30 with a history of maltreatment and 25 with no history of maltreatment. An interview was conducted with the child's legal guardian and instruments were administered: Juvenile Victimization Questionnaire (JVQ), Child Behavior Checklist (CBCL), and Spence Children's Anxiety Scale (SCAS). The following clinical instruments were administered to the children: JVQ, Trauma Symptom Checklist for Children (TSCC), and Children's Depression Inventory (CDI). Children underwent neuropsychological assessment. Data were analyzed by comparing the groups for clinical and cognitive variables. Differences were found between the groups in all executive functions. Most clinical symptomatology scales showed differences between the groups. Few associations were found between clinical and executive impairment profiles. Cognitive stimulation interventions, focused on inhibitory control, should be proposed in combination with psychotherapy.
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Affiliation(s)
- Janaína Nuñez Carvalho
- Catholic University of Rio Grande do Sul, Postgraduate Psychology department, Porto Alegre, Brazil
| | - Anelise Meurer Renner
- Catholic University of Rio Grande do Sul, Postgraduate Psychology department, Porto Alegre, Brazil
| | - Júlia Candia Donat
- Catholic University of Rio Grande do Sul, Postgraduate Psychology department, Porto Alegre, Brazil
| | - Tayse Conter de Moura
- Catholic University of Rio Grande do Sul, Postgraduate Psychology department, Porto Alegre, Brazil
| | - Rochele Paz Fonseca
- Catholic University of Rio Grande do Sul, Postgraduate Psychology department, Porto Alegre, Brazil
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van Stolk-Cooke K, Brown A, Maheux A, Parent J, Forehand R, Price M. Crowdsourcing Trauma: Psychopathology in a Trauma-Exposed Sample Recruited via Mechanical Turk. J Trauma Stress 2018; 31:549-557. [PMID: 30025175 PMCID: PMC6107385 DOI: 10.1002/jts.22303] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 03/21/2018] [Accepted: 04/02/2018] [Indexed: 11/09/2022]
Abstract
Although crowdsourcing websites like Amazon's Mechanical Turk (MTurk) allow researchers to conduct research efficiently, it is unclear if MTurk and traditionally recruited samples are comparable when assessing the sequela of traumatic events. We compared the responses to validated self-report measures of posttraumatic stress disorder (PTSD) and related constructs that were given by 822 participants recruited via MTurk and had experienced a DSM-5 Criterion A traumatic event to responses obtained in recent samples of participants recruited via traditional methods. Results suggested that the rate of PTSD in the present sample (19.8%) was statistically higher than that found in a recent systematic review of studies that used only traditional recruitment methods. The severity of PTSD reported in the MTurk sample was significantly greater than that reported in a college sample, d = 0.24, and significantly less than that reported in a veteran sample, d = 0.90. The factor structure of PTSD found in the MTurk sample was consistent with prevailing models of PTSD. Findings indicate that crowdsourcing may improve access to this hard-to-reach population.
