The physical health consequences of posttraumatic stress

Maria PacellaThe relation between posttraumatic stress and physical health is a fascinating one. On my ‘talent hunt’ at the ISTSS conference, I met Maria Pacella, who is currently completing her doctoral degree in Health Psychology at Kent State University, Ohio, USA. She examines the relation between traumatic stress and the development of mental and physical health problems in adults. Some fresh new findings below!

The following research describes a recent meta-analysis synthesizing the literature regarding PTSD/PTSD symptoms (PTSS) and comorbid physical health complaints. Related research conducted with samples of motor vehicle accident victims and people living with HIV is also discussed. For more information about our ongoing research studies, please see the Delahanty Stress and Health Lab website.

1. PTSD is associated with poor physical health

The relationship between PTSD and co-occurring mental health conditions — such as depression, substance use, and general anxiety — has received much attention in the literature. However, it is equally important to consider the impact of PTSD on physical health functioning. Given the biological alterations associated with PTSD, individuals with this disorder may be vulnerable to the development of, or worsening of, certain physical health conditions. A better understanding of the physical health consequences of PTSD will inform prevention and treatment practices, thereby reducing the economic burden created by the disorder.

Recently, we conducted a meta-analysis on the results of 62 empirical articles examining the relationship between PTSD and six physical health outcomes. Results revealed that individuals with PTSD suffered from greater health complaints in the following domains: Continue reading

The efficacy of cognitive behavioral therapy for children with PTSD

This week, we discuss a recent meta-analysis by Kowalik et al, which will also be input to a live Twitter journal club / chat. If you would like to join or just want to read the comments, have a look at #traumaresearch on Thursday February 23rd 10pm GMT (= 5pm New York, 23h Amsterdam, Friday 9am Melbourne).

Cognitive Behavioral Therapy (CBT) is probably the most used, or at least most recommended, treatment for children with Posttraumatic Stress Disorder (PTSD). As I am quite fond of systematic reviews and meta-analyses, the new meta-analysis on the efficacy of trauma focused CBT by Kowalik and colleagues quickly grabbed my attention. Although (and because?) I have a few critical questions regarding the publication, I think it merits attention from researchers and clinicians. Continue reading

4 Meta-analyses of predictors of PTSD in children: An overview

One of the main questions of child trauma psychologists is which children are most vulnerable for PTSD after a traumatic event. The answer would help us to develop interventions that address causes of distress and to focus on the children most in need.

Recently, a fourth meta-analysis on predictors of posttraumatic stress in children has been published, which makes it interesting to compare findings and methods (yes, in that order, for busy people). It gives clinicians insight in risk factors for PTSD and it shows academics what needs to be studied in the next few years.

These are the four meta-analyses I know of, published over a period of 6 years: Kahana et al. (2006), Cox et al. (2008), Alisic et al. (2011), and Trickey et al. (2012). In a nutshell, the reviews combined correlational effect sizes to see which risk factors are associated with children’s posttraumatic stress symptoms. Their methods varied, which I will summarize below, but the findings converge to a number of interesting conclusions. Continue reading

Does intervening early after trauma help children recover?

In 2012, the blog weekly features a summary or discussion of a recent scientific article on traumatic stress in children. This week: Kramer & Landolt (Dec 2011) about early interventions.

When children are exposed to a single traumatic event such as a car accident, a violent incident, or a disaster, many of them will recover naturally. However, a significant minority has difficulty getting back on track: 10 to 30% of the exposed children develop chronic symptoms, including Posttraumatic Stress Disorder (PTSD).

Can we intervene early to help children recover? Systematic reviews on the efficacy of early single interventions in adults have shown either no or even harmful effects so far. In particular psychological debriefing, where survivors are asked to ventilate their emotions, cause concerns. For example, Rose et al. (2009) concluded in their meta-analysis that compulsory psychological debriefing of adults should cease.   Continue reading

Predictors of PTSD in children and adults

We know that traumatic events occur quite often. We also know that most people are resilient, even though many survivors experience some distress in the direct aftermath of an event. Only a minority will develop longer-term stress symptoms. What are their characteristics? Who is ‘at risk’ after trauma? If we know the answer, we can target mental health care services to the survivors who are most in need.

In the last 30 years, more and more research has been published on predictors of posttraumatic stress. Mainly in adults, but also in children. Continue reading