Measures Of Posttraumatic Stress Disorder Symptom Severity Research Articles

The Effect of Cognitive Fusion on Change in PTSD and Depression Symptom Severity in Veterans Engaged in Group Psychotherapy.

Cognitive fusion occurs when people experience their thoughts as literally true and allow them to dictate behavior. Fusion has been shown to be associated with increased symptoms of post-traumatic stress disorder (PTSD) and depression; however, the association between change in cognitive fusion, PTSD, and depression symptoms has been relatively uninvestigated. Our study aims to examine the associations between PTSD, depression symptoms, and cognitive fusion in Canadian veterans from pre- to post-treatment. Clients (N = 287) completed measures of PTSD symptom severity, depression symptom severity, and cognitive fusion at pre- and post-treatment. Our results supported that pretreatment PTSD and depression symptom severity were found to be negatively associated with changes in pre- to post-treatment cognitive fusion, while pretreatment cognitive fusion was not associated with changes in depression or PTSD symptoms. Furthermore, pretreatment depression symptoms predicted pre- to post-treatment changes in PTSD symptoms. However, pretreatment PTSD symptoms did not predict changes in depression symptoms. These findings highlight the importance of understanding the bidirectional associations between PTSD, depression, and cognitive fusion. Furthermore, our results are indicative of PTSD and depression symptoms playing a role in the change in cognitive fusion (e.g., defusion) and of depression playing a larger role in the maintenance of PTSD symptoms. Theoretical and practical implications are discussed.

Associations between sleep problems and posttraumatic stress symptoms, social functioning, and quality of life in refugees with posttraumatic stress disorder.

Many patients with posttraumatic stress disorder (PTSD) suffer from sleep problems, leading to impairments in social functioning and quality of life. Refugees are at high risk for sleep problems due to stressful life circumstances and a high PTSD prevalence. However, limited data on the frequency of sleep problems in refugees with diagnosed PTSD exist. This study examined the frequency of sleep problems in refugees with PTSD and their associations with symptoms of PTSD. Additionally, we investigated the contribution of sleep problems to social functioning and quality of life. Participants (N = 70) were refugees from different countries of origin currently living in Germany. All participants met the criteria for PTSD and completed measures of PTSD symptom severity, subjective sleep problems, social impairment, and quality of life. There was a very high frequency of sleep problems in the sample (100%), and sleep problems were significantly associated with both clinician-rated, r = .47, and self-rated, r = .30, PTSD symptom severity after controlling for overlapping items. Contrary to expectations, sleep problems did not predict social impairment, d = 0.16, nor quality of life, d = 0.13, beyond the effect of other PTSD symptoms. The findings highlight the widespread frequency of sleep problems among refugees. Future studies should assess the causal nature of the association between sleep problems and measures of psychosocial functioning in more detail and examine its dynamic change over time.

Anger and predictors of drop-out from PTSD treatment of veterans and first responders.

Drop-out is an important barrier in treating post-traumatic stress disorder (PTSD) with consequences that negatively impact clients, clinicians and mental health services as a whole. Anger is a common experience in people with PTSD and is more prevalent in military veterans. To date, no research has examined if anger may predict drop-out in military veterans or first responders. The present study aimed to determine the variables that predict drop-out among individuals receiving residential treatment for PTSD. Ninety-five military veterans and first responders completed pre-treatment measures of PTSD symptom severity, depression, anxiety, anger, and demographic variables. Logistic regression analyses were used to determine if these variables predicted drop-out from treatment or patterns of attendance. Female gender was predictive of drop-out. However, when analysed by occupation female gender was predictive of drop-out among first responders and younger age was predictive of drop-out in military participants. Anger, depression, anxiety and PTSD symptom severity were not predictive of drop-out in any of the analyses. No variables were found to predict attendance patterns (consistent or inconsistent) or early versus late drop-out from the programme. These results suggest that although anger is a relevant issue for treating PTSD, other factors may be more pertinent to drop-out, particularly in this sample. In contrast with other findings, female gender was predictive of drop-out in this study. This may indicate that in this sample, there are unique characteristics and possible interacting variables that warrant exploration in future research.

