Is it possible that chronic worry may be linked to an increased likelihood of developing PTSD?
I can remember my father telling me, “Take therefore no thought for the morrow: for the morrow shall take thought for the things of itself. Sufficient unto the day is the evil thereof.” (The Bible was quoted often in my home, and usually it was the King James.)
And now we’re finding out more about the impact of taking thought, or worry, on the quality of life.
As it turns out, chronic worry may be linked to a person’s risk for developing PTSD.
Naomi Breslau, PhD, of the Epidemiology Department of Michigan State University wanted to find out whether chronic worrying could play a role in heightening a person’s risk of suffering PTSD after a traumatic episode.
She and her colleagues analyzed data from a 10-year study of approximately one thousand randomly chosen young members of a southeastern Michigan HMO.
When the longitudinal epidemiological study started, participants answered twelve questions to measure their chronic anxiety, depression, and their tendency to overreact to daily stressors (all frequent contributors to what is often characterized as “neuroticism”).
Follow-ups were done at the three, five, and ten-year marks.
Approximately half of the participants experienced a traumatic event during the course of the study, though only five percent developed PTSD.
The interesting thing is, this five percent tended to score higher on the neuroticism scale during the study’s four assessment phases. And increased likelihood of PTSD in cases where participants scored high on neuroticism was statistically significant.
These findings are notable because neuroticism was measured before the participants experienced trauma, suggesting that it may be an indicator for vulnerability to developing PTSD rather than a characteristic that develops as a result of trauma.
This study is impressive because of its longitudinal nature especially because the researchers obtained data before the incidence of trauma in participants.
However, we do need to be careful in interpreting its results. We can’t say for sure that chronic worry is causative, we can only say there is an association with the likelihood of developing PTSD.
And while we might never be able to prevent traumatic events from happening, studies like this one can at least
help us recognize who might be at higher risk for suffering long-term effects of trauma and tailor treatment accordingly.
If you’d like to read more about this study, it was published in Psychological Medicine, November 30, 2012.
What characteristics have you noticed that might be precursors to PTSD?
Please share your experience in the comment section below.
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This is an interesting study but it begs the question in that it doesn’t look at what is responsible for neurotic worrying in the first place. So many of us have experienced very early pre-verbal, even pre-birth trauma that we don’t consciously remember but is affecting us daily. I appreciate the research into what may contribute to PTSD, but I think it would be helpful to also look at potential very early influences.
Hello,
Interesting article. I wonder if this studie also look for what causes worrying?
Nicole Ditz, Trauma Specialist says: (to Sue Greene below)
November 13, 2014 at 8:23 pm
Sue, I understand what you are saying and agree that children who are temperamentally difficult may be responded to with more frustration by frazzled and emotionally dysregulated parents. However, many of these children have one or two parents who are calm and external nervous system regulators for these children. I know this from hearing the stories of many of my client parents and also my best friend is a head teacher in early child development at the Waldorf school and runs many parenting groups in which she witnesses anxious, fretful toddlers with very calm, well regulated mothers.
Also, sometimes the child with a sensitive nervous system is very quiet and timid and easy to care for by a parent but their underlying quiet dysregulation is missed, overlooked and not properly attuned with by a mother more preoccupied with a rambunctious, acting out child.
So it is very complicated, but certainly I don’t believe developmental trauma is linked to a child’s temperament. So much depends on the parents knowing how to adjust themselves to becoming a good temperamental fit for that particular child.
As a therapist, I adjust my style to each of my individual clients according to their temperament, even though I am consistently warm and empathic. Some clients tend a very gentle touch and others thrive on my being more active and dynamic.
I think parents need to go through an extensive training program before being licensed as suitable parents. Final word.
I agree with what Nicole & others are pointing out, & I am sceptical. How can any study really know for sure that a child did not suffer any trauma since birth to the age of 18mos. during the most vital attachment period? I know many women like myself, who raised children in the 70’s, were still led to believe that letting our babies cry themselves to sleep alone in their room at night was the best way to avoid spoiling them and setting them up for becoming too needy. Or that we should not run to hold them as soon as they cry out. I can’t imagine supporting that kind of philosophy today,(&with 6 grand children) with the early childhood development wisdom we have in this day and age, but the belief still it prevails. Just try to bring the topic of parenting up at a social gathering or at the office ie: about infants sleeping in a room alone away from the mother or about spanking and you will feel the tension in the room get very heated and tense immediately. Our ed. systems need to do a much better job at helping young adolescent girls and boys learn the basics in early childhood development. Most of our adult life time will be spent being parents, we need to spend at least as much time teaching teens about parenting skills as we do instructing them how to drive a car safely.
I remain a sceptic about any study that places too much weight upon a child’s genetic predisposition to neurosis as the foundation for PTSD.