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Affiliation(s)
| | - Andrew Brown
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Anne Maheux
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Justin Parent
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Rex Forehand
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
| | - Matthew Price
- Department of Psychology, University of Vermont, Burlington, Vermont, USA
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Bae SM, Kang JM, Chang HY, Han W, Lee SH. PTSD correlates with somatization in sexually abused children: Type of abuse moderates the effect of PTSD on somatization. PLoS One 2018; 13:e0199138. [PMID: 29927990 PMCID: PMC6013160 DOI: 10.1371/journal.pone.0199138] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 06/01/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose Somatization is a major post-traumatic symptom in sexually abused children. Thus, the present study aimed to determine the relationship between post-traumatic stress disorder (PTSD) symptoms and somatization, and between intelligence and somatization in child sexual abuse victims and to elucidate whether type of abuse had an effect on the relationship between PTSD symptoms and somatization. Methods This study evaluated the somatizations (Child Behavioral Checklist/6–18 [CBCL]), PTSD symptoms (Trauma Symptom Checklist for Children [TSCC]), and intelligence levels of 63 sexually abused children. Correlation and regression analyses were performed to predict somatization based on PTSD symptoms, intelligence, age, and type of sexual abuse, and to find moderating effect of type of abuse on the effect of PTSD symptom on somatization. Results PTSD symptoms (β = 0.471, p = 0.001) and intelligence (β = 0.327, p = 0.021) were associated with somatization. Type of abuse was not, by itself, correlated with somatization (β = 0.158, p = 0.281), but it did have a moderating effect on the effect of PTSD symptoms on somatization (Type of abuse*PTSD symptoms, β = -0.299, p = 0.047). PTSD symptoms were associated with somatization only among those who experienced the molestation type of abuse. Conclusions Somatization in sexually abused children was influenced by the severity of PTSD symptoms and intelligence, and the effect of the PTSD symptoms on somatization was moderated by type of abuse. Specifically, the rape type of abuse may attenuate the effect of post-traumatic symptoms on somatization.
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Affiliation(s)
- Seung Min Bae
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
- Sunflower Children’s Center, Incheon, Republic of Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
- Sunflower Children’s Center, Incheon, Republic of Korea
| | - Hyoung Yoon Chang
- Department of Psychiatry and Behavioral Sciences, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Woori Han
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
- * E-mail:
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Ghazali SR, Chen YY, Aziz HA. Childhood Maltreatment and Symptoms of PTSD and Depression Among Delinquent Adolescents in Malaysia. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:151-158. [PMID: 32318145 PMCID: PMC7163867 DOI: 10.1007/s40653-017-0196-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Adolescents in the juvenile justice system are known to suffer from various psychological disorders. Less is known about how childhood psychological trauma is related to psychological disorders among delinquent adolescents in Malaysia. This study investigated the relationship between childhood maltreatment and depressive and Posttraumatic Stress Disorder (PTSD) symptoms. Of 327 adolescents 96% were exposed to at least one childhood victimization. Significant differences were found for all types of victimization (i.e. maltreatment, sexual abuse, severe assault, neglect, and family victimization) between delinquent and non-delinquent adolescents. Females were more likely to be involved in family victimization, while males were more likely to experience severe assault and crime victimization. Delinquent adolescents reported depressive and PTSD symptoms significantly more than non-delinquent adolescents. The prevalence of PTSD and depressive symptoms among delinquents was 20.8 and 52.7% respectively. Highly victimized delinquent adolescents and/or those victimized in family-related events were at significantly higher risk to develop psychiatric symptoms.
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Affiliation(s)
- Siti Raudzah Ghazali
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, 94300 Sarawak Malaysia
| | - Yoke Yong Chen
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, 94300 Sarawak Malaysia
| | - Hafizah Abdul Aziz
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, 94300 Sarawak Malaysia
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12
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Boals A, Trost Z, Rainey E, Foreman ML, Warren AM. Severity of traumatic injuries predicting psychological outcomes: A surprising lack of empirical evidence. J Anxiety Disord 2017; 50:1-6. [PMID: 28501651 DOI: 10.1016/j.janxdis.2017.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 03/21/2017] [Accepted: 04/25/2017] [Indexed: 10/19/2022]
Abstract
Despite widespread beliefs that trauma severity is related to levels of posttraumatic stress symptoms (PTSS), the empirical evidence to support such beliefs is lacking. In the current study we examined Injury Severity Score (ISS), a medical measure of event severity for physical injuries, in a sample of 460 patients admitted to a Level 1 Trauma Center. Results revealed no significant relationship between ISS and PTSS, depression, pain, and general physical and mental health at baseline, three months, and six months post-injury. However, at 12 months post-injury, ISS significantly predicted depression, pain, and physical health, but was unrelated to PTSS. The effect sizes of these relationships were small and would not remain significant if any adjustments for multiple comparisons were employed. We conclude that the relationship between ISS and PTSS is, at best, weak and inconsistent. The results are discussed in the broader picture of event severity and psychological outcomes.
