Motor vehicle accident trauma exposure: Personality profiles associated with posttraumatic diagnoses

Abstract

Personality profiles associated with diagnostically distinct posttraumatic responses were examined. Profiles were compared between three groups defined on the basis of posttraumatic diagnosis following motor vehicle accident (MVA) trauma exposure. The diagnostic groups were: Posttraumatic Stress Disorder (PTSD), Acute Stress Disorder (ASD) without progression to PTSD, and subclinical responses. Participants were male and female community volunteers aged 18 to 77 (N = 83) who had all been exposed to an MVA meeting the DSM-IV diagnostic criteria for a traumatic event. The Personality Assessment Inventory (Morey, 1991) was used to assess psychological variables in the framework of posttraumatic diagnostic groups. The PTSD group scored significantly higher than the ASD and subclinical groups on scales assessing somatic complaints, anxiety, anxiety related disorders, depression, non-psychotic symptoms of schizophrenia, and negative relationships. The profile of the ASD group was characterized by self report of greater interpersonal warmth and a trend for greater egocentricity than the PTSD group. There were no significant differences in the personality profiles of the ASD and subclinical groups. The role of personality factors in posttraumatic adjustment is discussed in the context of previous literature.     

The relationships between family functioning and attachment orientations to post-traumatic stress symptoms among young adults who were evacuated from Gaza Strip settlements as adolescents

Background and Objectives: This study examined post-traumatic stress disorder (PTSD) symptoms among young adults that were evicted from their residences in Gaza settlements (“Gush Katif”) as adolescents and actively participated in the resistance events. Furthermore, we examined the moderating role of exposure to forced relocation on the association between attachment orientations and family functioning and PTSD symptoms. Design: We conducted a correlative, cross-sectional study in 2013. Methods: Participants were Israeli evicted residents (ER group; N = 102), comparison groups of evicted nonresidents (ENR group; N = 27), and nonevicted nonresidents (NENR group; N = 53). All participants completed a battery of self-reported questionnaires. Results: The ER group reported a higher number of PTSD symptoms as compared to the comparison groups. However, ER participants did not differ from ENR and NENR participants in their perception of family functioning. Importantly, the group (ER vs. NENR) moderated the association between attachment-anxiety and PTSD symptoms and between family adaptability and PTSD symptoms. Conclusions: Nine years after the forced relocation from Gaza settlements, young adults that were evicted from their residences as adolescents suffer from PTSD symptoms that are more related to the relocation itself than the stress entailed in the resistance events.     

The integration of emotions in memories: Cognitive‐emotional distinctiveness and posttraumatic stress disorder

The current study examined cognitive‐emotional distinctiveness (CED), the extent to which emotions are linked with event information, in memories associated with PTSD. Participants either with PTSD (n = 68) or without PTSD (n = 40) completed a modified multidimensional scaling technique to measure CED for their most negative and most positive events. The results revealed that participants in the PTSD group evidenced significantly lower levels of CED. This group difference remained significant when we limited the analysis to traumatic events that led to a PTSD diagnosis (n = 33) in comparison to control participants who nominated a traumatic event that did not result in PTSD (n = 32). Replicating previous findings, CED levels were higher in memories of negative events, in comparison to positive events. These results provide empirical evidence that memories associated with PTSD do contain special organizational features with respect to the links between emotions and memory. Implications for understanding and treating PTSD are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Individuals high in neuroticism are not more reactive to adverse events

Numerous studies have related neuroticism to negative emotional outcomes of adverse life events, including post-traumatic stress disorder (PTSD) symptoms. However, the nature of the relationship between neuroticism and post-trauma symptoms is unclear. The purpose of this study was to prospectively examine whether individuals high in neuroticism, relative to low neuroticism individuals, show a larger increase in symptoms after an adverse event. A sample of infantry troops completed questionnaires before deployment to Iraq (n = 214) and about five months (n = 170; 76%) thereafter. The findings showed that, after controlling for an indicator of trauma severity, (a) higher neuroticism individuals reported more PTSD symptoms, depression symptoms, and somatic problems after negative events, and (b) these relationships disappeared after controlling for pre-trauma symptoms. There were no significant differences between individuals high and low in neuroticism in the increase in symptoms from pre to post-trauma. This suggests that individuals high in neuroticism are not more reactive to adverse events.     

