Risk and resilience in trajectories of post-traumatic stress symptoms among first responders after the 2011 Great East Japan Earthquake: 7-year prospective cohort study

Saito, Taku; Does, Florentine H S van der; Nagamine, Masato; Wee, Nic J. van der; Shigemura, Jun; Yamamoto, Taisuke; Takahashi, Yoshitomo; Koga, Minoru; Toda, Hiroyuki; Yoshino, Aihide; Vermetten, Eric; Giltay, Erik J.

doi:10.1192/bjp.2022.2

Cited by 8 publications

(11 citation statements)

References 26 publications

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“…In a 7-year prospective cohort study, five symptom severity trajectories were identified: resilient (54.7%), recovery (24.5%), incomplete recovery (10.7%), late-onset (5.7%), and chronic (4.3%). 51 In the overview above, several overlapping results have been reported regarding the longitudinal course of PTSD. This results in several perspectives.…”

Section: Chronological Course Of the Disordermentioning

confidence: 99%

“…The largest study using LGMM identifying trajectories was performed on 56,388 first responders who were part of the Japan Ground Self‐Defense Force involved in the 2011 Great East Japan Earthquake. In a 7‐year prospective cohort study, five symptom severity trajectories were identified: resilient (54.7%), recovery (24.5%), incomplete recovery (10.7%), late‐onset (5.7%), and chronic (4.3%) 51 …”

Section: State‐of‐the‐artmentioning

confidence: 99%

“…In a 7‐year prospective cohort study, five symptom severity trajectories were identified: resilient (54.7%), recovery (24.5%), incomplete recovery (10.7%), late‐onset (5.7%), and chronic (4.3%). 51 …”

Section: State‐of‐the‐artmentioning

confidence: 99%

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Toward staging differentiation for posttraumatic stress disorder treatment

Nijdam

Vermetten

McFarlane

2022

Acta Psychiatr Scand

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Objectives Several medical and psychiatric disorders have stage‐based treatment decision‐making methods. However, international treatment guidelines for posttraumatic stress disorder (PTSD) fail to give specific treatment recommendations based on chronicity or stage of the disorder. There is convincing evidence of a finite range of PTSD symptom trajectories, implying that different phenotypes of the disorder can be distinguished, which are highly relevant for a staging typology of PTSD. Methods State‐of‐the‐art review building on prior work on staging models in other disorders as a mapping tool to identify and synthesize toward PTSD. Results We propose a four‐stage model of PTSD ranging from stage 0: trauma‐exposed asymptomatic but at risk to stage 4: severe unremitting illness of increasing chronicity. We favor a symptom description in various chronological characteristics based on neurobiological markers, information processing systems, stress reactivity, and consciousness dimensions. We also advocate for a separate phenomenology of treatment resistance since this can yield treatment recommendations. Conclusion A staging perspective in the field of PTSD is highly needed. This can facilitate the selection of interventions that are proportionate to patients' current needs and risk of illness progression and can also contribute to an efficient framework to organize biomarker data and guide service delivery. Therefore, we propose that a neurobiologically driven trajectory‐based typology of PTSD can help deduct several treatment recommendations leading to a more personalized and refined grid to strategize, plan and evaluate treatment interventions.

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Section: Chronological Course Of the Disordermentioning

confidence: 99%

Section: State‐of‐the‐artmentioning

confidence: 99%

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Toward staging differentiation for posttraumatic stress disorder treatment

Nijdam

Vermetten

McFarlane

2022

Acta Psychiatr Scand

Self Cite

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“…7,8,9,10 Recent research has therefore focused on analyzing trajectories of PTSS after traumatic events. 11,12,13,14,15,16,17 Trajectories of PTSS are usually classified into four types: resilient, chronic, recovery, and delayed-onset. 11, 13, 14, 16 The resilient type shows stable low or no PTSD severity.…”

Section: Introductionmentioning

confidence: 99%

Pre-event psychiatric states predict trajectories of post-traumatic stress symptoms during the COVID-19 pandemic

Nakai,

Kubo,

Oka

et al. 2024

Preprint

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Recent time-dependent analyses of stress-related disorders have identified heterogeneity of trajectories and their modifying factors. While psychiatric patients are vulnerable to stress events, it is unclear how psychiatric conditions in the general population modulate subsequent stress responses. Using our longitudinal online survey from before the COVID-19 pandemic to post-pandemic follow-ups (n = 3815 Japanese adults), here we identified four trajectories of post-traumatic stress symptoms (PTSS) a latent growth mixture model; resilient, chronic, mild chronic, and early response. The depression/anxiety were identified as specific risk factors for the early-response trajectory. In contrast, general psychiatric burden and social withdrawal were identified as common risk/protective factors. Further, we estimated "baseline" PTSS to determine the predictability of the PTSS prognosis from pre-pandemic states. The chronic group showed significantly higher baseline PTSS scores than the mild-chronic and early-response groups, both of which were significantly higher than the resilient group. We concluded that prior psychiatric conditions significantly affect the PTSS trajectory. These results suggest that prior psychiatric conditions may be considered for the prevention and treatment of maladaptive stress responses.

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“…7,8,9,10 Recent research has therefore focused on analyzing trajectories of PTSS after traumatic events. 11,12,13,14,15,16,17 Trajectories of PTSS are usually classi ed into four types: resilient, chronic, recovery, and delayedonset. 11,13,14,16 The resilient type shows stable low or no PTSD severity.…”

Section: Introductionmentioning

confidence: 99%

Pre-event psychiatric states predict trajectories of post-traumatic stress symptoms during the COVID-19 pandemic

Chiba,

Kubo,

Nakai

et al. 2024

Preprint

View full text Add to dashboard Cite

Recent time-dependent analyses of stress-related disorders have identified heterogeneity of trajectories and their modifying factors. While psychiatric patients are vulnerable to stress events, it is unclear how psychiatric conditions in the general population modulate subsequent stress responses. Using our longitudinal online survey from before the COVID-19 pandemic to post-pandemic follow-ups (n = 3815 Japanese adults), here we identified four trajectories of post-traumatic stress symptoms (PTSS) a latent growth mixture model; resilient, chronic, mild chronic, and early response. The depression/anxiety were identified as specific risk factors for the early-response trajectory. In contrast, general psychiatric burden and social withdrawal were identified as common risk/protective factors. Further, we estimated “baseline” PTSS to determine the predictability of the PTSS prognosis from pre-pandemic states. The chronic group showed significantly higher baseline PTSS scores than the mild-chronic and early-response groups, both of which were significantly higher than the resilient group. We concluded that prior psychiatric conditions significantly affect the PTSS trajectory. These results suggest that prior psychiatric conditions may be considered for the prevention and treatment of maladaptive stress responses.

show abstract

Risk and resilience in trajectories of post-traumatic stress symptoms among first responders after the 2011 Great East Japan Earthquake: 7-year prospective cohort study

Cited by 8 publications

References 26 publications

Toward staging differentiation for posttraumatic stress disorder treatment

Toward staging differentiation for posttraumatic stress disorder treatment

Pre-event psychiatric states predict trajectories of post-traumatic stress symptoms during the COVID-19 pandemic

Pre-event psychiatric states predict trajectories of post-traumatic stress symptoms during the COVID-19 pandemic

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