One. might make the case that, from watching the news, internstional, nstional and local, that people who are not chronicslly anxious are dissociating. Factually, the world is smply not a very safe
place. In this remark I am including the private homes of many people. How many news stories have you heard recently of children. being stolen from their very own beds (I heard my first at age six with the case of Suan Degnan in Chicago and my latest on lasy night’s local news in Florida). And these are relatively mild compared to the stories of child soldiers, human trafficking, etc.
To me what is worrisome is that there is no popular uprising to organize and do something about these things, since police organizations clearly cannot handle them adequately. Instead, people who concern themselves are labelled neurotic. That seems crazy to me.
As several have mentioned, there is a nuge , link between a country going to war and its citizens subsequently experience the collateral damage from secondary PTSD, violence against others and self (suicide) and drug abuse by returning militwry personnel. I am still suffering from the effects of addiction to morphine by my uncles returning from WWII, by being deprived of a relationship with an uncle who was blown up by a land mine on his way back to base in Belgium the day after the war ended, and other war related family events too numerous to mention. When deciding wjether to enter wars, or celebrating “heroes “protecting our freedom” do we consider effects of loss on the mothers who gave birth to and raised these people, and the collateral damage to their families and friends? It seems to me that they are often sent to protect the economic interests of a few rather than our freedom, but we as a culture all pay a huge price in the ways we have been discussing. Maybe we need to examine the effects on a propensity to go to war and repeat a trauma by people who have previously been traumatized by war and its aftermath and also the “heroic” propaganda which does not always match the circumstances (no WMDs, for example). This is not a side issue but a central question for our society. This work has huge implications and should be studied in interdisciplinary studies.
The cited study is observationall and cannot demonstrate any “role”, since many other factors may predispose the neurotically inclined to PTSD. There’s an interesting neuroscience conference on the _role_ of gut bacteria on mental well being with possibly more compelling data — see Nature News Nov 13, 2014.
I have a research background and have been a licensed mental health clinician, and find this summary
problematic because a numner of terms like “chronic worry” and “neuroticism” are used interchangeably without being adequately defined. Therefor it is not clear to me what is being concluded or indeed whether the correlation being claimed makes sense, or what the direction of causality is. Also,are we sure these people did not have a previous Trauma, or that they did not inherit the effects of trauma as was referred to in the talk yesterday? This all seems a little loose to me from a scientific viewpoint.
I’m wondering if those participants who scored high on “neuroticism,” were then screened for pre-existing, early childhood trauma, e.g. birth trauma,attachment complications.
Robert
A couple of indicators of early childhood trauma which are seldom spoken of in the mental health community are PHYSICAL– a clinical diagnosis that used to be called PANDAS (a sort of OCD), and a spleen (the *seat of worry* in at least two medical systems), that’s about to rupture.
I agree about the need for trauma healing/support to be available to our students in the schools. I find it so hard to find mental health support for the students where I work (2nd largest school district in the country) that is not based only on behavior modification and/or CBT. These students need the SE work, many have issues of developmental trauma, so many.
Related to this article, apparently research also shows that prenatal exposure to certain things can impact a child and lead to chronic worry – fascinating stuff….a child who comes out of the womb not crying (has to be given cold then hot water by medical staff until baby cries) is typically frozen from an already overwhelming prenatal experience (attempt to end life by mother, chronic stress etc).
Let me know how I can be active in bringing trauma healing to our students!!
Has anybody looked at adoptees as possibly being more prone to develop PTSD? The adopted baby has not had a chance to read the adoption papers and all they know is that their mother disappeared and some new lady is taking care of them. I can’t believe it just doesn’t affect them. babies recognize their mothers. It’s got to be like a death in some way no matter how perfect the new mother is.
Another angle of this is whether or not an adopted child is more prone to PTSD specifically from interpersonal abuse.
For that matter I’ve heard very little about PTSD analog symptoms, i.e. people who meet ALL the parameters of the DSM V except the very first one – life or limb threatening circumstances. In Washington State most professionals accept the presence of PTSD for interpersonal emotional abuse, but I wonder about the rest of the country or world.
The big take away for me at this point in the series is WE NEED TO NURTURE OUR BABIES. Everything else comes after that. And since we have derailed somewhere in this process it will be a long-term fix.
I have to remind myself often “one starfish at a time”. We help one person, they help another person and it fans out. And nurturing ourselves and the adults around us helps too.
Thanks to you Ruth, and all the presenters, for sharing this information.
If you’re reading this, you’re all set, pardren!