Posttraumatic Stress Disorder and executive dysfunction among children and adolescents: A Latent Profile Analysis

Background/ObjectiveThe current study aimed to examine the relationship between Posttraumatic Stress Disorder (PTSD) symptoms and executive dysfunction in children and adolescents after psychological trauma.MethodParticipants were 13,438 of children and adolescents aged 6 to 18 years exposed to the 2008 Wenchuan earthquake. PTSD and dysexecutive symptoms were assessed using the UCLA PTSD Reaction Index for Children and the Self-Report Dysexecutive Questionnaire. Latent Profile Analysis (LPA) was conducted using Mplus version 7.4. Subgroup differences in trauma exposure and quality of life were calculated using ANCOVA.ResultsA 4-class parallel model was found to best describe latent PTSD symptom profiles and executive dysfunction. Individuals in higher symptom groups showed more trauma exposure and lower quality of life.ConclusionsThis LPA study shed light on the relationship between PTSD and executive dysfunction symptoms in children and adolescents. The correlation between PTSD and executive dysfunction was maintained after individual differences were taken into consideration. Our findings provide a new view on how PTSD relates to executive dysfunction and several suggestions for treating child and adolescent PTSD patients.     

Engagement in community activities and trust in local leaders as concomitants of psychological distress among Israeli civilians exposed to prolonged rocket attacks

Background and objectives: Present study, conducted in the aftermath of the 2014 Israel–Gaza conflict, investigated psychological toll of exposure to rockets attacks in a sample of residents of central and southern Israel. Analyses focused on the distress-protective functions of collectively grounded resources: engagement in community activities and trust in local leadership.

Design: This cross-sectional study was conducted between 2 and 3 months after the hostilities.

Method: Participants (N?=?764) were recruited by an online survey company that distributed a questionnaire assessing, in addition to focal predictors, sociodemographic factors and prior exposure to trauma. The outcome variables were post-traumatic stress disorder (PTSD) and nonspecific distress symptoms.

Results: Conservative regression analyses revealed that greater exposure to rocket attacks was predictive of higher levels of posttraumatic stress symptoms. Higher engagement in community activities exhibited a partial trauma-buffering function. However, higher levels of trust in local leaders appeared to exacerbate, rather than diminish, negative impact of rocket exposure on PTSD. Symptoms of psychological distress were not influenced neither by trauma exposure nor by stressor interactions with resources. Trust in local leadership exerted a beneficial main effect on distress.

Conclusions: Collectively based resources are important for coping in times of community-wide stressors, yet their role is complex.     

Posttraumatic play in young children exposed to terrorism: An empirical study

The phenomenon of “posttraumatic play” (PTP) has received much clinical recognition and little empirical support. The objective of this study was to examine various aspects of PTP in young children exposed to terror events and their relation to posttraumatic stress disorder (PTSD). Individual play sessions, conducted with 29 young Israeli children directly exposed to terrorism (M age = 5.47, SD = 1.34) and 25 matched unexposed children (M age = 5.62, SD = 0.87), were coded using the Children's Play Therapy Instrument–Adaptation for Terror Research (CPTI‐ATR; S.E. Chazan & E. Cohen, 2003). Analyses using these ratings showed (a) significant differences between the two groups, (b) significant associations with the caregiver's reports on child's exposure, and (c) significant associations with the caregiver's reports on the child's PTSD symptoms. Play activity ratings of predominant negative affects, frequent acting‐out/morbid themes, lowered developmental level, and reduced awareness of the child of him‐ or herself as a player significantly predicted more PTSD symptoms. PTP which included more coping strategies classified as “overwhelmed reexperiencing” and less “reenactment with soothing” was associated with a higher level of PTSD. Play analysis with the CPTI‐ATR may be helpful in identifying PTSD in children and also guide the selection of therapeutic techniques.     

