Premium
The Dynamic Relations Among Peritraumatic Posttraumatic Stress Symptoms: An Experience Sampling Study During Wartime
Author(s) -
Gelkopf Marc,
Lapid Pickman Liron,
Carlson Eve B.,
Greene Talya
Publication year - 2019
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22374
Subject(s) - arousal , posttraumatic stress , mood , psychology , intrusion , psychiatry , clinical psychology , medicine , geochemistry , neuroscience , geology
The associations among peritraumatic posttraumatic stress symptoms (P‐PTSS) in the immediate aftermath of trauma exposure, including those in the posttraumatic stress disorder clusters of intrusions, avoidance, negative cognitions and mood (NCM), and arousal, might indicate mechanisms through which enduring PTSD develops. During a period of war, exposed participants ( N = 181) were sent twice‐daily questionnaires for 30 days via smartphone. We repeatedly assessed the predictive associations between the P‐PTSS clusters over time. We performed a multilevel pathway analysis built of multiple triple sequence responses (6,221 cases) on each of the four P‐PTSS clusters at a mean time lag of 12 hr (Model A) and 24 hr (Model B) for 181 participants, 85 of whom had been diagnosed with a serious mental illness. Arousal predicted intrusion in Models A and B, b A = 0.08, 95% CI [0.03, 0.12], p < .001 and b B = 0.03, 95% CI [0.00, 0.07], p = .051, respectively; and NCM in Models A and B, b A = 0.09, 95% CI [0.05, 0.12], p < .001 and b B = 0.06, 95% CI [0.03, 0.09], p < .001, respectively. Intrusion predicted arousal in Model B, b B = 0.05, 95% CI [0.01, 0.08], p = .010. NCM predicted arousal, b A = 0.10, 95% CI [0.05, 0.14], p < .001, and avoidance b A = 0.05, 95% CI [0.00, 0.11], p = .052, in Model A. Avoidance did not predict any other cluster. Arousal seemed to be acting as a hub, strengthening feedback loops to and from NCM and intrusion.