Trajectories of Posttraumatic Stress in Youths After Natural Disasters

Lai, Betty S.; Greca, Annette M. La; Brincks, Ahnalee M.; Colgan, Courtney; D’Amico, M.; Lowe, Sarah R.; Kelley, Mary Lou

doi:10.1001/jamanetworkopen.2020.36682

Cited by 26 publications

(30 citation statements)

References 50 publications

(172 reference statements)

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“…High rates of PTSD (37%) observed in adolescents even several years after the wildfire (23) remain both surprising and concerning as, for example, Bonanno's (24) review of chronic PTSD following experience of traumatic events suggests rates are typically much lower, between 6.6 and 17.8%. There maybe specific trajectories that put some individuals at increased risk for chronic distress (25). Persistent dysregulation has been described in cases of complex PTSD, in which trauma disrupts formative developmental periods (26).…”

Section: Discussionmentioning

confidence: 99%

Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization

et al. 2021

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In the wake of the massive Canadian wildfire of May 2016 in the area of Fort McMurray Alberta, we observed increased rates of mental health problems, particularly post-traumatic stress disorder (PTSD), in school-aged adolescents (ages 11–19). Surprisingly, we did not see these rates decline over the 3.5-year follow-up period. Additionally, our research suggested that the impact of this mass incident resulted in other unanticipated effects, including the finding that children who were not present for and relatively unaffected by the wildfire showed a similar PTSD symptom profile to children more directly involved, suggesting some degree of spillover or stress contagion. A potential explanation for these high rates in individuals who were not present could be undiagnosed retraumatization in some of the students. To investigate this possibility, we compared two groups of students: those who reported the wildfire as their most significant trauma (n = 740) and those who had their most significant trauma prior to the wildfire (n = 295). Those with significant pre-existing trauma had significantly higher rates of both depression and PTSD symptoms, although, unexpectedly the groups exhibited no differences in anxiety level. Taken together, this evidence suggests retraumatization is both longer-lasting and more widespread than might be predicted on a case-by-case basis, suggesting the need to reconceptualize the role of past trauma history in present symptomatology. These findings point to the need to recognize that crises instigated by natural disasters are mass phenomena which expose those involved to numerous unanticipated risks. New trauma-informed treatment approaches are required that incorporate sensitivity to the collective impact of mass crises, and recognize the risk of poorer long-term mental health outcomes for those who experienced trauma in the past.

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Section: Discussionmentioning

confidence: 99%

Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization

et al. 2021

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“…Age at war was not associated with categorical PTSD and only weakly associated in the subscale of persistent avoidance of trauma-related stimuli in the dimensional analyses. The literature point to a putative risk of younger age for PTSD (Powers et al 2014 ; Lai et al 2021 ). Notably, our sample consisted of adult participants with age at war > 16 years which might reduce the contribution of age as predictive factor for PTSD in the present analyses.…”

Section: Discussionmentioning

confidence: 99%

Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort

Weber¹,

Maihofer

Jakšić

et al. 2021

J Neural Transm

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Objectives Posttraumatic stress disorder (PTSD) is triggered by extremely stressful environmental events and characterized by high emotional distress, re-experiencing of trauma, avoidance and hypervigilance. The present study uses polygenic risk scores (PRS) derived from the UK Biobank (UKBB) mega-cohort analysis as part of the PGC PTSD GWAS effort to determine the heritable basis of PTSD in the South Eastern Europe (SEE)-PTSD cohort. We further analyzed the relation between PRS and additional disease-related variables, such as number and intensity of life events, coping, sex and age at war on PTSD and CAPS as outcome variables. Methods Association of PRS, number and intensity of life events, coping, sex and age on PTSD were calculated using logistic regression in a total of 321 subjects with current and remitted PTSD and 337 controls previously subjected to traumatic events but not having PTSD. In addition, PRS and other disease-related variables were tested for association with PTSD symptom severity, measured by the Clinician Administrated PTSD Scale (CAPS) by liner regression. To assess the relationship between the main outcomes PTSD diagnosis and symptom severity, each of the examined variables was adjusted for all other PTSD related variables. Results The categorical analysis showed significant polygenic risk in patients with remitted PTSD and the total sample, whereas no effects were found on symptom severity. Intensity of life events as well as the individual coping style were significantly associated with PTSD diagnosis in both current and remitted cases. The dimensional analyses showed as association of war-related frequency of trauma with symptom severity, whereas the intensity of trauma yielded significant results independently of trauma timing in current PTSD. Conclusions The present PRS application in the SEE-PTSD cohort confirms modest but significant polygenic risk for PTSD diagnosis. Environmental factors, mainly the intensity of traumatic life events and negative coping strategies, yielded associations with PTSD both categorically and dimensionally with more significant p-values. This suggests that, at least in the present cohort of war-related trauma, the association of environmental factors and current individual coping strategies with PTSD psychopathology was stronger than the polygenic risk.