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Elderton A, Berry A, Chan C. A Systematic Review of Posttraumatic Growth in Survivors of Interpersonal Violence in Adulthood. TRAUMA, VIOLENCE & ABUSE 2017; 18:223-236. [PMID: 26459504 DOI: 10.1177/1524838015611672] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This review critically evaluates the literature on posttraumatic growth in survivors of interpersonal violence, integrating the findings from 12 quantitative and 4 qualitative studies. The following databases were searched using predetermined terms: AMED, EMBASE, MEDLINE, PsycINFO, BNI, CINAHL, and Web of Knowledge. The review's findings suggest that the mean prevalence of growth in interpersonal violence survivors is around 71% (range 58-99%). The highest level of growth was consistently experienced in the "appreciation of life" domain. However, survivors reported growth in the four remaining domains: "personal strength," "new possibilities," "experience of relationships with others," and "outlook on life." The nature of the relationship between growth and distress was inconsistent across studies. A combination of pretrauma, peritrauma, and posttrauma variables were found to be related to the degree of growth survivors experienced. Methodological weaknesses of the quantitative studies included the predominant use of retrospective, cross-sectional, correlational designs, discrepancy in the measurement of growth, insufficient sample sizes for power calculations in five studies and limited external validity. Qualitative findings were limited by sampling methods, insufficient information about interview schedules, the lack of credibility checks, and evidence of reflexivity demonstrated by some studies. Implications for practice, policy, and future research are discussed.
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Affiliation(s)
- Anna Elderton
- 1 Children's Psychological Medicine, Oxford Children's Hospital, Headington, Oxford, United Kingdom
| | - Alexis Berry
- 2 Oxford Institute of Clinical Psychology Training, Isis Education Centre, University of Oxford, Roosevelt Drive, Warneford Hospital, Headington, Oxford, United Kingdom
- 3 Older People's Mental Health Services, Northamptonshire Healthcare NHS Foundation Trust, Northampton, United Kingdom
| | - Carmen Chan
- 2 Oxford Institute of Clinical Psychology Training, Isis Education Centre, University of Oxford, Roosevelt Drive, Warneford Hospital, Headington, Oxford, United Kingdom
- 4 Berkshire Traumatic Stress Service, Berkshire, United Kingdom
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14
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Bromet EJ, Atwoli L, Kawakami N, Navarro-Mateu F, Piotrowski P, King AJ, Aguilar-Gaxiola S, Alonso J, Bunting B, Demyttenaere K, Florescu S, de Girolamo G, Gluzman S, Haro JM, de Jonge P, Karam EG, Lee S, Kovess-Masfety V, Medina-Mora ME, Mneimneh Z, Pennell BE, Posada-Villa J, Salmerón D, Takeshima T, Kessler RC. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys. Psychol Med 2017; 47:227-241. [PMID: 27573281 PMCID: PMC5432967 DOI: 10.1017/s0033291716002026] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies. METHOD Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders). RESULTS Disaster-related PTSD prevalence was 0.0-3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk. CONCLUSION Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions.
