TY - JOUR
T1 - Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: Pooled results from the International Consortium to predict PTSD
AU - Lowe, Sarah R.
AU - Ratanatharathorn, Andrew
AU - Lai, Betty S.
AU - van der Mei, Willem
AU - Barbano, Anna C.
AU - Bryant, Richard A.
AU - Delahanty, Douglas L.
AU - Matsuoka, Yutaka J.
AU - Olff, Miranda
AU - Schnyder, Ulrich
AU - Laska, Eugene
AU - Koenen, Karestan C.
AU - Shalev, Arieh Y.
AU - Kessler, Ronald C.
PY - 2020
Y1 - 2020
N2 - 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.MethodsThis 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.ResultsFive 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.ConclusionsThe 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.
AB - 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.MethodsThis 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.ResultsFive 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.ConclusionsThe 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.
KW - Latent class growth analysis
KW - posttraumatic stress
KW - resilience
KW - traumatic injuries
UR - http://www.scopus.com/inward/record.url?scp=85078914959&partnerID=8YFLogxK
U2 - https://doi.org/10.1017/S0033291719004008
DO - https://doi.org/10.1017/S0033291719004008
M3 - Article
C2 - 32008580
SN - 0033-2917
JO - Psychological Medicine
JF - Psychological Medicine
ER -