Posttraumatic Stress Disorder in the National Comorbidity Survey

Kessler, Ronald C.; Sonnega, Amanda; Bromet, Evelyn J.; Hughes, Michael L.; Nelson, Christopher P.

doi:10.1001/archpsyc.1995.03950240066012

Cited by 9,068 publications

(7,574 citation statements)

References 39 publications

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“…However, roughly a quarter to a half of VTE cases, overall, are classified as occurring in the absence of major established risk factors,6 thus emphasizing the need for greater understanding of susceptibility to VTE. PTSD is twice as common in women as in men,11 and our findings suggest that elevated PTSD symptoms (over and above the effects of trauma type and depression, a psychological disorder that is frequently comorbid with PTSD and has also been linked with risk of VTE9, 10) may be an important vulnerability factor for developing VTE in women. Given that VTE is a leading cause of mortality among pregnant and recently postpartum women,3 and in light of female‐specific risk factors for VTE related to reproductive hormone exposure,3 pregnant women with PTSD symptoms or women with PTSD symptoms who are using hormone therapy may represent especially vulnerable groups with respect to VTE risk.…”

Section: Discussionmentioning

confidence: 65%

“…Growing evidence suggests that psychosocial factors, such as depression, which have been linked to cardiovascular risk more broadly, are also associated with VTE risk in particular 9, 10. The majority of individuals in the general population (at least 60% according to most studies11, 12) are exposed to 1 or more traumatic events (eg, sexual assault, physical assault, combat, natural disasters) during their lifetime. Posttraumatic stress disorder (PTSD) is a psychological consequence of exposure to such traumatic events, and is characterized by symptoms of re‐experiencing of the trauma, avoidance of trauma reminders, negative alterations in mood and thinking, and hyperarousal.…”

Section: Introductionmentioning

confidence: 99%

“…Posttraumatic stress disorder (PTSD) is a psychological consequence of exposure to such traumatic events, and is characterized by symptoms of re‐experiencing of the trauma, avoidance of trauma reminders, negative alterations in mood and thinking, and hyperarousal. PTSD is twice as common in women than in men; ≈1 in 10 women are estimated to develop PTSD in their lifetime 11. PTSD has been increasingly identified as a cardiovascular risk factor,13 with effects particularly striking in women 14.…”

Section: Introductionmentioning

confidence: 99%

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Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

Sumner

Kubzansky

Kabrhel

et al. 2016

JAHA

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BackgroundTrauma exposure and posttraumatic stress disorder (PTSD) have been linked to myocardial infarction and stroke in women, with biological and behavioral mechanisms implicated in underlying risk. The third most common cardiovascular illness, venous thromboembolism (VTE), is a specific health risk for women. Given previous associations with other cardiovascular diseases, we hypothesized that high levels of trauma and PTSD symptoms would be associated with higher risk of incident VTE in younger and middle‐aged women.Methods and ResultsWe used proportional hazards models to estimate hazard ratios (HRs) and 95% CIs for new‐onset VTE (960 events) over 22 years in 49 296 women in the Nurses’ Health Study II. Compared to no trauma exposure, both trauma exposure and PTSD symptoms were significantly associated with increased risk of developing VTE, adjusting for demographics, family history, and childhood adiposity. Women with the most PTSD symptoms exhibited the greatest risk elevation: trauma/6 to 7 symptoms: HR=2.42 (95% CI, 1.83–3.20); trauma/4 to 5 symptoms: HR=2.00 (95% CI, 1.55–2.59); trauma/1 to 3 symptoms: HR=1.44 (95% CI, 1.12–1.84); trauma/no symptoms: HR=1.72 (95% CI, 1.43–2.08). Results were similar, although attenuated, when adjusting for VTE‐relevant medications, medical conditions, and health behaviors.ConclusionsWomen with the highest PTSD symptom levels had nearly a 2‐fold increased risk of VTE compared to women without trauma exposure in fully adjusted models. Trauma exposure alone was also associated with elevated VTE risk. Trauma and PTSD symptoms may be associated with a hypercoagulable state. Treatment providers should be aware that women with trauma exposure and PTSD symptoms may be vulnerable to VTE.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

Sumner

Kubzansky

Kabrhel

et al. 2016

JAHA

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“…Lifetime prevalence is estimated at 1.3–12.2% (Karam et al, 2014). The probability of developing PTSD after a traumatic event varies according several risk factors (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014, Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995) which can be classified as pre-trauma (sex, IQ, prior trauma exposure, prior mental disorder, genetics, personality factors), related to trauma (perceived fear of death, assaultive trauma, severity of trauma, physical injury) or post-trauma (high heart rate, low social support, financial stress, pain severity, intensive care stay, traumatic brain injury, peritraumatic dissociation, acute stress disorder, disability; Sareen, 2014). Functional and emotional impairments impact on quality of life.…”

Section: Introductionmentioning

confidence: 99%

e-PTSD: an overview on how new technologies can improve prediction and assessment of Posttraumatic Stress Disorder (PTSD)

