Change Patterns of Posttraumatic and Grief Disorders and Their Somatic Variables in Ongoing Trauma
Bibliographic record
Abstract
Importance: This study provides insight into change patterns of posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), and prolonged grief disorder (PGD) under conditions of continuous trauma. Clarification of how these disorders are associated with somatization and pain is essential for the assessment and development of integrated care models for continuous trauma-exposed populations. Objective: To examine longitudinal change patterns of PTSD, CPTSD, and PGD and assess their associations with somatization and pain. Design, Setting, and Participants: A population-based cohort study was conducted between November 2023 and December 2024 using an online panel survey in a nationally representative sample of Israeli adults (aged 18-71 years) exposed to the October 7, 2023, terror attack and subsequent war. Quota sampling was used to match the national census on age and sex. Eligibility criteria included age 18 years or older, Hebrew fluency, residency in Israel during data collection, and provision of written informed consent. Change patterns were identified across 2 measurements, approximately 1 year apart. Main Outcomes and Measures: Probable PTSD and CPTSD were assessed using the International Trauma Questionnaire and PGD via the International Grief Questionnaire, based on standard cutoffs. Somatization was measured using the Somatic Symptom Scale-8 and pain using the Short-Form McGill Pain Questionnaire. Results: Of the 2028 participants at baseline (mean [SD] age, 42.7 [14.6] years; 51.4% women), 1598 (78.8%) completed the follow-up assessment 1 year later (mean [SD] age, 42.7 [14.6] years; 51.4% women). PTSD decreased from 17.8% to 8.2% and CPTSD from 13.1% to 9.3%; PGD remained stable (4.4% to 4.3%). The resilient pattern was most common (PTSD and CPTSD, 62.7%; PGD, 93.0%). Chronic, delayed, and shifting patterns (PTSD and CPTSD, 3.0%-4.5%; PGD, 1.7%-2.6%) were significantly associated with greater somatization (PTSD and CPTSD, η2 = 0.205; 95% CI, 0.200-0.215; P < .001; PGD, η2 = 0.036; 95% CI, 0.029-0.042; P < .001), sensory pain (PTSD and CPTSD, η2 = 0.087; 95% CI, 0.075-0.099; P < .001; PGD, η2 = 0.029; 95% CI, 0.015-0.043; P < .001), and affective pain (PTSD and CPTSD, η2 = 0.088; 95% CI, 0.071-0.105; P < .001; PGD, η2 = 0.033; 95% CI, 0.017-0.049; P < .001), with large effect sizes for PTSD and CPTSD somatization and small to medium effect sizes for all other associations. Conclusions and Relevance: This cohort study provides a longitudinal view of stress-related disorders during ongoing trauma, showing dynamic PTSD and CPTSD patterns and stable PGD. The association between psychological distress and somatic burden emphasizes the need for trauma-informed care addressing mental and physical health under long-term exposure.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".