Abstract

Introduction: Following a mass casualty event, such as the Paris terrorist attacks of 13 November 2015, first responders need to identify individuals at risk of PTSD. Physical peritraumatic symptoms involving the autonomic nervous system may be useful in this task.

Objective: We sought to determine the trajectory of physical response intensity in individuals exposed to the Paris terrorist attacks using repeated measures, and to examine its associations with PTSD. Using network modelling, we examined whether peritraumatic physical symptom associations differed by PTSD status.

Methods: Physical reactions were assessed using the Subjective Physical Reactions Scale at three time points: peritraumatic by retrospective recall, then current at one year (8–18 months) and three years (30–42 months) after the attacks. Interaction networks between peritraumatic physical reactions were compared according to PTSD status.

Results: On the one hand, the reported intensity of physical reactions was significantly higher in the PTSD group at all time points. On the other hand, using the dynamic approach, more robust positive interactions between peritraumatic physical reactions were found in the PTSD group one and three years after the attacks. Negative interactions were found in the no-PTSD group at one year. Peritraumatic physical numbness was found to be the most central network symptom in the PTSD group, whereas it was least central in the no-PTSD group.

Discussion: Network analysis of the interaction between peritraumatic physical subjective responses, particularly physical numbness, may provide insight into the clinical course of PTSD. Our knowledge of the brain regions involved in dissociation supports the hypothesis that the periaqueductal grey may contribute to the process leading to physical numbing.

Conclusions: Our findings highlight the role of peritraumatic somatic symptoms in the course of PTSD. Peritraumatic physical numbness appears to be a key marker of PTSD and its identification may help to improve early triage.

Details

Title
Peritraumatic physical symptoms and the clinical trajectory of PTSD after a terrorist attack: a network model approach
Author
Berthail, Benoit 1 ; Trousselard, Marion 2 ; Lecouvey, Gregory 3 ; Fraisse, Florence 3 ; Peschanski, Denis 4 ; Eustache, Francis 3 ; Gagnepain, Pierre 3 ; Dayan, Jacques 5   VIAFID ORCID Logo 

1  French Military Health Service Academy, Paris, France; Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France 
2  French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France; APEMAC, Université de Lorraine, Metz, France 
3  Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France 
4  EHESS, CNRS, UMR8209, Université Paris I Panthéon Sorbonne, HESAM Université, Paris, France 
5  Normandie Université, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France; Centre Hospitalier Guillaume Régnier, Pôle Hospitalo-Universitaire de Psychiatrie de l’Enfant et de l’Adolescent, Université Rennes 1, Rennes, France 
Publication year
2023
Publication date
2023
Publisher
Taylor & Francis Ltd.
e-ISSN
20008066
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/20008066.2023.2225154
ProQuest document ID
2907075311
Copyright
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons  Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.