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Posttraumatic Stress Disorder (PTSD) in the General Population
Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Psychology.
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis explored the epidemiology of Posttraumatic Stress Disorder (PTSD) and different aspects of the disorder. Firstly, we investigated the lifetime prevalence of traumatic experiences and PTSD in the general adult population in Sweden and evaluated the impact of different trauma types, trauma frequency, and perceived distress. The results show that traumatic experiences are common and PTSD is not rare; roughly one out of ten traumatic events results in PTSD, with a 5.6% lifetime prevalence. The female/male ratio is 2:1. The risk for PTSD increases considerably with a high trauma-associated emotional impact. The distressing impact of a given trauma appears to be higher in women than in men, indicating an increased vulnerability in women. Secondly, we hypothesized that traffic road accidents (TRA’s) are one of the most prevalent types of traumatic events in Swedish society; therefore, we examined the impact of event and response characteristics associated with TRA’s on PTSD development. The data demonstrate that of those who had experienced a TRA (n=1074, 58.9%), 6.1% reported lifetime PTSD. TRA’s associated with fatal accidents and injury to oneself and related to high distress more than double the risk for PTSD. Thirdly, we compared the relative merits of the DSM-IV’s three-factor solution for PTSD symptoms to alternative models. We found that the symptomatology is equally well accounted for using all factor analytic models as yet presented in the literature; the DSM-IV, we found, provides as good a fit to data as other models. Fourthly, we examined the neurofunctional correlates of PTSD symptoms and whether a treatment-induced (serotonin reuptake inhibitor - SSRI) reduction of PTSD symptoms is associated with altered rCBF during symptom provocation. Our results indicate that PTSD symptoms correlates with areas involved in memory, emotion, attention, and motor control and that SSRI treatment normalizes provocation-induced rCBF in these areas.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2003. , p. 66
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 0282-7492 ; 129
Keywords [en]
Psychology, posttraumatic stress disorder, trauma, epidemiology, general population, prevalence, traffic road accidents, DSM-structure, positron emission tomography, regional cerebral blood flow, symptom provocation, selective serotonin reuptake inhibitor
Keywords [sv]
Psykologi
National Category
Psychology
Research subject
Clinical Psychology
Identifiers
URN: urn:nbn:se:uu:diva-3528ISBN: 91-554-5697-9 (print)OAI: oai:DiVA.org:uu-3528DiVA, id: diva2:163135
Public defence
2003-10-03, Sal IX, Universitetshuset, Uppsala, 09:15
Opponent
Supervisors
Available from: 2003-09-05 Created: 2003-09-05Bibliographically approved
List of papers
1. Trauma exposure and posttraumatic stress disorder in the general population
Open this publication in new window or tab >>Trauma exposure and posttraumatic stress disorder in the general population
2005 (English)In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 111, no 4, p. 291-299Article in journal (Refereed) Published
Abstract [en]

Objective:  To examine the lifetime prevalence of trauma experiences and post-traumatic stress disorder (PTSD).

Method:  Questionnaire-assessed PTSD, the type of traumatic event experienced, perceived trauma impact, and trauma frequency in 1824 randomly selected men and women.

Results:  PTSD lifetime prevalence was estimated at 5.6% with a 1 : 2 male-to-female ratio, in spite of men reporting greater trauma exposure. The highest PTSD risk was associated with sexual and physical assault, robbery and multiple trauma experiences. Controlling for trauma type did not account for gender differences, while controlling for experienced distress did.

Conclusion:  The conditional probability for PTSD varied as a function of trauma type, frequency and impact of the event, with increased rates associated with prevalent trauma exposure and higher perceived distress. The latter accounted for the gender effect, suggesting that gender differences in PTSD in part represent a generally greater vulnerability to stress in women.

National Category
Psychology
Identifiers
urn:nbn:se:uu:diva-90685 (URN)10.1111/j.1600-0447.2004.00463.x (DOI)15740465 (PubMedID)
Available from: 2003-09-05 Created: 2003-09-05 Last updated: 2017-12-14Bibliographically approved
2. Traffic road accidents, and posttraumatic stress disorder in the general population
Open this publication in new window or tab >>Traffic road accidents, and posttraumatic stress disorder in the general population
(English)Manuscript (preprint) (Other academic)
National Category
Social Sciences
Identifiers
urn:nbn:se:uu:diva-90686 (URN)
Available from: 2003-09-05 Created: 2003-09-05 Last updated: 2014-05-09
3. The structure of posttraumatic stress symptoms: A model fitting approach
Open this publication in new window or tab >>The structure of posttraumatic stress symptoms: A model fitting approach
Manuscript (Other academic)
Identifiers
urn:nbn:se:uu:diva-90687 (URN)
Available from: 2003-09-05 Created: 2003-09-05 Last updated: 2010-01-13Bibliographically approved
4. Brain function in a patient with torture related post-traumatic stress disorder before and after fluoxetine treatment: a positron emission tomography provocation study
Open this publication in new window or tab >>Brain function in a patient with torture related post-traumatic stress disorder before and after fluoxetine treatment: a positron emission tomography provocation study
Show others...
2001 (English)In: Neuroscience Letters, ISSN 0304-3940, E-ISSN 1872-7972, Vol. 297, no 2, p. 101-104Article in journal (Refereed) Published
Abstract [en]

We report positron emission tomographic measurements of regional cerebral blood flow (rCBF) in a male patient with war and torture related post-traumatic stress disorder (PTSD) during symptom provocation. The subject was exposed to war related sounds before and after treatment with a selective serotonin reuptake inhibitor (SSRI; Fluoxetine; Fontex((R))). Therapy reduced PTSD symptoms, provoked anxiety and heart rate. Before treatment trauma reminders resulted in decreased rCBF in the insula, prefrontal, and inferior frontal cortices. Increased activity was evident in the cerebellum, precuneus and supplementary motor cortex. This was normalized after SSRI administration. Prefrontal and cingulate rCBF correlated with heart rate. Hence, the anxiolytic effect of SSRI for PTSD could be mediated by prefrontal and paralimbic cortices. Data suggest that SSRI treatment normalize provocation induced rCBF alterations in areas involved in memory, emotion, attention and motor-control.

Keywords
torture, anxiety, fear, positron emission tomography, neuroimaging, regional cerebral blood-flow
National Category
Medical and Health Sciences Social Sciences
Identifiers
urn:nbn:se:uu:diva-90688 (URN)10.1016/S0304-3940(00)01674-8 (DOI)11121880 (PubMedID)
Available from: 2003-09-05 Created: 2003-09-05 Last updated: 2017-12-14Bibliographically approved

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