Skip to main content Accessibility help
×
Home
Hostname: page-component-684899dbb8-p6h7k Total loading time: 0.373 Render date: 2022-05-26T18:06:34.985Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD

Published online by Cambridge University Press:  03 February 2020

Sarah R. Lowe*
Affiliation:
Yale University, School of Public Health
Andrew Ratanatharathorn
Affiliation:
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
Betty S. Lai
Affiliation:
Lynch School of Education and Human Development, Boston College, Chestnut Hill, USA
Willem van der Mei
Affiliation:
Data Scientist, New York County Defender Services
Anna C. Barbano
Affiliation:
Department of Psychology, University of Toledo
Richard A. Bryant
Affiliation:
School of Psychology, University of New South Wales, Sydney, NSW2052, Australia Brain Dynamics Centre, Westmead Institute of Medical Research, University of Sydney, Westmead, Australia
Douglas L. Delahanty
Affiliation:
Kent State University, Department of Psychological Sciences, Kent, OH, USA
Yutaka J. Matsuoka
Affiliation:
Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
Miranda Olff
Affiliation:
Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands ARQ National Psychotrauma Centre, Diemen, The Netherlands
Ulrich Schnyder
Affiliation:
University of Zurich, Zurich, Switzerland
Eugene Laska
Affiliation:
Steven and Alexandra Cohen Veterans Center for the Study of Posttraumatic Stress and Traumatic Brain Injury, Department of Psychiatry, New York University School of Medicine
Karestan C. Koenen
Affiliation:
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
Arieh Y. Shalev
Affiliation:
Department of Psychiatry, New York University School of Medicine, New York, New York
Ronald C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
*
Author for correspondence: Sarah R. Lowe, E-mail: sarah.lowe@yale.edu

Abstract

Background

Research exploring the longitudinal course of posttraumatic stress disorder (PTSD) symptoms has documented four modal trajectories (low, remitting, high, and delayed), with proportions varying across studies. Heterogeneity could be due to differences in trauma types and patient demographic characteristics.

Methods

This analysis pooled data from six longitudinal studies of adult survivors of civilian-related injuries admitted to general hospital emergency departments (EDs) in six countries (pooled N = 3083). Each study included at least three assessments of the clinician-administered PTSD scale in the first post-trauma year. Latent class growth analysis determined the proportion of participants exhibiting various PTSD symptom trajectories within and across the datasets. Multinomial logistic regression analyses examined demographic characteristics, type of event leading to the injury, and trauma history as predictors of trajectories differentiated by their initial severity and course.

Results

Five trajectories were found across the datasets: Low (64.5%), Remitting (16.9%), Moderate (6.7%), High (6.5%), and Delayed (5.5%). Female gender, non-white race, prior interpersonal trauma, and assaultive injuries were associated with increased risk for initial PTSD reactions. Female gender and assaultive injuries were associated with risk for membership in the Delayed (v. Low) trajectory, and lower education, prior interpersonal trauma, and assaultive injuries with risk for membership in the High (v. Remitting) trajectory.

Conclusions

The results suggest that over 30% of civilian-related injury survivors admitted to EDs experience moderate-to-high levels of PTSD symptoms within the first post-trauma year, with those reporting assaultive violence at increased risk of both immediate and longer-term symptoms.

Type
Original Article
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

ICPP members: Soraya Seedat, Stellenbosch University; Terri deRoon-Cassini, Medical College of Wisconsin; Sara Freedman, Bar IlanUniversity; Joanne Mouthaan, Leiden University; Marit Sijbrandij, VU University; Mirjam van Zuiden, Academic Medical Center; Daisuke Nishi, University of Tokyo School of Medicine; Alexander McFarlane, Center for Traumatic Studies, University of Adelaide, Derrick Silove, University of New South Wales School of Psychiatry; Meaghan O'Donnell, University of Melbourne; Wei Qi, New York University; Martin Gevonden, Vrije Universiteit

