Browsing by Author "Lee, Chiyoung"

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    Understanding Onset, Dynamic Transitions, and Associated Inequality Risk Factors for Adverse Posttraumatic Neuropsychiatric Sequelae After Trauma Exposure
    (American Psychiatric Association, 2024-11-06) Lee, Chiyoung; House, Stacey L.; Beaudoin, Francesca L.; Neylan, Thomas C.; Clifford, Gari D.; Linnstaedt, Sarah D.; Germine, Laura T.; Rauch, Scott L.; Haran, John P.; Storrow, Alan B.; Lewandowski, Christopher; Musey, Paul I., Jr.; Hendry, Phyllis L.; Sheikh, Sophia; Punches, Brittany E.; Swor, Robert A.; Hudak, Lauren A.; Pascual, Jose L.; Seamon, Mark J.; Harris, Erica; Pearson, Claire; Peak, David A.; Domeier, Robert M.; Rathlev, Niels K.; O'Neil, Brian J.; Sergot, Paulina; Sanchez, Leon D.; Bruce, Steven E.; Sheridan, John F.; Harte, Steven E.; Koenen, Karestan C.; Kessler, Ronald C.; McLean, Samuel A.; Yang, Qing; An, Xinming; Emergency Medicine, School of Medicine
    Objective: Several gaps remain in the understanding of the onset, dynamic transitions, and associated risk factors of adverse posttraumatic neuropsychiatric sequelae (APNS) in the acute post-trauma window. Based on serial assessments of symptoms from a large cohort study, we identified homogeneous statuses across multiple APNS symptom domains and investigated the dynamic transitions among these statuses during the first 2 months after trauma exposure. Furthermore, we studied how symptom onset and transitions are affected by equity-relevant characteristics. Methods: The analysis was based on 2557 participants enrolled in the Advancing Understanding of RecOvery afteR traumA (AURORA). APNS symptoms comprised pain, depression, sleep discontinuity, nightmares, avoidance, re-experience, anxiety, hyperarousal, somatic symptoms, and mental fatigue. We identified the homogeneous status of APNS symptoms at baseline, 1 month, and 2 months, and explored transition probabilities among these statuses using latent transition analysis. Equity-relevant characteristics included gender, race, education, family income, childhood trauma, and area deprivation. Results: Three homogeneous statuses-low-, moderate-, and severe-symptom-were identified. While the majority of trauma survivors with severe- or moderate-symptom status maintained the same status over time, some transitioned to a less severe symptom status, particularly within the first month. Specifically, females, non-whites, and those with higher childhood trauma were associated with a decreased likelihood of transitioning to a less severe symptom status. From one to 2 months, lower income was associated with a decreased likelihood of transitioning from moderate-to low-symptom status. Conclusions: The findings can inform early intervention strategies for APNS, potentially reducing health disparities among trauma survivors.