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Affiliation(s)
- E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - L. Atwoli
- Department of Mental Health, Moi University School of Medicine, Eldoret, Kenya
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - F. Navarro-Mateu
- Subdirección General de Salud Mental, Servicio Murciano de Salud, IMIB-Arrixaca, CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia, Spain
| | - P. Piotrowski
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - A. J. King
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | | | - J. Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Barcelona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - B. Bunting
- School of Psychology, University of Ulster, Londonderry, UK
| | - K. Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - S. Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - G. de Girolamo
- IRCCS St. John of God Clinical Research Centre, Brescia, Italy
| | - S. Gluzman
- Ukrainian Psychiatric Association, Kiev, Ukraine
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - P. de Jonge
- Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E. G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
- Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - V. Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France
| | - M. E. Medina-Mora
- Ramon de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Z. Mneimneh
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - B.-E. Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - D. Salmerón
- Department of Epidemiology, Department of Health and Social Sciences, Murcia Regional Health Council, IMIB-Arrixaca, CIBER Epidemiología y Salud Pública (CIBERESP), Universidad de Murcia, Murcia, Spain
| | - T. Takeshima
- Department of Health and Welfare for the Disabled, Health and Welfare Bureau, Kawasaki City, Japan
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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15
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Zhou X, Zhen R, Wu X. Posttraumatic stress disorder symptom severity and control beliefs as the predictors of academic burnout amongst adolescents following the Wenchuan Earthquake. Eur J Psychotraumatol 2017; 8:1412227. [PMID: 29296242 PMCID: PMC5738653 DOI: 10.1080/20008198.2017.1412227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 11/21/2017] [Indexed: 11/01/2022] Open
Abstract
Background: Previous studies indicate that posttraumatic stress disorder (PTSD) and control beliefs can affect burnout and their unique role in this situation has been examined, but fewer studies have examined their combined role in adolescent's academic burnout following traumatic events. Objective: This study examined the combined effect of PTSD symptom severity and control beliefs on academic burnout among adolescents, and assessed the moderating role of primary and secondary control beliefs in the relation between PTSD symptom severity and academic burnout. Methods: Seven hundred and forty-five adolescents were investigated using self-report questionnaires, and a series of regression equations examined the impact of PTSD severity and control beliefs on academic burnout. Results: PTSD symptom severity is associated positively with academic burnout, while primary and secondary control beliefs have a negative relation with academic burnout. In addition, primary control beliefs buffer the positive effects of PTSD symptom severity on academic burnout. We found that the positive relation between PTSD symptom severity and academic burnout in the low primary control beliefs group is more intense than that found in the high primary control beliefs group. Conclusions: PTSD symptom severity is a risk factor, whereas primary and secondary control beliefs are protective factors in academic burnout. In addition, PTSD symptom severity and primary control beliefs have a combined effect on academic burnout in adolescents following natural disasters.
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Affiliation(s)
- Xiao Zhou
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.,I-Core Research Center for Mass Trauma, Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Rui Zhen
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
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16
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17
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Eve DJ, Steele MR, Sanberg PR, Borlongan CV. Hyperbaric oxygen therapy as a potential treatment for post-traumatic stress disorder associated with traumatic brain injury. Neuropsychiatr Dis Treat 2016; 12:2689-2705. [PMID: 27799776 PMCID: PMC5077240 DOI: 10.2147/ndt.s110126] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Traumatic brain injury (TBI) describes the presence of physical damage to the brain as a consequence of an insult and frequently possesses psychological and neurological symptoms depending on the severity of the injury. The recent increased military presence of US troops in Iraq and Afghanistan has coincided with greater use of improvised exploding devices, resulting in many returning soldiers suffering from some degree of TBI. A biphasic response is observed which is first directly injury-related, and second due to hypoxia, increased oxidative stress, and inflammation. A proportion of the returning soldiers also suffer from post-traumatic stress disorder (PTSD), and in some cases, this may be a consequence of TBI. Effective treatments are still being identified, and a possible therapeutic candidate is hyperbaric oxygen therapy (HBOT). Some clinical trials have been performed which suggest benefits with regard to survival and disease severity of TBI and/or PTSD, while several other studies do not see any improvement compared to a possibly poorly controlled sham. HBOT has been shown to reduce apoptosis, upregulate growth factors, promote antioxidant levels, and inhibit inflammatory cytokines in animal models, and hence, it is likely that HBOT could be advantageous in treating at least the secondary phase of TBI and PTSD. There is some evidence of a putative prophylactic or preconditioning benefit of HBOT exposure in animal models of brain injury, and the optimal time frame for treatment is yet to be determined. HBOT has potential side effects such as acute cerebral toxicity and more reactive oxygen species with long-term use, and therefore, optimizing exposure duration to maximize the reward and decrease the detrimental effects of HBOT is necessary. This review provides a summary of the current understanding of HBOT as well as suggests future directions including prophylactic use and chronic treatment.
