Beyond fear, helplessness, and horror: Peritraumatic reactions associated with posttraumatic stress symptoms among traumatized delinquent youth.

Abstract

This study investigated associations among peritraumatic reactions, including the triad of fear, helplessness, and horror specified in Criterion A2 of the DSM-IV-R, and posttraumatic stress disorder (PTSD) diagnostic status and symptom severity among a sample of 555 juvenile justice-involved adolescents (188 girls and 367 boys). Results of hierarchical and logistic regression analyses indicated that, with the exception of helplessness, peritraumatic reactions beyond the DSM-IV-R triad, particularly disorganized behavior and confusion, were more strongly associated with PTSD diagnosis and symptoms among these youth than were the A2 criteria. Gender differences also emerged in the pattern of results, with disorganized behavior and dissociation associated more strongly with PTSD symptom levels among girls than boys. In addition, investigation of the relations between peritraumatic reactions and the recently proposed 5-factor model of PTSD symptom clusters showed that peritraumatic disorganization was the most consistently associated with PTSD symptoms, whereas peritraumatic helplessness was uniquely associated with Numbing among boys and Dissociation among girls. These results have implications for informing the DSM-5 as well as adding to the evidence base for deriving developmentally sensitive criteria for the diagnosis of PTSD among youth exposed to trauma.