Post‐traumatic stress disorder as moderator of other mental health conditions

Bryant, Richard A.

doi:10.1002/wps.20975

Cited by 15 publications

(16 citation statements)

References 10 publications

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“…Complex PTSD is typically associated with sustained, repeated, and multiple forms of traumatic experiences, which are typical in individuals with EDs, especially those in higher levels of care [ 13 , 20 , 40 , 41 ]. It is important to note that PTSD and complex PTSD are major mediators and/or moderators of psychiatric comorbidity over and above the effects of traumatic events or experiences alone [ 42 – 45 ]. To fully appreciate the impact of trauma, the Substance Abuse and Mental Health Administration of the United States has emphasized the importance of the “three E ’s,” i.e., E vent(s), E xperience(s), and E ffect(s) [ 46 , 47 ].…”

Section: Introductionmentioning

confidence: 99%

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

Brewerton

2022

J Eat Disord

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Background Multiple published sources from around the world have confirmed an association between an array of adverse childhood experiences (ACEs) and other traumatic events with eating disorders (EDs) and related adverse outcomes, including higher morbidity and mortality. Methods In keeping with this Special Issue’s goals, this narrative review focuses on the ACEs pyramid and its purported mechanisms through which child maltreatment and other forms of violence toward human beings influence the health and well-being of individuals who develop EDs throughout the life span. Relevant literature on posttraumatic stress disorder (PTSD) is highlighted when applicable. Results At every level of the pyramid, it is shown that EDs interact with each of these proclaimed escalating mechanisms in a bidirectional manner that contributes to the predisposition, precipitation and perpetuation of EDs and related medical and psychiatric comorbidities, which then predispose to early death. The levels and their interactions that are discussed include the contribution of generational embodiment (genetics) and historical trauma (epigenetics), social conditions and local context, the ACEs and other traumas themselves, the resultant disrupted neurodevelopment, subsequent social, emotional and cognitive impairment, the adoption of health risk behaviors, and the development of disease, disability and social problems, all resulting in premature mortality by means of fatal complications and/or suicide. Conclusions The implications of these cascading, evolving, and intertwined perspectives have important implications for the assessment and treatment of EDs using trauma-informed care and trauma-focused integrated treatment approaches. This overview offers multiple opportunities at every level for the palliation and prevention of EDs and other associated trauma-related conditions, including PTSD.

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Section: Introductionmentioning

confidence: 99%

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

Brewerton

2022

J Eat Disord

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“…Despite their limited number of items, these three subscales demonstrated adequate reliability and criterion validity as indicated by strong correlations with measures of distress. Indeed, traumatic symptoms are reported to predicted psychological distress, reduced resilience, disordered gaming, substance abuse, disordered eating, and reckless behaviors (e.g., suicidality) during COVID-19 [11,17,37,38]. Therefore, identification of people with possibly high scores on PTSD symptoms may have implications for the diagnosis and treatment of such a demanding condition.…”

Section: Discussionmentioning

confidence: 99%

“…This may be expected in populations who inherently display chronically greater levels of distress than healthy people. Indeed, PTSD and its symptoms may evoke the rise of comorbid psychological problems [17]. Therefore, clinical interviews may follow to identify patients who may have moodrelated psychiatric conditions.…”

Section: Discussionmentioning

confidence: 99%

“…The internal consistency of the Arabic IES-R in sample 1 and sample 2 is excellent (coefficient alpha = 0.93 and 0.92). Dimensionality tests revealed that the Arabic IES-R comprises six subscales: avoidance (items: 5,8,11,17,22), intrusion (items: 1, 3, 6, 9, 20), numbing (items: 7, 12, 13, 14), hyperarousal (items: 16, 18, 19, 21), sleep disturbance (items: 2, 15), and irritability (items: 4, 10). The internal consistency of these subscales in sample 1 and sample 2 in order ranges from acceptable to very good (coefficient alpha = 0.82, 0.81, 0.67, 0.77, 0.77, and 0.89) and (coefficient alpha = 0.82, 0.74, 0.68, 0.74, 0.77, and 0.87), respectively [31].…”

Section: Study Instrumentsmentioning

confidence: 99%

“…As per Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), posttraumatic stress disorder (PTSD) is a psychiatric disorder, which develops in individuals who are exposed to or threatened to face traumatic events (e.g., death, natural and manmade disasters, severe accidents, terrorist attacks, war/combat, rape/sexual violence, or severe injuries) [3,16]. PTSD can precede or exacerbate psychiatric conditions (e.g., depression and anxiety disorders, suicidality, illicit drugs use, eating disorders, and psychosis) as well as physical and behavioral indicators (e.g., chronic pain and tobacco use) [17]. Negative alterations in cognitions and mood as well as anxiety and insomnia are reported as key bridging nodes for PTSD and psychiatric co-morbidity [18].…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Event Scale – Revised: Examining its cutoff scores among Arab psychiatric patients and healthy adults within the context of COVID-19 as a collective traumatic event

Ali¹,

Al-Dossary²,

Almarwani³

et al. 2023

Preprint

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The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 &amp; 0.91, p values = 0.001, 95% CI: 0.80-0.92 &amp; 0.87 to 0.94, sensitivity = 0.85 &amp; 0.87, specificity = 0.73 &amp; 0.83, Youden index = 0.58 &amp; 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.

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Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial

Carmassi,

Sampogna,

Di Vincenzo

et al. 2023

Brain and Behavior

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BackgroundThe coronavirus disease of 2019 (COVID‐19) pandemic is an unprecedented traumatic event that has severely impacted social, economic, and health well‐being worldwide. The COvid Mental hEalth Trial was specifically designed to evaluate the impact of the COVID‐19 pandemic and its containment measures on the mental health of the Italian general population in terms of COVID‐19‐related acute stress disorder (ASD) symptoms.MethodsThe present cross‐sectional study is based on an online survey carried out in the period March–May 2020. Italian general adult population was invited to compile an anonymous survey, which included the severity of acute stress symptoms scale/National Stressful Events Survey Short Scale to investigate the occurrence and severity of ASD symptoms.ResultsThe final sample consisted of 20,720 participants. During the lockdown, subjects with pre‐existing mental health problems reported a statistically significant higher risk of acute post‐traumatic symptoms compared to the general population (B: 2.57; 95% CI:2.04–3.09; p < .0001) and health care professionals (B: .37; 95% CI: .02–0.72; p < .05). According to multivariate regression models, the levels of acute post‐traumatic symptoms (p < .0001) were higher in younger and female respondents. Social isolation and sleep disorder/insomnia represented positive predictors of acute stress (B = 3.32, 95% CI = 3.08–3.57).ConclusionsConcerns about the risk of infection as well as social isolation caused a higher incidence of acute post‐traumatic stress symptoms that may predict the subsequent development of post‐traumatic stress disorder symptoms in the long term.

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Post‐traumatic stress disorder as moderator of other mental health conditions

Cited by 15 publications

References 10 publications

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

The Impact of Event Scale – Revised: Examining its cutoff scores among Arab psychiatric patients and healthy adults within the context of COVID-19 as a collective traumatic event

Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial

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