Dimensional structure of posttraumatic stress disorder symptoms after cardiac arrest

Presciutti, Alex; Frers, Amy; Sumner, Jennifer A.; Anbarasan, Deepti; Roh, David; Park, Soo‐Jin; Claassen, Jan; Shaffer, Jonathan A.; Agarwal, Sachin

doi:10.1016/j.jad.2019.03.064

Cited by 9 publications

(3 citation statements)

References 32 publications

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“…Results of the current study build on a large body of confirmatory factor analytic research supporting the five-factor dysphoric arousal model of PTSD symptoms (Armour et al, 2016), and it extends it to a sample of postpartum women. Even though all three models tested fited the data well, as in other CFA studies of PTSD (e.g., Presciutti et al, 2019;Sumner et al, 2014), we found that the five-factor dysphoric arousal model provided optimal fit. Our study thus supports a more nuanced approach to the underlying structure of PTSD in postpartum women compared to the few extant studies in perinatal samples that supported either two-factor (Reichenheim et al, 2018) or four-factor (Gelaye et al, 2017) models.…”

Section: Discussionsupporting

confidence: 70%

“…While a fair amount of research has focused on PTSD symptom dimensions among veterans (Harpaz-Rotem et al, 2014;Pietrzak et al 2010;Tsai et al, 2015) and civilian populations such as World Trade Center responders (Pietrzak et al, 2014) and cardiac arrest patients (Presciutti et al, 2019), minimal research has examined the dimensionality of PTSD in postpartum women. Two recent studies examined PTSD symptom structure in perinatal populations (Gelaye et al, 2017;Reichenheim et al, 2018), with mixed results.…”

Section: Introductionmentioning

confidence: 99%

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Elucidating posttraumatic stress symptom dimensions and health correlates among postpartum women

Thomas

Cleveland

Pietrzak

et al. 2021

Journal of Affective Disorders

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Background: Posttraumatic stress disorder (PTSD) is associated with interpersonal dysfunction and adverse maternal health during the perinatal period (extending from conception through one year postpartum). However, PTSD is a heterogeneous disorder, and little is known about which aspects of this disorder may be particularly deleterious to the health of new mothers. Such data may inform more personalized approaches to PTSD prevention and treatment among postpartum women. Methods: Using confirmatory factor analysis, we compared three models of PTSD symptom structure-the fourfactor dysphoria model, four-factor emotional numbing model, and five-factor dysphoric arousal model-in 1,663 postpartum women from the Community and Child Health Network (CCHN). We examined associations between PTSD symptom dimensions of the best-fitting model with four correlates relevant to maternal health and functioning-parenting stress, partner relationship stress, relationship satisfaction, and contraceptive use.Results: Though all models fit well, the five-factor dysphoric arousal model provided optimal fit. Symptom dimensions from this model-re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal-evidenced differential associations with the maternal health indicators. Numbing symptoms were most strongly associated with indicators of poor interpersonal functioning, whereas dysphoric arousal symptoms were most strongly related to low-efficacy contraceptive use. Limitations: Our cross-sectional study assessed DSM-IV PTSD symptoms. Conclusions: PTSD symptoms among postpartum women are best-represented by five factors. Numbing symptoms (e.g., restricted affect, detachment) are most strongly associated with interpersonal difficulties, whereas dysphoric arousal symptoms (e.g., agitation, irritability) are linked with low-efficacy contraceptive use. Screening for these symptoms may help promote the health of new mothers.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Elucidating posttraumatic stress symptom dimensions and health correlates among postpartum women

Thomas

Cleveland

Pietrzak

et al. 2021

Journal of Affective Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

“…6 This five-factor model has demonstrated a better fit to DSM-IV PTSD symptom data in a broad range of trauma survivors. 5,7,8 It is also reflected in contemporary structural models of DSM-5 PTSD symptoms. 9,10 This model has also yielded stronger associations with external measures of psychopathology than less nuanced phenotypic models.…”

Section: Introductionmentioning

confidence: 99%

Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study

et al. 2021

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Background Accumulating evidence implicates the endocannabinoid system, including variants in the cannabinoid-1 receptor gene ( CNR1), in the pathophysiology of posttraumatic stress disorder (PTSD). The synonymous G1359A variant (rs1049353) in the CNR1 gene has been linked to PTSD in individuals exposed to childhood abuse. In this study, the effects of the rs1049353 genotype and childhood abuse on overall PTSD symptoms, as well as PTSD symptom clusters were examined in order to examine how this interaction relates to the phenotypic expression of this disorder. Method Data were analyzed from 1,372 Caucasian U.S. veterans who participated in the National Health and Resilience in Veterans Study. Multivariable analyses were conducted to evaluate the association between rs1049353 genotype, childhood abuse, and their interaction in relation to PTSD symptoms. Results A significant interaction between rs1049353 genotype and childhood abuse was observed, with A allele carriers with histories of childhood abuse reporting greater severity of PTSD symptoms, most notably anxious arousal, relative to G/G homozygotes. Significant main effects of childhood abuse on overall PTSD symptoms, and re-experiencing, emotional numbing, and dysphoric arousal symptom clusters, as well as of A allele carrier status on anxious arousal symptoms were observed. Conclusions Results of this study replicate prior work and suggest that the rs1049353-by-childhood abuse interaction is particularly associated with the manifestation of anxious arousal symptoms of PTSD. Taken together, these findings underscore the importance of considering the phenotypic heterogeneity of PTSD in gene-environment studies of this multifaceted disorder.

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Psychological Distress After Sudden Cardiac Arrest and Its Impact on Recovery

et al. 2022

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Dimensional structure of posttraumatic stress disorder symptoms after cardiac arrest

Cited by 9 publications

References 32 publications

Elucidating posttraumatic stress symptom dimensions and health correlates among postpartum women

Elucidating posttraumatic stress symptom dimensions and health correlates among postpartum women

Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study

Psychological Distress After Sudden Cardiac Arrest and Its Impact on Recovery

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