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Affiliation(s)
- David J Eve
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, Morsani College of Medicine
| | - Martin R Steele
- Veterans Reintegration Steering Committee, Veterans Research, University of South Florida, Tampa, FL, USA
| | - Paul R Sanberg
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, Morsani College of Medicine
| | - Cesar V Borlongan
- Department of Neurosurgery and Brain Repair, Center of Excellence for Aging and Brain Repair, Morsani College of Medicine
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18
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Henriques T, Moraes CLD, Reichenheim ME, Azevedo GLD, Coutinho ESF, Figueira ILDV. Transtorno do estresse pós-traumático no puerpério em uma maternidade de alto risco fetal no Município do Rio de Janeiro, Brasil. CAD SAUDE PUBLICA 2015; 31:2523-34. [DOI: 10.1590/0102-311x00030215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 06/19/2015] [Indexed: 11/21/2022] Open
Abstract
Resumo O objetivo deste artigo é estimar a magnitude de transtorno do estresse pós-traumático (TEPT) no puerpério em uma maternidade de referência para agravos perinatais e identificar subgrupos vulneráveis. Trata-se de um estudo transversal realizado uma maternidade de alto risco fetal no Rio de Janeiro, Brasil, com 456 mulheres que realizaram o parto na instituição. O Trauma History Questionnaire e o Post-Traumatic Stress Disorder Checklist foram utilizados para captar experiências traumáticas e sintomas de TEPT, respectivamente. A prevalência geral de TEPT foi de 9,4%. O TEPT mostrou-se mais prevalente entre mulheres com três ou mais partos, que tiveram recém-nascido com Apgar no 1º minuto menor ou igual a sete, com histórico de agravo mental antes ou durante a gravidez, com depressão pós-parto, que sofreram violência física ou psicológica perpetrada por parceiro íntimo na gravidez, que tiveram experiência sexual não desejada e que foram expostas a cinco ou mais traumas. Rápido diagnóstico e tratamento são fundamentais para melhorar a qualidade de vida da mulher e a saúde do recém-nascido.
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19
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Breslau N, Koenen KC, Luo Z, Agnew-Blais J, Swanson S, Houts RM, Poulton R, Moffitt TE. Childhood maltreatment, juvenile disorders and adult post-traumatic stress disorder: a prospective investigation. Psychol Med 2014; 44:1937-1945. [PMID: 24168779 PMCID: PMC4107193 DOI: 10.1017/s0033291713002651] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND We examine prospectively the influence of two separate but potentially inter-related factors in the etiology of post-traumatic stress disorder (PTSD): childhood maltreatment as conferring a susceptibility to the PTSD response to adult trauma and juvenile disorders as precursors of adult PTSD. METHOD The Dunedin Multidisciplinary Health and Development Study (DMHDS) is a birth cohort (n = 1037) from the general population of New Zealand's South Island, with multiple assessments up to age 38 years. DSM-IV PTSD was assessed among participants exposed to trauma at ages 26-38. Complete data were available on 928 participants. RESULTS Severe maltreatment in the first decade of life, experienced by 8.5% of the sample, was associated significantly with the risk of PTSD among those exposed to adult trauma [odds ratio (OR) 2.64, 95% confidence interval (CI) 1.16-6.01], compared to no maltreatment. Moderate maltreatment, experienced by 27.2%, was not associated significantly with that risk (OR 1.55, 95% CI 0.85-2.85). However, the two estimates did not differ significantly from one another. Juvenile disorders (ages 11-15), experienced by 35% of the sample, independent of childhood maltreatment, were associated significantly with the risk of PTSD response to adult trauma (OR 2.35, 95% CI 1.32-4.18). CONCLUSIONS Severe maltreatment is associated with risk of PTSD response to adult trauma, compared to no maltreatment, and juvenile disorders, independent of earlier maltreatment, are associated with that risk. The role of moderate maltreatment remains unresolved. Larger longitudinal studies are needed to assess the impact of moderate maltreatment, experienced by the majority of adult trauma victims with a history of maltreatment.
