Trajectories of Anhedonia Symptoms after Traumatic Injury.

Anhedonia describes the inability or difficulty of experiencing or seeking pleasure. Previous research has demonstrated a relationship between posttraumatic stress disorder (PTSD) or experiencing trauma and anhedonia symptoms; however, little to no work has been done to understand the evolution of anhedonia symptoms after trauma. We aimed to identify anhedonia trajectories following traumatic injury. One hundred ninety-five participants were recruited from the emergency department of a Level-1 Trauma Center after experiencing a traumatic injury. To measure anhedonia symptoms, participants completed the Snaith-Hamilton Pleasure Scale (SHAPS) at 2-weeks, 3-months, and 6-months post-injury. Using latent class mixture modeling, we ran a trajectory analysis with three timepoints of SHAPS scores and compared mental and physical health outcomes across trajectories. Most of the sample fell in the resilient trajectory (85%), while the remainder were in a remitting trajectory (7%) where symptoms decreased over time, and a delayed (6%) trajectory where symptoms did not emerge until 3-months after injury. In the resilient trajectory, there was consistently low levels of PTSD, pain, depression, and anxiety relative to the other trajectories. In the delayed trajectory, depression and PTSD were chronically elevated and pain levels were consistent but mild. In the remitting trajectory, PTSD and depression symptoms decreased over time. Identified anhedonia trajectories mirrored trajectories commonly reported for PTSD symptoms after injury. Evaluating anhedonia trajectories and how they relate to mental health outcomes may inform targeted interventions for traumatic injury patients.

History of Racial Discrimination by Police Contributes to Worse Physical and Emotional Quality of Life in Black Americans After Traumatic Injury.

BACKGROUND: Black Americans are more likely than their White counterparts to experience traumatic injury and worse functional outcomes. Unfair police treatment has been identified as one specific form of racial discrimination potentially driving these deleterious outcomes. The aim of the investigation was to better understand the relationship between experiences of discrimination by police and trauma-specific quality of life outcomes, including PTSD symptom severity, in Black Americans following traumatic injury. METHOD: Traumatically injured Black American adults (N = 53) presenting to a level 1 trauma center completed a measure of police and law enforcement discrimination at baseline, and quality of life and PTSD were assessed 6 months later. RESULTS: Stepwise regressions results showed more frequent discrimination by police and law enforcement significantly predicted lower emotional and physical well-being 6 months after injury. Further, more frequent police discrimination resulted in more severe PTSD symptoms by 6 months after injury. CONCLUSIONS: Findings underscore that following an injury not specifically related to discrimination by police, patients' historical, negative police experiences contributed to worse physical and emotional recovery in the present. These findings, in unison with prior investigations, reveal the need to consider patients' history of negative police experiences as a social determinant of health in their recovery.