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Comorbid Depression and Other Predictors of PTSD Severity in Urban Public Transit Employees

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Abstract

The purpose of the study was to determine whether post traumatic stress disorder (PTSD) with Major Depressive Disorder (MDD) among urban public transit employees who were exposed to a workplace traumatic event is associated with greater PTSD severity over the 6-month follow-up period compared to PTSD without MDD, and also to identify predictors of PTSD severity among these employees. Information about Axis-I diagnosis and PTSD severity were collected from the SCID-I and the Modified PTSD Symptom Scale (MPSS) respectively. PTSD without MDD (N = 29) and PTSD with MDD (N = 37) groups were not significantly different in terms of PTSD severity. The severity of depression (p = 0.01), female (p = 0.01), non-Caucasian (p = 0.01), perceived high workplace related stress (p = 0.02), and history of lifetime trauma (p = 0.01) were significantly associated with greater PTSD severity after controlling other variables. This study highlights the importance of modifiable variables for reducing PTSD severity after a workplace traumatic event in transit employees.

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References

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, DSM-IV-TR edn. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Bance, S., Links, P. S., Strike, C., Bender, A., Eynan, R., Bergmans, Y., et al. (2014). Help-seeking in transit workers exposed to acute psychological trauma: A qualitative analysis. Work (Reading, Mass.), 48(1), 3–10.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., Kovacs, M., & Garrison, B. (1985). Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalized with suicidal ideation. [Research Support, U.S. Gov’t, P.H.S.]. American Journal of Psychiatry, 142(5), 559–563.

    Article  CAS  PubMed  Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    Article  CAS  PubMed  Google Scholar 

  • Bender, A., Eynan, R., O’Grady, J., Nisenbaum, R., Shah, R., & Links, P. S. (2016). Best practice intervention for post-traumatic stress disorder among transit workers. Work, 54(1), 59–71.

    Article  PubMed  Google Scholar 

  • Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. The Journal of Nervous and Mental Disease, 174(12), 727–735.

    Article  CAS  PubMed  Google Scholar 

  • Boyer, R., & Brunet, A. (1996). Prevalence of post-traumatic stress disorder in bus drivers. Sante Mentale Au Quebec, 21(1), 189–208.

    Article  CAS  PubMed  Google Scholar 

  • Breslau, N., Davis, G. C., Andreski, P., & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48(3), 216–222.

    Article  CAS  PubMed  Google Scholar 

  • Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., & Andreski, P. (1998). Trauma and posttraumatic stress disorder in the community: The 1996 Detroit Area Survey of Trauma. Archives of General Psychiatry, 55(7), 626–632.

    Article  CAS  PubMed  Google Scholar 

  • Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. [Meta-Analysis]. Journal of Consulting and Clinical Psychology, 68(5), 748–766.

    Article  CAS  PubMed  Google Scholar 

  • Brunet, A., Boyer, R., Brillon, P., Ehrensaft, E., & Stephenson, R. (1998). Lifetime exposure to traumatic events among a sample of city bus drivers. Psychological Reports, 83(3 Pt 2), 1155–1160.

    Article  CAS  PubMed  Google Scholar 

  • Campbell, D. G., Felker, B. L., Liu, C. F., Yano, E. M., Kirchner, J. E., Chan, D., et al. (2007). Prevalence of depression-PTSD comorbidity: Implications for clinical practice guidelines and primary care-based interventions. [Randomized Controlled Trial Research Support, U.S. Gov’t, Non-P.H.S.]. Journal of General Internal Medicine, 22(6), 711–718.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carlson, E. B., Putnam, F. W., Ross, C. A., Torem, M., Coons, P., Dill, D. L., et al. (1993). Validity of the dissociative experiences scale in screening for multiple personality disorder: A multicenter study. [Multicenter Study]. The American Journal of Psychiatry, 150(7), 1030–1036.

    Article  CAS  PubMed  Google Scholar 

  • Dubester, K. A., & Braun, B. G. (1995). Psychometric properties of the dissociative experiences scale. The Journal of Nervous and Mental Disease, 183(4), 231–235.

    Article  CAS  PubMed  Google Scholar 

  • Falsettin, S. A., Resnick, H. S., Resick, P. A., & Kilpatrick, D. G. (1993). The modified PTSD symptom scale: A brief self-report measures of posttraumatic stress disorder. The Behavior Therapist, 16, 161–162.

    Google Scholar 

  • Fedovskiy, K., Higgins, S., & Paranjape, A. (2008). Intimate partner violence: How does it impact major depressive disorder and post traumatic stress disorder among immigrant Latinas? Journal of Immigrant and Minority Health/Center for Minority Public Health, 10(1), 45–51.

    Article  CAS  Google Scholar 

  • First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1997). Structured clinical interview for DSM-IV Axix I disorders––patient edition (SCID-I/P, Version 2.0). New York, NY: Biometric Research, New York State Psychiatric Institute.

    Google Scholar 

  • Green, B. L., Lindy, J. D., Grace, M. C., & Leonard, A. C. (1992). Chronic posttraumatic stress disorder and diagnostic comorbidity in a disaster sample. The Journal of Nervous and Mental Disease, 180(12), 760–766.

    Article  CAS  PubMed  Google Scholar 

  • Greenawalt, D. S., Tsan, J. Y., Kimbrel, N. A., Meyer, E. C., Kruse, M. I., Tharp, D. F., et al. (2011). Mental health treatment involvement and religious coping among African American, hispanic, and white veterans of the wars of Iraq and Afghanistan. Depression Research and Treatment, 2011, 192186.