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“…The extant research suggests that there are a number of factors that influence stability and change and that the remission of symptoms may be less evident in certain circumstances and contexts (La Lai et al, 2021;Weems et al, 2010;Yule et al, 2000). Moreover, even if a decrease in PTSD symptoms, per se, occurs, there may be lasting effects that are more insidious in nature with PTSD evolving into other symptoms and related impairment (Weems et al, 2013).…”

Section: Trajectories Of Ptsd Over Timementioning

confidence: 99%

“…Low-symptom youth (32.6%) had stable lower scores that were higher than the cutoff score. Resilient youth (53.8%) displayed continuous, more stable lower scores than youth on the low-symptom trajectory over all five assessments (see also Lai et al, 2021;Masten & Obradovic, 2008;Masten & Osofsky, 2010;Weems & Graham, 2014). A critical feature in the accurate empirical identification of resilient youth is comparability in terms of the level of exposure in each of the trajectories.…”

Section: Trajectories Of Ptsd Over Timementioning

confidence: 99%

Toward a Developmental Model of Continuity and Change in PTSD Symptoms following Exposure to Traumatic and Adverse Experiences

Weems

McCurdy

Scozzafava

2021

Journ Child Adol Trauma

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A developmental understanding of the expression of posttraumatic stress (PTS) symptoms following trauma in childhood requires identifying continuity and change in not just overall symptoms but in the individual symptoms as well. Such models of change also require understanding multiple dimensions of time. That is, longitudinal change-the passage of time-may have different effects on symptom expression depending on when in time an individual entered the study -such as what age they were when first assessed. This paper addresses these ideas with an overview of the developmental differences in the assessment of PTS from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), longitudinal research on posttraumatic stress disorder (PTSD) symptoms, and providing synthesis within a symptom network perspective. We then provide an illustration of how individual PTSD symptoms change over time at different ages (elementary versus middle school) with a secondary analysis of data from a previously reported study (n = 191 youth, aged 8-15, assessed at two time points six months apart). The reanalysis of the data suggests both continuity and change in symptoms over time (i.e., some symptoms were more stable than other symptoms) with differences in symptom rates and their longitudinal change as a function of age (i.e., some symptoms more common or more stable in younger versus older or older versus younger). We close with avenues for future research aimed at better understanding symptom cascades over time and at different ages and potential implications for future iterations of assessment/classification systems.

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Trajectories of Posttraumatic Stress in Youths After Natural Disasters

Abstract: This cohort study uses integrated data from 4 studies of US youths exposed to major hurricanes to assess trajectories of posttraumatic stress symptoms and investigate factors associated with those trajectories.

Cited by 26 publications

References 50 publications

Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization

Collective Trauma and Mental Health in Adolescents: A Retrospective Cohort Study of the Effects of Retraumatization

Association of polygenic risk scores, traumatic life events and coping strategies with war-related PTSD diagnosis and symptom severity in the South Eastern Europe (SEE)-PTSD cohort

Toward a Developmental Model of Continuity and Change in PTSD Symptoms following Exposure to Traumatic and Adverse Experiences

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