Epigenetic prediction of 17β-estradiol and relationship to trauma-related outcomes in women

17β-estradiol (E2) levels in women correlate with multiple neuropsychiatric symptoms, including those that are stress-related. Furthermore, prior work from our group has demonstrated that E2 status influences DNA methylation (DNAm) across the genome. We developed and validated a DNAm-based predictor of E2 (one of four naturally occurring estrogens) using a training set of 183 females and a test set of 79 females from the same traumatized cohort. We showed that predicted E2 levels were highly correlated with measured E2 concentrations in our testing set (r ​= ​0.75, p ​= ​1.8e-15). We further demonstrated that predicted E2 concentrations, in combination with measured values, negatively correlated with current post-traumatic stress disorder (PTSD) (β ​= ​−0.38, p ​= ​0.01) and major depressive disorder (MDD) diagnoses (β ​= ​−0.45, p ​= ​0.02), as well as a continuous measure of PTSD symptom severity (β ​= ​−2.3, p ​= ​0.007) in females. Finally, we tested our predictor in an independent data set (n ​= ​85) also comprised of recently traumatized female subjects to determine if the predictor would generalize to a different population than the one on which it was developed. We found that the correlation between predicted and actual E2 concentrations in the external validation data set was also high (r ​= ​0.48, p ​= ​3.0e-6). While further validation is warranted, a DNAm predictor of E2 concentrations will advance our understanding of hormone-epigenetic interactions. Furthermore, such a DNAm predictor may serve as an epigenetic proxy for E2 concentrations and thus provide an important biomarker to better evaluate the contribution of E2 to current and potentially future psychiatric symptoms in samples for which E2 is not measured.

Examining the impact of a Healing Touch intervention to reduce posttraumatic stress disorder symptoms in combat veterans.

This study examined the use of Healing Touch (HT), a biofield therapy, as an intervention in treating posttraumatic stress disorder (PTSD). It exemplifies the upswing of biofield (energy field) therapies that have been taking place recently for a number of clinical conditions, including cancer, pain, arthritis, movement restriction, and energy psychology. Theoretically, the human body is the physical aspect of an individualized field of energy (biofield) in which electrical activity functions as a complex, organized whole or system. Hypothetically, this system plays a critical role in the effective treatment of PTSD. Trauma-induced congested energy in vital areas of the human body, particularly the chakras and the funnel-shaped crown-to-transpersonal channel, impedes the natural release of unwanted energy of emotions, thereby becoming a major obstacle to treatment. This qualitative and quantitative study examined the use of HT as an effective intervention to break up and clear away congested energy, promote a strong energy flow, and allow the natural release of unwanted energy of emotions to normalize. The test group would average a mean reduction of symptom severity of at least 18 points after 10 treatments, as measured by the psychometrically sound self report measure of PTSD symptom severity for military use. In a 2-armed randomized crossover waitlist controlled trial, combat veterans experienced the impact of HT techniques complementing standard care on the severity of their PTSD symptoms. The test group's mean reduction of symptom severity was a clinically significant 18.11 points, along with a reliable change of 5.57 points for the control group. Overall, subjects reported a range of positive physical and psychological effects. Although continued research using larger samples is needed, it may be concluded that HT is a low-risk, low-cost intervention for PTSD that should be implemented as a treatment option, especially in combination with "gold-standard" therapies. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

DNA methylation of NR3C1 and FKBP5 is associated with posttraumatic stress disorder, posttraumatic growth, and resilience.

