Anxiety sensitivity as a transdiagnostic risk factor for trajectories of adverse posttraumatic neuropsychiatric sequelae in the AURORA study.

Autor: Short NA; Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA; Department of Psychology, University of Nevada, Las Vegas, NV, 89154, USA. Electronic address: nicole.short@unlv.edu., van Rooij SJH; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA., Murty VP; Department of Psychology, Temple University, Philadelphia, PA, 19121, USA., Stevens JS; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA., An X; Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., Ji Y; Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., McLean SA; Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., House SL; Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA., Beaudoin FL; Department of Epidemiology, The Brown University School of Public Health, Providence, RI, 02930, USA., Zeng D; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27559, USA., Neylan TC; Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA., Clifford GD; Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA., Linnstaedt SD; Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., Germine LT; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA; The Many Brains Project, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA., Bollen KA; Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA., Rauch SL; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA., Haran JP; Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, 01655, USA., Lewandowski C; Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, 48202, USA., Musey PI Jr; Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA., Hendry PL; Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA., Sheikh S; Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA., Jones CW; Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA., Punches BE; Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, 43210, USA; Ohio State University College of Nursing, Columbus, OH, 43210, USA., Swor RA; Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, 48309, USA., McGrath ME; Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA., Hudak LA; Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA., Pascual JL; Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA., Seamon MJ; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, 19104, USA., Datner EM; Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, PA, 19141, USA; Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA., Pearson C; Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, 48202, USA., Peak DA; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA., Merchant RC; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA., Domeier RM; Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA., Rathlev NK; Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA., O'Neil BJ; Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, 48202, USA., Sergot P; Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, 77030, USA., Sanchez LD; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA., Bruce SE; Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA., Pietrzak RH; National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA., Joormann J; Department of Psychology, Yale University, New Haven, CT, 06510, USA., Barch DM; Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA., Pizzagalli DA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA., Sheridan JF; Division of Biosciences, Ohio State University College of Dentistry, Columbus, OH, 43210, USA; Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA., Smoller JW; Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, 02114, USA; Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, 02142, USA., Harte SE; Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA., Elliott JM; Kolling Institute, University of Sydney, St Leonards, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, 2006, Australia; Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA., Kessler RC; Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA., Koenen KC; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA., Jovanovic T; Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, 48202, USA.
Jazyk: angličtina
Zdroj: Journal of psychiatric research [J Psychiatr Res] 2022 Dec; Vol. 156, pp. 45-54. Date of Electronic Publication: 2022 Sep 27.
DOI: 10.1016/j.jpsychires.2022.09.027
Abstrakt: Anxiety sensitivity, or fear of anxious arousal, is cross-sectionally associated with a wide array of adverse posttraumatic neuropsychiatric sequelae, including symptoms of posttraumatic stress disorder, depression, anxiety, sleep disturbance, pain, and somatization. The current study utilizes a large-scale, multi-site, prospective study of trauma survivors presenting to emergency departments. Hypotheses tested whether elevated anxiety sensitivity in the immediate posttrauma period is associated with more severe and persistent trajectories of common adverse posttraumatic neuropsychiatric sequelae in the eight weeks posttrauma. Participants from the AURORA study (n = 2,269 recruited from 23 emergency departments) completed self-report assessments over eight weeks posttrauma. Associations between heightened anxiety sensitivity and more severe and/or persistent trajectories of trauma-related symptoms identified by growth mixture modeling were analyzed. Anxiety sensitivity assessed two weeks posttrauma was associated with severe and/or persistent posttraumatic stress, depression, anxiety, sleep disturbance, pain, and somatic symptoms in the eight weeks posttrauma. Effect sizes were in the small to medium range in multivariate models accounting for various demographic, trauma-related, pre-trauma mental health-related, and personality-related factors. Anxiety sensitivity may be a useful transdiagnostic risk factor in the immediate posttraumatic period identifying individuals at risk for the development of adverse posttraumatic neuropsychiatric sequelae. Further, considering anxiety sensitivity is malleable via brief intervention, it could be a useful secondary prevention target. Future research should continue to evaluate associations between anxiety sensitivity and trauma-related pathology.
