Posttraumatic Stress Disorder Symptom Criteria Research Articles

Posttraumatic stress disorder in disaster-exposed youth: examining diagnostic concordance and model fit using ICD-11 and DSM-5 criteria

BackgroundCompeting definitions of posttraumatic stress disorder (PTSD) have been proposed by ICD-11 and DSM-5; it is unclear which diagnostic model works best for children and adolescents. Although other studies have predicted the impact of these models by approximating the criteria using older measures, this study advances the research by comparing measures designed to assess ICD-11 and DSM-5 criteria in hurricane-exposed youth. This study evaluates ICD-11 and DSM-5 (both the standard and preschool-age) diagnostic models by identifying diagnostic rates, evaluating diagnostic concordance, investigating the predictive value of constructs associated with PTSD (demographics, disaster threat and exposure, functional impairment), and examining model fit.MethodThe sample was exposed to Hurricane Ian (2022), a deadly Category 5 hurricane. Parents reported on disaster exposure and their child’s PTSD symptoms (n = 152; ages 7–17) using the International Trauma Questionnaire for Children and Adolescents Caregiver Version (ITQ-CG) for ICD-11 criteria and UCLA PTSD Reaction Index for DSM-5, Parent/Caregiver Report Version (RI-5) for DSM-5 criteria.ResultsICD-11 PTSD symptom criteria rates were 24% and dropped to 20% when the impairment criterion was added. PTSD symptom criteria rates were 11% (10% with impairment) for DSM-5 and 13% (12% with impairment) for DSM-5 Preschool. ICD-11 rates were higher than DSM-5 and DSM-5 Preschool rates. There was no difference between DSM-5 and DSM-5 Preschool rates of PTSD. There was moderate to substantial concordance between ICD-11 and the DSM-5 models. All diagnostic models were associated with exposure and impairment, but only ICD-11 was associated with threat. ICD-11 was the only one to evidence acceptable model fit.ConclusionsUsing the ITQ-CG and RI-5 to assess PTSD in youth, results showed higher PTSD diagnostic rates for ICD-11 than DSM-5; this contradicts prior findings (based off approximated ICD-11 criteria) and seems largely due to differences in symptom thresholds used by the two measures. The ITQ-CG exhibited excellent model fit and was associated with several constructs important to PTSD.

Reliability and Validity of the Diagnostic Interview Trauma and Stressors- Intellectual Disability in Adults with Mild Intellectual Disabilities or Borderline Intellectual Functioning

ABSTRACT Objective To assess the reliability and construct validity of the Diagnostic Interview Trauma and Stressors- Intellectual Disability – Adult version (DITS-ID-adults) in adults with mild intellectual disabilities or borderline intellectual functioning (MID-BIF). Method The DITS-ID-adults, Brief Symptom Inventory–18 (BSI–18), and Impact of Event Scale-Intellectual Disability (IES – ID) were administered to 97 participants with MID-BIF who lived in supported housing. The Anxiety, Depression, and Mood Scale (ADESS) and Behavior Problems Inventory (BPI) were administered to their relatives. Results The interrater reliability of the DITS-ID-adults was good to excellent. The construct validity of the DITS-ID-adults was good, based on positive correlations between the BSI–18, IES-ID, ADESS and DITS-ID-adults, and mainly positive correlations between the BPI and DITS-ID-adults (r = .21 to r = .75). Reporting potentially traumatic events listed under the A criterium for PTSD was associated with fulfilling PTSD symptom criteria. In this sample, 58% were classified with post-traumatic stress disorder (PTSD) according to the DITS-ID-adults, while PTSD diagnosis on file was low (7%). Conclusion The present findings support the DITS-ID-adults as a reliable and valid basis for classifying PTSD in individuals with MID-BIF.

Prevalence of Posttraumatic Stress Disorder and Depression Among Internally Displaced Persons in Mogadishu-Somalia.