References

Andruff, H., Carraro, N., Thompson, A., Gaudreau, P., & Louvet, B. (2009). Latent class growth modelling: A tutorial. Tutorials in Quantitative Methods for Psychology 5, 1124.CrossRefGoogle Scholar
Benjet, C., Bromet, E., Karam, E. G., Kessler, R. C., McLaughlin, K. A., Ruscio, A. M., … Alonso, , J. (2016). The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychological medicine 46, 327343.CrossRefGoogle ScholarPubMed
Berlin, K. S., Williams, N. A., & Parra, G. R. (2014). An introduction to latent variable mixture modeling (Part 1): Overview and cross-sectional latent class and latent profile analysis. Journal of Pediatric Psychology 39, 174187. 10.1093/jpepsy/jst084CrossRefGoogle Scholar
Berntsen, D., Johannessen, K. B., Thomsen, Y. D., Bertelsen, M., Hoyle, R. H., & Rubin, D. C. (2012). Peace and war: Trajectories of posttraumatic stress disorder symptoms before, during, and after military deployment in Afghanistan. Psychological Science 23, 15571565.CrossRefGoogle ScholarPubMed
Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., & Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress 8, 7590.10.1002/jts.2490080106CrossRefGoogle ScholarPubMed
Boasso, A. M., Steenkamp, M. M., Nash, W. P., Larson, J. L., & Litz, B. T. (2015). The relationship between course of PTSD symptoms in deployed US Marines and degree of combat exposure. Journal of Traumatic Stress 28, 7378.CrossRefGoogle Scholar
Bonanno, G. A., & Diminich, E. D. (2013). Annual research review: Positive adjustment to adversity–trajectories of minimal–impact resilience and emergent resilience. Journal of Child Psychology and Psychiatry 54, 378401.CrossRefGoogle ScholarPubMed
Bonanno, G. A., Kennedy, P., Galatzer-Levy, I. R., Lude, P., & Elfström, M. L. (2012). Trajectories of resilience, depression, and anxiety following spinal cord injury. Rehabilitation Psychology 57, 236.10.1037/a0029256CrossRefGoogle ScholarPubMed
Bonanno, G. A., Romero, S. A., & Klein, S. I. (2015). The temporal elements of psychological resilience: An integrative framework for the study of individuals, families, and communities. Psychological Inquiry 26, 139169.CrossRefGoogle Scholar
Bryant, R. A., Creamer, M., O'Donnell, M. L., Silove, D., & McFarlane, A. C. (2008). A multisite study of the capacity of acute stress disorder diagnosis to predict posttraumatic stress disorder. The Journal of Clinical Psychiatry 69, 923929.10.4088/JCP.v69n0606CrossRefGoogle ScholarPubMed
Bryant, R. A., Nickerson, A., Creamer, M., O'donnell, M., Forbes, D., Galatzer-Levy, I., … Silove, D. (2015). Trajectory of post-traumatic stress following traumatic injury: 6-year follow-up. The British Journal of Psychiatry 206, 417423.CrossRefGoogle ScholarPubMed
Delahanty, D. L., Raimonde, A. J., Spoonster, E., & Cullado, M. (2003). Injury severity, prior trauma history, urinary cortisol levels, and acute PTSD in motor vehicle accident victims. Journal of Anxiety Disorders 17, 149164.CrossRefGoogle ScholarPubMed
deRoon-Cassini, T. A., Mancini, A. D., Rusch, M. D., & Bonanno, G. A. (2010). Psychopathology and resilience following traumatic injury: A latent growth mixture model analysis. Rehabilitation Psychology 55, 1.CrossRefGoogle ScholarPubMed
Dickstein, B. D., Suvak, M., Litz, B. T., & Adler, A. B. (2010). Heterogeneity in the course of posttraumatic stress disorder: Trajectories of symptomatology. Journal of Traumatic Stress 23, 331339.CrossRefGoogle ScholarPubMed
DiGangi, J. A., Gomez, D., Mendoza, L., Jason, L. A., Keys, C. B., & Koenen, K. C. (2013). Pretrauma risk factors for posttraumatic stress disorder: A systematic review of the literature. Clinical Psychology Review 33, 728744.CrossRefGoogle ScholarPubMed
Fan, F., Long, K., Zhou, Y., Zheng, Y., & Liu, X. (2015). Longitudinal trajectories of post-traumatic stress disorder symptoms among adolescents after the Wenchuan earthquake in China. Psychological Medicine 45, 28852896.CrossRefGoogle ScholarPubMed