Attentional bias to violent images in survivors of dating violence

This study investigated the time-course characteristics of attentional bias, such as vigilance and maintenance, towards violent stimuli in dating violence (DV) survivors. DV survivors with PTSD symptoms (DV-PTSD group; n=14), DV survivors without PTSD symptoms (Trauma Control group; n=14), and individuals who were never exposed to dating violence (NDV group; n=15) viewed slides that presented four categories of images (violent, dysphoric, positive, and neutral) per slide, for ten seconds. Our results revealed that the DV-PTSD group spent more time on violent stimuli than did the Trauma Control or NDV groups. The DV survivors, both with and without PTSD symptoms, spent more time on dysphoric stimuli and less time on happy stimuli than did the NDV group. In addition to the effects of PTSD, researchers should also be considering the effects of simple traumatic exposure.     

PTSD and Emotional Distress Symptoms Measured After a Motor Vehicle Accident: Relationships with Pain Coping Profiles

This study explored differences among pain patients classified as Dysfunctional, Interpersonally Distressed, and Adaptive Copers on the Multidimensional Pain Inventory with respect to PTSD symptomatology, anxiety, and depression. Eighty-five patients with pain complaints who had experienced a serious motor vehicle accident were classified into these three pain coping categories and assessed using clinician and self-report measures. Results indicated that patients classified as Adaptive Copers (n = 24) showed less PTSD symptomatology, anxiety, and depressed mood, relative to individuals classified as Dysfunctional (n = 36) and as Interpersonally Distressed (n = 25), who did not differ on these dimensions. Emotional responses during the accident (fear, helplessness, danger, perceived control, and certainty that one would die) did not differentiate the groups. Pain profiles contributed to the prediction of self-reported PTSD symptoms, controlling for state anxiety. These data suggest that pain patients with both Dysfunctional and Interpersonally Distressed coping profiles are at elevated risk for a range of posttrauma problems following a serious motor vehicle accident.     

Life outcomes influenced by war-related experiences during the Gulf crisis

This study examined the life outcomes of children exposed to the Gulf crisis in 1990–1991. We expected war-trauma exposure and psychological distress symptoms to predict poorer educational and occupational outcomes. Participants were 151 Kuwaiti citizens who were assessed during childhood (in 1993; M age = 10.6 years), and who were reassessed 10 years later in young adulthood (in 2003; M age = 21.2 years). Participants completed measures of intelligence, war-trauma exposure, posttraumatic stress symptoms, anxiety symptoms, depressive symptoms, intervening life events, and life outcomes. Results indicated that war-trauma exposure negatively impacted children's educational and occupational outcomes as young adults. Boys with higher levels of war-trauma exposure were less likely to attend University. Posttraumatic stress and anxiety symptoms also predicted poorer educational and occupational outcomes. However, this relationship was not significant when we accounted for children's intelligence. Depressive symptoms were not predictive of children's educational or occupational outcomes. Results suggest that war-trauma exposure may have life-altering effects on children. Tailored, early interventions are needed for children exposed to war traumas.     