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Affiliation(s)
- Naomi Breslau
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Columbia Mailman School of Public Health, New York, NY, USA
| | - Zhehui Luo
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Jessica Agnew-Blais
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Sonja Swanson
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Renate M. Houts
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Richie Poulton
- Dunedin Multidisciplinary Health & Development Research Unit, Department of Preventive & Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
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20
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Peirce JM, Schacht RL, Brooner RK, King VL, Kidorf MS. Prospective risk factors for traumatic event reexposure in community syringe exchange participants. Drug Alcohol Depend 2014; 138:98-102. [PMID: 24629781 PMCID: PMC4001832 DOI: 10.1016/j.drugalcdep.2014.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 01/10/2014] [Accepted: 02/05/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Traumatic event reexposure in injecting drug users is associated with increased drug use and potential for psychiatric symptoms. This is the first study to examine fixed and time-varying factors that are prospectively associated with new traumatic event reexposure in injecting drug users. METHODS Injecting drug users registered in a syringe exchange program were enrolled in a 16-month parent study comparing strategies to increase drug abuse treatment enrollment. Participants (N=162) completed baseline measures of demographics, psychiatric treatment history, and lifetime traumatic event exposure. Monthly follow-ups assessed past-month traumatic event exposure, days of heroin and cocaine use, criminal activity, and drug abuse treatment participation. Generalized estimating equations models tested the influence of fixed baseline and time-varying factors on traumatic event reexposure in the same month, the following month, and two months later. RESULTS Significant fixed risk factors for traumatic event reexposure include female gender and past psychiatric treatment. In addition, each past traumatic event exposure was associated with an increased likelihood of reexposure. After accounting for all other factors, each day of cocaine use was associated with a small but persistent increased risk of traumatic event reexposure. Reexposure to a traumatic event in the prior month more than doubled the risk of subsequent reexposure. CONCLUSIONS Injecting drug users experience a pattern in which drug use is associated with increased risk of subsequent traumatic event reexposure, and traumatic event reexposure is associated with further drug use and continued reexposure. Implications for addressing these concerns in injecting drug users are presented.
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Affiliation(s)
- Jessica M. Peirce
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224
| | - Rebecca L. Schacht
- Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Math/Psychology Building, Room 312, Baltimore, MD 21250
| | - Robert K. Brooner
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224
| | - Van L. King
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224
| | - Michael S. Kidorf
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224
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Bistoen G, Vanheule S, Craps S. Nachträglichkeit: A Freudian perspective on delayed traumatic reactions. THEORY & PSYCHOLOGY 2014. [DOI: 10.1177/0959354314530812] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Freudian concept of Nachträglichkeit is central to the psychoanalytical understanding of trauma. However, it has not received much attention within the contemporary field of trauma studies. This paper attempts to reconstruct the logic inherent to this concept by examining Freud’s remarks on the case of Emma. Furthermore, it is argued that Nachträglichkeit offers an interesting perspective on both (a) the well-established yet controversial finding that traumatic reactions sometimes follow in the wake of non-Criterion A events (so-called minor stressors or life events) and (b) the often-neglected phenomenon of delayed-onset PTSD. These two phenomena will appear to be related in some instances. Nachträglichkeit clarifies one way in which traumatic encounters are mediated by subjective dimensions above and beyond the objective particularities of both the event and the person. It demonstrates that the subjective impact of an event is not given once and for all but is malleable by subsequent experiences.
