Prognostic influence of witness/victim experiences and PTSD-specific symptoms on working and educational capacity: a comparison between two groups of individuals post-trauma

Abstract

BackgroundTrauma exposure depends of the type of trauma and can result in the development of posttraumatic stress disorder (PTSD). The type of traumatization (such as Holocaust experiences and other sources of trauma) and specific symptoms of PTSD have influences on the outcome, and specific symptoms of PTSD influence personal and professional outcomes. Another factor is the role of the victim in their traumatization. Some patients are actively traumatized through being victims of torture, while others are passively traumatized by witnessing the traumatization of others.MethodsWe compared two groups of victim/witness trauma sufferers (PTSD vs. Holocaust-experience PTSD (HE-PTSD)) with regard to PTSD symptoms, educational and working capacity, and functional outcome parameters.ResultsHE-PTSD survivors with victim/witness trauma experience showed substantially more specific PTSD symptoms and higher symptom-specific intensities but had high social function and education levels. The intensity and type of intrusive memories and sociodemographic factors do not seem to have a prognostic influence on working or educational outcomes.ConclusionsIdentifying the combined victim/witness experience seems to play an important prognostic role in the assessment of PTSD victims. Further studies should consider these findings within other specific traumatization groups.

Differences in Intrusive Memory Experiences in Post-traumatic Stress Disorder after Single, Re- and Prolonged Traumatization

“…We hypothesize that the frequency and quality of IMEs differ among patients with single, re- and prolonged traumatization. Although data from this study population have been published before ( Muller et al, 2015 ), the present study reports extensive results on specific questions regarding these IME.…”

“…Triggers must be differentiated in adverse IMEs as scenes or sensual experiences that lead to IMEs, which are defined as re-experiencing symptoms of parts of a trauma within the PTSD context. These experiences appear to be temporary, with strong inter-individual variations in the perceived intensity and extent of the re-experienced trauma ( Kleim et al, 2013 ; Berntsen and Rubin, 2014 ; Muller et al, 2015 ).…”

“…PTSD patients can be categorized into three groups: single-trauma patients, re-traumatized patients (single or multiple repetitions of an earlier trauma) and patients who have been traumatized over a period of years and suffered from a number of different traumatic experiences ( Taubenfeld et al, 2009 ; Holmes et al, 2010 ; Bryant et al, 2011 ; Besser et al, 2014 ). Existing research provides limited knowledge regarding this heterogeneous group’s re-living of traumatic experiences through IMEs at the specific perceptual level ( Hellawell and Brewin, 2004 ; Duke et al, 2008 ; Muller et al, 2015 ). Little is known about factors determining the quality of such experiences at the predominant perceptual level.…”

“…Re-traumatization is believed to cause greater PTSD symptoms than single traumatization does ( Schock et al, 2010 ). However, few data are available for direct comparisons of these different types of trauma ( Muller et al, 2015 ). Thus, our research objective was to compare these special traumatization groups.…”

“…However, the sensory quality and threshold intensity of triggers that elicit IMEs may differ ( Biermann et al, 2010 ; Muller et al, 2011 ; Post et al, 2014 ). Nevertheless, considering the factors influencing symptom variety might be crucial to individual therapy and to our understanding of PTSD ( Holmes et al, 2010 ; Muller et al, 2015 ). We hypothesize that the frequency and quality of IMEs differ among patients with single, re- and prolonged traumatization.…”