Stereotypical thinking as a mediating factor in the association between exposure to terror and post-traumatic stress disorder symptoms among Israeli youth

Background and Objectives: The negative impact of exposure to terror on mental health, as well as on the perceptions of each side of the conflict toward the other, is well-documented. However, the association between stereotyping, concomitant with perceived threat, and anxiety, was rarely investigated. The current study examined information processing attributes and exposure to terror as predictors of PTSD symptoms among youth at inter-group conflict, with stereotypical thinking toward a threatening out-group as a possible mediator. Design: Cross-sectional, with exposure to terror, need for cognitive structure (NCS), efficacy at fulfilling the need for closure (EFNC) and self-esteem, predicting stereotypical thinking and PTSD symptoms. Method: Ninth graders (N?=?263) from two residential areas in Israel, varying in their degree of exposure to terror, responded to a self-report questionnaire tapping the above variables. Results: Stereotypical thinking was found to mediate the association between exposure to terror and PTSD symptoms, but not the association between the NCS and EFNC interaction and PTSD symptoms. Conclusions: The findings support terror management theory, so that a negative and rigid perception makes it difficult to construct coherent world-view, thus contributing to aggregation of existential anxiety and PTSD symptoms.     

Trauma in Resettled Iraqi Refugees: Differences between Those Seeking Psychological Treatment and Those Not Seeking Psychological Treatment

Psychological distress experienced by resettling refugees has been well documented, with posttraumatic stress disorder (PTSD) and depression being prevalent outcomes. This study examined psychological and physiological measures of trauma exposure in 2 groups of Iraqi refugees resettled in Australia, those seeking psychological treatment (n = 25) versus those not seeking treatment (n = 22). Data from a group of healthy sex- and age-matched controls (n = 32) were collected to facilitate norm comparisons for physiological arousal. Continuous recording of electrocardiogram data examined resting heart rate (HR). Refugees seeking treatment had significantly higher levels of PTSD symptomology and depression levels compared to non-treatment-seeking refugees; however, there was no difference in the number of trauma events endorsed. Finally, resting HR was significantly higher in both refugee groups compared with healthy controls; however, there was no difference between the refugee groups. Clinical consideration of this excessive trauma exposure and elevated autonomic arousal is warranted.     

Serotonin transporter 5-HTTLPR genotype is associated with intrusion and avoidance symptoms of DSM-5 posttraumatic stress disorder (PTSD) in Chinese earthquake survivors

Background and Objectives: Prior studies have found that the serotonin transporter gene-linked polymorphic region (5-HTTLPR) interacts with trauma exposure to increase general risk for Posttraumatic Stress Disorder (PTSD). However, there is little knowledge about the effects of the interaction on distinct symptom clusters of PTSD. This study aimed to investigate the relation between the interaction of 5-HTTLPR and earthquake-related exposures and a contemporary phenotypic model of DSM-5 PTSD symptoms in a traumatised adult sample from China.

Design: A cross-sectional design with gene-environment interaction (G?×?E) approach was adopted. Methods: Participants were 1131 survivors who experienced 2008 Wenchuan earthquake. PTSD symptoms were assessed with the PTSD Checklist for DSM-5 (PCL-5). The 5-HTTLPR polymorphism was genotyped with capillary electrophoresis (CE) in ABI 3730xl genetic Analyzer.

Results: Although there was no significant interaction between 5-HTTLPR and traumatic exposure on total PTSD symptoms, respondents with the LL genotype of 5-HTTLPR who were highly exposed to the earthquake experienced lower intrusion and avoidance symptoms than those with the S-allele carriers.

Conclusions: The findings suggest that the 5-HTTLPR may have an important impact on the development of PTSD and add to the extant knowledge on understanding and treating of posttraumatic psychopathology.     

Victimization and PTSD in a Faroese youth total-population sample

Petersen, T., Elklit, A. & Olesen, J. G. (2010). Victimization and PTSD in a Faroese youth total-population sample. Scandinavian Journal of Psychology, 51, 56–62.
The prevalence of twenty traumatic events and negative life events in relation to posttraumatic stress disorder (PTSD) was studied in a Faroese total-population sample of 687 eighth-grade students with a mean age of 14.2 years. Ninety-four percent of the females and 89% of the males were directly exposed to or had witnessed at least one traumatic event or a negative life event. The odds ratios for PTSD after direct and indirect exposure to specific events are described. The lifetime prevalence of PTSD was 20%, whereas another 14% reached a subclinical level of PTSD. After exposure, females had PTSD more than twice as often as males. Being exposed to multiple traumatic events, living with a single parent, and having experienced a traumatic event or a negative life event within the last year were all associated with PTSD and its subscales.     