I have commented 2X in my life puillcby about what happened to me growing up. One time here and another on another sibling abuse type forum. I may never do it again, I may wait for your book and have a complete melt down reading it, or I will once again lock it all away and hope it dissapears. But it wont, it comes back, it’s traumatic and it seems to involve every relationship i have ever been in (abuse started under 1yrs of age) from sister. Family stories are meant to be funny? As far back as I can remember my mother making jokes of my abuse? It took me all these years to realize she was manipulating what happened so that I wouldnt complain? Anyway, im sure we all have horrific stories. I have left my email address. I need to read your book, please please put me on your email notice if that’s possible. I’m also interested in any sort of support group (Canada west coast) see I can’t even say where I live. I too will probably lose my family, well my mother for sure. My sister still manipulates her at 43yrs old. I am so glad I found this blog, please keep me in mind if anyone here forms a group?? I’ve never done anythign like this before, but I’m worth it so I have to start soon xx
A childhood trauma of bloody memories and a lifetime of worry and betrayal. My dad was a chronic worrier. I have COMT gene mutation that makes me tend to worry. Hydroxy b12 is my medicine but I still worry.
Thank you for sharing. Those are very helpful information. Would like to know more about what this medicine help you with mostly?
Thank You for this opportunity to learn more.
Reading all the great thoughtful comments that are being contributed to this space, it confirms what I have always suspected. The American social system produces a high rate of trauma and dysfunction due to its highly competitive structure and failure at sufficient safety and nurturing. Oddly enough, serving the needs of a traumatized population leads to huge profits from ambiguous feel good industries that promise to solve your problems with the right diet, right product, right…magic bullet. A susceptible population then seems highly desirable.
If a child is born predisposed to having a hyper alert, overly sensitive nervous system, it’s hard to think that developmental trauma wouldn’t follow…because of the way that child’s behavior interacts with the environment. Meaning, regardless of an identifiable big T trauma…a baby / child that is temperamental and not easy to soothe … would often get frustrated responses from their environment (caregivers, sibs, etc)and those responses would be experienced as invalidating…leading to chronic trauma on top of the existing predisposition. Right? It’s both the genetic loading and the way that loading then interacts with the environment.
Sue, I understand what you are saying and agree that children who are temperamentally difficult may be responded to with more frustration by frazzled and emotionally dysregulated parents. However, many of these children have one or two parents who are calm and external nervous system regulators for these children. I know this from hearing the stories of many of my client parents and also my best friend is a head teacher in early child development at the Waldorf school and runs many parenting groups in which she witnesses anxious, fretful toddlers with very calm, well regulated mothers.
Also, sometimes the child with a sensitive nervous system is very quiet and timid and easy to care for by a parent but their underlying quiet dysregulation is missed, overlooked and not properly attuned with by a mother more preoccupied with a rambunctious, acting out child.
So it is very complicated, but certainly I don’t believe developmental trauma is linked to a child’s temperament. So much depends on the parents knowing how to adjust themselves to becoming a good temperamental fit for that particular child.
As a therapist, I adjust my style to each of my individual clients according to their temperament, even though I am consistently warm and empathic. Some clients tend a very gentle touch and others thrive on my being more active and dynamic.
I think parents need to go through an extensive training program before being licensed as suitable parents. Final word.
I worked with Viet Nam Vets as a volunteer at the VA in Menlo Park, CA in the 1980’s and also volunteered on the schizophrenia ward. I came to think that those who had mental troubles before the war experience had less bounce back ability than those who were wounded with out this kind of baggage. It was during that time that I learned about Secondary PTSD and came to realize that I suffered from it due to my father’s WWII experiences. Our whole family suffered without knowing this and my mother was deeply affected for the rest of their 62 year marriage.
Your comments on the webnar yesterday were very helpful to me as I begin to recognize my behaviors as a result of traumas I have experienced, physical, sexual and emotional.
My current situation is that after two bad falls in 2013, my now 97 year old mother, amazingly recovered, has come to live with me and my husband. My depression I think has been linked to the trauma of care giving her during that time and then having her live with us suddenly this spring has been experienced as chronic headaches and poor recovery from sinus surgery and dental procedures.
After the webnar yesterday, I chose to go off all pain meds and consider moment by moment that I do not have to be at the effect of the trauma and feeling of helplessness of having a very controlling and manipulating mother in our home.
I am an artist and have seen great progress reflected in my work when breakthroughs have occurred in my recovery work, so I will purpose to nurture myself by doing artistic and creative things more consistently in the future. I spend time in prayer and study each morning to prepare me for each day and to turn my life over to the Lord.
Thank you for helping me to objectify things that seemed overwhelming and God bless you all as you continue to make your findings known.
Sincerely,
Harriet Priska
I wanted to respond to two of the below comments made by Elana goell and Stephanie Tweed.
