Understanding Onset, Dynamic Transitions, and Associated Inequality Risk Factors for Adverse Posttraumatic Neuropsychiatric Sequelae After Trauma Exposure
Year: 2024
Type: article
Abstract: Objective: Several gaps remain in the understanding of the onset, dynamic transitions, and associated risk factors of adverse posttraumatic neuropsychiatric sequelae (APNS) in the acute post-trauma window. Based on serial assessments of symptoms from a large cohort study, we identified homogeneous statuses across multiple APNS symptom domains and investigated the dynamic transitions among these statuses during the first 2 months after trauma exposure. Furthermore, we studied how symptom onset and transitions are affected by equity-relevant characteristics. Methods: The analysis was based on 2557 participants enrolled in the Advancing Understanding of RecOvery afteR traumA (AURORA). APNS symptoms comprised pain, depression, sleep discontinuity, nightmares, avoidance, re-experience, anxiety, hyperarousal, somatic symptoms, and mental fatigue. We identified the homogeneous status of APNS symptoms at baseline, 1 month, and 2 months, and explored transition probabilities among these statuses using latent transition analysis. Equity-relevant characteristics included gender, race, education, family income, childhood trauma, and area deprivation. Results: Three homogeneous statuses-low-, moderate-, and severe-symptom-were identified. While the majority of trauma survivors with severe- or moderate-symptom status maintained the same status over time, some transitioned to a less severe symptom status, particularly within the first month. Specifically, females, non-whites, and those with higher childhood trauma were associated with a decreased likelihood of transitioning to a less severe symptom status. From one to 2 months, lower income was associated with a decreased likelihood of transitioning from moderate-to low-symptom status. Conclusions: The findings can inform early intervention strategies for APNS, potentially reducing health disparities among trauma survivors.
Authors: Chiyoung Lee, Stacey L. House, Francesca L. Beaudoin, Thomas C. Neylan, Gari D. Clifford, Sarah D. Linnstaedt, Laura T. Germine, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey, Phyllis L. Hendry, Sophia Sheikh, Brittany E. Punches, Robert A. Swor, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Erica Harris, Claire Pearson, David A. Peak, Robert M. Domeier, Niels K. Rathlev, Brian J. O'Neil, Paulina Sergot, Leon D. Sanchez, Steven E. Bruce, John F. Sheridan, Steven E. Harte, Karestan C. Koenen, Ronald C. Kessler, Samuel A. McLean, Qing Yang, Xinming An
Institutions: Georgia Institute of Technology, University of Arizona, Emory University, University of California, San Francisco, Brown University, Washington University in St. Louis, The Wallace H. Coulter Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Harvard University, McLean Hospital, University of Massachusetts Chan Medical School, Vanderbilt University Medical Center, Henry Ford Health, Henry Ford Hospital, Indiana University Indianapolis, Indiana University School of Medicine, University of Florida, The Ohio State University, Oakland University, University of Pennsylvania, Jefferson Einstein Philadelphia Hospital, Wayne State University, Massachusetts General Hospital, Trinity Health Michigan, Trinity Health Ann Arbor Hospital, Baystate Medical Center, Detroit Receiving Hospital, The University of Texas Health Science Center at Houston, Brigham and Women's Hospital, University of Missouri–St. Louis, The Ohio State University Wexner Medical Center, University of Michigan, Michigan Medicine, Duke University
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,120
Funders: National Science Foundation, U.S. Department of Justice, U.S. Department of Veterans Affairs, Bill and Melinda Gates Foundation, Robert Wood Johnson Foundation, Gordon and Betty Moore Foundation, Henry J. Kaiser Family Foundation, MAYDAY Fund, Brigham and Women's Hospital, American Psychiatric Association, Blue Cross and Blue Shield of Florida Foundation, Jackson Laboratory, Microsoft Research, Google, University of Missouri, Harvard University, Frances McClelland Institute for Children, Youth, and Families, Jazz Pharmaceuticals, Rainwater Charitable Foundation, Verily Life Sciences, One Mind, European Commission, National Institutes of Health, Substance Abuse and Mental Health Services Administration, Samsung, University of North Carolina at Chapel Hill, Medical School, University of Michigan, College of Dentistry, Ohio State University, National Institute on Aging, National Institute of Mental Health, Medical Research and Materiel Command
OpenAlex ID: W4404112664