Nearly 2.6 million people have been forced into displacement camps in Somalia as a result of frequent conflicts exacerbated by climate change disasters. Although the psychological impact of war and natural disasters is well documented elsewhere, little is known about the unseen scars of psychological trauma among internally displaced persons (IDPs) in Somalia. This study was carried out between January and February 2021 and sought to determine the prevalence of post-traumatic stress disorder (PTSD) and depression among IDPs and examine the association between displacement and these psychiatric conditions. A cross-sectional quantitative study was conducted among 401 IDPs in Mogadishu. The Harvard Trauma Questionnaire was used to determine the levels of trauma exposure and PTSD, and Hopkins Symptom Checklist-25 was used to estimate the prevalence of depression. Multivariate and bivariate analyses were performed to analyze the association between demographic and displacement variables and the outcomes of PTSD and depression. More than half (59%) of participants met the symptom criteria of depression, and nearly a third (32%) of respondents met the symptom criteria for PTSD. The most prevalent traumatic event was a lack of food or water (80.2%). Important predictive factors for the development of psychiatric morbidity were unemployment, cumulative traumatic exposure, and frequency and duration of displacement. The study revealed high levels of depressive disorder and PTSD among IDPs in Mogadishu. Furthermore, this study provided evidence of IDPs' susceptibility to trauma exposure and lack of essential services and goods. The study highlighted the importance of the provision of Mental Health and Psychosocial Support (MHPSS) services in IDP camps.

Yoga Plus Mantram Repetition to Reduce Chronic Pain in Veterans With Post-Traumatic Stress Disorder: A Feasibility Trial.

Veterans with post-traumatic stress disorder (PTSD) are more likely to report chronic pain than veterans without PTSD. Yoga has been shown to reduce both chronic pain and PTSD symptoms in clinical trials. The goal of our study was to assess the feasibility and acceptability of conducting a randomized controlled trial (RCT) that combined yoga and mantram repetition (Yoga + MR) into one program for military veterans with both chronic pain and PTSD. In this feasibility RCT, 27 veterans were randomized to either Yoga + MR or a relaxation intervention. Due to the COVID-19 pandemic, in-person recruitment, assessments, and intervention attendance were re-evaluated. Although remote delivery of aspects of the study were utilized, interventions were delivered in-person. Feasibility benchmarks met included full recruitment in 12months or less, 75%+ retention at initial follow-up assessment, 50%+ attendance rate, and 75%+ of participants satisfied with the interventions. The sample was racially and ethnically diverse, and 15% of participants were women. Participant recruitment lasted approximately 11months. Out of 32 participants initially randomized, two participants asked to be dropped from the study and three did not meet PTSD symptom criteria. For the remaining 27 participants, retention rates were 85% at 12 weeks and 81% at 18weeks. Participants attended 66% of in-person yoga and 55% of in-person relaxation sessions. Satisfaction was high, with 100% of yoga participants and 75%/88% of relaxation participants agreeing or strongly agreeing they were satisfied with the intervention/instructors. After 12weeks (end of intervention), Yoga + MR participants reported reduced back-pain related disability (primary outcome), reduced alcohol use, reduced fatigue, and increased quality of life, while relaxation group participants reported reductions in pain severity, PTSD symptoms, and fatigue. Amidst many research challenges during the pandemic, recruitment, retention, and efficacy results from this feasibility trial support advancement to a larger RCT to study Yoga + MR for chronic pain and PTSD.

Risk factors for the presence and persistence of posttraumatic stress symptoms following traumatic brain injury in U.S. service members and veterans.

