Illness course and outcomes
The course and outcomes of PTSD vary widely between individuals. This category considers the outcomes that affect day to day life, including forgiveness, post-traumatic growth, relapse, remission, self-harm, and employment. Click on the tabs below to access all the information, or browse the drop-down menu to the left.
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How is criminal offending related to PTSD? Criminal offending covers a wide range of behaviours including destructive acts, stealing, assault, and abuse. Such behaviour interferes with a person’s continuity of treatment, and increases the burden on patients, their caregivers, and society in general. Identifying factors associated with criminal offending may lead to early identification of those most at risk and preventative interventions. What is the evidence for criminal offending in people with PTSD? Moderate quality evidence found increased rates of domestic violence in veterans with PTSD compared to veterans without PTSD, although the evidence is very inconsistent. Moderate to high…
How is dietary patterns related to PTSD? People with mental disorders may be at increased risk of nutritional deficiencies due to poor diet. Poor diet is a major and modifiable cause of comorbid conditions, including metabolic syndrome and obesity. During pregnancy, it also contributes to the risk of developmental problems in the foetus. What is the evidence for dietary patterns in people with PTSD? Moderate quality evidence found there may be increased rates of poor dietary patterns in people with PTSD, although the evidence is very inconsistent. August 2021 Image: ©matka_Wariatka – Fotolia – stock.adobe.com
How is employment related to PTSD? Employment status is often indicative of the extent of one’s functional ability. Employment outcomes involve rates of employment and success in retaining employment, as well as patient characteristics, their environments, and interventions that influence employment rates. What is the evidence for employment in people with PTSD? Moderate to low quality evidence finds lower rates of returning to work in people with post-injury PTSD than in people without post-injury PTSD. August 2021 Image: ©fotofabrika – stock.adobe.com
How is forgiveness related to PTSD? Forgiveness involves reducing negative thoughts, feelings, and behaviours toward a transgressor, as well as enhancing positive ones. It involves a willingness to abandon resentments, negative judgment, and indifferent behaviour, while fostering compassion, generosity, and love. Studies have found evidence for both physical and psychological health benefits associated with forgiveness. This is because forgiving has the potential to break cycles of rumination and negative affect, which reduces stress and in turn improves various indicators of health. Long-term forgiveness habits (trait forgiveness) might better predict improved health outcomes than forgiving a specific offender or transgression (state…
How are functional outcomes related to PTSD? Functional outcomes refer to aspects of general life and day-to-day functioning. These may be impacted as a consequence of PTSD-related impairments, such as increased symptom severity. These in turn can impact adversely on treatment outcomes. What is the evidence for functional outcomes in people with PTSD? Moderate to high quality evidence finds PTSD symptoms were significantly associated with less social support and physical quality of life in cancer patients. Moderate quality evidence suggests there may be poorer functioning in people with PTSD compared to people with anxiety disorders, particularly poor occupational functioning. August…
We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. August 2021 Image: ©Masson – stock.adobe.com
What is illness onset of PTSD? Differences are observed in the age of onset of mental disorders, which may be influenced by genetic and/or environmental factors. While most individuals develop symptoms of PTSD within three months of the trauma, some symptoms can appear later and persist for months and sometimes years. Understanding the factors associated with the onset of symptoms could lead to better understanding of the disorder and earlier and improved intervention strategies for patients. What is the evidence for illness onset of PTSD? Moderate to high quality evidence finds the average age of onset of PTSD is 26.6…
Pathways to care
How are pathways to care relevant to people with PTSD? The help-seeking efforts made by an individual and their families when symptoms of PTSD are apparent, and the clinical services made available as a result of these efforts, are collectively known as ‘pathways to care’. Pathways to care can also encompass service structures that have not been actively sought by the individual. What is the evidence for pathways to care? Moderate to low quality evidence found the most commonly reported facilitators to initiation of evidence-based interventions for PTSD were flexibility of manualised approaches, less fear of increasing client distress, less…
How is physical activity related to PTSD? Increased physical activity has the potential to improve physical and mental health. Individuals with serious mental illnesses are more likely to be sedentary than the general population and are consequently at high risk for chronic medical conditions associated with inactivity. Positive psychological effects from physical activity in clinical populations have been reported, including improved quality of life. What is the evidence for physical activity in people with PTSD? Moderate quality evidence found lower levels of physical activity in people with PTSD compared to people without a mental illness. Lower levels of physical activity…
What is post-traumatic growth in PTSD? Post-traumatic growth refers to positive psychological changes that occur after exposure to a traumatic event, and that are beyond previous levels of functioning. Growth can involve spiritual change, better relationships, more appreciation of life, new possibilities, and increased personal strength. This growth involves both the struggle and symptoms associated with trauma exposure and any positive outcomes that represent adaptation to the traumatic event. What is the evidence for post-traumatic growth and PTSD symptoms? Moderate to high quality evidence found a small to medium-sized association between increased severity of PTSD symptoms and increased post-traumatic growth….
How is relapse related to PTSD? Studies have found high rates of relapse within a year of discharge from psychiatric institutions, with most being within the first three months. Sociodemographic and hospitalisation characteristics may influence the risk of relapse. Identifying the predictors of readmission improve interventions to reduce the cost and burden to systems, patients, and families. They can also inform health policies. What is the evidence for relapse in people with PTSD? Moderate quality evidence found an increased risk of readmission in people with a prior psychiatric hospitalisation, particularly longer hospital stays. Being discharged to residential rather than another…
How are religious beliefs related to PTSD? Religiosity refers to religious activity, dedication, and beliefs. This table covers the available evidence on the relationship between religion and PTSD. What is the evidence for religiosity in people with PTSD? Moderate to high quality evidence found no significant changes in religious beliefs after exposure to trauma. August 2021 Image: © Lucian Milasan – stock.adobe.com
What is remission in PTSD? Remission is achieved when there are long-term improvements in PTSD symptoms, and subsequent improvements in overall functioning. While many people fully recover from PTSD over time, some do not, with symptoms continuing and fluctuating over time. What is the evidence for remission in people with PTSD? Moderate to high quality evidence found that around 44% of adults who were not receiving treatment remitted from PTSD within seven years post-trauma exposure. Remission rates were highest in the first five months after trauma exposure, and in adults exposed to natural disasters rather than those exposed to physical…
We have not found any systematic reviews on this topic that meet the Library’s inclusion criteria. Pending enough primary studies, we invite reviews on this topic to be conducted. Alternatively we will endeavour to conduct our own review to fill this gap in the Library. August 2021 Image: ©nadezhda soboleva – stock.adobe.com
Suicide and self-harm
What is suicide and self-harm in PTSD? There has been much research dedicated to determining potential risk factors for suicide, which may have clinically important applications for prevention. Many of the important risk factors for suicide in the general population can also apply to people with PTSD, including suffering from depression or having a history of previous suicide attempts or ideation. However, factors specific to PTSD, such as exposure to trauma, may also contribute to an increased risk of suicide or self-harm. What is the evidence for suicide and self-harm in people with PTSD? Moderate quality evidence finds a large…
What is treatment non-adherence in PTSD? Non-adherence to treatments reduces the success of the treatment regimen and the ability to achieve remission from illness. Greater adherence to treatments can contribute to more successful management of the symptoms of PTSD and subsequent better quality of life. It also improves attitudes towards treatment, as well as increasing insight and confidence. What is the evidence for treatment non-adherence in people with PTSD? Moderate to high quality evidence found a dropout rate of around 18-21% from psychological treatments for PTSD. Rates were highest in longer studies with more sessions, and in group treatments rather…
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