Bourla

Mouchabac

El‐Hage

et al. 2018

European Journal of Psychotraumatology

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Background: New technologies may profoundly change our way of understanding psychiatric disorders including posttraumatic stress disorder (PTSD). Imaging and biomarkers, along with technological and medical informatics developments, might provide an answer regarding at-risk patient’s identification. Recent advances in the concept of ‘digital phenotype’, which refers to the capture of characteristics of a psychiatric disorder by computerized measurement tools, is one paradigmatic example. Objective: The impact of the new technologies on health professionals practice in PTSD care remains to be determined. The recent evolutions could disrupt the clinical practices and practitioners in their beliefs, ethics and representations, going as far as questioning their professional culture. In the present paper, we conducted an extensive search to highlight the articles which reflect the potential of these new technologies. Method: We conducted an overview by querying PubMed database with the terms [PTSD] [Posttraumatic stress disorder] AND [Computer] OR [Computerized] OR [Mobile] OR [Automatic] OR [Automated] OR [Machine learning] OR [Sensor] OR [Heart rate variability] OR [HRV] OR [actigraphy] OR [actimetry] OR [digital] OR [motion] OR [temperature] OR [virtual reality]. Results: We summarized the synthesized literature in two categories: prediction and assessment (including diagnostic, screening and monitoring). Two independent reviewers screened, extracted data and quality appraised the sources. Results were synthesized narratively. Conclusions: This overview shows that many studies are underway allowing researchers to start building a PTSD digital phenotype using passive data obtained by biometric sensors. Active data obtained from Ecological Momentary Assessment (EMA) could allow clinicians to assess PTSD patients. The place of connected objects, Artificial Intelligence and remote monitoring of patients with psychiatric pathology remains to be defined. These tools must be explained and adapted to the different profiles of physicians and patients. The involvement of patients, caregivers and health professionals is essential to the design and evaluation of these new tools.

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“…Studies have shown that traumatic losses in this group can lead to both PCBD and PTSD (Momartin, Silove, Manicavasagar, & Steel, 2004; Nickerson et al, 2014; Stammel et al, 2013). Comorbidity of PCBD and/or PTSD with other psychiatric disorders such as major depressive disorder (MDD) (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995; Schaal, Dusingizemungu, Jacob, Neuner, & Elbert, 2012), psychotic disorders (Sareen, Cox, Goodwin, & Asmundson, 2005) and substance abuse disorders (Kessler et al, 1995) is often observed. Furthermore, refugees are confronted with ongoing stressors that can fuel the risk for psychopathology (Laban 2004, 2005), such as insecurity about residential status, concerns about wellbeing of family members left behind, socioeconomic disadvantage, and adaptation to the host culture.…”

mentioning

confidence: 99%

Day patient treatment for traumatic grief: preliminary evaluation of a one-year treatment programme for patients with multiple and traumatic losses

Heus

Hengst

Rie

et al. 2017

European Journal of Psychotraumatology

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Background: Bereaved individuals who have lost a loved one under traumatic circumstances can develop symptoms of Persistent Complex Bereavement Disorder (PCBD) and/or Posttraumatic Stress Disorder (PTSD). This is particularly common in refugees, as they frequently have been confronted with multiple traumatic losses. For patients with severe PTSD and traumatic grief a treatment programme was developed, embedding individual traumatic grief focused therapy in a group-based multidisciplinary day patient treatment programme. The day patient treatment comprised a weekly five-hour programme consisting of three phases with a duration of four months each. Objective: To evaluate the feasibility and potential effectiveness of the treatment programme. Method: Data were analyzed from 16 participants treated between October 2013 and March 2014. PTSD severity and PTSD/PCBD diagnoses were measured during the initial and final phases of treatment using the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Traumatic Grief Inventory Self Report (TGI-SR). One clinical case is presented in more detail. Treatment attendance was also registered and therapist satisfaction was evaluated in a focus group. Results: Thirteen patients (81%) completed the treatment. Each day of the treatment programme was attended by a mean of 76% of the participants. In the focus group, therapists noted symptom reduction in their patients and they therefore regarded Brief Eclectic Psychotherapy for Traumatic Grief (BEP-TG) as an effective therapy for their patients. During treatment, significant decreases in PTSD severity as well as diagnosable PTSD and PCBD were observed. Conclusions: Results support the feasibility and potential effectiveness of the day patient treatment programme for traumatic grief. The programme appears to be particularly suitable for refugees with severe PTSD and PCBD psychopathology, who may not benefit enough from usual care.

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Posttraumatic Stress Disorder in the National Comorbidity Survey

Cited by 9,068 publications

References 39 publications

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

Associations of Trauma Exposure and Posttraumatic Stress Symptoms With Venous Thromboembolism Over 22 Years in Women

e-PTSD: an overview on how new technologies can improve prediction and assessment of Posttraumatic Stress Disorder (PTSD)

Day patient treatment for traumatic grief: preliminary evaluation of a one-year treatment programme for patients with multiple and traumatic losses

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