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Stress dynamics that maintain posttraumatic stress disorder across 20 years
Whitney R Ringwald1, Scott Feltman2, Sean A P Cloutson3
1Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
Psychological Medicine
|May 19, 2025
Summary
Individual differences in how people react to stress and how their symptoms persist significantly impact the long-term course of posttraumatic stress disorder (PTSD). Understanding these stress-symptom dynamics is key to managing PTSD chronicity.
Area of Science:
- Psychiatry
- Psychology
- Epidemiology
Background:
- Posttraumatic stress disorder (PTSD) is a chronic and impairing condition.
- The mechanisms maintaining PTSD symptoms are poorly understood due to heterogeneous presentations.
- Individual differences in stress-symptom dynamics may explain PTSD heterogeneity and maintenance.
Purpose of the Study:
- To examine how individual differences in stress-symptom dynamics relate to the long-term maintenance of PTSD.
- To investigate the clinical utility of these dynamics in relation to PTSD chronicity and mental health care use.
Main Methods:
- Longitudinal study of 7,308 World Trade Center responders over up to 20 years.
- Multilevel structural equation models to analyze stable and time-varying symptom and stressor components.
- Modeled within-person stress reactivity, stress generation, and symptom/stress persistence.
Main Results:
- Stress reactivity, stress generation, and symptom persistence were significant on average.
- Significant individual differences in the strength of these dynamics were observed.
- Individuals with pronounced dynamics showed persistent PTSD symptoms and higher healthcare costs.
Conclusions:
- Individual differences in stress-symptom dynamics are crucial factors in PTSD chronicity.
- These dynamics contribute significantly to the clinical burden and healthcare utilization in PTSD.
Keywords:
internalizing psychopathologylife eventslife stresslongitudinalmultilevel structural equation modelMore Related Videos
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