Fink, D. S., Lowe, S., Cohen, G. H., Sampson, L. A., Ursano, R. J., Gifford, R. K., … Galea, S. (2017). Trajectories of posttraumatic stress symptoms after civilian or deployment traumatic event experiences. Psychological Trauma: Theory, Research, Practice, and Policy 9, 138.CrossRefGoogle ScholarPubMed
Galatzer-Levy, I. R., Ankri, Y., Freedman, S., Israeli-Shalev, Y., Roitman, P., Gilad, M., & Shalev, A. Y. (2013). Early PTSD symptom trajectories: Persistence, recovery, and response to treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS). PLoS ONE 8, e70084.CrossRefGoogle Scholar
Galatzer-Levy, I. R., Huang, S. H., & Bonanno, G. A. (2018). Trajectories of resilience and dysfunction following potential trauma: A review and statistical evaluation. Clinical Psychology Review 63, 4155.CrossRefGoogle ScholarPubMed
Hepp, U., Moergeli, H., Buchi, S., Bruchhaus-Steinert, H., Kraemer, B., Sensky, T., & Schnyder, U. (2008). Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study. The British Journal of Psychiatry 192, 376383.CrossRefGoogle ScholarPubMed
Hovens, J., Van der Ploeg, H., Klaarenbeek, M., Bramsen, I., Schreuder, J., & Rivero, V. V. (1994). The assessment of posttraumatic stress disorder: With the clinician administered PTSD scale: Dutch results. Journal of Clinical Psychology 50, 325340.3.0.CO;2-M>CrossRefGoogle ScholarPubMed
Jung, T., & Wickrama, K. (2008). An introduction to latent class growth analysis and growth mixture modeling. Social and Personality Psychology Compass 2, 302317.CrossRefGoogle Scholar
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Benjet, C., Bromet, E. J., Cardoso, G., … Ferry, F. (2017). Trauma and PTSD in the WHO world mental health surveys. European Journal of Psychotraumatology 8, 1353383.CrossRefGoogle ScholarPubMed
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry 52, 10481060.CrossRefGoogle ScholarPubMed
Lai, B. S., La Greca, A. M., Auslander, B. A., & Short, M. B. (2013). Children's symptoms of posttraumatic stress and depression after a natural disaster: Comorbidity and risk factors. Journal of Affective Disorders 146, 7178.10.1016/j.jad.2012.08.041CrossRefGoogle ScholarPubMed
Lowe, S. R., Blachman-Forshay, J., & Koenen, K. C. (2015). Trauma as a public health issue: Epidemiology of trauma and trauma-related disorders. In Evidence based treatments for trauma-related psychological disorders: A practical guide for clinicians, (pp. 1140). Cham, Switzerland: Springer International Publishing.Google Scholar
Lowe, S. R., Galea, S., Uddin, M., & Koenen, K. C. (2014). Trajectories of posttraumatic stress among urban residents. American Journal of Community Psychology 53, 159172.CrossRefGoogle ScholarPubMed
Lowe, S. R., Joshi, S., Galea, S., Aiello, A. E., Uddin, M., Koenen, K. C., & Cerdá, M. (2017). Pathways from assaultive violence to posttraumatic stress, depression, and generalized anxiety symptoms through stressful life events: Longitudinal mediation models. Psychological Medicine 47, 25562566. doi:10.1017/S0033291717001143CrossRefGoogle Scholar
Matsuoka, Y., Nishi, D., Nakajima, S., Yonemoto, N., Hashimoto, K., Noguchi, H., … Kim, Y. (2009). The Tachikawa cohort of motor vehicle accident study investigating psychological distress: Design, methods and cohort profiles. Social Psychiatry and Psychiatric Epidemiology 44, 333340.CrossRefGoogle ScholarPubMed
McLaughlin, K. A., Koenen, K. C., Hill, E. D., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2013). Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child & Adolescent Psychiatry 52, 815830. e14.CrossRefGoogle Scholar
Mouthaan, J., Sijbrandij, M., Luitse, J. S., Goslings, J. C., Gersons, B. P., & Olff, M. (2014). The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms. Psychoneuroendocrinology 45, 179186.CrossRefGoogle ScholarPubMed
Muthén, L., & Muthén, B. (1998). Mplus user's guide, 7th Edn, Los Angeles. CA: Muthén & Muthén 2012.Google Scholar
