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Trajectories of daily PTSD symptoms in recent traumatic injury victims.

ABSTRACT: OBJECTIVE:Prior research has identified different PTSD symptom (PTSS) trajectories over months and years posttrauma that warrant different levels of clinical attention. Earlier identification of at-risk trauma victims can facilitate efficient and appropriate intervention efforts. METHOD:Using latent class growth analysis, we examined daily PTSS trajectories beginning 6 weeks postinjury in 68 injury victims. Resulting classes were compared on key characteristics at 6 and 21 weeks postinjury. RESULTS:Three trajectories were identified: a nonreactive class (67.8%) with low initial symptom levels that remained low, a moderate-stable class (27.9%) with elevated symptom levels that remained constant, and a severe-increasing class (4.4%) with high symptom levels that increased. CONCLUSIONS:High-risk injury victims can be identified by their daily PTSS, allowing for early identification of those at risk for elevated distress and in greater need for intervention. (PsycINFO Database Record

SUBMITTER: Hruska B

PROVIDER: S-EPMC5083227 | biostudies-literature | 2016 Nov

REPOSITORIES: biostudies-literature

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Trajectories of daily PTSD symptoms in recent traumatic injury victims.

Hruska Bryce B Pacella Maria L ML George Richard L RL Delahanty Douglas L DL

Psychological trauma : theory, research, practice and policy 20160530 6

<h4>Objective</h4>Prior research has identified different PTSD symptom (PTSS) trajectories over months and years posttrauma that warrant different levels of clinical attention. Earlier identification of at-risk trauma victims can facilitate efficient and appropriate intervention efforts.<h4>Method</h4>Using latent class growth analysis, we examined daily PTSS trajectories beginning 6 weeks postinjury in 68 injury victims. Resulting classes were compared on key characteristics at 6 and 21 weeks p ...[more]

PMID: 27243573

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Project description:ImportanceExecutive functions are critical for school and social success. Although these functions are adversely affected by pediatric traumatic brain injury (TBI), recovery patterns are not well established.ObjectiveTo examine 3-year trajectories of selected children's executive functions after TBI.Design, setting, and participantsThis prospective cohort study was conducted from January 22, 2013, to September 30, 2015, with 3-year follow-up at the level I pediatric trauma centers Primary Children's Hospital in Salt Lake City, Utah and Children's Memorial Hermann Hospital in Houston, Texas. Study participants included children aged 2 to 15 years with TBI or orthopedic injury (OI) who were treated at the participating hospitals. Children were consecutively recruited and stratified by injury severity and age group. A total of 625 children consented and completed a baseline survey; 559 (89%) children completed at least 1 follow-up and composed the analysis cohort. It was hypothesized that recovery would differ by injury severity, age at injury, and sex. Data analyses were performed from June to October 2019.Main outcomes and measuresGrowth curve models examined the pattern of change in the Emotional Control, Inhibit, Working Memory, and Plan-Organize subscales of the Behavior Rating Inventory of Executive Function (BRIEF) or BRIEF-Preschool. For all BRIEF subscales, higher scores indicate worse symptoms, and a score of 65 or greater represents clinical impairment.ResultsA total of 559 children (mean [SD] age, 8.6 [4.4] years; 356 boys [64%], 328 non-Hispanic White children [59%]) were included in the study: 155 (28%) children had mild TBI, 162 (29%) had complicated mild or moderate TBI, 90 (16%) had severe TBI, and 152 (27%) had OI. Growth curve trajectories varied by BRIEF subscale and injury severity. Overall, children with TBI did not return to their preinjury baseline, with a stepwise worsening of each outcome at 36 months by TBI severity compared with OI. Among children with severe TBI, trajectories accelerated fastest, indicating increased problems, from injury to 12 months for the Emotional Control (9.0 points; 95% CI, 6.0-11.9 points), Inhibit (3.6 points; 95% CI, 1.6-5.6 points), and Working Memory (7.0 points; 95% CI, 4.1-9.9 points) subscales. Their trajectories plateaued, with a secondary acceleration before 36 months for the Emotional Control and Working Memory subscales. Children with mild TBI had worse 36-month scores on all subscales except Inhibit compared with OI. Recovery patterns were similar for boys and girls.Conclusions and relevanceIn this longitudinal cohort study of children with TBI, trajectory analysis revealed that some children worsen after a recovery plateau, suggesting a need for longitudinal reassessment beyond 1 year postinjury.

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Trajectories of daily PTSD symptoms in recent traumatic injury victims.

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Trajectories of daily PTSD symptoms in recent traumatic injury victims.

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