First off I want to say I agree with many of your points, it is hard to know what comes first as in very early trauma or anxiety. However, I can tell you it is well known through comprehensive research that there are real genetic suseptibilities via temperament and genotypes to developing anxiety, emotional reactivity and hyperactive amygdalae/increased autonomic arousal in people who never even experience trauma in their lives. If they are traumatized, they are often significantly more symptomatic than those with a more resilient genetic outlay. It makes sense, doesn’t it?
I can see the difference in how temperament interacts with trauma amongst my own clientele with comparable levels of childhood trauma–they all have symptoms but to vastly different degrees, in part due to their temperaments. The ones who talk about being introverted, timid, anxious as young children seem to have the most debilitating symptoms of ptsd.
My own father and his only sibling had very different adaptations to the holocaust, with my father being much more symptomatic than his calmer sister. He told me many times that he was a very anxious child for as far back as he can remember, long before the traumatic events.
The best book I have ever read on the subject of anxiety/worry from a biological, cultural, environmental, relational, anthropological, philosphical, and genetic perspective is a recent opus (2013) by Scott Stossel called My Age of Anxiety: Fear, hope, dread, and the search for peace of Mind.
By the way, I write this not only as a therapist but also as a survivor of milder complex trauma who remembers being anxious as far back as the crib.
Lastly, I agree that the word “neuroticism” needs to be changed. It is perjorative and a blame the victim type of term, developed during a time that patriarchy ruled and female trauma survivors were thought of as “hysterical”!
This really looks like an interesting book. I will make sure to read through it. I needed some such reading and this is what I am so glad finding. Thank you.
Thank you for this discussion and hosting this meaningful program. I’m studying compassion fatigue for my dissertation inf Health Psychology so have found this work intriguing. I would like to read the article in depth but was unable to find it in the Nov 2012 issue of Psychological Medicine.
Thank you once again for this forum of wonderful body of work.
We need to understand more why the subjects developed chronic anxiety. It may be that they had early attachment trauma (complex trauma) so that it is not the chronic anxiety that is correlated but earlier trauma.
I also realize how hypervigilant I was as a child growing up in a home with severe mental illness. We were handed off to relatives when my mother had breaks, unable to care for us. On retiring from 23 years on Army active duty, I was found to have PTSD, but not all due to combat exposure, rather due to constant worry about protecting my troops and their family members in the rear, exacerbated by the suicide of my own 20 year old son. This research and hypothesis once again emphasizes the importance of attending to our patient’s entire health, physical, mental, and spiritual, addressing everyday chronic stresses before they become crises. Chronic worry coupled with childhood trauma can result in adult issues.
I suspect this may be why soldiers become more prone to PTSD when they have multiple deployments with not much time in between. If they haven’t had time to process and integrate the stress and hyper vigilance from a one deployment, their body/mind would be in a similar state to the high worriers in this study.
Being sent back into war zones in this ‘worry state’ would make them much more susceptible to PTSD.
Thank you so much for your informative posts. This one begs the question “which came first, the chicken or the egg?” As a chronic worrier and a person who has suffered from PTSD since 2002, I was very interested in this article.
I know that I was not “born” a worrier; I became one however, growing up in a household with mental illness and domestic violence. How would you teach a child “not to worry” when they are in a situation that endangers their life on a daily basis? Isn’t that one of the causes of PTSD in the first place? If one had no reason to worry, I do not believe that PTSD would become an issue. Worry will not cease until a person feels that they are “safe” and able to handle whatever comes their way. Genetic risk factors, childhood adversity, poverty etc creates situations that can be cause for tremendous fear and worry (especially in young children who have no tools for coping in such situations.)
I appreciate the statement that “while we cannot say that chronic worry is causative, we can only say that there is an association with the likelihood of developing PTSD.” However, my question is how could there NOT be an association? Being in situations that causes one to fear for their life is the main cause of PTSD. Being in that situation for long periods of time causes unremitting stress, anxiety and worry…perhaps not in everyone; but those who were exposed to such situations before they were old enough to develop coping skills to deal with such situations. My concern is labeling this “neuroticism.”
Thank you again for sharing this information!
Hi there. As a retired educator, trauma survivor, and one who has spent time worrying about whether or not ‘I have PTSD,’ or if ‘I have had students with PTSD,’ I would implore you to find avenues for sharing this information with school districts, organizations that provide professional development opportunities for teachers, and even. . . I dare say it. . . universities that provide teacher education.
Your series has been helpful, because as a retiree and survivor, I can now take the time needed to
read and respond to many more ideas that offer help w. the education of children. But I’m also keenly
aware that the internationalizing of schools in combination with raising the economic status of people around the world has created a situation where we are bringing more children into the American education system whom, due to the effects of things like war, isolation, extreme poverty. . . may have had a greater proclivity for trauma.
Wishing you all the best with your work. The more information you share in a pro-active way, perhaps the better off we are.
Karen Melaas, M.Ed.