A comparison of posttraumatic stress disorder in veterans with and without spinal cord injury. Immediate treatment with propranolol decreases posttraumatic stress disorder two months after trauma Predicting posttraumatic stress symptoms from pretraumatic risk factors: a 2-year prospective follow-up study in firefighters. Posttraumatic stress disorder following assault: the role of cognitive processing, trauma memory, and appraisals. Posttraumatic stress disorder after injury: does admission to intensive care unit increase risk? Symptoms of traumatic stress in mothers of children victims of a motor vehicle accident. Corticotrophin-Releasing Hormone Type 1 Receptor Gene (CRHR1) Variants Predict Posttraumatic Stress Disorder Onset and Course in Pediatric Injury Patients
The authors assessed effects of  paraplegic and quadriplegic spinal cord injuries ( SCIs )  on posttraumatic stress disorder ( PTSD ) by comparing severity and prevalence of PTSD in these groups to a sample of controls who experienced traumatic injuries other than SCI . The authors found that veterans with quadriplegia reported significantly less severe current PTSD symptoms than controls who were not significantly different from veterans with paraplegia . These results suggest that sustaining a quadriplegic SCI decreases risk of current PTSD , whereas sustaining a paraplegic SCI is associated with greater risk of PTSD , although the risk is no greater than that incurred from experiencing the trauma itself BACKGROUND This study investigated the efficacy of propranolol prescribed shortly after trauma exposure in the prevention of  posttraumatic stress disorder ( PTSD ) symptoms and diagnosis . METHODS Eleven patients received 40 mg of propranolol 3 times daily for 7 days , followed by a taper period of 8 - 12 days . They were compared with eight patients who refused propranolol but agreed to participate in the study . Though nonr and omized , the two groups did not differ on demographics , exposure characteristics , physical injury severity , or peritraumatic emotional responses . RESULTS Posttraumatic stress disorder rates were higher in the group who refused propranolol ( 3/8 ) compared with those who received the medication ( 1/11 ) , as were the levels of PTSD symptoms ( U = 85 , p = .037 ) . CONCLUSIONS Our results are consistent with earlier findings and suggest that propranolol may be useful for mitigating PTSD symptoms or perhaps even preventing the development of PTSD OBJECTIVE Most studies focusing on risk factors for posttraumatic stress disorder ( PTSD ) have used retrospective study design s. Only a small number of studies have prospect ively examined risk factors in the immediate aftermath of trauma exposure in predicting PTSD symptoms . The purpose of this study was to identify predictive risk factors for posttraumatic stress symptoms and comorbid psychopathological symptoms present during the time before exposure to traumatic stress in a high-risk population . METHOD Forty-three professional firefighters were assessed immediately after basic training  ( baseline ) and at 6 , 9 , 12 , and 24 months after entry into firefighter service .  Subjects were screened for psychopathological symptoms , including symptoms of PTSD , depression , and anxiety . Subjects were also characterized with regard to personality traits such as self-efficacy , hostility , and alexithymia . Neuroendocrine activity was assessed by examination of awakening and diurnal salivary cortisol profiles and 24-hour urinary catecholamine excretion . Multiple linear regression analysis was used to analyze posttraumatic stress symptoms at 24-month follow-up as a function of pretraumatic characteristics . RESULTS A high level of hostility and a low level of self-efficacy at baseline accounted for 42 % of the variance in posttraumatic stress symptoms after 2 years . Subjects who had both risk factors at baseline showed a significant increase in measures of PTSD symptoms , depression , anxiety , general psychological morbidity , global symptom severity , and alexithymia during the 2-year period . Biological characteristics were not predictive of the development of psychopathological symptoms . CONCLUSIONS These results suggest that specific personality traits may constitute markers of vulnerability to the development of psychopathological symptoms after trauma exposure . Early identification of preexisting risk factors is needed to provide effective prevention and intervention for individuals who are at risk of developing trauma-related disorders Two studies of assault victims examined the roles of ( a ) disorganized trauma memories in the development of posttraumatic stress disorder ( PTSD ) , ( b ) peritraumatic cognitive processing in the development of problematic memories and PTSD , and ( c ) ongoing dissociation and negative appraisal s of memories in maintaining symptomatology . In the cross-sectional study ( n = 81 ) , comparisons of current , past , and no-PTSD groups suggested that peritraumatic cognitive processing is related to the development of disorganized memories and PTSD . Ongoing dissociation and negative appraisal s served to maintain PTSD symptoms . The prospect i ve study ( n = 73 ) replicated these findings longitudinally .  