Brain-Based Biotypes of Psychiatric Vulnerability in the Acute Aftermath of Trauma
Abstract
Objective:
Methods:
Results:
Conclusions:
METHODS
Participants
Cohort | ||||||
---|---|---|---|---|---|---|
Discovery (N=69) | Replication (N=77) | Group Comparison | ||||
Characteristic | N | % | N | % | χ 2 | p |
Site | 1.81 | 0.61 | ||||
1 | 5 | 7.2 | 2 | 2.6 | ||
2 | 28 | 40.7 | 32 | 41.6 | ||
3 | 19 | 27.5 | 24 | 31.2 | ||
4 | 17 | 24.6 | 19 | 24.7 | ||
Female | 51 | 73.9 | 48 | 62.3 | 2.23 | 0.14 |
Race/ethnicity | 6.62 | 0.09 | ||||
Hispanic/Latino | 11 | 15.9 | 12 | 15.6 | ||
White | 20 | 29.0 | 34 | 44.2 | ||
Black/African American | 37 | 53.6 | 27 | 35.1 | ||
Asian, Hawaiian, American Indian, or other | 1 | 1.4 | 4 | 5.2 | ||
Education | 20.02 | 0.05 | ||||
Less than high school | 3 | 4.3 | 3 | 3.9 | ||
High school diploma/GED | 26 | 37.7 | 16 | 20.8 | ||
Some college/associate’s degree | 29 | 42.0 | 29 | 37.6 | ||
Bachelor’s degree | 8 | 11.6 | 19 | 24.7 | ||
Master’s degree | 3 | 4.3 | 8 | 10.4 | ||
Doctorate | 0 | 0.0 | 2 | 2.6 | ||
Employment status | 2.15 | 0.71 | ||||
Employed | 48 | 69.6 | 48 | 62.3 | ||
Retired | 1 | 1.4 | 3 | 3.9 | ||
Homemaker | 1 | 1.4 | 1 | 1.3 | ||
Student | 2 | 2.9 | 4 | 5.2 | ||
Unemployed, disabled, or other | 9 | 13.0 | 14 | 18.2 | ||
Data missing | 8 | 11.6 | 7 | 9.1 | ||
Yearly family income | 4.49 | 0.48 | ||||
<$19,000 | 17 | 24.6 | 17 | 22.1 | ||
$19,001–$35,000 | 18 | 26.1 | 19 | 24.7 | ||
$35,001–$50,000 | 10 | 14.5 | 13 | 16.9 | ||
$50,001–$75,000 | 4 | 5.8 | 9 | 11.7 | ||
$75,001–$100,000 | 3 | 4.3 | 7 | 9.1 | ||
>$100,000 | 9 | 13.0 | 5 | 6.5 | ||
Data missing | 8 | 11.6 | 7 | 9.1 | ||
Trauma type | 42.82 | 9.51 × 10 –7 | ||||
Motor vehicle collision | 69 | 100.0 | 41 | 53.2 | ||
Physical assault | 0 | 0.0 | 15 | 19.5 | ||
Sexual assault | 0 | 0.0 | 2 | 2.6 | ||
Incident causing traumatic stress exposure to many people | 0 | 0.0 | 1 | 1.3 | ||
Nonmotorized collision (e.g., bicycle, skateboard) | 0 | 0.0 | 6 | 7.8 | ||
Fall <10 feet | 0 | 0.0 | 4 | 5.2 | ||
Burn | 0 | 0.0 | 1 | 1.3 | ||
Animal-related | 0 | 0.0 | 3 | 3.9 | ||
Other | 0 | 0.0 | 4 | 5.2 | ||
Mean | SD | Mean | SD | t | p | |
Age (years) | 33.6 | 12.1 | 35.3 | 13.7 | –0.80 | 0.42 |
Injury severity scale | 2.5 | 2.4 | 2.3 | 1.8 | 0.80 | 0.42 |
Patient-rated chance of dying | 5.6 | 3.6 | 4.8 | 3.3 | 1.48 | 0.14 |
Demographic Variables and Psychiatric Assessment
MRI
Acquisition.
fMRI tasks.
Preprocessing and analysis.
Fear-potentiated startle.
Clustering Analysis
Analysis of Posttrauma Outcomes by Cluster
RESULTS
Covariance Among the fMRI Tasks and Regions of Interest
Clustering of Individuals Using Task-Based fMRI 2 Weeks Posttrauma
Prospective Trajectories of Mental Health Among the Four Clusters
Cluster-Based Compared With Dimensional Models for Predicting Longitudinal Posttrauma Outcomes
Convergent Validity With Fear-Learning Phenotypes
Voxel-Wise Whole-Brain Comparison of Cluster Groups
DISCUSSION
Interpretation of the Biotypes
Limitations
CONCLUSIONS
Footnotes
Supplementary Material
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