This study aimed to identify risk factors predictive of the presence and persistence of posttraumatic stress disorder (PTSD) symptom reporting following traumatic brain injury (TBI). Participants were 1,301 U.S. service members and veterans (SMVs) divided into four groups: uncomplicated mild TBI (mTBI; n = 543); complicated mild, moderate, severe, and penetrating TBI (n = 230); injured controls (n = 340); and noninjured controls (n = 188). We examined 25 factors related to demographic, injury-related, military-specific, treatment/health care need, and mental health/social support variables. Seven factors were statistically associated with the presence of DSM-IV-TR symptom criteria for PTSD: premorbid IQ, combat exposure, depression, social participation, history of mTBI, need for managing mood and stress, and need for improving memory and attention, p < .001 (51.3% variance). When comparing the prevalence of these risk factors in a longitudinal cohort (n = 742) across four PTSD trajectory groups (i.e., asymptomatic, improved, developed, persistent), a higher proportion of participants in the persistent PTSD group reported worse depression, a lack of social participation, and history of mTBI. Additionally, a higher proportion of participants in the persistent and developed PTSD groups reported the need for managing mood/stress and improving memory/attention. When considered simultaneously, the presence of ≥ 1 or ≥ 2 risk factors was associated with a higher proportion of participants in the developed and persistent PTSD groups, ps < .001. These risk factors may be useful in identifying SMVs at risk for the development and/or persistence of PTSD symptoms who may need intervention.

Post-Traumatic Stress Disorder in People with Visual Impairment Compared with the General Population.

Background: People with a visual impairment appear to have an increased risk of experiencing potentially traumatizing life events and possibly also subsequently developing post-traumatic stress disorder (PTSD). This study investigated the point prevalence of PTSD in people with a visual impairment compared with the general population of Norway and examined factors associated with PTSD among people with a visual impairment. Methods: A telephone-based survey was administered to a probability sample of 1216 adults with a visual impairment. Of these, 736 (61% response rate) participated. A probability sample from the general population served as a reference (n = 1792, 36% response rate). PTSD was measured with the PTSD Checklist for the DSM-5 (PCL-5), based on the currently most bothersome event reported from the Life Events Checklist for DSM-5 (LEC-5). We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Results: The prevalence of PTSD was higher among people with a visual impairment than in the general population, both for men (9.0% vs. 3.8%) and women (13.9% vs. 8.5%). The prevalence rates of PTSD from the illness or injury that had caused the vision loss (men 3.9%, women 2.2%) accounted for a considerable part of the difference between the populations. For women, PTSD related to sexual assaults also contributed significantly to a higher PTSD prevalence in the visually impaired versus the general population (5.2% vs. 2.2%), while for men there were no other event categories which resulted in significant differences. Among people with a visual impairment, the higher risk of PTSD was associated with lower age, female gender, having acquired the vision loss, and having other impairments in addition to the vision loss. Conclusion: The higher prevalence of PTSD in people with a visual impairment suggests that vulnerability to mental health problems is associated with serious life events. The higher incidence than in the general population is partly due to the illness or injury that had led to the vision loss and partly due to people with vision loss appearing to be more vulnerable through exposure to other types of potentially traumatizing events, such as sexual abuse.

Prefrontal transcranial magnetic stimulation for depression in US military veterans – A naturalistic cohort study in the veterans health administration

BackgroundRepetitive transcranial magnetic stimulation (TMS) is an evidence-based treatment for pharmacoresistant major depressive disorder (MDD), however, the evidence in veterans has been mixed. To this end, VA implemented a nationwide TMS program that included evaluating clinical outcomes within a naturalistic design. TMS was hypothesized to be safe and provide clinically meaningful reductions in MDD and posttraumatic stress disorder (PTSD) symptoms. MethodsInclusion criteria were MDD diagnosis and standard clinical TMS eligibility. Of the 770 patients enrolled between October 2017 and March 2020, 68.4% (n = 521) met threshold-level PTSD symptom criteria. Treatments generally used standard parameters (e.g., left dorsolateral prefrontal cortex, 120% motor threshold, 10 Hz, 3000 pulses/treatment). Adequate dose was operationally defined as 30 sessions. MDD and PTSD symptoms were measured using the 9-item patient health questionnaire (PHQ-9) and PTSD checklist for DSM-5 (PCL-5), respectively. ResultsOf the 770 who received at least one session, TMS was associated with clinically meaningful (Cohen's d>1.0) and statistically significant (all p<.001) reductions in MDD and PTSD. Of the 340 veterans who received an adequate dose, MDD response and remission rates were 41.4% and 20%, respectively. In veterans with comorbid PTSD, 65.3% demonstrated clinically meaningful reduction and 46.1% no longer met PTSD threshold criteria after TMS. Side effects were consistent with the known safety profile of TMS. LimitationsInclude those inherent to retrospective observational cohort study in Veterans. ConclusionsThese multisite, large-scale data supports the effectiveness and safety of TMS for veterans with MDD and PTSD using standard clinical approaches.