    Article  PubMed  PubMed Central  Google Scholar 

  • Griffiths, A., Cox, T., Karanika, M., Khan, S., & Tomas, J. M. (2006). Work design and management in the manufacturing sector: Development and validation of the Work Organisation Assessment Questionnaire. Occupational and Environmental Medicine, 63(10), 669–675.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Henderson, S., Duncan-Jones, P., Byrne, D. G., & Scott, R. (1980). Measuring social relationships. The interview schedule for social interaction. Psychological Medicine, 10(4), 723–734.

    Article  CAS  PubMed  Google Scholar 

  • Irish, L. A., Fischer, B., Fallon, W., Spoonster, E., Sledjeski, E. M., & Delahanty, D. L. (2011). Gender differences in PTSD symptoms: An exploration of peritraumatic mechanisms. Journal of Anxiety Disorders, 25(2), 209–216.

    Article  PubMed  Google Scholar 

  • Karam, E. G. (1997). Comorbidity of posttraumatic stress disorder and depression. In C. Fullerton & Ursano, R.J. (Ed.), Posttraumatic stress disorder: Acute and long-term responses to traumas and disaster (Vol. 51, pp. 77–90). Washington: American Psychiatric Press.

    Google Scholar 

  • Karunakara, U. K., Neuner, F., Schauer, M., Singh, K., Hill, K., Elbert, T., et al. (2004). Traumatic events and symptoms of post-traumatic stress disorder amongst Sudanese nationals, refugees and Ugandans in the West Nile. African Health Sciences, 4(2), 83–93.

    PubMed  PubMed Central  Google Scholar 

  • Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048–1060.

    Article  CAS  PubMed  Google Scholar 

  • Luxton, D. D., Skopp, N. A., & Maguen, S. (2010). Gender differences in depression and PTSD symptoms following combat exposure. Depression and Anxiety, 27(11), 1027–1033.

    Article  PubMed  Google Scholar 

  • Marziali, E. A. (1987). People in your life. Development of a social support measure for predicting psychotherapy outcome. The Journal of Nervous and Mental Disease, 175(6), 327–338.

    Article  CAS  PubMed  Google Scholar 

  • Moore, L. J., & Boehnlein, J. K. (1991). Posttraumatic stress disorder, depression, and somatic symptoms in U.S. Mien patients. Journal of Nervous and Mental Disease, 179(12), 728–733.

    Article  CAS  PubMed  Google Scholar 

  • National Institute for Clinical Excellence. (2005). Retrieved from http://www.nice.org.uk/.

  • O’Hare, T., Sherrer, M. V., & Shen, C. (2006). Subjective distress from stressful events and high-risk behaviors as predictors of PTSD symptom severity in clients with severe mental illness. Journal of Traumatic Stress, 19(3), 375–386.

    Article  PubMed  Google Scholar 

  • Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129(1), 52–73.

    Article  PubMed  Google Scholar 

  • Phillips, D. L., & Segal, B. E. (1969). Sexual status and psychiatric symptoms. American Sociological Review, 34(1), 58–72.

    Article  CAS  PubMed  Google Scholar 

  • Segal, D. L., Coolidge, F. L., Cahill, B. S., & O’Riley, A. A. (2008). Psychometric properties of the Beck Depression Inventory II (BDI-II) among community-dwelling older adults. [Comparative Study]. Behavior Modification, 32(1), 3–20.

    Article  PubMed  Google Scholar 

  • Shah, R., Shah, A., & Links, P. (2012). Post-traumatic stress disorder and depression comorbidity: Severity across different populations. Neuropsychiatry, 2(6), 521–529.

    Article  Google Scholar 

  • Shalev, A. Y., Freedman, S., Peri, T., Brandes, D., Sahar, T., Orr, S. P., et al. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. The American Journal of Psychiatry, 155(5), 630–637.

    Article  CAS  PubMed  Google Scholar 

  • Skodol, A. E., Schwartz, S., Dohrenwend, B. P., Levav, I., Shrout, P. E., & Reiff, M. (1996). PTSD symptoms and comorbid mental disorders in Israeli war veterans. British Journal of Psychiatry, 169(6), 717–725.

    Article  CAS  PubMed  Google Scholar 

  • Smith, P. N., Cukrowicz, K. C., Poindexter, E. K., Hobson, V., & Cohen, L. M. (2010). The acquired capability for suicide: A comparison of suicide attempters, suicide ideators, and non-suicidal controls. Depression and Anxiety, 27(9), 871–877.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stein, M. B., & Kennedy, C. (2001). Major depressive and post-traumatic stress disorder comorbidity in female victims of intimate partner violence. Journal of Affective Disorders, 66(2–3), 133–138.

    Article  CAS  PubMed  Google Scholar 

  • Stein, M. B., Walker, J. R., Hazen, A. L., & Forde, D. R. (1997). Full and partial posttraumatic stress disorder: Findings from a community survey. The American Journal of Psychiatry, 154(8), 1114–1119.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychiatry, Lawson Health Research Institute, Western University, London, ON, Canada

    Ravi Shah, Rahel Eynan & Paul S. Links

  2. St. Michael’s Hospital, Toronto, ON, Canada

    Rosane Nisenbaum

  3. Women’s College Research Institute, Toronto, ON, Canada

    Catherine Classen

Authors
  1. Ravi Shah
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  2. Rosane Nisenbaum
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  3. Catherine Classen
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  4. Rahel Eynan
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  5. Paul S. Links
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Correspondence to Ravi Shah.

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Shah, R., Nisenbaum, R., Classen, C. et al. Comorbid Depression and Other Predictors of PTSD Severity in Urban Public Transit Employees. Community Ment Health J 53, 224–232 (2017). https://doi.org/10.1007/s10597-016-0029-z

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  • DOI: https://doi.org/10.1007/s10597-016-0029-z

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