Understandings of the biological mechanisms underpinning posttrauma responses are limited. This pilot study aimed to expand research in this area by examining the relationship between DNA methylation of stress genes nuclear receptor subfamily 3 group C member 1 (NR3C1) and FK06 binding protein 5 (FKBP5) with an array of posttrauma responses of posttraumatic stress disorder (PTSD) symptom severity, posttraumatic growth (PTG), and resilience. First-year paramedicine students (N = 47) completed self-report measures of PTSD symptom severity, PTG, and resilience and provided a saliva sample for methylation analysis. Surrogate variable analyses identified covariates after which generalized regression models were performed to identify genomic sites significantly associated with PTSD symptom severity, PTG, or resilience. Methylation of different FKBP5 and NR3C1 sites was significantly associated with PTSD symptom severity, PTG, and resilience. Methylation in FKBP5 site cg07485685 was a predictor of both PTSD symptom severity and resilience in opposite directions. This is the first study investigating methylation changes in PTG, and overall the results suggest that NR3C1 and FKBP5 methylation is associated with both positive and negative posttrauma responses. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The association of PTSD symptom severity with amygdala nuclei volumes in traumatized youths

The amygdala is a core component in neurobiological models of stress and stress-related pathologies, including post-traumatic stress disorder (PTSD). While numerous studies have reported increased amygdala activity following traumatic stress exposure and in PTSD, the findings regarding amygdala volume have been mixed. One reason for these mixed findings may be that the amygdala has been considered as a homogenous entity, while it in fact consists of several nuclei with unique cellular and connectivity profiles. Here, we investigated amygdala nuclei volumes of the basolateral and the centrocorticomedial complex in relation to PTSD symptom severity in 47 young survivors from the 2011 Norwegian terror attack 24–36 months post-trauma. PTSD symptoms were assessed 4–5, 14–15 and 24–36 months following the trauma. We found that increased PTSD symptom severity 24–36 months post-trauma was associated with volumetric reductions of all basolateral as well as the central and the medial nuclei. However, only the lateral nucleus was associated with longitudinal symptom development, and mediated the association between 4–5 months and 24–36 months post-trauma symptoms. The results suggest that the amygdala nuclei may be differentially associated with cross-sectional and longitudinal measures of PTSD symptom severity. As such, investigations of amygdala total volume may not provide an adequate index of the association between amygdala and stress-related mental illness.

An Empirical Crosswalk for the PTSD Checklist: Translating DSM-IV to DSM-5 Using a Veteran Sample.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) introduced numerous revisions to the fourth edition's (DSM-IV) criteria for posttraumatic stress disorder (PTSD), posing a challenge to clinicians and researchers who wish to assess PTSD symptoms continuously over time. The aim of this study was to develop a crosswalk between the DSM-IV and DSM-5 versions of the PTSD Checklist (PCL), a widely used self-rated measure of PTSD symptom severity. Participants were 1,003 U.S. veterans (58.7% with PTSD) who completed the PCL for DSM-IV (the PCL-C) and DSM-5 (the PCL-5) during their participation in an ongoing longitudinal registry study. In a randomly selected training sample (n = 800), we used equipercentile equating with loglinear smoothing to compute a "crosswalk" between PCL-C and PCL-5 scores. We evaluated the correspondence between the crosswalk-determined predicted scores and observed PCL-5 scores in the remaining validation sample (n = 203). The results showed strong correspondence between crosswalk-predicted PCL-5 scores and observed PCL-5 scores in the validation sample, ICC = .96. Predicted PCL-5 scores performed comparably to observed PCL-5 scores when examining their agreement with PTSD diagnosis ascertained by clinical interview: predicted PCL-5, κ = 0.57; observed PCL-5, κ = 0.59. Subsample comparisons indicated that the crosswalk's accuracy did not differ across characteristics including gender, age, racial minority status, and PTSD status. The results support the validity of this newly developed PCL-C to PCL-5 crosswalk in a veteran sample, providing a tool with which to interpret and translate scores across the two measures.

