Relationship between anxiety sensitivity and post-traumatic stress symptoms in trauma-exposed adults: A meta-analysis

Chiu, Henry Tak Shing; Low, Debbie Chi Wing; Chan, Angel Hiu Tung; Meiser-Stedman, Richard

doi:10.1016/j.janxdis.2024.102857

Cited by 2 publications

(2 citation statements)

References 110 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Identifying mechanisms that determine a chronic symptom course is imperative to develop more targeted and effective interventions and to reduce socioeconomic burden. Psychological mechanisms involving transactions between stressful life events and symptoms are among the more promising candidates for explaining the long-term maintenance of PTSD, and they can be directly translated into intervention targets (Chiu et al, 2024;Hammen, 1991;Monroe & Harkness, 2005). Next, we review four mechanisms that have been proposed to help explain PTSD symptoms over time, which we term: 1) Stress Reactivity, 2) Stress Generation, 3) Symptom Persistence, and 4) Stress Persistence.…”

Section: Mechanisms Of Stress That Maintain Posttraumatic Stress Diso...mentioning

confidence: 99%

“…One candidate mechanism is stress reactivity, which refers to how stressful events occurring after the initial trauma can exacerbate symptoms. Stressors may be especially potent for people with PTSD due to pre-trauma vulnerabilities associated with the condition or due to increased sensitivity resulting from traumatic experiences (Brewin et al, 2000;Chiu et al, 2024;Nievergelt et al, 2019). Regardless of whether heightened reactivity emerges before or after a trauma, the underlying processes could be cognitive (e.g., biased appraisals; Ehlers & Clark, 2000), behavioral (e.g., unhealthy coping; Seligowski et al, 2015), or physiological (Fonkoue et al, 2020;Pole, 2007;Shvil et al, 2013;Stam, 2007).…”

Section: Possible Stress-symptom Maintenance Mechanisms Of Ptsdmentioning

confidence: 99%

See 1 more Smart Citation

Stress dynamics that maintain posttraumatic stress disorder across 20 years

Ringwald,

Feltman,

Clouston

et al. 2024

Preprint

View full text Add to dashboard Cite

Posttraumatic stress disorder (PTSD) is often chronic and impairing. Maintenance mechanisms underpinning the long-term stability of symptoms remain poorly understood due to heterogenous presentation. We parsed this heterogeneity by examining how individual differences in key stress-symptom mechanisms relate to the long-term maintenance of PTSD. Our sample was composed of 7,308 trauma-exposed World Trade Center responders who self-reported PTSD symptoms and stressful life events at annual monitoring visits for up to 20 years (average=8.8 visits; [range=4–16]). We used multilevel structural equation models to separate the stable and time-varying components of symptoms and stressful life events. At the within-person level, we modeled stress reactivity by cross-lagged associations between stress and future symptoms, stress generation by cross-lagged associations between symptoms and future stress, and autoregressive effects represented symptom persistence and stress persistence. Clinical utility of the stress-symptom mechanisms was evaluated by their associations with PTSD chronicity and mental health care utilization. Stress reactivity, stress generation, and symptom persistence were significant on average (s=.03–.16). There were significant individual differences in the strength of each mechanism (interquartile ranges=.06–.12). Correlations among within-person processes showed some mechanisms are intertwined (e.g., more reactive people also generate stress in a vicious cycle) and some represent distinct phenotypes (e.g., people are reactive or have persistent symptoms). On average, people in the top deciles of most mechanisms had clinically significant symptom levels across the monitoring period and their mental health services cost 6-17× more per year than people at the median levels. Assessing and treating patients according to their stress-symptom dynamics could enable delivery of timely, targeted interventions that can improve the course of PTSD.

show abstract

Section: Mechanisms Of Stress That Maintain Posttraumatic Stress Diso...mentioning

confidence: 99%