A Bayesian Structural Equation Modeling Factor Analysis of the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 in a Polyvictimized Sample of Adolescents.

The revised criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual necessitated the development of new screening tools for youth, one of the most widely used of which is the UCLA Posttraumatic Stress Disorder Reaction Index for DSM-5 (RI-5). Thus far, the few studies that have investigated the RI-5's factor structure have supported a four-factor model. However, to date this research has been limited to youth with histories of exposure to single-event traumatic stressors, a significant limitation as evidence suggests many trauma-exposed youth report exposure to multiple types of traumatic stressors, or polyvictimization. It is imperative to determine the generalizability of previous factor models to specific populations which they are purported to represent. We investigated whether the RI-5's four-factor model replicated in a sample of 455 polyvictimized justice-involved adolescents. Initial confirmatory factor analysis demonstrated that the four-factor model did not converge. Therefore, we utilized Bayesian Structural Equations Modeling (BSEM) to determine why the previously proposed factor structure did not converge. The BSEM model suggested that the global factor structure was acceptable and did not require addition or subtraction of any factor or cross-factor loadings. However, small and moderate residual covariances resulted in model misspecification, suggesting there may be additional associations not captured by the current DSM-5 model for polyvictimized youth. Future work should continue examining the RI-5's factor structure in order to better understand whether the current results are unique and how measurements assessing DSM-5 PTSD symptom criteria perform in diverse trauma-exposed youth populations.

Post-Traumatic Stress Disorder and Associated Factors during the Early Stage of the COVID-19 Pandemic in Norway.

The COVID-19 outbreak and the sudden lockdown of society in March 2020 had a large impact on people’s daily life and gave rise to concerns for the mental health in the general population. The aim of the study was to examine post-traumatic stress reactions related to the COVID-19 pandemic, the prevalence of symptom-defined post-traumatic stress disorder (PTSD), and factors associated with post-traumatic stress in the Norwegian population during the early stages of the COVID-19 outbreak. A survey was administered via social media channels, to which a sample of 4527 adults (≥18 years) responded. Symptom-defined PTSD was measured with the PTSD Checklist for the DSM-5. The items were specifically linked to the COVID-19 pandemic. We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Associations with PTSD were examined with single and multiple logistic regression analyses. The prevalence of symptom-defined PTSD was 12.5% for men and 19.5% for women. PTSD was associated with lower age, female gender, lack of social support, and a range of pandemic-related variables such as economic concerns, expecting economic loss, having been in quarantine or isolation, being at high risk for complications from COVID-19 infection, and having concern for family and close friends. In conclusion, post-traumatic stress reactions appear to be common in the Norwegian population in the early stages of the COVID-19 outbreak. Concerns about finances, health, and family and friends seem to matter.

Feasibility and potential effectiveness of an intensive trauma-focused treatment programme for families with PTSD and mild intellectual disability

ABSTRACT Background Persons with mild intellectual disabilities or borderline intellectual functioning (MID-BIF; IQ 50–85) have a higher risk of being exposed to traumatic events and developing posttraumatic stress disorder (PTSD). EMDR therapy has shown to be applicable, safe and potentially effective for the treatment of PTSD in individuals with MID-BIF. However, in traumatized multi-problem families with MID-BIF and (impending) out of home placement of children, standard PTSD treatment in an outpatient setting may not be appropriate. Objective To evaluate the feasibility and potential effectiveness of KINGS-ID, a six-week clinical trauma-focused treatment programme consisting of intensive EMDR therapy with parents and children, and parental skills training followed by two weeks of parent support at home. Method Six families (nine parents of whom six had MID-BIF) and 10 children (all having MID-BIF) participated in the KINGS-ID programme. Seven parents and seven children had PTSD. Data were collected within a single case study design. For each family member data were collected during baseline (three measurements), treatment (seven weekly measurements), posttreatment (three measurements) and at follow-up (three measurements). Results None of the family members dropped out. Within the first two treatment weeks all but one child and one parent no longer met PTSD symptom criteria. In both children and parents, trauma-related symptoms and daily life impairment significantly decreased following treatment and in parents a significant decrease in symptoms of general psychopathology and parental stress was found. Results were maintained at six-month follow-up. Conclusions The findings of the current study are promising given that the treatment programme seems to offer new perspectives for traumatized multi-problem families with MID-BIF.