Latent factor structure of PTSD symptoms in veterans with a history of mild traumatic brain injury and close-range blast exposure.

Confirmatory factor analysis (CFA) has previously been employed to examine the latent factor structure of posttraumatic stress disorder (PTSD) symptoms with mixed results. A limited number of studies examined PTSD factor structure among veterans of recent military conflicts. This study examined the relationship between PTSD factor structure and the hallmark conditions of these conflicts, mild traumatic brain injury (mTBI) and close-range blast exposure (CBE). The fit of previously proposed PTSD factor models was compared in a cohort of 387 combat-exposed veterans, with stratified analyses comparing factor structure models between those with a history of military-related mTBI and CBE (n = 106) and those without either of these antecedents (n = 151). CFAs were conducted using criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994). The 4-factor emotional numbing (EN) model yielded the best fit when using a clinician-administered assessment of PTSD symptoms regardless of mTBI/CBE exposure status. However, when using a self-report measure of PTSD symptom severity, the EN model yielded best fit for those with mTBI/CBE exposure history while the 5-factor dysphoric arousal (DA) model was preferable among combat-exposed veterans with no history of mTBI/CBE exposure. Factors including mTBI and blast exposure and type of assessment tools must be considered when determining preferable PTSD latent factor structure models. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Polysubstance Use Among Veterans in Intensive PTSD Programs: Association With Symptoms and Outcomes Following Treatment

Objective: A distinct group of patients has recently been described who experience polysubstance use disorder characterized by use of multiple addictive substances. This study examines baseline characteristics and longitudinal outcomes of a group of such patients in specialized intensive Veterans Health Administration posttraumatic stress disorder (PTSD) programs and followed 4 months after discharge. Methods: Patients with diagnosed PTSD or subsyndromal PTSD and who used a single substance at baseline were compared to those who used two or three and more than three different addictive substances on measures of PTSD symptom severity and functioning. Comparisons were also adjusted for differences in total days of any substance use and other potentially confounding factors. Patients were reclassified according to the number of substances used at follow-up and again compared on symptoms and functioning. Results: Bivariate analysis of baseline data (N = 8,240) showed frequent polysubstance use (n = 3,695, 44.8% of the sample) and that use of greater numbers of substances was associated with more severe PTSD symptoms as well as more total days of substance use. At follow-up after treatment, 58.2% of the original sample (n = 4,797) was assessed. Polysubstance use was less frequent (n = 756, 15.8% of the follow-up sample), but showed a similar association with more severe symptoms, although differences were attenuated after adjusting for total days of substance use. Conclusions: Polysubstance use, conceptualized within the multimorbidity perspective, is associated with increased severity of PTSD symptoms among veterans with dual diagnoses requiring complex interventions, the evaluation of which will require innovative trial designs.

The Influence of Posttraumatic Stress Disorder on Health Functioning in Active-Duty Military Service Members.

Researchers have suggested that posttraumatic stress disorder (PTSD) is associated with significant healthcare burden and utilization of medical services. The purpose of this study was to examine the impact of PTSD symptoms on health functioning among active-duty military personnel. Participants in the study were 366 treatment-seeking service members who had returned from deployment and were participating in a larger PTSD treatment study. Assessments included measures of PTSD symptom severity, combat experiences, life stress, health functioning, alcohol use, and depression. We hypothesized that at baseline, PTSD severity and its symptom clusters would be significantly associated with poorer physical and mental health functioning. We conducted separate hierarchical multiple regressions to examine the predictive contribution the hypothesized factors would have on the variance in physical and mental health scores. Consistent with previous literature, we found that PTSD severity was significantly associated with poorer mental health functioning, B = -0.25, SE = 0.08, β = -0.15, t(342) = -3.07, R2 = .37, p = .002; however, contrary to our hypotheses, PTSD severity was not associated with poorer physical health functioning. Further, the hyperarousal symptom cluster was significantly associated with poorer physical health functioning, B = -0.83, SE = 0.26, β = -0.18, t(340) = -3.16, R2 = .11, p = .002, but not mental health functioning. Limitations of our study included the use of self-report measures only and lack of objective measures. Future directions for study include examination of how health functioning perceptions change over a longer duration of PTSD symptoms and after treatment.

