Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study

Waller, Michael; Charlson, Fiona J; Ireland, Renee; Whiteford, Harvey; Dobson, Annette

doi:10.1017/s2045796015000517

“…However, CAPS is a Some studies indicate that experiencing multiple similar traumatic events increases the risk of a high score on the IES-R. The study conducted by Waller et al proved a significant association between numbers of experienced traumatic events and severity of PTSD symptoms, [34]. The findings are consistent with the cumulative effects of stressful events being associated with increasing PTSD symptoms, [38].…”

Section: Discussionmentioning

confidence: 84%

“…reporting more events had a higher mean PLC-score compared to those who reported no events. The study concluded that number of stressful events was significantly associated with more symptoms of PTSD, [34].…”

Section: The Caps -Clinical Administered Ptsd Scalementioning

confidence: 97%

Evaluation of Tools to Assess Psychological Distress: How to Measure Psychological Stress Reactions in Citizen Responders– A Systematic Review

Kragh¹,

Folke²,

Andelius³

et al. 2019

Preprint

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Background Dispatched citizen responders are increasingly involved in out-of-hospital cardiac arrest (OHCA) resuscitation which can lead to severe stress. It is unknown which psychological assessment tools are most appropriate to evaluate psychological distress in this population. The aim of this systematic review was to identify and evaluate existing assessment tools used to measure psychological distress with emphasis on citizen responders who attempted resuscitation. Methods A systematic literature search conducted by two reviewers was carried out in March 2018 and revised in July 2018. Four databases were searched: PubMed, PsycInfo, Scopus, and The Social Sciences Citation Index. A total of 504 studies examining assessment tools to measure psychological distress reactions after acute traumatic events were identified, and 9 fulfilled the inclusion criteria for further analysis. The selected studies were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network. Results The Impact of Event Scale (IES) and The Impact of Event Scale-Revised (IES-R) were the preferred assessment tools, and were used on diverse populations exposed to various traumatic events. One study included lay rescuers performing bystander cardiopulmonary resuscitation and this study used the IES. The IES and the IES-R also have proven a high validity in various other populations. The Clinical administered PTSD scale (CAPS) was applied in two studies. Though the CAPS is comparable to both the IES-R and the IES, the CAPS assess PTSD symptoms in general and not in relation to a specific experienced event, which makes the scale less suitable when measuring stress due to a specific resuscitation attempt. Conclusions The IES and the IES-R seem to be solid measures for psychological distress among people experiencing an acute psychological traumatic event. However, only one study has assessed psychological distress among citizen responders in OHCA for which the IES-R scale was used, and therefore, further research on this topic is warranted.

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“…However, CAPS is a Some studies indicate that experiencing multiple similar traumatic events increases the risk of a high score on the IES-R. The study conducted by Waller et al proved a significant association between numbers of experienced traumatic events and severity of PTSD symptoms, [37]. The findings are consistent with the cumulative effects of stressful events being associated with increasing PTSD symptoms, [41].…”

Section: Discussionmentioning

confidence: 84%

“…The study found that personnel reporting more events had a higher mean PLC-score compared to those who reported no events. The study concluded that number of stressful events was significantly associated with more symptoms of PTSD, [37].…”

Section: The Caps -Clinical Administered Ptsd Scalementioning

confidence: 97%

Evaluation of Tools to Assess Psychological Distress: How to Measure Psychological Stress Reactions in Citizen Responders– A Systematic Review

Kragh¹,

Folke²,

Andelius³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Dispatched citizen responders are increasingly involved in out-of-hospital cardiac arrest (OHCA) resuscitation which can lead to severe stress. It is unknown which psychological assessment tools are most appropriate to evaluate psychological distress in this population. The aim of this systematic review was to identify and evaluate existing assessment tools used to measure psychological distress with emphasis on citizen responders who attempted resuscitation. Methods A systematic literature search conducted by two reviewers was carried out in March 2018 and revised in July 2018. Four databases were searched: PubMed, PsycInfo, Scopus, and The Social Sciences Citation Index. A total of 504 studies examining assessment tools to measure psychological distress reactions after acute traumatic events were identified, and 9 fulfilled the inclusion criteria for further analysis. The selected studies were assessed for methodological quality using the Scottish Intercollegiate Guidelines Network. Results The Impact of Event Scale (IES) and The Impact of Event Scale-Revised (IES-R) were the preferred assessment tools, and were used on diverse populations exposed to various traumatic events. One study included lay rescuers performing bystander cardiopulmonary resuscitation and this study used the IES. The IES and the IES-R also have proven a high validity in various other populations. The Clinical administered PTSD scale (CAPS) was applied in two studies. Though the CAPS is comparable to both the IES-R and the IES, the CAPS assess PTSD symptoms in general and not in relation to a specific experienced event, which makes the scale less suitable when measuring stress due to a specific resuscitation attempt. Conclusions The IES and the IES-R seem to be solid measures for psychological distress among people experiencing an acute psychological traumatic event. However, only one study has assessed psychological distress among citizen responders in OHCA for which the IES-R scale was used, and therefore, further research on this topic is warranted.