Competing Interests: Declaration of competing interest Dr. Neylan has received research support from NIH, VA, and Rainwater Charitable Foundation, and consulting income from Jazz Pharmaceuticals. In the last three years Dr. Clifford has received research funding from the NSF, NIH and LifeBell AI, and unrestricted donations from AliveCor, Amazon Research, the Center for Discovery, the Gordon and Betty Moore Foundation, MathWorks, Microsoft Research, the Gates Foundation, Google, One Mind Foundation, and Samsung Research. Dr. Clifford has financial interest in AliveCor, and receives unrestricted funding from the company. He also is the CTO of MindChild Medical and CSO of LifeBell AI and has ownership in both companies. These relationships are unconnected to the current work. Dr. Rauch reports grants from NIH during the conduct of the study; personal fees from SOBP (Society of Biological Psychiatry) paid role as secretary, other from Oxford University Press royalties, other from APP (American Psychiatric Publishing Inc.) royalties, other from VA (Veterans Administration) per diem for oversight committee, and other from Community Psychiatry/Mindpath Health paid board service, including equity outside the submitted work; other from National Association of Behavioral Healthcare for paid Board service; and Leadership roles on Board or Council for SOBP, ADAA (Anxiety and Depression Association of America), and NNDC (National Network of Depression Centers). Dr. Sophia Sheikh has received funding from the Florida Medical Malpractice Joint Underwriter's Association Dr. Alvin E. Smith Safety of Healthcare Services Grant; Allergan Foundation; the NIH/NIA-funded Jacksonville Aging Studies Center (JAX-ASCENT; R33AG05654); and the Substance Abuse and Mental Health Services Administration (1H79TI083101-01); and the Florida Blue Foundation. Dr. Jones has no competing interests related to this work, though he has been an investigator on studies funded by AstraZeneca, Janssen, Holigic, Inc, and Ophirex. Dr. Datner serves as Medical Advisor for Cayaba Care. Dr. Joormann receives consulting payments from Janssen Pharmaceuticals. Dr. Barch has received function from the NIMH, NIDA, and the American Foundation for Suicide Prevention, and consults for Boehringer-Ingelheim. Over the past 3 years, Dr. Pizzagalli has received consulting fees from Albright Stonebridge Group, Boehringer Ingelheim, Compass Pathways, Concert Pharmaceuticals, Engrail Therapeutics, Neumora Therapeutics (former BlackThorn Therapeutics), Neurocrine Biosciences, Neuroscience Software, Otsuka Pharmaceuticals, and Takeda Pharmaceuticals; honoraria from the Psychonomic Society (for editorial work) and Alkermes, and research funding from NIMH, Dana Foundation, Brain and Behavior Research Foundation, and Millennium Pharmaceuticals. In addition, he has received stock options from Neumora Therapeutics (former BlackThorn Therapeutics), Compass Pathways, Engrail Therapeutics, and Neuroscience Software. Dr. Harte has no competing interests related to this work, though in the last three years he has received research funding from Aptinyx and Arbor Medical Innovations, and consulting payments from Aptinyx, Heron Therapeutics, and Eli Lilly. Dr. Elliott reports support from the National Institutes of Health (NIH) through Grant Numbers R01HD079076 & R03HD094577: Eunice Kennedy Shriver National Institute of Child Health & Human Development; National Center for Medical Rehabilitation Research. He also reports funding from New South Wales Health, Spinal Cord Injury Award (2020–2025) and consulting fees (<$15,000 per annum) from Orofacial Therapeutics, LLC. In the past 3 years, Dr. Kessler was a consultant for Datastat, Inc., Holmusk, RallyPoint Networks, Inc., and Sage Pharmaceuticals. He has stock options in Mirah, PYM, and Roga Sciences. PTSD = posttraumatic stress disorder. Clinical outcomes were calculated using the following cut-offs: Clinically significant new or worsening pain = increased pain from pre-to posttrauma by ≥ 2 points on the pain numeric rating scale (Bijur et al., 2003); PTSD ≥31 on the Posttraumatic Stress Disorder Checklist (PCL; Weathers et al., 2013); Depression ≥60 on the Patient-Reported Outcome Measurement Information System (PROMIS; Cella et al., 2010); Insomnia = Insomnia Severity Index scores of at least 15 (Morin et al., 2011). Of note, a brief PROMIS anxiety scale was administered, precluding the ability to assess clinically significant symptoms based on typical cut-off scores. Thus, means for anxiety are reported (range = 0–16).
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Databáze: MEDLINE
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