Document Type
Article
Publication Date
1-7-2023
Abstract
The 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.
Recommended Citation
Beaudoin, Francesca L; An, Xinming; Basu, Archana; Ji, Yinyao; Liu, Mochuan; Kessler, Ronald C; Doughtery, Robert F; Zeng, Donglin; Bollen, Kenneth A; House, Stacey L; Stevens, Jennifer S; Neylan, Thomas C; Clifford, Gari D; Jovanovic, Tanja; Linnstaedt, Sarah D; Germine, Laura T; Rauch, Scott L; Haran, John P; Storrow, Alan B; Lewandowski, Christopher; Musey, Paul I; Hendry, Phyllis L; Sheikh, Sophia; Jones, Christopher W; Punches, Brittany E; Kurz, Michael C; Swor, Robert A; Murty, Vishnu P; McGrath, Meghan E; Hudak, Lauren A; Pascual, Jose L; Datner, Elizabeth M; Chang, Anna Marie; Pearson, Claire; Peak, David A; Merchant, Roland C; Domeier, Robert M; Rathlev, Niels K; Neil, Brian J O'; Sergot, Paulina; Sanchez, Leon D; Bruce, Steven E; Baker, Justin T; Joormann, Jutta; Miller, Mark W; Pietrzak, Robert H; Barch, Deanna M; Pizzagalli, Diego A; Sheridan, John F; Smoller, Jordan W; Harte, Steven E; Elliott, James M; Koenen, Karestan C; Ressler, Kerry J; and McLean, Samuel A, "Use of Serial Smartphone-Based Assessments to Characterize Diverse Neuropsychiatric Symptom Trajectories in a Large Trauma Survivor Cohort" (2023). Department of Emergency Medicine Faculty Papers. Paper 217.
https://jdc.jefferson.edu/emfp/217
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
36609484
Language
English
Comments
This article is the author’s final published version in Translational Psychiatry, Volume 13, Issue 1, January 2023, Article number 4.
The published version is available at https://doi.org/10.1038/s41398-022-02289-y. Copyright © Beaudoin et al.