Peritraumatic Distress and the Course of Posttraumatic Stress Disorder Symptoms: A Meta-Analysis

Abstract

Objective: To examine how peritraumatic distress modulates the severity of posttraumatic stress disorder (PTSD) according to the timing of the PTSD symptom assessments. Method:A systematic literature review of English-and French-language studies having administered the Peritraumatic Distress Inventory (PDI) was conducted. Meta-analyses were performed on correlations relating PDI and PTSD symptom scores obtained from the sampled studies. The meta-analyses, which included calculations of regression slopes, took into consideration the time at which PTSD symptoms were assessed following the traumatic event and the timing of the PDI assessment. Results:The literature review yielded a total of 22 studies. The meta-analysis performed over all studies resulted in a pooled correlation coefficient of 0.55 between the PDI and PTSD symptom scores. Meta-regression analyses conducted over all data revealed no apparent decrease in the correlations according to the timing of the PTSD symptom assessments. However, there were numerical or statistically significant declines in regression slopes when the meta-regressions were separately conducted on studies having administered the PDI either within, or following, a 1-month period after a traumatic event.Conclusions: While PDI or PTSD symptom score correlations remain generally significant, they tend to decline as time elapses between the traumatic event and the PTSD assessment. This suggests there may be factors other than peritraumatic distress that increasingly account for the long-term trajectory PTSD symptoms. W W WObjectif : Examiner comment la détresse péritraumatique module la gravité du trouble de stress post-traumatique (TSPT) selon le choix du moment des évaluations des symptômes du TSPT.Méthode : Une revue systématique de la littérature des études en anglais et en français qui ont administré l'inventaire de détresse péritraumatique (PDI) a été menée. Des méta-analyses ont été exécutées sur les corrélations relatives aux scores de symptômes du PDI et du TSPT obtenus des études échantillonnées. Les méta-analyses, qui comportaient des calculs de pentes des droites de régression, ont pris en considération le moment où les symptômes de TSPT ont été évalués suivant l'événement traumatique et le choix du moment de l'évaluation du PDI.Résultats : La revue de la littérature a produit un total de 22 études. Les méta-analyses effectuées sur toutes les études ont donné un coefficient de corrélation combiné de 0,55 entre les scores de symptômes du PDI et du TSPT. Les analyses de méta-régression menées sur toutes les données n'ont révélé aucune diminution apparente des corrélations selon le choix du moment des évaluations des symptômes du TSPT. Cependant, il y a eu des baisses numériques ou statistiquement significatives des pentes de droites de régression lorsque les méta-régressions ont été menées séparément sur les études qui ont administré le PDI, soit pendant ou suivant une période d'un mois après l'événement traumatique. Conclusions :Bien que les corrélations des scores de sympt...

Peritraumatic dissociation predicts posttraumatic stress disorder symptoms via dysfunctional trauma-related memory among war-affected children

“…The importance of PD in predicting PTSD among these Palestinian children concurs with adult survivors of war and peace-time traumas (Lensvelt-Mulders et al, 2008; Thomas et al, 2012) but differs from some findings among children exposed to single peace-time trauma (Dalgleish et al, 2008). The importance of PD as a severe risk for PTSD symptoms among war-affected Palestinian children may lie in the chronicity of life threat and adversities.…”

“…Research suggests pre-, peri-, and post-trauma responses to be decisive for the development of PTSD (Olff et al, 2015), with acute stress disorder (ASD) and peritraumatic dissociation (PD) playing an important role (Kassam-Adams et al, 2012). Among adults there is evidence about PD predicting PTSD (for a meta-analysis, see Lensvelt-Mulders et al, 2008; Ozer, Best, Lipsey, & Weiss, 2003), especially in the short run (Thomas, Saumier, & Brunet, 2012; van der Velden & Wittman, 2008). Yet, among children and adolescents evidence is very limited and findings are inconclusive, as some research among young vehicle-accident survivors has confirmed that PD forms a severe risk for PTSD (Bui et al, 2010), while others showed minor importance (Dalgleish et al, 2008).…”

Prediction of Posttraumatic Stress Disorder From Peritraumatic Dissociation and Distress Among Men and Women Victims of Violent Crimes

“…Peritraumatic distress (PDI) refers to emotional and physical stress responses that occur during or immediately after the traumatic event (Thomas, Saumier, & Brunet, 2012). It primarily involves the perception that one's life in endangered as well as the presence of negative emotions such as fear, horror, helplessness, shame and anger.…”

Understanding the relationship between disaster-related prenatal maternal stress and child motor development: The QF2011 Queensland Flood Study

“…The traumatic stress literature shows that peritraumatic reactions play a key role in the development of longer term PTS: distress during or immediately after a traumatic event can predict the development of PTSD symptoms, and dissociation can predict symptom persistence (Brunet et al, 2001;Thomas et al, 2012). However, there is some debate about the strength and nature of this relationship.…”

“…Exposure to a potentially traumatic event can trigger immediate (peritraumatic) reactions of distress or dissociation, and these can predict subsequent posttraumatic stress (Brunet, Weiss, Metzler, Best, & et al, 2001;Thomas, Saumier, & Brunet, 2012). For example, Nishi et al (2010) found that motor vehicle accidents predicted peritraumatic distress, which in turn predicted PRENATAL MATERNAL STRESS AND CHILD MOTOR DEVELOPMENT [37] ongoing posttraumatic stress symptoms.…”