Post-traumatic stress reactions and doctor-certified sick leave after a workplace terrorist attack: Norwegian cohort study

ObjectiveTo explore the association between the psychosocial work environment and the risk of sick leave among governmental employees with symptom-defined post-traumatic stress disorder (PTSD) after a workplace bomb attack.DesignA prospective...

Serious life events and post-traumatic stress disorder in the Norwegian population.

It has been suggested that countries with more resources and better healthcare have populations with a higher risk of post-traumatic stress disorder (PTSD). Norway is a high-income country with good public healthcare. To examine lifetime trauma exposure and the point prevalence of PTSD in the general Norwegian population. A survey was administered to a national probability sample of 5500 adults (aged ≥18 years). Of 4961 eligible individuals, 1792 responded (36%). Responders and non-responders did not differ significantly in age, gender or urban versus rural residence. Trauma exposure was measured using the Life Events Checklist for the DSM-5. PTSD was measured with the PTSD Checklist for the DSM-5. We used the DSM-5 diagnostic guidelines to categorise participants as fulfilling the PTSD symptom criteria or not. At least one serious lifetime event was reported by 85% of men and 86% of women. The most common event categories were transportation accident and life-threatening illness or injury. The point prevalence of PTSD was 3.8% for men and 8.5% for women. The most common events causing PTSD were sexual and physical assaults, life-threatening illness or injury, and sudden violent deaths. Risk of PTSD increased proportionally with the number of event categories experienced. High estimates of serious life events and correspondingly high rates of PTSD in the Norwegian population support the paradox that countries with more resources and better healthcare have higher risk of PTSD. Possible explanations are high expectations for a risk-free life and high attention to potential harmful mental health effects of serious life events. None.

Patterns and temporal precedence of symptom change during cognitive processing therapy for military sexual trauma-related posttraumatic stress disorder.

Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD), including for veterans with military sexual trauma (MST)-related PTSD. Most CPT research to date has focused on pre- to post-treatment change in total PTSD symptoms; however, PTSD symptom criteria may not change equivalently over the course of treatment. For example, changes in re-experiencing symptoms have been shown to precede changes in other PTSD criteria during other PTSD treatments (i.e. virtual reality exposure therapy, venlafaxine ER). An improved understanding of the mechanism of change in PTSD symptoms during CPT may assist in optimizing treatment. The purpose of this study was to identify the pattern and temporal precedence of change in PTSD symptom criteria during and after CPT using cross-lagged panel analyses. Data from veterans (n = 32) enrolled in a randomized clinical trial investigating the effectiveness of CPT for MST-related PTSD were utilized for this secondary analysis. Using hierarchical linear modelling, each symptom criterion was entered as a predictor of subsequent change in the other PTSD symptom criteria. All symptom criteria followed a logarithmic pattern of change. Hyperarousal symptoms were found to both predict and temporally precede change in avoidance symptoms, but not re-experiencing symptoms. Re-experiencing and avoidance symptoms did not predict change in other PTSD symptom criteria. These findings provide initial support that targeting and reducing hyperarousal symptoms may be a key component of PTSD intervention with CPT. Additional research is needed to identify factors that predict change in PTSD-related re-experiencing symptoms.

