Trauma Blog

Using registries and electronic health record data to study posttraumatic psychopathology
Date posted: 03/22/2024
Topic: Assessment and Psychometrics
In this blog, we discuss use of registry and electronic health record (EHR) data—considered forms of “big data”—for studying PTSD and other psychiatric conditions in populations after trauma. We discuss strengths and weaknesses of applying these data for research, and give three applied examples from our work, which were presented as part of our symposium at the 2023 ISTSS Annual Meeting.

Grief vs. Depression: Are they related to the bereaved or the deceased?
Date posted: 01/2/2024
Topic: Assessment and Psychometrics
We do not know why, after the loss of a loved one, some people develop depression, while some others may experience a prolonged grief disorder. This blog discusses our recent research on the differential correlates of depression and prolonged grief symptoms in a population-based sample. We found that depressive symptoms are primarily associated with the characteristics of the bereaved, whereas prolonged grief symptoms are primarily associated with the characteristics of the deceased. 

Research Methods: The Case for Nonlinear Dynamic Systems
Date posted: 09/29/2022
Topic: Assessment and Psychometrics
Nonlinear dynamic systems (NDS) is a general theory that describes and predicts changes over time (i.e., dynamics; Gregson & Guastello, 2011). Whereas a linear approach assumes that input is proportional to output, NDS allows us to model sudden changes, such as properly timed jumps from small inputs producing vast changes to a system. Although a substantial body of research has identified variables critical to understanding trauma exposure and its aftereffects—such as factors related to resilience or vulnerability—it often attempts to examine these dynamic constructs in a static, linear fashion. I will briefly discuss why the general linear approach may fall short and how NDS allows us to look at critical variables in ways that capture complex relationships.
 

Outline by Rachel Cusk
StressPoints
Date posted: 05/25/2022
Topic: Assessment and Psychometrics
Recent critiques appearing in respected magazines, Harper’s (Self, 2021), The New Yorker (Sehgal, 2022), and the literary website Lit Hub Daily (Johnson, 2022), have attacked contemporary fiction for portraying the effects of psychological trauma as central to the development of their characters’ personalities and motivations and, in the case of autobiographical works, as decisive factors in the authors’ own lives. Sehgal and Self each express concern that the weight given to psychological trauma in recent works supplants older narrative traditions which they hold to reflect a higher level of complexity and sophistication. In addition, both Sehgal and Self seem dubious about the legitimacy of posttraumatic stress disorder as defined in the Diagnostic and Statistical Manual of the American Psychiatric Association. They contend that the signs and symptoms described are culturally determined phenomena rather than universal human reactions.

Do disorders comorbid with PTSD differ between servicemen and women?
Date posted: 04/19/2022
Topic: Assessment and Psychometrics
Psychological comorbidity, or when mental health disorders co-occur, is an important health issue because it is common and may negatively affect quality of life and treatment for individuals with more than one disorder. Approximately 80% of both civilians and active duty military service members with posttraumatic stress disorder have a comorbid disorder. Further understanding which comorbid disorders most commonly present with PTSD—and among whom—is critical for developing treatments that directly address these symptom presentations to improve functioning for those with psychological comorbidity. 

SIG Spotlight: The “Middle-Out” Approach to Conceptualizing (and Reconceptualizing) Traumatic Stress
StressPoints
Date posted: 03/31/2022
Topic: Assessment and Psychometrics
The diagnostic criteria for posttraumatic stress disorder (PTSD) in the DSM-5 have become the most inherently complex to date, with 20 possible symptoms, four factors (with some studies recommending seven factors), and 636,120 different symptom combinations (Armour et al., 2016; Galatzer-Levy & Bryant, 2013). In addition to this complexity and heterogeneity, issues of comorbidity have become more common with PTSD than with any other psychiatric disorder (Koenen et al., 2008). For example, approximately half of those with PTSD have a comorbid diagnosis of a depressive disorder (Elhai et al., 2008; Flory & Yehuda, 2015). This diagnostic murkiness raises sobering questions, ranging from the internal coherence, structure, and dimensionality of PTSD to broader nosological issues regarding the logic and methods by which psychiatric disorders are identified, differentiated, and classified. Many categorical diagnostic criteria were constructed to maximize clinical utility. Nevertheless, their relative utility for other research applications, including theory-building; measurement; nosology; and investigations into the etiology, clinical course of, and discriminability between diagnostic constructs, remain questionable as diagnostic classifications often do little to “carve nature at the joints” (Zachar & Kendler, 2017). The release of both DSM-5-TR and ICD-11 this year, including the introduction of a new prolonged grief disorder (PGD) in each, underscores the need to clarify clinically important distinctions between related diagnostic entities (e.g., PTSD vs. PGD), as well as to ensure that their internal structures (i.e., dimensionality) and resulting complexity (think diagnostic permutations) does not expand beyond what is truly useful.

Developmental Traumatology: Schools as a Context for Children’s Recovery After Climate ‎Change-Related Disasters
StressPoints
Date posted: 01/27/2022
Topic: Assessment and Psychometrics
Climate-related disasters have devastating effects for entire communities, but disproportionately impact certain populations, including school-aged children (Ersoy & Kocak, 2016; Raker et al., 2020). In this article, we consider children’s disaster-related mental health as it relates to school environments, which are both potentially supportive and particularly vulnerable settings in post-disaster contexts.

Media Matters: Could Your Body or Brain Be Putting You at Increased Risk for Developing Psychiatric ‎Symptoms Following Certain Media Consumption?‎
StressPoints
Date posted: 01/27/2022
Topic: Assessment and Psychometrics
Many of the Media Matters pieces in StressPoints have examined the way different media platforms enable increased ease of access and frequency of portraying traumatic events (e.g., images or video footage of war, terrorism, mass casualties, natural events). Although there are mixed results in the literature, there is evidence to indicate that viewing portrayals of traumatic events in the media could lead to increased symptoms of posttraumatic stress disorder (PTSD; Holman et al., 2020). 

Developmental Traumatology: Trauma and Fetal Alcohol Exposure: Neurodevelopmental ‎Implications
StressPoints
Date posted: 07/29/2021
Topic: Assessment and Psychometrics
As awareness of how childhood trauma affects neurodevelopment grows, questions arise about symptom complexity and how neurodevelopment is affected by other comorbid conditions. Youth exposed to toxic stress from early, severe and/or chronic maltreatment can show alterations in brain structure and connectivity that impact cognition, emotion regulation and stress reactivity (Teicher & Samson, 2016). However, neurodevelopment is also influenced by genetics and other types of adversity, including in utero exposure to substances. As child maltreatment co-occurs frequently with parental substance use and prenatal alcohol exposure, understanding the relationship between the two is important to differential diagnosis and treatment.

Media Matters: Next-Generation 911 Technology and Potential Impacts on First Responder Mental Health
StressPoints
Date posted: 05/27/2021
Topic: Assessment and Psychometrics
Emergency medical services in the United States currently rely primarily on audio calls and location data to respond to emergencies. With the increasing use of other means of communication such as text messages and video calls, however, communications centers are moving towards incorporating Next-Generation 911 (NG911) technology that allows callers to share texts, photos, and video with communications personnel. This enhanced medium of communication has potential advantages and disadvantages, just as the expansion of other media platforms have increased accessibility to information while also potentially increasing psychological distress related to these events (see previous Media Matters in StressPoints for review: Massa & Jones, 2020).