Heart rate reactivity to trauma-related imagery as a measure of PTSD symptom severity: Examining a new cohort of Veterans

For over three decades, there has been considerable research documenting increased physiological reactivity to trauma-related stimuli as a characteristic feature of posttraumatic stress disorder (PTSD). The present study explored the potential for physiological assessment to aid in defining and validating screening criteria for the presence of significant PTSD-related symptoms in a sample of OEF/OIF/OND Veterans seeking care in a VA post-deployment health clinic. Heart rate reactivity scores during the imagining phase of the script-driven imagery paradigm were compared across groups of individuals with and without probable PTSD diagnoses, as defined by PCL-IV cutoff scores ranging from 40 to 60. Significant differences were found for groups defined by PCL-IV cutoff scores of 50 and 60, with 50 producing the largest effect size. Diagnosing PTSD is made challenging by the presence of overlapping symptoms shared with other diagnoses, as well as by the necessity for patients to accurately report their symptoms. An objective physiological measure capable of accurately differentiating individuals with and without PTSD provides potential adjunctive diagnostic and treatment information to clinicians. The present findings support the validity of physiological reactivity during SDI as a NIMH RDoC measure that can be used in research and clinical applications assessing trauma-related symptom severity.

A relative weights comparison of trauma-related shame and guilt as predictors of DSM-5 posttraumatic stress disorder symptom severity among US veterans and military members.

Veterans and military service members have increased risk for post-traumatic stress disorder (PTSD) and consequent problems with health, psychosocial functioning, and quality of life. In this population and others, shame and guilt have emerged as contributors to PTSD, but there is a considerable need for research that precisely demonstrates how shame and guilt are associated with PTSD.This study examined whether a) trauma-related shame predicts PTSD severity beyond the effects of trauma-related guilt and b) shame accounts for a greater proportion of variance in PTSD symptoms than guilt. We collected cross-sectional self-report data on measures of PTSD symptom severity based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, trauma-related shame, and trauma-related guilt via online survey. Participants included 61 US veterans and active duty service members. Hierarchical multiple regression and relative weights analysis were used to test hypotheses. In step 1 of regression analysis, guilt was significantly associated with PTSD.However, when shame was added to the model, the effect of guilt became non-significant, and only shame significant predicted PTSD.Results from relative weights analysis indicated that both shame and guilt predicted PTSD, jointly accounting for 46% of the variance in PTSD. Compared to guilt, trauma-related shame accounted for significantly more explained variance in PTSD. This study provided evidence that among US veterans and service members, trauma-related shame and guilt differ in their association with PTSD and that trauma-related shame, in particular, is associated with the severity of PTSD. Trauma-related shame and guilt explained almost half of the observed variance in PTSD symptom severity among this sample of US military veterans and service members. Trauma-related shame and guilt each made a unique contribution to PTSD severity after accounting for the similarity between these two emotions; however, shame was particularly associated with increased PTSD severity. These results highlight the importance of assessing and addressing trauma-related shame and guilt in PTSD treatment among military populations. We suggest that emotion- and compassion-focused techniques may be particularly relevant for addressing trauma-related shame and guilt. Limitations of the study Cross-sectional data does not allow for determination of causal relationships. Although sufficiently powered, the sample size is small. The present sample self-selected to participate in a study about stress and emotions.

Rescaling the Post-Traumatic Stress Disorder Checklist for Use in Primary Care.

The Posttraumatic Stress Disorder (PTSD) Checklist (PCL) is a 17-item self-report measure of PTSD symptom severity that has demonstrated excellent psychometric properties across a variety of settings, purposes, and populations. The PCL is widely used in busy Department of Defense primary care settings as part of routine PTSD screening, requiring that it is easy for patients to complete and providers to score. The clinical utility of the PCL may be improved through use of a zero-anchored Likert-type response scale by providing intuitive anchors for respondents and fewer calculations for clinic staff; however, changes to the response scale may invalidate the known psychometric properties of the measure. The purpose of this study is to evaluate the equivalence of a zero-anchored PCL to the traditional one-anchored PCL. Differences in total scores were examined using inferential confidence intervals. Substantial overlap of the inferential confidence intervals and small Rg (maximum probable difference) value of 0.68 indicated that the zero-anchored PCL is equivalent to the one-anchored PCL on the basis of our specified delta (amount of difference considered inconsequential). These findings support the use of a zero-anchored PCL in clinical practice, and more broadly, the use of zero-anchored measures in the larger field of psychological assessment.

Global arginine bioavailability, a marker of nitric oxide synthetic capacity, is decreased in PTSD and correlated with symptom severity and markers of inflammation

IntroductionPsychiatric, physical and biological aspects of posttraumatic stress disorder (PTSD) may be associated with dysfunctions in several cellular processes including nitric oxide (NO) production. NO is synthesized from arginine in a reaction carried out by NO synthase (NOS) enzymes. The recently introduced “global arginine bioavailability ratio” (GABR; ratio of arginine to [ornithine+citrulline]) has been proposed as a reliable approximation of NO synthetic capacity in vivo. The objectives of the present study were to test the hypotheses that (i) subjects with combat-related PTSD have lower GABR scores than combat controls, (ii) GABR score is inversely associated with the severity of psychopathological measures, (iii) GABR score is inversely associated with markers of inflammation. MethodsMetabolic profiling for plasma samples (i.e. arginine, citrulline and ornithine) and inflammation markers (interleukin [IL]-6, IL-1β, tumor necrosis factor [TNF]-α, interferon [IFN]-γ and C-reactive protein [CRP]) were assessed in 56 combat-exposed males with PTSD and 65 combat-exposed males without PTSD. We assessed severity of PTSD (Clinician Administered PTSD Scale [CAPS]) and depression (Beck Depression Inventory-II [BDI-II]) as well as history of early life trauma (Early Trauma Inventory [ETI]) and affectivity (Positive and Negative Affect Schedule [PANAS]). ResultsThe GABR value was (i) significantly lower in PTSD subjects compared to controls (p=0.001), (ii) significantly inversely correlated with markers of inflammation including IL6 (p=0.04) and TNFα (p=0.02), and (iii) significantly inversely correlated with CAPS current (p=0.001) and lifetime (p<0.001) subscales, ETI (p=0.045) and PANAS negative (p=0.006). Adding antidepressant use or MDD diagnosis as covariates led to similar results. Adding age and BMI as covariates also led to similar results, with the exception of IL6 and ETI losing their significant association with GABR. DiscussionThis study provides the first evidence that global arginine bioavailability, a marker of NO synthetic capacity in vivo, is lower in veterans with PTSD and is negatively associated with some markers of inflammation as well as with measures of PTSD symptom severity, negative affectivity and childhood adverse experiences. These findings add to the accumulating evidence that specific cellular dysfunction may be associated with the symptomatology of PTSD and may help to explain the higher burden of cardio-metabolic disturbances seen in this disorder.

Treatment of active duty military with PTSD in primary care: A follow-up report

First-line trauma-focused therapies offered in specialty mental health clinics do not reach many veterans and active duty service members with posttraumatic stress disorder (PTSD). Primary care is an ideal environment to expand access to mental health care. Several promising clinical case series reports of brief PTSD therapies adapted for primary care have shown positive results, but the long-term effectiveness with military members is unknown. The purpose of this study was to determine the long-term outcome of an open trial of a brief cognitive-behavioral primary care-delivered protocol developed specifically for deployment-related PTSD in a sample of 24 active duty military (15 men, 9 women). Measures of PTSD symptom severity showed statistically and clinically significant reductions from baseline to posttreatment that were maintained at the 6-month and 1-year follow-up assessments. Similar reductions were maintained in depressive symptoms and ratings of global mental health functioning.

The Relationship Between Posttraumatic Stress Symptoms and Physical Health in a Survey of U.S. Veterans of the Iraq and Afghanistan Era

Although a large body of literature has linked posttraumatic stress disorder (PTSD) with poor physical health among older veterans, less is known regarding the association between PTSD and health among relatively younger cohorts of veterans. The current study examined the association between PTSD and self-reported health among a sample of veterans who served in the recent conflicts in Iraq and Afghanistan. Veterans (N = 1030) who served in the wars in Iraq and Afghanistan completed measures of PTSD symptom severity and self-rated health between September 2009 and February 2010. Analyses examined the association between PTSD symptoms and health outcomes. In analyses adjusted for age, sex, race, and combat exposure, PTSD symptom severity was positively related to the number of health conditions and health symptoms reported (ps<0.001). Additionally, in analyses adjusted for age, sex, race, combat exposure, number of health conditions, and number of health symptoms, PTSD symptom severity was associated with an increased likelihood of rating one's health as poor or fair and an increased likelihood of reporting that one's physical health limits participation in activities (ps<0.001). These findings suggest that, consistent with previous research, PTSD symptom severity has a broad negative effect on physical health among veterans of the Iraq and Afghanistan era. Health promotion among veterans with PTSD may help attenuate risk of physical health consequences.

The Child PTSD Symptom Scale: Psychometric properties in female adolescent sexual assault survivors.

Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and valid measure of PTSD symptom severity in school-age children exposed to natural disasters (Foa, Johnson, Feeny, & Treadwell, 2001). However, the psychometric properties of the CPSS are not known in youths who have experienced other types of trauma. The current study aims to fill this gap by examining the psychometric properties of the interview (CPSS-I) and self-report (CPSS-SR) administrations of the CPSS in a sample of 91 female youths with sexual abuse-related PTSD, a population that is targeted in many treatment studies. Scores on both the CPSS-I and CPSS-SR demonstrated good to excellent internal consistency. One-week test-retest reliability assessed for CPSS-SR scores was excellent (r=.86); interrater reliability of CPSS-I scores was also excellent (r=.87). Symptom-based diagnostic agreement between the CPSS-SR and CPSS-I was excellent at 85.5%; scores on both the CPSS-SR and CPSS-I also demonstrated good convergent validity (74.5-76.5% agreement) with the PTSD module of The Schedule of Affective Disorders and Schizophrenia for School-Age Children--Revised for DSM--IV (K-SADS; Kaufman, Birmaher, Brent, & Rao, 1997). The strong psychometric properties of the CPSS render it a valuable instrument for PTSD screening as well as for assessing symptom severity.

EMDR Treatment for Posttraumatic Stress Disorder, With Focus on Hippocampal Volumes: A Pilot Study

EMDR Treatment for Posttraumatic Stress Disorder, With Focus on Hippocampal Volumes: A Pilot Study

Identifying PTSD personality subtypes in a workplace trauma sample

The authors sought to identify personality clusters derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology Five Scales in a sample of workplace claimants with posttraumatic stress disorder (PTSD). Three clusters--low pathology, internalizing, and externalizing were recovered similar to those obtained by M. W. Miller and colleagues (2003, 2004, 2007) in samples of combat veterans and sexual assault victims. Internalizers and externalizers scored comparably on measures of PTSD symptom severity, general distress, and negative affect. Internalizers were uniquely characterized by anhedonia and depressed mood; externalizers by antisocial behavior, substance abuse, and anger/aggression.