Combat and operational risk factors for post-traumatic stress disorder symptom criteria among United States air force remotely piloted aircraft “Drone” warfighters

The prevalence and expression of post-traumatic stress disorder (PTSD) symptoms among United States Air Force remotely piloted aircraft (RPA; commonly referred to as “drones”) warfighters exposed to battlefield trauma via remote, electronic warfare is relevant and critical to the effective delivery of mental health care for this population. RPA warfighters (n = 715) with real-time exposure to at least one traumatic event participated in an online survey. Measures included the PTSD Checklist for DSM-5 (PCL-5) and survey of exposure to traumatic events during the course of operational combat missions. A total of 6.15% met PTSD symptom criteria; those in the age ranges of 31–35 and 36–40 and those working 51 or more hours per week had greater odds of meeting symptom criteria. For combat-related events, the number of events in which RPA warfighters witnessed civilian bystanders being killed by enemy forces or felt shared responsibility for the injury or death of bystanders were also significant predictors, regardless of whether the risk was anticipated or unanticipated. The results of this study suggest that specific types of exposure and participation in missions with specific outcomes, albeit via electronic, remote means, are associated with an increased risk for meeting PTSD symptom criteria.

Prevalence and Course of Symptom-Defined PTSD in Individuals Directly or Indirectly Exposed to Terror: A Longitudinal Study

Objective: It is well established that direct exposure to terrorism can result in posttraumatic stress disorder (PTSD). However, individuals indirectly exposed to terrorism may also develop symptoms of PTSD. This study examined the prevalence and course of symptom-defined PTSD in employees who were present and not present at the site of a workplace terror attack. Methods: Survey data from ministerial employees were collected 10, 22, and 34 months after the 2011 bombing in the government district of Oslo. A total of 3,520 employees were initially invited to the study. Response rates of eligible participants were 56% (N = 1,974) at T1, 55% (N = 1,780) at T2, and 54% (N = 1,578) at T3. PTSD was measured using the Post-traumatic Stress Disorder Checklist—Specific (PCL-S). Symptom-defined PTSD was specified as meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), B, C, and D criteria. Results: Our findings showed a low and declining prevalence of symptom-defined PTSD in employees indirectly exposed to a workplace terror attack (4%, 3%, and 2% at the three respective times). In employees present at the site of the explosion, PTSD was six- to eightfold more prevalent (24%, 17%, and 17%). Conclusions: Individuals indirectly exposed to terrorism may develop long-lasting posttraumatic stress reactions fulfilling PTSD symptom criteria. Due to the large number of individuals that may be indirectly exposed to terrorism, even a low risk of PTSD may result in high numbers of individuals with substantial posttraumatic stress. Our findings have implications for the planning and implementation of health care services beyond those directly exposed after large-scale terror events.

Post-Traumatic Stress Symptoms in United States Air Force Aeromedical Evacuation Nurses and Technicians.

Critical Care Air Transport Teams (CCATT) are specialized military medical personnel who provide high-acuity care in an aeromedical environment. The rate of post-traumatic stress disorder (PTSD) symptoms was assessed in CCATT personnel and their rates were compared to general aeromedical evacuation (AE) personnel. As part of a computer-based occupational stress survey, 188 crew members (138 AE nurses and technicians, 50 CCATT nurses and respiratory therapists) completed the PTSD Checklist - Military Version. A categorical MEET/DOES NOT MEET CRITERIA variable was created, and a Fisher's exact test was computed to identify differences between groups. Contingency table analyses were used to assess associations between demographic and occupational variables with meeting criteria. χ2 or Fisher's exact test results, relative risks, and 95% confidence intervals were obtained, with 4.35% of AE and 14.00% of CCATT crew members meeting PTSD symptom criteria. The CCATT crew members were 3.22 times (95% confidence interval = 1.14-9.12) more likely to meet symptom criteria than AE, and for CCATT meeting criteria, the most commonly endorsed symptoms were arousal and avoidance. The demographic and occupational factors assessed in this study were not associated with meeting PTSD symptom criteria. Current findings are discussed in relation to current research on post-traumatic stress in ground-based critical care personnel.

Post-Traumatic Stress Disorder Symptomatology in People affected by Home Eviction in Spain.