The Latent Threat of Community Violence: Indirect Exposure to Local Homicides and Adolescents’ Mental Health in Colombia

This study examines the relation between adolescents’ indirect exposure to local homicides and mental health disorders and post‐traumatic stress disorder (PTSD) symptoms. We employ a sample of 300 adolescents ( representative for Bogotá, Colombia, and geocoded data on violent crimes recorded by the national police. Findings show that one SD increment in local homicides is associated with increments by 0.17 SD in the mental health disorder index and a 0.14 SD increase in the PTSD score index, even after accounting for adolescents’ direct exposure to violence. The estimated effect for PTSD was larger for adolescents’ who were directly exposed to violence and for those living in multidimensionally poor households, whereas no detectable effects were found for adolescents who perceived their residential neighborhood as relatively safe.     

Exposure to War Trauma, War-Related PTSD, and Psychological Impact of Subsequent Hurricane

This study explored the impact of psychological outcomes to war on response to subsequent natural disaster. Participants were 312 military personnel, 66% of whom saw Gulf War duty. All were exposed to the 1992 Hurricane Andrew. Troops were compared on reported traumatic events, hurricane impact responses, and psychological symptoms in subgroups defined by war or no war exposure prior to hurricane and by presence or absence of war-related posttraumatic stress disorder (PTSD). Data were gathered in face-to-face clinical assessments. War trauma prior to hurricane was associated with more reported traumatic events, greater fears for safety during the hurricane, and heightened psychological symptoms. Troops with preexisting war-related PTSD showed more adverse psychological hurricane sequelae and reported more traumatic events, higher depression, anxiety, anger, PTSD symptoms, and physical symptoms, and lower self-esteem than those free of diagnoses. Results point to the negative influence of exposure to one traumatic event on the experience of and response to a subsequent stressor.     

Toxic Environment of war: Maternal prenatal heavy metal load predicts infant emotional development

BackgroundPeople in war zones are exposed to heavy metal contamination deriving from new-generation weapons, in addition to exposure to psychologically traumatizing war events. Pregnant women and their children-to-be are particularly vulnerable to both biological and psychological war effects.ObjectiveThe aim of the current study was to analyse the impact of maternal prenatal heavy metal contamination on infant emotional development and to examine the potential moderating role of maternal symptoms of post-traumatic stress disorder (PTSD) in the association between heavy metal load and infant emotional development.MethodsThe participants were 502 Palestinian mothers, pregnant in their first trimester during the 2014 War on Gaza. The mothers were recruited at their delivery (T1) and followed at the infants’ age of 6–7 months (T2; N = 392). The load of five weapon-related heavy metals (chromium, mercury, vanadium, strontium, and uranium) was analysed by Inductively Coupled Plasma Mass Spectrometry (ICP/MS) from mothers’ hair samples at childbirth (T1). Assessment of maternal PTSD symptoms was based on the Harvard Trauma Questionnaire (HTQ) and infant emotional development on the Infant Behavior Questionnaire (IBQ), both reported by mothers (T2).ResultsTwo of the analysed metals, chromium and uranium, adversely predicted children’s early emotional development, indicated by decreased positive affectivity, increased negative emotionality, and problems in early orientation and regulation. Mother’s PTSD did not moderate the impact of heavy metal contamination on children’s emotional development.ConclusionsAdverse impact of war is not limited to those who experience it directly, but is passed on to future generations through multiple mechanisms. International organizations are obliged to protect parents and infants from the modern weaponry in wars.     