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“…First, they raise the possibility that there may be a long-lasting physiologic response to trauma exposure that can exist independently of whether an individual meets criteria for PTSD at any given point in time. This would provide a potential explanation for the repeatedly observed but so far unexplained pattern of individuals sometimes showing PTSD symptoms only after a substantial delay following their trauma exposure, or intermittently over time ( Mota et al, 2016 ; Utzon-Frank et al, 2014 ; Waller et al, 2015 ). The existence of a generalized mechanism whereby reactivity to NE is persistently increased following trauma exposure could also help to explain some of the increase in stress reactivity seen in PTSD as well as other disorders, such as the finding that individuals with both a primary psychotic disorder and a history of childhood trauma show increases in mood symptoms and in psychotic symptoms in response to stress ( Lardinois et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Evidence for altered brain reactivity to norepinephrine in Veterans with a history of traumatic stress

Hendrickson

¹

,

Raskind

²

,

Millard

³

et al. 2018

Neurobiology of Stress

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BackgroundIncreases in the quantity or impact of noradrenergic signaling have been implicated in the pathophysiology of posttraumatic stress disorder (PTSD). This increased signaling may result from increased norepinephrine (NE) release, from altered brain responses to NE, or from a combination of both factors. Here, we tested the hypothesis that Veterans reporting a history of trauma exposure would show an increased association between brain NE and mental health symptoms commonly observed after trauma, as compared to Veterans who did not report a history of trauma exposure, consistent with the possibility of increased brain reactivity to NE after traumatic stress.MethodsUsing a convenience sample of 69 male Veterans with a history of combat-theater deployment, we examined the relationship between trauma-related mental health symptoms and the concentration of NE in cerebrospinal fluid (CSF). CSF NE levels were measured by HPLC in CSF from morning lumbar puncture. Behavioral symptoms associated with diagnoses of PTSD, depression, insomnia, or post-concussive syndrome (PCS), which together cover a wide variety of symptoms associated with alterations in arousal systems, such as sleep, mood, concentration, and anxiety, were assessed via self-report (PTSD Checklist [PCL] for PTSD, Patient Health Questionnaire 9 [PHQ9] for depression, Pittsburgh Sleep Quality Index [PSQI] for sleep problems including insomnia, and Neurobehavioral Symptom Inventory [NSI] for PCS) and structured clinical interview (Clinician-Administered PSTD Scale [CAPS]). Individuals meeting criterion A of the DSM-IV diagnostic criteria for PTSD were considered trauma-exposed. Linear regression models were used to quantify the association between CSF NE and symptom intensity in participants with and without a history of trauma exposure, as well as in participants with a history of trauma exposure who were currently taking the noradrenergic receptor antagonist prazosin.ResultsFifty-two Veterans met criteria for a history of trauma exposure; of these, 36 met criteria for PTSD. CSF NE levels were not significantly different in Veterans with a history of trauma compared to those without, nor in Veterans with PTSD as compared to those without. Veterans with a history of trauma and who were not using the medication prazosin demonstrated a significantly more positive correlation between CSF NE and behavioral symptom expression than Veterans who had not experienced traumatic stress. No relationship between CSF NE and behavioral symptom expression was found in Veterans who had experienced traumatic stress and were taking prazosin at the time of the assessments.ConclusionsThese results are consistent with increased central nervous system responsiveness to noradrenergic signaling in individuals with a history of traumatic exposure, raising the possibility that there may be long-lasting physiologic effects of trauma-exposure that exist independently of whether an individual meets criteria for PTSD at any given point in time. Exploration of the mechanism by which b...

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Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study

Cited by 7 publications

References 35 publications

Evaluation of Tools to Assess Psychological Distress: How to Measure Psychological Stress Reactions in Citizen Responders– A Systematic Review

Evaluation of Tools to Assess Psychological Distress: How to Measure Psychological Stress Reactions in Citizen Responders– A Systematic Review

Evaluation of Tools to Assess Psychological Distress: How to Measure Psychological Stress Reactions in Citizen Responders– A Systematic Review

Evidence for altered brain reactivity to norepinephrine in Veterans with a history of traumatic stress

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