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22
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Miller JK, Wiener JM. PTSD recovery, spatial processing, and the val66met polymorphism. Front Hum Neurosci 2014; 8:100. [PMID: 24616687 PMCID: PMC3935252 DOI: 10.3389/fnhum.2014.00100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 02/10/2014] [Indexed: 12/31/2022] Open
Affiliation(s)
| | - Jan M Wiener
- Department of Psychology, Bournemouth University Dorset, UK
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23
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The role of intelligence in posttraumatic stress disorder: does it vary by trauma severity? PLoS One 2013; 8:e65391. [PMID: 23762357 PMCID: PMC3677906 DOI: 10.1371/journal.pone.0065391] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/30/2013] [Indexed: 11/22/2022] Open
Abstract
Background Only a small minority of trauma victims develops post-traumatic stress disorder (PTSD), suggesting that victims vary in their predispositions to the PTSD response to stressors. It is assumed that the role of predispositions in PTSD varies by trauma severity: when stressors are less severe, predispositions play a bigger role. In this study, we test whether the role of intelligence in PTSD varies by trauma severity. Specifically, does low intelligence plays a bigger part among victims of lower magnitude stressors than among victims of extreme stressors? Methods Data come from a longitudinal study of randomly selected sample in Southeast Michigan (n = 713). IQ was measured at age 6. PTSD was measured at age 17, using the NIMH-DIS for DSM-IV. Stressors were classified as extreme if they involved assaultive violence (e.g. rape, sexual assault, threatened with a weapon); other stressors in the list (e.g. disaster, accidents) were classified as lower magnitude. Assaultive violence victims had experienced assaultive violence plus other event types or only assaultive violence. Victims of other stressors were participants who had never experienced assaultive violence. We compared the influence of age 6 IQ on PTSD among persons exposed to assaultive violence vs. other stressors, using multinomial logistic regression. Results Relative risk ratio (RRR) for PTSD associated with a one point drop in age 6 IQ among victims of assaultive violence was 1.04 (95% CI 1.01, 1.06); among victims of other stressors, it was 1.03 (95% CI 0.99, 1.06). A comparison of the two RRRs indicates no significant difference between the two estimates (p = 0.652). IQ does not play a bigger role in PTSD among victims of other stressors than it does among victims of assaultive violence. Conclusions Lower IQ exerts an adverse PTSD effect on trauma victims, with no evidence of variability by the severity of trauma they have experienced.
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Abstract
We devised three measures of the general severity of events, which raters applied to participants' narrative descriptions: 1) placing events on a standard normed scale of stressful events, 2) placing events into five bins based on their severity relative to all other events in the sample, and 3) an average of ratings of the events' effects on six distinct areas of the participants' lives. Protocols of negative events were obtained from two non-diagnosed undergraduate samples (n = 688 and 328), a clinically diagnosed undergraduate sample all of whom had traumas and half of whom met PTSD criteria (n = 30), and a clinically diagnosed community sample who met PTSD criteria (n = 75). The three measures of severity correlated highly in all four samples but failed to correlate with PTSD symptom severity in any sample. Theoretical implications for the role of trauma severity in PTSD are discussed.
