Use of Serial Smartphone-Based Assessments to Characterize Diverse Neuropsychiatric Symptom Trajectories in a Large Trauma Survivor Cohort

Authors

• Francesca L Beaudoin, Brown University
• Xinming An, University of North Carolina at Chapel Hill
• Archana Basu, Harvard University
• Yinyao Ji, University of North Carolina at Chapel Hill
• Mochuan Liu, University of North Carolina at Chapel Hill
• Ronald C Kessler, Harvard Medical School
• Robert F Doughtery, Mindstrong Health
• Donglin Zeng, University of North Carolina, Chapel Hill
• Kenneth A Bollen, University of North Carolina at Chapel Hill
• Stacey L House, Washington University School of Medicine
• Jennifer S Stevens, Emory University School of Medicine
• Thomas C Neylan, University of California San Francisco
• Gari D Clifford, Emory University School of Medicine
• Tanja Jovanovic, Wayne State University
• Sarah D Linnstaedt, University of North Carolina at Chapel Hill
• Laura T Germine, Harvard Medical School
• Scott L Rauch, McLean Hospital
• John P Haran, University of Massachusetts Medical School
• Alan B Storrow, Vanderbilt University Medical Center
• Christopher Lewandowski, Henry Ford Health System
• Paul I Musey, Indiana University School of Medicine
• Phyllis L Hendry, University of Florida College of Medicine
• Sophia Sheikh, University of Florida College of Medicine
• Christopher W Jones, Cooper Medical School of Rowan University
• Brittany E Punches, University of Cincinnati
• Michael C Kurz, University of Alabama School of Medicine
• Robert A Swor, Oakland University William Beaumont School of Medicine
• Vishnu P Murty, Temple University
• Meghan E McGrath, Boston Medical Center
• Lauren A Hudak, Emory University School of Medicine
• Jose L Pascual, University of Pennsylvania
• Elizabeth M Datner, Thomas Jefferson UniversityFollow
• Anna Marie Chang, Thomas Jefferson UniversityFollow
• Claire Pearson, Wayne State University
• David A Peak, Massachusetts General Hospital
• Roland C Merchant, Brigham and Women's Hospital
• Robert M Domeier, Saint Joseph Mercy Hospital
• Niels K Rathlev, University of Massachusetts Medical School
• Brian J O' Neil, Wayne State University
• Paulina Sergot, University of Texas Health
• Leon D Sanchez, Harvard Medical School
• Steven E Bruce, University of Missouri
• Justin T Baker, Mindstrong Health
• Jutta Joormann, Yale University
• Mark W Miller, Boston University School of Medicine
• Robert H Pietrzak, Yale School of Medicine
• Deanna M Barch, Washington University in St. Louis
• Diego A Pizzagalli, Harvard Medical School
• John F Sheridan, OSU Wexner Medical Center
• Jordan W Smoller, Massachusetts General Hospital
• Steven E Harte, University of Michigan Medical School
• James M Elliott, University of Sydney
• Karestan C Koenen, Harvard University
• Kerry J Ressler, Harvard Medical School
• Samuel A McLean, University of North Carolina at Chapel Hill

Document Type

Article

Publication Date

1-7-2023

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.

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