Despite the higher proportion of foreclosures and home evictions executed in Spain, compared to other countries, and the known link between social exclusion and mental health problems, studies exploring this association in Spain remain scarce. This study investigated the link between the process of home eviction and the appearance of symptomatology of post-traumatic stress disorder (PTSD), anxiety, depression, and perceived stress. Two hundred and five people affected by the process of home eviction were assessed using a structured interview that included three validated assessment instruments for PTSD, perceived stress, anxiety and depression. Analysis involved comparison with the normative groups that formed the validation studies together with regression analysis to determine the major psychological and socio-demographic predictors of perceived stress. Of the participants, 95.1% reported that they were experiencing the process of home eviction with fear, helplessness, or horror. In PTSD symptomatology, they scored higher than the normative PTSD group in symptoms of avoidance (t = 5.01; p < .05), activation (t = 5.48; p < .01), and total score (t = 4.15; p < .05). Of this subgroup, 72.5% fulfilled the DSM-IV symptom criteria for PTSD. The major predictor of perceived stress was PTSD symptomatology (B = .09; p < .001). The process of home eviction in Spain is having an alarming impact on mental health of affected people calling for effective measures to provide psychological and social support.

Assessing posttraumatic stress disorder in children with mild to borderline intellectual disabilities

BackgroundEvidence suggests that children with mild to borderline intellectual disabilities (MBID; IQ 50–85) have an elevated risk for both being exposed to potentially traumatic events and developing a posttraumatic stress disorder (PTSD). In this target group, PTSD often remains undiscovered due to a lack of diagnostic instruments. Valid instruments for the assessment of PTSD in children with MBID are therefore needed.ObjectiveThe aim of the current study was to validate the adapted PTSD section of the Anxiety Disorders Interview Schedule for Children (ADIS-C) for the assessment of PTSD in children with MBID according to DSM-IV-TR and DSM-5 criteria.MethodEighty children (aged 6–18 years) with MBID who were referred to an outpatient psychiatric service and their primary caregivers were interviewed using the adapted ADIS-C.ResultsThe adapted ADIS-C PTSD section has excellent interrater reliability and good convergent validity. PTSD symptoms described spontaneously by children with MBID and their caregivers closely matched those included in the DSM-IV-TR and DSM-5. Many of the children who met Criterion A did not meet PTSD symptom criteria. Conversely, children meeting the full PTSD criteria were more likely than other children with MBID to have been exposed to at least one traumatic event meeting Criterion A and to a higher total number of potentially traumatic events.ConclusionsThe results support the reliability and validity of the adapted ADIS-C PTSD section for assessing PTSD in children with MBID. The use of this clinical interview helps to improve detection of PTSD and subsequent access to trauma-focused interventions for this at risk target group.

Needs Assessment of Hurricane Katrina Evacuees Residing Temporarily in Dallas.

This study assessed the psychosocial needs of Hurricane Katrina evacuees temporarily residing in Dallas, TX, after sheltering but prior to their permanent resettlement. Common trauma exposures were physical exposure to flood water, seeing corpses, witnessing death, and loss of family, friends, or home. Fewer than 10% met symptom criteria for disaster-related posttraumatic stress disorder (PTSD). More than one-fourth met major depressive disorder (MDD) symptom criteria post-disaster but only 15% had a new (incident) MDD episode after the disaster. Specific trauma exposures and some hurricane-related stressors contributed to risk for both Katrina-related PTSD symptom criteria and incident MDD, but other hurricane-related stressors were uniquely associated with incident MDD. Referral to mental health services was associated with meeting symptom criteria for PTSD and with incident MDD, but only about one-third of these individuals received a referral. Understanding the needs of disaster-exposed population requires assessing trauma exposures and identifying pre-disaster and post-disaster psychopathology.

Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

BackgroundCompared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD) have been modified in DSM-5.ObjectiveThe first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events.MethodNinety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed.ResultsThe DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47), whereas the DSM-IV symptom criteria were met by 44% (n=42). If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8%) than false positives (3%). A minority of participants (19%, n=18) indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R2=0.40) showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD.ConclusionsThe findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts.