4 Possible Subtypes of PTSD Powerful statistical tools advance our understanding of critical issues. Grant Hilary Brenner MD, FAPA Posted Jan 30, 2020

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Except: Full article here: https://www-psychologytoday-com.cdn.ampproject.org/c/s/www.psychologytoday.com/us/blog/experimentations/202001/4-possible-subtypes-ptsd?amp

Precision medicine” leverages technology and mathematical tools to individualize care. Precision-medicine approaches are on the cutting edge of medicine, and as such are not always ready for primetime. They are often the subject of controversy. Some clinicians and patients are eager to try new things right away, while others prefer to wait to see if they work and if they cause unexpected adverse reactions, also known as “side effects.”

The current study used “latent class analysis” with the National Epidemiological Survey on Alcohol and Related Conditions (NESARC III). This survey collected data from a representative sample to reflect the general U.S. population. Of the over 36,000 participants, almost 2,400 met criteria for PTSD at some point in their lives.

1. Dysphoric (23.8 percent): Intrusive thoughts; avoidance of situations and thoughts related to the trauma; negative thoughts and feelings; isolation, numbing and irritability; and difficulty with sleep and concentration.

They were more likely to be younger, and male. They were less likely to have experienced combat. They were less likely to receive medication for PTSD. They were more likely to be diagnosed with depression, and less likely to be diagnosed with anxiety. They were more likely to use nicotine.

2. Threat (26.1 percent): Increased re-experiencing symptoms; high self-blame and negative emotion; lower levels of loss of interest, numbing, isolation and irritability; and high levels of physiologic arousal (“hyperarousal”). They were more likely to be older, and less likely to have recent homelessness or unemployment.

They were more likely to have personally experienced natural disasters, and had illnesses or injury to people close to them. They were less likely to report childhood sexual abuse as their worst trauma, and reported better mental health. They tended to have fewer additional psychiatric diagnoses.

3. High Symptom (33.7 percent): Elevated levels of all symptoms except trauma-related amnesia and high-risk behaviors. They were more likely to be female, less likely to be White, reported lower education and income levels, and were more likely to have recent public assistance, homelessness, and unemployment. They were more likely to report combat and childhood sexual abuse as their worst trauma, were younger when they developed PTSD and had it longer, and reported worse mental and physical health.

They were more likely to have received therapy and/or medication treatment for PTSD. They had higher rates of other psychiatric conditions, including anxiety disorders, bipolar disorder, chronic depression, marijuana and alcohol use disorders, and personality disorders including Borderline, Schizotypal and Antisocial. This group most closely resembles cPTSD.

4. Low Symptom (16.3 percent): Lower levels of all symptoms, except for intrusive thoughts, negative emotions, and hypervigilance. People in this group were more likely to have higher income levels. They were more likely to report the worst trauma to someone close to them, rather than to themselves personally, and were less likely to report personal war trauma.

They tended to be older and have PTSD for a shorter time, and to have better mental and physical health. They were less likely to have received treatment with therapy and/or medications. They were less likely to have other psychiatric diagnoses, and less likely to have personality disorders.

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