title: Beware of multiple traumas in PTSD assessment: the role of reactivation mechanism in intrusive and hyper-arousal symptoms.
abstract: OBJECTIVE
  Post-traumatic stress disorder (PTSD) is a major public health problem defined by three symptom clusters: intrusion thoughts, avoidance mechanisms and hyper-arousal. Several authors have emphasized, that some or all of these symptoms related to a past traumatic experience could be reactivated, even after long asymptomatic periods. This study investigates the role of an additional trauma in the reactivation of a childhood trauma among a group of former hidden children (n = 65), the Jewish youths who spent World War II in various hideaway shelters in Nazi-occupied Europe. They were compared with a control group.
  
  
  METHODS
  The presence or absence of an additional trauma in adulthood was assessed and PTSD symptoms were measured by using the Impact of Event Scale-Revised.
  
  
  RESULTS
  An additional trauma reactivates PTSD symptoms of intrusion thoughts and, marginally, symptoms of hyper-arousal. At the opposite, symptoms of avoidance were not reactivated.
  
  
  CONCLUSIONS
  Our results confirm the role of an additional trauma in the reactivation of traumatic memories, related to an earlier trauma, in later life. Clinical and theoretical implications are discussed and perspectives are proposed.
authors.affiliation: a CHU Brugmann , Université Libre de Bruxelles , Brussels , Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Fossion
authors.forename: Christophe
authors.initials: C
authors.lastname: Leys
authors.forename: Chantal
authors.initials: C
authors.lastname: Kempenaers
authors.forename: Stephanie
authors.initials: S
authors.lastname: Braun
authors.forename: Paul
authors.initials: P
authors.lastname: Verbanck
authors.forename: Paul
authors.initials: P
authors.lastname: Linkowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001143:Arousal / Q000502:physiology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D047789:World War II
keywords: Impact of Event Scale-Revised; retraumatization; trauma reactivation