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Almli LM, Mercer KB, Kerley K, Feng H, Bradley B, Conneely KN, Ressler KJ. ADCYAP1R1 genotype associates with post-traumatic stress symptoms in highly traumatized African-American females. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:262-72. [PMID: 23505260 PMCID: PMC3738001 DOI: 10.1002/ajmg.b.32145] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 02/13/2013] [Indexed: 01/01/2023]
Abstract
Pituitary adenylate cyclase-activating polypeptide (PACAP) and its receptor (PAC1) play a critical role in biological processes that mediate stress response and have been implicated in psychological outcome following trauma. Our previous work [Ressler et al. (2011); Nature 470:492-497] demonstrated that a variant, rs2267735, in the gene encoding PAC1 (ADCYAP1R1) is associated with post-traumatic stress disorder (PTSD) in a primarily African-American cohort of highly traumatized females. We sought to extend and replicate our previous finding in a similarly trauma-exposed, replicate sample of 1,160 African-American adult male and female patients. Self-reported psychiatric measures were collected, and DNA was obtained for genetic analysis. Using linear regression models to test for association with PTSD symptom severity under an additive (allelic) model, we found a genotype × trauma interaction in females (P < 0.001), but not males (P > 0.1); however, there was no main effect of genotype as in our previous study. The observed interaction suggests a genetic association that increases with the degree of trauma exposure in females only. This interaction remained significant in females, but not males, after controlling for age (P < 0.001), income (P < 0.01), past substance abuse (P < 0.001), depression severity (P = 0.02), or child abuse (P < 0.0005), and all five combined (P = 0.01). No significant effects of genotype (or interactions) were found when modeling depression severity when controlling for comorbid PTSD symptom severity (P > 0.1), demonstrating the relative specificity of this variant for PTSD symptoms. A meta-analysis with the previously reported African-American samples revealed a strong association between PTSD symptom severity and the interaction between trauma and genotype in females (N = 1424, P < 0.0001).
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Affiliation(s)
- Lynn M. Almli
- Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia
| | - Kristina B. Mercer
- Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia,Howard Hughes Medical Institute, Chevy Chase, Maryland
| | | | - Hao Feng
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia
| | - Karen N. Conneely
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia,Department of Human Genetics, Emory University, Atlanta, Georgia
| | - Kerry J. Ressler
- Department of Psychiatry and Behavioral Science, Emory University, Atlanta, Georgia,Howard Hughes Medical Institute, Chevy Chase, Maryland,Correspondence to: Kerry J. Ressler, M.D., Ph.D., Department of Psychiatry and Behavioral, Sciences, Yerkes National Primate Research Center, Emory University, Atlanta, GA 30329.
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Hemmings SMJ, Martin LI, Klopper M, van der Merwe L, Aitken L, de Wit E, Black GF, Hoal EG, Walzl G, Seedat S. BDNF Val66Met and DRD2 Taq1A polymorphisms interact to influence PTSD symptom severity: a preliminary investigation in a South African population. Prog Neuropsychopharmacol Biol Psychiatry 2013; 40:273-80. [PMID: 23103549 DOI: 10.1016/j.pnpbp.2012.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 10/15/2012] [Accepted: 10/17/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND We evaluated the role that selected variants in serotonin transporter (5-HTT), dopamine receptor 2 (DRD2) and brain-derived neurotrophic factor (BDNF) genes play in PTSD symptom severity in an at-risk population. We also investigated the interaction between the genetic variants to determine whether these variables and the interactions between the variables influenced the severity of PTSD symptoms. METHODS PTSD symptoms were quantitatively assessed using the Davidson Trauma Scale (DTS) in 150 participants from an at-risk South African population. All participants were genotyped for the 5-HTTLPR, DRD2 Taq1A and BDNF Val66Met polymorphisms. Gene-gene interactions were investigated using various linear models. All analyses were adjusted for age, gender, major depressive disorder diagnosis, level of resilience, level of social support and alcohol dependence. RESULTS A significant interaction effect between DRD2 Taq1A and BDNF Val66Met variants on DTS score was observed. On the background of the BDNF Val66Val genotype, DTS score increased significantly with the addition of a DRD2 Taq1A A1 allele. However, on the BDNF Met66 allele background, the addition of an A1 allele was found to reduce total DTS score. CONCLUSIONS This study provides preliminary evidence for an epistatic interaction between BDNF Val66Met and DRD2 Taq1A polymorphisms on the severity of PTSD symptoms, where both too little and too much dopamine can result in increased PTSD symptom severity.
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Affiliation(s)
- Sian M J Hemmings
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
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