A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression

Abstract

BackgroundIt is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions.MethodNewly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews.ResultsIn all, 32 participants (8.3%) developed an episode of PTSD and 41 (10.6%) an episode of MD during follow-up. In all but nine cases (2.3%), episodes had remitted by the next assessment 4 months later. At 2 years, those with episodes of PTSD or MD during follow-up reported more days off work, poorer sleep, poorer quality of life, greater burn-out; and greater weight-gain for those with PTSD. In line with theories of PTSD and depression, analyses controlling for psychiatric and trauma history identified several pre-trauma predictors (cognitive styles, coping styles and psychological traits). Logistic regressions showed that rumination about memories of stressful events at the start of training uniquely predicted an episode of PTSD. Perceived resilience uniquely predicted an episode of MD.ConclusionsParticipants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training. Cognitive predictors of episodes of PTSD and MD are promising targets for resilience interventions.

Associations between moral injury, PTSD clusters, and depression among Israeli veterans: a network approach

“…Whereas other studies have shown depressive attribution style to be positively correlated with PTSD symptom severity (e.g. Kleim et al, 2011;Wild et al, 2016), this is the first study to highlight the crucial role of these depressive attributions in the relationships between PMIEs and PTSD. Thus, these findings may ultimately lead researchers to identify a possible intervention point, as will be discussed below.…”

Prediction of major depressive disorder onset in college students

“…However, these response rates compare favourably to those achieved in other large-scale prospective college student surveys (39-44%) (Eisenberg et al, 2013;Paul, Tsypes, Eidlitz, Ernhout, & Whitlock, 2015). In addition, (Berking, Wirtz, Svaldi, & Hofmann, 2014;Cole & Dendukuri, 2003;Ebert, Hopfinger, & Berking, 2017;Korten, Comijs, Lamers, & Penninx, 2012;Pelkonen, Marttunen, Kaprio, Huurre, & Aro, 2008;Wild et al, 2016). As a result, the strength of the composite risk index found here should be considered a lower bound estimate compared to the estimate that might be obtained in future research that includes additional predictors.…”

Moral injury process and its psychological consequences among Israeli combat veterans

“…According to our model, our main mediator of the association between transgressive acts of betrayal and PTSD symptoms was depressive attributions. Other studies have already shown that depressive attribution style correlated with PTSD symptom severity (e.g., Kleim et al., ; Wild et al., ). However, this is the first study to highlight the crucial role of these depressive attributions in the creation of PTSS following PMIEs, and may give us a lead to a possible intervention point.…”

“…Both cross‐sectional and longitudinal studies have pointed out that this pessimistic attributional style might be a cognitive risk factor that predicts depressive reactions and chronic depression (e.g., Wiersma et al., ). Given the strong comorbidity between PTSD and depression (Ginsburg, Ein‐Dor & Solomon, ), it is not surprising that the depressive attribution style also correlated with PTSD (e.g., Kleim, Gonzalo, & Ehlers, ; Wild, Smith, Thompson, Béar, Lommen, & Ehlers, ), number and distress of traumatic experiences, and posttraumatic cognitions (Désirée et al., 2012).…”