Posttraumatic Stress,Posttraumatic Growth,and Satisfaction With Life in Military Veterans

Objective: Military veterans are more likely than civilians to experience trauma and posttraumatic stress disorder (PTSD). Research suggests, however, that some people who experience trauma, including veterans, report posttraumatic growth (PTG), or positive personal changes following adversity. In this study, we tested a comprehensive model of PTG, PTSD, and satisfaction with life in a veteran population, exploring the roles of challenges to core beliefs, types of rumination, sex, and time since event. Method: Data were collected via Amazon’s Mechanical Turk, an online crowdsourcing website, from veterans (N = 197) who had experienced a stressful event within the last 3 years (M = 16.66 months, SD = 12.27 months). Structural equation modeling was used to test an integrated conceptual model of PTG, PTSD, and satisfaction with life. Results: Results showed that challenge to core beliefs was directly associated with both deliberate and intrusive rumination. Deliberate rumination was positively related to PTG; intrusive rumination was positively related to symptoms of PTSD. PTG and PTSD, in turn, mediated the relationship between rumination styles and satisfaction with life; PTG was related to higher satisfaction with life; and PTSD was negatively related to satisfaction with life. Results failed to show differences on any model variables as a function of time since event or sex. Conclusion: Results indicate that the intentional facilitation of PTG may be a complementary and alternative option to the reduction of PTSD symptoms for improving satisfaction with life. Findings suggest that efforts to facilitate PTG should be focused on strategies for promoting deliberate rumination.     

The association between dopamine D4 receptor exon III polymorphism and intensity of PTSD symptoms among flood survivors

Abstract

Thanks to the development of molecular genetics methods it is now possible to look for the genes which may contribute to posttraumatic stress disorder (PTSD). Polymorphism located in exon III of dopamine receptor type 4 (DRD4) gene was related to maladaptive stress responses as well as temperament traits related to PTSD. This study analyzed the association between the variable number tandem repeat (VNTR) DRD4 exon III polymorphism and intensity of PTSD symptoms in 107 (57 women and 50 men) survivors of a flood aged 14–62. Intensity of PTSD symptoms was measured using PTSD-F and PTSD-C questionnaires. Multivariate analysis of covariance (MANCOVA) was conducted to test the main and interactive effects of genotype and level of trauma exposure. Participants with at least one copy of the DRD4 long allele (seven or eight repetitions) had more intense PTSD symptoms on the Avoidance/Numbing scale (Cohen's f = .22) and the Total Scale (Cohen's f = .2) of the PTSD-F than participants who did not have these alleles in genotype. The results must be treated with caution, however, due to methodological restrictions and they need to be replicated on a larger sample.     

Prospective associations between changes in mental health symptoms and health-related quality of life in veterans seeking posttraumatic stress disorder residential treatment

Background and Objectives: This study examined prospective associations between changes in mental health symptoms (posttraumatic stress disorder [PTSD], depression) and health-related quality of life (physical health, psychological well-being) for veterans with PTSD. Design: This study focused on 139 patients who completed a residential treatment program for PTSD in the Veterans Health Administration. Methods: Patients completed the veteran-specific, 12-item Medical Outcomes Study Short Form, PTSD Checklist – Military version, and Beck Depression Inventory at pre-treatment, discharge, and a four-month follow-up. When accounting for demographic factors, combat exposure, and baseline scores on the respective outcome variables (e.g. mental health, physical health, PTSD, and depressive symptoms), a series of multivariate analyses were conducted for treatment-related changes in mental and physical health on the outcome measures. Results: Reductions in PTSD symptomatology during the treatment period were prospectively linked with better health-related outcomes at the four-month follow-up. In addition, improved physical health and psychological well-being during treatment were each similarly associated with better PTSD and depression outcomes in the months following treatment. Conclusions: Addressing concerns in mental and physical health might have synergistic effects across both domains, supporting the need for holistic models and integrated health care strategies for treating veterans with PTSD.