According to a recent study led by Yael Ankri of the Center for Traumatic Stress Studies at Hadassah University Hospital in Israel, some people who develop symptoms of posttraumatic stress (PTSD) after being exposed to a trauma can have rapid remission of symptoms. Ankri conducted the study to get a closer look into the trajectory of symptoms in PTSD and how this trajectory affected outcome for trauma survivors.
Some survivors of trauma are resilient and are resistant to any long-lasting negative effects. PTSD, however, creates a chronic and recurring reminder of the trauma and can develop into a debilitating illness for some survivors. Ankri sought to examine the differences in outcomes of people with PTSD over a period of 15 months.
Ankri evaluated a sample of 957 trauma survivors ten days after trauma exposure and several more times over the course of 15 months. A group of 125 survivors also received cognitive behavioral therapy (CBT) during the study period. Ankri introduced this element to compare the effects of CBT on differing trajectory groups. At conclusion, three symptom class groups emerged.
Rapid remitting individuals were those who saw significant symptoms reductions within five months. This group represented 56% of the participants. The slow remitting group, which included 27% of all participants, had a slow decrease in symptoms throughout the 15 months. The nonremitters made up 17% of the total sample and had little to no symptom reduction and were maintained acute symptoms or a chronic course of PTSD throughout the entire 15 months.
CBT appeared to be beneficial, but only significantly so for the slow-remitters. Why it was less effective for the nonremitters is unclear. Anrki also discovered that the participants with the most severe symptoms immediately following trauma exposure were most likely to fall into the nonremitting chronic group. Other factors that were common in nonremitters were older age and less education.
Finally, Anrki found evidence that depressive symptoms influenced negative outcome, but this evidence was not explored fully. “This is potentially valuable information as it indicates that depression symptomatology in the acute phase may be predictive of chronic posttraumatic stress,” added Ankri. In sum, these results provide new insights and new direction that can be applied to the study of PTSD.
Galatzer-Levy, I.R., Ankri, Y., Freedman, S., Israeli-Shalev, Y., Roitman, P., et al. (2013). Early PTSD symptom trajectories: Persistence, recovery, and response to treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS). PLoS ONE 8(8): e70084. doi:10.1371/journal.pone.0070084
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