Muzik, M., McGinnis, E. W., Bocknek, E., Morelen, D., Rosenblum, K. L., Liberzon, I., … Abelson, J. L. (2016). PTSD Symptoms across pregnancy and early postpartum among women with lifetime PTSD diagnosis. Depression and Anxiety 33, 584591.10.1002/da.22465CrossRefGoogle ScholarPubMed
Nash, W. P., Boasso, A. M., Steenkamp, M. M., Larson, J. L., Lubin, R. E., & Litz, B. T. (2015). Posttraumatic stress in deployed marines: Prospective trajectories of early adaptation. Journal of Abnormal Psychology 124, 155.CrossRefGoogle ScholarPubMed
Nickerson, A., Aderka, I. M., Bryant, R. A., & Hofmann, S. G. (2012). The relationship between childhood exposure to trauma and intermittent explosive disorder. Psychiatry Research 197, 128134.10.1016/j.psychres.2012.01.012CrossRefGoogle ScholarPubMed
Norris, F. H., Tracy, M., & Galea, S. (2009). Looking for resilience: Understanding the longitudinal trajectories of responses to stress. Social Science & Medicine 68, 21902198.CrossRefGoogle ScholarPubMed
Olff, M., Langeland, W., Draijer, N., & Gersons, B. P. (2007). Gender differences in posttraumatic stress disorder. Psychological Bulletin 133, 183.CrossRefGoogle ScholarPubMed
Pietrzak, R. H., Feder, A., Singh, R., Schechter, C. B., Bromet, E. J., Katz, C., … Crane, M. (2014). Trajectories of PTSD risk and resilience in world trade center responders: An 8-year prospective cohort study. Psychological Medicine 44, 205219.CrossRefGoogle ScholarPubMed
Pietrzak, R. H., Van Ness, P. H., Fried, T. R., Galea, S., & Norris, F. H. (2013). Trajectories of posttraumatic stress symptomatology in older persons affected by a large-magnitude disaster. Journal of Psychiatric Research 47, 520526.CrossRefGoogle ScholarPubMed
Qi, W., Ratanatharathorn, A., Gevonden, M., Bryant, R., Delahanty, D., Matsuoka, Y., … Seedat, S. (2018). Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): The International Consortium to Predict PTSD (ICPP) project. European Journal of Psychotraumatology 9, 1476442.CrossRefGoogle ScholarPubMed
Rui, P., Kang, K., & Ashman, J. (2016). National Hospital Ambulatory Medical Care Survey: 2016 emergency department summary tables. Available from: https://www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2016_ed_web_tables.pdf.Google Scholar
Shalev, A. Y., Ankri, Y., Israeli-Shalev, Y., Peleg, T., Adessky, R., & Freedman, S. (2012). Prevention of posttraumatic stress disorder by early treatment: Results from the Jerusalem trauma outreach And prevention study. Archives of General Psychiatry 69, 166176.CrossRefGoogle ScholarPubMed
Sripada, R. K., Pfeiffer, P. N., Rampton, J., Ganoczy, D., Rauch, S. A., Polusny, M. A., & Bohnert, K. M. (2017). Predictors of PTSD symptom change among outpatients in the US department of veterans affairs health care system. Journal of Traumatic Stress 30, 4553.CrossRefGoogle Scholar
Steenkamp, M. M., Dickstein, B. D., Salters-Pedneault, K., Hofmann, S. G., & Litz, B. T. (2012). Trajectories of PTSD symptoms following sexual assault: Is resilience the modal outcome? Journal of Traumatic Stress 25, 469474.CrossRefGoogle ScholarPubMed
Team, R. C. (2013). R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing.Google Scholar
Van de Schoot, R. (2015). Latent growth mixture models to estimate PTSD trajectories. European Journal of Psychotraumatology 6, 27503.CrossRefGoogle ScholarPubMed
Weathers, F. W., Keane, T. M., & Davidson, J. R. (2001). Clinician-administered PTSD scale: a review of the first ten years of research. Depression & Anxiety, 13, 132156.CrossRefGoogle ScholarPubMed
Weathers, F. W., Ruscio, A. M., & Keane, T. M. (1999). Psychometric properties of nine scoring rules for the clinician-administered posttraumatic stress disorder scale. Psychological Assessment 11, 124.CrossRefGoogle Scholar
Supplementary material: File

Lowe et al. supplementary material

Tables S1-S2 and Figures S1-S3

Download Lowe et al. supplementary material(File)
File 1 MB
14
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *