Peritraumatic Distress Research Articles

Validation de la version française de l'inventaire de détresse péritraumatique

This article outlines the French translation and validation of the Peritraumatic Distress Inventory (PDI) in a psychotrauma outpatient sample. A total of 127 French-speaking individuals were assessed from 2001 to 2002, at their first psychiatric visit for a traumatic event. An assessment at 3 months was offered by mail to control temporal stability. The PDI French validation has good internal consistency, with a 0.83 Cronbach's alpha coefficient. Test-retest shows a very satisfying temporal stability, with a 0.79 coefficient of intraclass correlation in a confidence interval between 0.61 and 0.89. The concurrent validity analyzed through the correlation with the Impact of Event Scale Revised (IES-R), the Peritraumatic Dissociation Questionnaire (PDEQ), and the General Health Questionnaire (GHQ) is very good. Further, the principal component analysis shows a bivariate solution that explains 45% of variance. The PDI French version has a satisfying psychometric validity. Moreover, the factor pattern in this translation is very close to that in the PDI's original version.

Peritraumatic reactions associated with the World Trade Center disaster.

The World Trade Center disaster was of unprecedented magnitude and impact in U.S. history. The authors conducted a pilot survey investigating these effects. A questionnaire regarding the disaster was sent to responders to an advertisement. It included demographic and disaster-exposure questions and three scales applied to "during and shortly after" the disaster. Despite widely ranging exposure, scores for distress (Peritraumatic Distress Inventory), dissociation (Peritraumatic Dissociative Experiences Questionnaire), and posttraumatic stress (Impact of Event Scale-Revised) were markedly elevated (N=75). After covariance for exposure, the distress factor of loss of control most strongly predicted both early dissociation and posttraumatic stress. Life threat specifically contributed to arousal. Dissociation did not contribute beyond distress to posttraumatic stress, with the exception of re-experiencing. This survey of reactions to the World Trade Center disaster revealed high levels of early symptoms and suggested similar but independent pathways toward dissociation and posttraumatic stress.

The Peritraumatic Distress Inventory: A Proposed Measure of PTSD Criterion A2

Meeting criterion A2 for the diagnosis of posttraumatic stress disorder (PTSD) in DSM-IV requires that an individual have high levels of distress during or after the traumatic event. Because of the paucity of valid and reliable instruments for assessing such responses, the authors developed a 13-item self-report measure, the Peritraumatic Distress Inventory, to obtain a quantitative measure of the level of distress experienced during and immediately after a traumatic event. The cross-sectional study group comprised 702 police officers and 301 matched nonpolice comparison subjects varying in ethnicity and gender who were exposed to a wide range of critical incidents. The Peritraumatic Distress Inventory was found to be internally consistent, with good test-retest reliability and good convergent and divergent validity. Even after controlling for peritraumatic dissociation and for general psychopathology, the authors found that Peritraumatic Distress Inventory scores correlated with two measures of posttraumatic stress symptoms. The Peritraumatic Distress Inventory holds promise as a measure of PTSD criterion A2. Future studies should prospectively examine the ability of the Peritraumatic Distress Inventory to predict PTSD and its associated biological and cognitive correlates in other trauma-exposed groups.

Predictors of posttraumatic stress symptoms among survivors of the Oakland/Berkeley, Calif., firestorm

The purpose of this study was to examine factors predicting the development of posttraumatic stress symptoms after a traumatic event, the 1991 Oakland/Berkeley firestorm. The major predictive factors of interest were dissociative, anxiety, and loss of personal autonomy symptoms reported in the immediate aftermath of the fire; contact with the fire; and life stressors before and after the fire. Subjects were recruited from several sources so that they would vary in their extent of contact with the fire. Of 187 participants who completed self-report measures about their experiences in the aftermath of the firestorm, 154 completed a follow-up assessment. Of these 154 subjects, 97% completed the follow-up questionnaires 7-9 months after the fire. The questionnaires included measures of posttraumatic stress and life events since the fire. Dissociative and loss of personal autonomy symptoms experienced in the fire's immediate aftermath, as well as stressful life experiences occurring later, significantly predicted posttraumatic stress symptoms measured 7-9 months after the firestorm by a civilian version of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder and the Impact of Event Scale. Dissociative symptoms more strongly predicted posttraumatic symptoms than did anxiety and loss of personal autonomy symptoms. Intrusive thinking differs from other kinds of posttraumatic symptoms in being related directly to the trauma and previous stressful life events. These findings suggest that dissociative symptoms experienced in the immediate aftermath of a traumatic experience and subsequent stressful experiences are indicative of risk for the later development of posttraumatic stress symptoms. Such measures may be useful as screening procedures for identifying those most likely to need clinical care to help them work through their reactions to the traumatic event and to subsequent stressful experiences.

Dissociation and hypnotizability in posttraumatic stress disorder

The authors compared the hypnotizability of 65 Vietnam veteran patients with posttraumatic stress disorder (PTSD) to that of a normal control group and four patient samples using the Hypnotic Induction Profile. The patients with PTSD had significantly higher hypnotizability scores than patients with diagnoses of schizophrenia (N = 23); major depression, bipolar disorder--depressed, and dysthymic disorder (N = 56); and generalized anxiety disorder (N = 18) and the control sample (N = 83). This finding supports the hypothesis that dissociative phenomena are mobilized as defenses both during and after traumatic experiences. The literature suggests that spontaneous dissociation, imagery, and hypnotizability are important components of PTSD symptoms.