Understanding Nightmares after Traumatic Events in Detroit (UNiTED): Prospective Associations with Interpersonal Violence and Posttraumatic Stress Disorder Symptoms

Document Type

Article

Publication Date

1-1-2024

Publication Title

Eur J Psychotraumatol

Abstract

ABSTRACT

BACKGROUND: Research suggests trauma-related nightmares (TRNs) during the acute aftermath of trauma may contribute to posttraumatic stress disorder (PTSD). However, it is unknown who is most vulnerable to TRNs, which is critical to identify at-risk patients toward whom early nightmare-focused treatments can be targeted to prevent PTSD.

OBJECTIVE: We tested trauma type (interpersonal violence [e.g. assault] vs non-interpersonal trauma [e.g. motor vehicle collision]) as a risk factor for TRNs in a predominantly low-income, Black, urban sample in Detroit, MI, USA.

METHOD: We recruited patients from the intensive care unit following traumatic injury (N = 88; M(age) = 39.53 ± SD 14.31 years, 67.0% male, 67.0% Black, 47.7% annual income ≤ $20,000) and administered surveys at three post trauma timepoints: one week (T1), one month (T2; n = 61), and two months (T3; n = 59). Trauma type was assessed at T1 via electronic medical records. Participants reported the extent to which their dreams' content was similar to the trauma for which they were hospitalized across T1-T3. Participants then completed the PTSD Checklist for DSM-5 at T3.Results: TRNs were more prevalent over time among patients exposed to interpersonal violence (80%) vs non-interpersonal trauma (48.7%, p = .005). Patients hospitalized for interpersonal violence faced greater odds for TRNs across timepoints relative to non-interpersonal trauma patients (Odds Ratio = 4.95, p = .021). TRNs, in turn, prospectively predicted PTSD symptoms such that TRNs at T2 presaged more severe PTSD at T3 (p = .040, η(p)(2 )= .31), above and beyond T1 PTSD status.

CONCLUSIONS: This prospective study provides first evidence that interpersonal violence exposure is a robust risk factor for TRNs, which prospectively contribute to PTSD symptom development. Early intervention on TRNs after interpersonal violence exposure may decrease PTSD risk. Future studies are encouraged to use ambulatory methods to capture nightmares sooner after they occur.

Interpersonal violence exposure is a risk factor for trauma-related nightmares. Trauma-related nightmares predict PTSD symptoms, above and beyond baseline PTSD. Treating nightmares early after interpersonal violence may decrease PTSD risk.

Medical Subject Headings

Humans; Stress Disorders, Post-Traumatic; Male; Female; Michigan; Adult; Dreams; Prospective Studies; Risk Factors; Violence; Middle Aged; Surveys and Questionnaires; Wounds and Injuries; Intensive Care Units

PubMed ID

39376120

Volume

15

Issue

1

First Page

2409561

Last Page

2409561

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