Use of serial smartphone-based assessments to characterize diverse neuropsychiatric symptom trajectories in a large trauma survivor cohort
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Published:2023-01-07
Issue:1
Volume:13
Page:
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ISSN:2158-3188
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Container-title:Translational Psychiatry
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language:en
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Short-container-title:Transl Psychiatry
Author:
Beaudoin Francesca L., An Xinming, Basu Archana, Ji YinyaoORCID, Liu Mochuan, Kessler Ronald C.ORCID, Doughtery Robert F., Zeng Donglin, Bollen Kenneth A., House Stacey L., Stevens Jennifer S.ORCID, Neylan Thomas C.ORCID, Clifford Gari D., Jovanovic TanjaORCID, Linnstaedt Sarah D.ORCID, Germine Laura T.ORCID, Rauch Scott L., Haran John P., Storrow Alan B., Lewandowski ChristopherORCID, Musey Paul I., Hendry Phyllis L., Sheikh SophiaORCID, Jones Christopher W., Punches Brittany E.ORCID, Kurz Michael C., Swor Robert A., Murty Vishnu P., McGrath Meghan E., Hudak Lauren A., Pascual Jose L.ORCID, Datner Elizabeth M., Chang Anna M.ORCID, Pearson Claire, Peak David A., Merchant Roland C., Domeier Robert M., Rathlev Niels K., Neil Brian J. O’, Sergot Paulina, Sanchez Leon D.ORCID, Bruce Steven E.ORCID, Baker Justin T.ORCID, Joormann Jutta, Miller Mark W.ORCID, Pietrzak Robert H., Barch Deanna M.ORCID, Pizzagalli Diego A.ORCID, Sheridan John F., Smoller Jordan W.ORCID, Harte Steven E., Elliott James M., Koenen Karestan C.ORCID, Ressler Kerry J.ORCID, McLean Samuel A.ORCID
Abstract
AbstractThe authors sought to characterize adverse posttraumatic neuropsychiatric sequelae (APNS) symptom trajectories across ten symptom domains (pain, depression, sleep, nightmares, avoidance, re-experiencing, anxiety, hyperarousal, somatic, and mental/fatigue symptoms) in a large, diverse, understudied sample of motor vehicle collision (MVC) survivors. More than two thousand MVC survivors were enrolled in the emergency department (ED) and completed a rotating battery of brief smartphone-based surveys over a 2-month period. Measurement models developed from survey item responses were used in latent growth curve/mixture modeling to characterize homogeneous symptom trajectories. Associations between individual trajectories and pre-trauma and peritraumatic characteristics and traditional outcomes were compared, along with associations within and between trajectories. APNS across all ten symptom domains were common in the first two months after trauma. Many risk factors and associations with high symptom burden trajectories were shared across domains. Both across and within traditional diagnostic boundaries, APNS trajectory intercepts, and slopes were substantially correlated. Across all domains, symptom severity in the immediate aftermath of trauma (trajectory intercepts) had the greatest influence on the outcome. An interactive data visualization tool was developed to allow readers to explore relationships of interest between individual characteristics, symptom trajectories, and traditional outcomes (http://itr.med.unc.edu/aurora/parcoord/). Individuals presenting to the ED after MVC commonly experience a broad constellation of adverse posttraumatic symptoms. Many risk factors for diverse APNS are shared. Individuals diagnosed with a single traditional outcome should be screened for others. The utility of multidimensional categorizations that characterize individuals across traditional diagnostic domains should be explored.
Publisher
Springer Science and Business Media LLC
Subject
Biological Psychiatry,Cellular and Molecular Neuroscience,Psychiatry and Mental health
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