AI Predicts PTSD Risk Based on Stories About What Brought Patients to the Emergency Room

NEW YORK, Nov. 9, 2026 /PRNewswire/ -- An AI tool can analyze patients' narratives about injuries that sent them to the emergency room to predict who will later develop post-traumatic stress disorder (PTSD), a new study found.

About 43 million patients are admitted to a US emergency department (ED) each year with physical injuries (trauma), and more than a quarter of them develop PTSD, according to past studies. That makes the ED a checkpoint for catching the condition early, but clinicians face time constraints severe enough to rule out the use of standard screening questionnaires.

Led by NYU Langone Health researchers, the new study found that the team's set of AI models — each analyzing the trauma narratives of 145 ED patients — correctly identified more than 95.4 percent of at-risk patients. In a head-to-head test, the AI tool, called PREVIA, flagged 100 percent of 30 cases from the same patient group that went on to develop PTSD, while an ED clinician specializing in PTSD correctly identified 89 percent of these cases.

"This is the first study to show that a patient's spontaneous answers to a single, routine care question — 'What brought you to the ED?' — carries enough of a psychological signal to forecast their PTSD risk a month later," said senior study author Katharina Schultebraucks, PhD, associate professor in the departments of psychiatry and population health at NYU Langone. "PREVIA can serve as an AI screener that identifies at-risk patients and explains why, without adding any time to intake in busy emergency rooms."

Published online November 9 in Nature Communications, the new work examined the capabilities of generative AI, which predicts options for the next word in a sentence based on how billions of people used that word in context. This sensitivity to language lets the models analyze a person's description of what happened to them to find patterns linked to their risk of developing PTSD, the researchers said. The patients' answers were recorded and transcribed for analysis.

"The emergency department is often the only point of contact a trauma survivor has with the healthcare system before symptoms become much harder to treat," added Dr. Schultebraucks, who is also co-director of computational psychiatry at NYU Grossman School of Medicine. "By identifying at-risk patients at that first encounter, PREVIA could open a window for timely care approaches, when preventive intervention is most effective."

The first month after trauma is a key window for finding those at risk for PTSD because many patients are no longer in contact with the hospital after that, the researchers said. Current questionnaires — such as the Peritraumatic Dissociative Experiences Questionnaire and the Posttraumatic Adjustment Scale — effectively forecast PTSD development, yet only about 28 percent of EDs routinely screen for PTSD at all, and only two-thirds of those use validated tools.

This likely reflects overcrowding and limited clinician time, typically about 15–20 minutes per patient, which forces clinicians to prioritize immediate medical concerns over lengthy mental health assessments, the study authors said.

PREVIA was designed as a pipeline of steps that use different AI tools based on their strengths (e.g., the Llama model tends to emphasize signs of PTSD risk, while Mistral highlights protective and contextual factors that could buffer against it). Specifically, the tool's first layer scans the language of a patient's narrative for symptoms that happen during the initial trauma, like loss of control or amnesia, as well as early symptoms that show up while a person is in the ED, such as feeling disconnected from the body. Both types of symptoms have been linked to later PTSD development.

The second layer of the team's AI tool also weighs risk factors such as pre-existing mental health problems or lower socioeconomic status, alongside protective factors such as coping skills or strong social support. A third AI model synthesizes these assessments into a structured summary, reducing the chance that any single model dominates the results. A final layer combines that summary with demographic information (e.g., age, sex), trauma type, and known PTSD prevalence rates to produce a risk score with a plain-language explanation.

Experiments confirmed that this three-layer design consistently outperformed simpler configurations across most performance metrics. Unlike AI that succeeds or fails for reasons unknown, PREVIA explains its reasoning and grounds predictions in established PTSD risk factors. Results with the tool were also validated by comparing them to diagnoses made for the same cases using Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the gold standard clinical interview for diagnosing PTSD.

"We built PREVIA on open-source models with no training or fine-tuning required," said Dr. Schultebraucks. "That means other hospitals can test it independently, without access to proprietary software or our patient data, which is essential for widespread adoption."

Along with Dr. Schultebraucks, authors of the study from NYU Langone were Victoria Mueller, Jyoti Yadav, Annie Farnsworth, Charlotte Hilberdink, Sapir Gershov, and Arieh Shalev in the Department of Psychiatry, Eric Oermann in the Department of Neurosurgery, and Stephen Wall in the Ronald O. Perelman Department of Emergency Medicine.

The study was funded by the National Institute for Mental Health grant R01 MH129856 (PI Dr. Katharina Schultebraucks).

About NYU Langone Health
NYU Langone Health is a fully integrated health system that consistently achieves the best patient outcomes through a rigorous focus on quality that has resulted in some of the lowest mortality rates in the nation. Vizient Inc. has ranked NYU Langone No. 1 out of 118 comprehensive academic medical centers across the country four years in a row, and "U.S. News & World Report" recently ranked four of its clinical specialties No. 1 in the nation. NYU Langone offers a comprehensive range of medical services with one high standard of care across seven inpatient locations, its Perlmutter Cancer Center, and more than 330 outpatient locations in the New York area and Florida. The system also includes two tuition-free medical schools, in Manhattan and on Long Island, and a vast research enterprise.

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SOURCE NYU Grossman School of Medicine and NYU Langone Health