Cognitive and memory assessment s completed within 12-weeks postassault predicted 6-month symptoms . Assault severity measures explained 22 % of symptom variance ; measures of cognitive processing , memory disorganization , and appraisal s increased prediction accuracy to 71 % BACKGROUND This study aim ed to index the prevalence of posttraumatic stress disorder ( PTSD ) after injury requiring intensive care unit ( ICU ) admission to investigate whether an ICU admission after injury increases risk for PTSD and to identify predictors of PTSD after ICU admission . METHODS A two-group ( those admitted to the ICU vs. those not admitted to ICU ) , prospect i ve , cohort study of 829 r and omly selected injury patients from five major trauma hospitals across Australia . We collected information on factors that may increase risk for PTSD including demographic variables ( gender , age , income , education , and marital status ) , preinjury mental health status ( prior trauma , psychiatric history , and prior social support ) , and injury characteristics ( mild traumatic brain injury , injury severity , length of hospital admission , discharge destination , pain , and perceived threat ) . PTSD was measured at 12 months by structured clinical interview .  RESULTS ICU patients were significantly more likely to have PTSD at 12 months than trauma controls ( 17 % vs. 7 % ) . Stepwise logistic regressions showed that an ICU admission significantly contributed to the development of PTSD after controlling for demographic , preinjury mental health status , and injury characteristic variables . CONCLUSIONS Injury patients are three times more likely to develop later PTSD if they have an ICU admission . Given we controlled for many risk variables , it seems that an ICU admission itself may contribute to the development of PTSD . Mental health services such as screening and early intervention may be particularly useful for this population BACKGROUND Motor vehicle accidents ( MVAs ) are the main cause of Posttraumatic stress disorder ( PTSD ) in industrialized countries . This includes the frequently occurring but understudied situation of parents learning that their children were injured . However , unlike in other types of trauma survivors , little is known about the predictors of PTSD symptoms in mothers whose child has suffered an MVA . METHODS A group of 72 mothers and 28 fathers were prospect ively assessed for peritraumatic distress , peritraumatic dissociation , and PTSD symptoms 1 and 5 weeks after their child had suffered an MVA . RESULTS Levels of peritraumatic distress and dissociation were comparable to other trauma victims , 18 % of the mothers were considered to be suffering from probable PTSD . In mothers , significant positive correlations were found between PTSD symptoms and peritraumatic distress ( r=.34 ) and dissociation ( r=.37 ) , whereas mothers ' PTSD symptoms were associated with decreased peritraumatic dissociation in fathers ( r=-.37 ) . Even after controlling for covictim/witness status , peritraumatic distress was a predictor of mothers ' PTSD symptoms , explaining 14 % of the variance . CONCLUSIONS Peritraumatic response and PTSD symptoms should be routinely assessed among parents whose child has experienced a traumatic event Posttraumatic stress disorder ( PTSD ) is a common and disabling anxiety disorder that may occur in the aftermath of exposure to potentially traumatic life events . PTSD is moderately heritable , but few specific molecular variants accounting for this heritability have been identified . Genes regulating the hypothalamic-pituitary-adrenal ( HPA ) axis , such as corticotrophin-releasing hormone type 1 receptor gene ( CRHR1 ) , have been implicated in traumatic-stress related phenotypes but have yet to be studied in relation to PTSD . The present study sought to examine the relation between 9 single nucleotide polymorphisms ( SNPs ) in the CRHR1 gene and posttraumatic stress symptoms in a prospect i ve study of pediatric injury patients ( n = 103 ) who were first assessed in the acute aftermath of their injury at the hospital . Results indicated that multiple SNPs were associated with acute symptoms at a univariate level , and after correction for multiple testing , rs12944712 was significantly related to acute PTSD symptoms . Longitudinal latent growth curve analyses suggest that rs12944712 is also related to both acute symptom level and trajectory of symptoms over time . The present study adds support for the role of CRHR1 in the stress response following potentially traumatic event exposure in youth . It should be noted that the sample size in this study was small , and therefore statistical power was low ; following , results from this study should be considered preliminary . Although results are not definitive , the findings from this study warrant future replication studies on how variation in this gene relates to response to traumatic event exposure in youth
Conclusion : Combinations of peri- and post-injury factors appear to be influential in the development of PTSD among persons with SCI .
Objectives : To summarise quantitatively the available evidence relating to pretraumatic , peritraumatic and posttraumatic characteristics that may increase or decrease the risk of developing posttraumatic stress disorder ( PTSD ) following spinal cord injury ( SCI ) .