Date Presented 04/03/2025
Posttraumatic stress disorder (PTSD) is a debilitating condition. We specify patterns of participation restrictions by objective and subjective dimensions in PTSD and indicate the importance of the subjective experience of cognition, sensory regulation, and environmental suitability.
Primary Author and Speaker: Lena Lipskaya-Velikovsky
Contributing Authors: Ruth Shapira
PURPOSE: To investigate the extent of participation restrictions in PTSD and possible mechanisms for change, we compared objective and subjective participation dimensions to healthy population; and explore contribution of clients’ factors and environment to participation.
DESIGN: Cross-sectional, comparative, with convenience sampling.
METHOD: Sixty two individuals with PTSD (aged 34.3±9.2; women: 24, 77.4%) and matched healthy controls, completed standard assessments for cognitive profile, executive functions (EF) based on self-report and performance, sensory processing, self-efficacy, functional capacity, environmental properties, participation in daily life in objective (diversity, intensity, place of doing and with whom) and subjective (enjoyment, satisfaction, meaningfulness) dimensions, and PTSD symptoms.
RESULTS: Participation diversity, intencity and enjoyment were inferior in PTSD (2.7<t<3.1, p<.01). Individuals with PTSD performed more activities alone and at home (3.2<χ2<3.9, p<.01), and experienced low meaning within the participation. Diversity was associated with self-reported EF (r=0.47, p<.05), environment properties (r=0.5, p<.01), and sensory alterations (t(27)=2.517, p<0.05); intensity with self-reported EF (r=0.45, p<.05), and sensory alterations (t(27)=2.6, p<0.05), and experience of meaning was inferior for those with sensory avoidance (t(27) =2.8, p<.01).
CONCLUSIONS: Participation restrictions in PTSD encompass both objective and subjective dimensions. Cognitive and sensory regulation as well as environment suitability are of importance for participation in PTSD, while, uniquely, objective client factors are of less impact comparing to subjective ones.
IMPACT STATEMENT: The participation restrictions raise major concern given their profound effect on well-being, health and burden. This study suggest possible mechanisms for the participation promotion in PTSD with the ultimate goal of contribution to well-being and health.
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