2-ASAP: Improving early risk detection and indicated prevention for PTSD

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Many people experience one or more traumatic events during their lives, such as a car accident or an assault. Fortunately, most people experience relatively mild or short-lasting psychological complaints in the aftermath of such events. Yet, for a substantial amount of people, these traumatic events will result in the onset of severe and long-lasting psychological problems. Posttraumatic stress disorder (PTSD) is among the most common problems following trauma, developing in approximately 5-10 percent of trauma-exposed people.

The early weeks following a traumatic event present a crucial opportunity to implement preventive interventions aimed at reducing the occurrence of long-term posttraumatic stress disorder (PTSD), as well as the negative consequences and societal costs associated with it. However, these interventions are effective and practical only when they are specifically targeted towards individuals who are at a high risk of developing long-term PTSD.

Existing screening instruments are not adequate
The existing prognostic screening instruments, which are used to identify individuals at risk of developing long-term PTSD, have not been successful in accurately predicting this outcome when applied during the initial weeks after the trauma. One reason for this failure could be that these instruments do not adequately capture the diverse patterns and causes of PTSD. In other words, PTSD can manifest in various ways and have different underlying factors, making it challenging for current screening tools to account for this complexity.

The Towards Accurate Screening And Prevention (2-ASAP) consortium aims to develop a new screening instrument that can accurately assess the risk of individuals developing long-term posttraumatic stress disorder (PTSD) when applied soon after a traumatic event. This new instrument aims to overcome the limitations of existing screening tools by incorporating machine learning techniques. The consortium project involves collaboration among various partners, including Utrecht University, Amsterdam University Medical Centers, Slachtofferhulp Nederland (Victim's Support Netherlands), Arq National Psychotrauma Center, and Erasmus Medical Center.

Scope of available screening instruments
In this specific project, the 2-ASAP consortium and ASReview will collaborate to conduct a systematic scoping review of existing prognostic risk screening instruments for posttraumatic stress disorder (PTSD). The purpose of this review is to gather a current and comprehensive understanding of available screening instruments and their accuracy in classifying individuals at risk for PTSD. The goal is to identify common elements among accurate and less accurate instruments.

NWO Grant
Furthermore, the consortium received a grant from the NWO (Dutch Research Council) to facilitate a significant advancement in the screening process. Most commonly used databases, such as Web of Science or Scopus, are closed source and predominantly contain studies from Western countries published in expensive journals. This leads to biases, as many studies are written in English or focus exclusively on English publications, creating a Western-centric perspective. To address this, the consortium emphasizes the importance of using more inclusive databases. The goal is to establish a completely open-source, inclusive, and near-real-time pipeline for systematic reviewing of PTSD screening instruments. This pipeline aims to eliminate restrictions in the search query that potentially introduce biases toward Western studies or the English language. It also emphasizes the need to continuously update the collection of relevant studies to stay current with the evolving research landscape.


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